Thursday, March 3


In the back and forth legal battle that is the Terri Schindler-Schiavo controversy -- truly a poignant human interest story beyond the pale -- perhaps the most vexing issue is whether Terri categorically stated, purportedly to her husband prior to her brain damage in 1990, that she was not, under any set of circumstances, to be kept alive were she ever to be in the state (or a comparable state) she is in today. And whether that condition today is a "persistent vegetative state," as her husband and his attorney contend, or one of being only "cognitively disabled," as her parents, siblings, and their attorney claim, is beside the point. It's not germane to this particular claim of Michael's.

I say that because Terri's purported conversation with her husband on this subject was not so richly detailed (he never described it that way) as to have anticipated exactly either of those specific medical scenarios. Indeed, some reports say it may have occured solely as a result of her having watched a moving television account of the Karen Ann Quinlan story, about a woman who lapsed into "PVS" and required an artificial respirator (or so her doctors thought) to keep her alive. It was Terri's wishes, according to some interpretations of Michael's account, that she never wanted to be kept alive artificially by means of a respirator. But, then, what if she meant instead that she did not want to be hooked up to any kinds of tubes, machines, and I.V.s? How can anyone ever know if what they think about such things at a moment in time --say in their late 20s -- is what they'd truly want to have done in their 40s, 50s, 60s, or beyond? My father, who has a chronic pulmonary disease, told me several years ago that he would never allow himself to be hooked up to oxygen to stay alive. Today he's on oxygen 24/7 and has made the necessary adjustments in his life to accomodate such a constraint. Medical science changes; people change; attitudes change; life, for most, remains precious.

And to be sure, if Terri had said anything at all to Michael on this topic, she never subsequently reduced it to writing, never executed a living will, never provided an advanced, written directive of any kind. Besides, living wills are designed more to protect doctors, than they are to protect patients anyway. According to P.J. King, Chairman, Bioethics Committee, Pro-Life Wisconsin, living wills "are not about giving patients control over their health care; they are about taking away decision-making authority (from the patient) and giving it to the physician." He continues: "A standard living will focuses on just one option -- the rejection of medical care."

But back to Terri and Michael. Had it been a serious conversation between them, and with a wife expressing to her husband a categorical desire on such a sober subject, would they not have seen an attorney? Certainly were it only a passing statement, they'd likely not have. Husbands and wives do this sort of thing all the time, expressing a thought of the moment, an impulsive desire, a hastily-drawn conclusion, an ironic whim, some banter about this, that, or the other. A serious-minded statement, particularly if reiterated and a life or death matter, usually draws some action by either spouse. But something said on the spur of the moment and never mentioned again, or at least without the emphasis and assuredness inherent in the initial comment, passes without action like so many things do between partners.

And were this all not enough to complicate matters thoroughly in ascertaining Terri's true intent, if she ever had an intent in this regard in the first place, is the fact that her husband Michael didn't mention this purported conversation until 1998, according to his in-laws, Bob and Mary Schindler. 1998! Why would that amount of time have elapsed without any mention by her husband of Terri's purported, serious-minded wishes? How would you view such a disparity were you a judge or juror? And is a simple gastric feeding tube providing water and nourishment to Terri really artificial, medical life support -- the sort of "extraordinary means" that doctors sometimes take to sustain the life of the seriously ill or injured, or to postpone the eventual death of the terminally ill? I think not. But whether experts in the field would agree with me or not, is that what Terri likely told husband Michael way back then -- namely:

"I don't ever want my life sustained, even with just food and water, Michael. Just have the doctors pull the feeding tube and regardless of my suffering or how long it may take before my life is extinguished. That's what I want and I am counting on you"

I think not.