Friday, March 18, 2005

Defining Death, Defining Rights, Defining Your Wishes

The whole Terri Schiavo story is so depressing that I hesitate to even write about it, as I'm not sure there's much I can contribute that's terribly original. However, there does seems to be a lot of confusion in many of the news articles (I'm afraid) and blog postings (no surprise) I'm reading about the difference between these terms: comatose, persistent vegetative state and brain dead. There are very important differences among these terms, so let's describe them:

>Comatose - someone in a coma is unconcious and could possibly recover, Terri Schiavo is not in a coma.

>Brain dead - this term probably should be done away with, since it often only causes confusion; it is used to refer to the total absence of electrical activity in the brain. Brain dead = dead. Therefore, as of this writing, Terri Schiavo is technically neither dead nor "brain dead."

>Persistent vegetative state (PVS) - someone in this state is not comatose; nor are they dead (or brain dead); the areas of their brain capable of thought are nonfunctioning, while some parts of their nervous system which allow the body to live may still be alive. Terri Shaivo is in a persistent vegetative state.

I don't mean to be unkind, but, unfortunately, there's a reason that the word "vegetative" is used in this description. All that is left of Terri Shiavo is a fleshy hull. The thinking part of her brain cannot regenerate any more than the World Trade Centers can rise up out of the ground and rebuild themselves. To think otherwise, unfortunately, is to depend upon unscientific reasoning.

In defense of their desire to keep Terri alive, some people have offered examples of people recovering from comas and going on to lead normal lives. Terri is not in a coma though, she is in a persistent vegetative state. See the importance for drawing the distinction now?

If I were in a PVS, I would not want anyone attempting to keep me alive. In doing so, they would only be attending to and grooming their own denial. I wouldn't be there. Therefore, I certainly wouldn't be able to defend myself or speak up for myself or make my wishes known, would I? Yes, there is a very good reason to make your wishes clearly known to your loved ones before something horrible ever happens to you as it did to Terri.

Let her, let me die in dignity.

More on PVS:

This term is commonly, but incorrectly, referred to as "brain-death." It can follow a coma.
People in a persistent vegetative state cannot think, speak or respond to commands and are not aware of their surroundings. They may have noncognitive functions and breathing and circulation may remain relatively intact.

They also might move spontaneously and even grimace, cry or laugh. Some people might regain some awareness after being in a persistent vegetative state but others might remain in the state for decades.

Source: National Institutes of Health - via
Yes, there's this: Some people might regain some awareness after being in a persistent vegetative state but others might remain in the state for decades.

Some people may regain some awareness, yes. But that doesn't mean you can't prove beyond all reasonable doubt that a particular person will not. And, apparently, that's what several doctors and judges have now decided.

From everything I've read, Terri Schiavo is not among those in a persistent vegetative state, who can recover. Her brain has largely been replaced by spinal fluid. It's a cruel fact of biology that she cannot recover.

Another argument I'd like to dismiss: To everyone who keeps bringing up "the rights of the parents" in order to defend Terri's understandably distressed parents: At what point do the right of *any* family members supercede the rights of *any* individual?

>If I declare what I wish to happen to me in such a state, my parents have no right to overrule my rights.

>If I do not declare my wishes, then the decision goes to my next of kin. If I'm married, that is my spouse, NOT my parents.

An aside: Sad to say, medical practitioners do over-ride the wishes of individuals all the time. Perhaps with good reason in some instances. I worked in the field of organ donation, and I know this: Some people who wish to be organ donors do not become donors because the hospitals are afraid of going against their spouse's or family's wishes. Even if you sign a donor card, which in many places is legally binding, they may not use your organs if your family says no--despite the fact that a court might actually support the hospital's decision. Hospitals just don't want to risk being sued, and, more nobly, they don't want to provide additional duress to a grieving family.

However, studies have shown that if you do let your family know your wishes, they're far more likely to carry them out, even if they personally disagree with your decision.

The bottom line: however uncomfortable it may be, TELL TO YOUR FAMILY ABOUT YOUR WISHES!

It's very hard to remain dispassionate about this story--especially when it's been politicized the way it has. In fact, I have some pretty passionate thoughts about it, and I believe my thoughts are steeped in my own sense of what is right and moral. Therefore, it's not particularly constructive for those who would like to keep Terri "alive" to call the rest of us fascists and Nazis. But neither would it be constructive for anyone supporting "the right to die," as I most emphatically do, to call those who oppose me idiots and Neanderthals. Like abortion, this is a complicated issue, and well-intentioned people will disagree. On the other hand, there are some who are using Terri as a political pawn without any thought of her dignity. Literally seeking to move her about the country in an effort to put her on display. That's just despicable.

Final Note: If you have any doubts about Terri's condition, read this Reason article, which describes her condition in much more detail than most articles you'll come across. It ends this way:
So is Terri Schiavo still alive? The odds are way against it. It's time that her long-suffering parents and the grandstanding politicians let her go in peace.
Sadly, those words were written in October 2003.

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