In responses to my
article on Terri Schiavo, there was a common theme: nobody wants
to wind up as she did: a person on a tube.
not winding up as she has will require specific steps on your part.
I have doubts that the letter-writers have taken formal steps to
avoid this condition.
I intend to. Soon. No, really. Soon.
make a conscious decision regarding how much your life is worth
to you. If you really don’t know, then don’t expect anyone else
decide how long you think is reasonable to be kept on the tube in
a vegetative state. A week? Two weeks? A month? There are cases
where someone has awakened after a decade in a coma. In 1999, on
Christmas day, Patti White Bull
of Santa Fe, New Mexico, awoke after 16 years of being on a feeding
tube. Her husband, who divorced her three years into her coma, came
for a visit. In 2003, Terry Wallis
of Mountain View, Arkansas, awoke after exactly 19 years of being
in a coma.
decide who is going to pay if you do fall into a coma. Do you want
these people to pay? An insurance company, Medicare (taxpayers),
a physician who was successfully sued for malpractice, or your family?
decide now how you intend to get your wishes followed. If you specify
in writing that you will allow only three weeks on a feeding tube,
then require removal, will the hospital allow this? Will it remove
the tubes and send you home? What if members of your family are
divided? What if one group threatens to sue the hospital for removing
the tubes? It would be better to specify how much money you authorize
to keep you on the tube, with a specific cut-off price for payment
by any third party. When that limit is reached, you will have the
hospital’s administration on your side. “Pull the tube!”
what if the private money runs out? Will Medicare or Medicaid intervene
what if Medicare’s money runs out? Will Medicare pull the tubes?
of these are relevant issues. Almost no one has thought about them.
Almost no one has taken steps to do anything about this.
of Americans die each year intestate. A court has to divvy up the
assets. A man who refuses to make out a simple will is unlikely
to put in writing his wishes regarding feeding tubes.
letters I got regarding Mrs. Schiavo were all over the range of
opinion: let her die, let her live, it’s her husband’s decision,
it’s the state’s decision, it’s her family’s decision. In short,
there was no agreement.
is not going to be much agreement.
disagreement is the state’s opportunity. Legalized euthanasia is
consistent with legalized abortion. If the state sees a way to cut
costs, it will eventually cut costs.
are not strongly committed to cost-cutting in general. Instead,
they are adamant about making sure that the services they want at
below-market prices are not cut. If that means cutting some other
special-interest group’s feeding tube, that’s fine with them.
by one, the feeding tubes will be cut — all except the salaries
for the state’s tube-cutters. That will be the last tube to be cut.
the day that it is cut, free men should celebrate.
DILEMMA OF TECHNOLOGY
felt guilty in 1900 when grandma, age 86, died of pneumonia. That
was how millions of people died in 1900. There was no way to prevent
this. Guilt arrived on the day that wonder drugs made it possible
to give granny another breath.
technological imperative says, “If it can be done, it must
be done.” The medical technological imperative says: “If he can
be saved, he must be saved!” Medical technology has increased
everyone’s level of guilt.
is not free. Someone must pay. Who? We cannot decide as a nation.
This is why the country is divided over the Schiavo case. Yet it
is a life-and-death issue. It has to be dealt with judicially. It
will set a legal precedent.
Schiavo need not die in the near future, economically or technologically
speaking. But if she lives, there are legal issues regarding divorce
and remarriage. The legal precedent seems to be that if a self-interested
third party wants to pull the plug for either judicial or economic
reasons, irrespective of the willingness of others to pay, then
that person’s wishes will be respected.
Mrs. Schiavo’s wishes were when her wishes counted judicially are
unknown and unprovable. They are a matter of hearsay. This is not
true of your wishes today.
of us would say, “Send me home after [xx] weeks on the tube.” But
this is irrelevant. After we are in a coma, what we might say today
is judicially irrelevant — a matter of hearsay. This is why
we should put this in writing and have it notarized. Then we must
make sure we have signed over the power of attorney to someone we
know will follow our instructions. This may not be a spouse.
problem is guilt. “I want him [her] to have the best care possible.”
The key question: At what price? The second question: Who will pay?
you do not want to disinherit your heirs, you had better get question
#2 answered, so that no one feels compelled to pay a heavier price
than you prefer today.
more people have opinions about what should be done with Mrs. Schiavo
than have left written instructions to keep them out of Mrs. Schiavo’s
condition. Opinions are cheap. Actions are not.
you have an opinion one way or the other, then make sure that you
have left notarized instructions to the person to whom you have
transferred in writing the power of attorney. If you think Mrs.
Schiavo’s case should be decided in a particular way, make sure
that those who will decide on your behalf have written evidence
of your opinion regarding your future condition.
be ye doers of the word, and not hearers only, deceiving your own
selves” (James 1:22).