The Schiavo case brought the issue before us again. Despite efforts to change the paradigm the argument crystalized into two main branches, one in support of life and one opposed to the costs of supporting that life. That is a pattern we can see in too much of politics.
We know from experience that arguments in that condition are nearly impossible to resolve. It requires another solution. An important third solution is that so called "vegetative" states are extremely rare. They are about as likely as a coin landing on its edge Because they are so rare the data generated is extremely valuable. It is worth far more to medical research than the cost of the IV solution, expensive as that might be. It is important to note here that this does not suggest any "weird" or obtrusive research be done. That is not necessary. The ordinary unobtrusive data of heart rate, brain wave patterns, breath rates, if present, temperatures and responses to such unobtrusive stimuli as various levels of light, sound, aroma and standard feeding formulae generate very valuable data that when published in medical journals can offset any costs of room and supplies, in fact many times over.
This brings us to living wills. Many people seem willing to stipulate in writing that should they fall into a serious and apparently unrecoverable condition from which they can no longer communicate that they not continue to be a financial burden to their families.
There is perhaps no sin in yielding to an inescapable financial reality. Perhaps Michael Schiavo believes he is standing up for such people and doing a civic service. But an alternative has been noted here.
It is possible a person could feel such distaste for life permanently in a hospital bed as to stipulate in writing that even should the resources be available they should be removed. If that is what Terri said, then serious consideration should be given to that wish. It is not clear such a wish was indicated. Unless it can be proven beyond any doubt the person wished to die they should be kept alive. Even could it be proven the person wished to die, there are serious ethical questions. Most religions consider suicide a sin of despair. Many secular laws deny the "right to die" and this was reaffirmed in opposition to the controversial Dr. Kevorkian. Obviously laws against suicide are nearly impossible to enforce and for that reason might fail to receive attention. It can and has been made clear though that the public does not need to help anyone commit suicide and can put such obstacles to suicide as it might in the way.
Yesterday on talk radio the opinion was expressed that "state law says" the spouse makes the medical decisions by default and it is as simple as that in the Schiavo case. The gross error there is that a serious and legal difference exists between a medical decision and an obvious life and death decision. For example when doctors recommend a heart replacement no one is usually certain whether that is best, not even the doctors, who would inform the patient that there are serious risks in the surgery which might not succeed, might result in death. No one really knows for an absolute certain fact whether the surgery would be best. There is only the educated belief that it is likely better than not for that patient who would already be quite ill. In that case where the decision is a medical one, involving medical opinion only, then the spouse has the decision when the patient cannot communicate.
When a decision involves the obvious taking of human lives, for example dropping pianos on their heads, pushing them off steep, high cliffs or the like, that is not a "medical" decision. That would be murder. No one over the age of reason, doctor or not, believes any of those things will help in any medical way. The opinion of the doctor or the spouse is not involved.
The Florida law is unique as there does appear or seem to be a provision for removing life support. It however is based on what is still in the science fiction stage. You may recall how a federal law against partial birth abortions was turned down because it made no provision for the life of the mother and how it was argued here that the condition could not be legislated because it was not defined. What exactly are the signs that the life of the mother is endangered? None were given. None could be legislated. None should have interfered with the passage of the bill, yet the bill was not passed. Again in the case of "persistent vegetative state" what is the proof the person will not recover? Unless that proof is given it cannot be legislated. The Florida law is therefore inapplicable with present science.
The scientific fact is that too little is known about these things to say we are certain no recovery is possible. If the "medical ethics committee" approved by the "Florida Bio-ethics Network" says that they know Schiavo cannot recover, and that is required by the Florida law, they must know what the signs and indications of this are. Since they do not, no life support removal is possible at this time. Not legally anyway.
An appalling number of people are willing to go on talk radio lately and say how "undignified" Schiavo's condition is. More appalling is how many of those would consider themselves good soldiers. While it might by some stretch of laws against suicide be correct to allow a person to refuse in advance writing life support under those conditions if that is their wish, it is not correct to say that such life support is "undignified." People enduring conditions like that are heroes. We might learn more about such conditions and be better prepared in the future to reverse them. Their "suffering" if they even are suffering might save someone else's life in the future. See the good soldier.
There are some sad, strange "scientists" out there. So many of you are willing to kill for stem cell research but not willing to preserve life for research? How did that happen?
While information that could save lives has an important value to most people, information on how to have eight children at once is probably of interest to a very small and unusual group, so small and unusual that their curiosity should not command use of public money. Should science establish medically safe ways to repeat such multiple births there would certainly be no exceptional funding source for the care and support of the children.
With the public paying more attention to these issues for well over a decade now after this article was originally posted it is becoming apparent that the article was and is correct. Medical conditions that cause consideration of deliberately terminating life support are indeed extremely rare. They are so rare in fact that the costs of covering them in insurance plans could be very low despite the enormous long term expense of each case. It will be necessary of course to compile dependable data on the various risks and solutions in order to devise plans that can meet the needs now and in the foreseeable future. Serious drawbacks to this idea include that many people do not want the responsibility of deciding one way or the other on such insurance plans and sweeping mandates are becoming very unpopular.