Friday, April 01, 2005

The Elephant in the Room

Fashionably late to the party as always, I have finally decided to join a few million of my closest friends in the blogosphere. I have no idea how often I will end up posting or on what range of topics, but the time has come to have a repository of my thoughts on issues as they happen.

And in picking this time to start, I am pretty much forced to address THE issue of the day/week/month, even though it has completely beaten me down by this point, that being the end of life saga of Terri Schiavo.

This appears to be a case of the correct application of a very bad, and arguably immoral, law.

I believe that the Florida courts acted properly given with what they had to work. Congress injecting itself into the situation by passing legislation specific to the outcome of a single case offends my senses of federalism and limited government. I cede that there might have been a Constitutional due process argument to be made in the federal courts, but Congress attempting to bully those courts is as reprehensible to me as is the current practice of the judiciary circumventing the will of the people by legislating from the bench.

That it was the legal thing to do did not make it the right thing to do. The will of the woman herself should have been the deciding factor if discernable, but in this case anybody who says her wishes were respected is engaging in base speculation (and the spread of misinformation) and nothing more. Hearsay evidence from somebody with significant conflicts of interest is hardly proof that this is what she would have wanted, and that is really all we had here. It is certainly possible that they had these types of discussions at some point, but even if so did they move from the somewhat common discussion of being kept alive on life support (which has nothing to do with this case, another commonly repeated bit of misinformation) to the realm of being hydrated and nourished if the individual is incapacitated?

Given that her wishes were unknown, who should make such a monumental decision? The easy answer is the legal guardian, but that is problematic at best in this case given that said guardian had a vested interest in deciding in his own best interests and not in hers. He had certainly been consistent in making decisions against her best interests in the past, from denying her medical treatment and testing to denying her therapy, any or all of which might have improved her condition. He certainly had financial incentives to hasten her death from very early in the process. I discount the incentive of moving on to his new family, as he was offered and refused an easy divorce, so that was clearly not driving his actions. Not to be ignored is the nontrivial possibility that he contributed to her falling into this condition in the first place and wanted any evidence to go away. While ascribing her condition to him is irresponsible, the physical evidence that he had serially abused her, including evidence of multiple broken bones in the past and of strangulation at some point, makes it impossible to dismiss outright either.

What is clear is that he aggressively wanted her to die from very early in the process, at least by the time he gained the medical malpractice verdict, and that he made every effort to block evaluations and treatment of her condition in life and, ultimately, in death as he also tried to block a potential autopsy. He wanted to paint her as a hopeless cause and sought to deny the possibility of any evidence to the contrary being brought to the table. Why is open to discussion, but the central pattern of his actions is not.

Should medical professionals or the courts be able to step in when a guardian acts against the interests of a patient without personal instructions? Should there be mechanism for appointing a new guardian in cases of clear conflict of interest? Should end of life decisions be made without consideration of the entire immediate family? There are no easy answers. It is sad that a woman had to die to bring to light these holes in existing statutory law.

I will look at political aspects of this case in a future post.

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At 4/07/2005 8:16 AM, Blogger Martha said...

Congrats on getting a blog. It's long overdue for some one like you, who articulates himself so well and also manages to put it down on paper (so to speak) just as well. I'll be checking it regularly.


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