Praying for certainty
UNLIKE MANY of those weighing in on the Terri Schiavo matter, I am having trouble working myself into a lather of outraged certainty.
Is Michael Schiavo's profoundly disabled wife in a persistent vegetative state, as so many insist? Or is she, as others claim, at least dimly aware of her circumstances? Is her condition quite irreversible? Or might she yet regain consciousness, as Sarah Scantlin of Hutchinson, Kan., did last month after 20 years in a coma? I couldn't say for sure. How is it that so many others can?
Are the congressional leaders who wrote a law authorizing a federal court review of Terri Schiavo's case disgraceful hypocrites meddling where they don't belong? The Los Angeles Times thinks so: In an editorial, it damned the Republicans for their ''constitutional coup d'etat" and ''Stalinist . . . usurpation of power" and accused them of trying ''to appease their radical right-wing constituents." Would the editorial board have been so angry if, instead of a patient on life support, it were an inmate on Death Row whom lawmakers were so anxious to save?
Is Michael Schiavo a selfish heel, eager to be rid of a useless wife so he can finally marry the girlfriend with whom he is raising two children? Or is he a decent man doing his best by a stricken wife, faithfully struggling to liberate her from a life he is sure she would reject if she could? ''Most Americans," declares Douglas R. Scott of Life Decisions International in a press release that shows up by e-mail, ''understand that Mike Schiavo and his lawyer simply want to kill this wonderful woman who . . . is in the way of their personal agendas." Scott must have remarkable sources to be able to state so authoritatively what Mr. Schiavo and his lawyer want, to say nothing of what ''most Americans understand."
My instinct is to agree with President Bush that ''in extraordinary circumstances like this, it is wise to always err on the side of life." I find it admirable, not awful, that congressmen and senators would go to such lengths to provide Terri Schiavo's parents with another chance to plead for her life in court. Yet I recognize that the last thing our legal system needs is a new federal law every time there is a dispute about whether to end life support for a patient in a vegetative state.
It may well be that Terri Schiavo would not have wanted to be kept alive in her present condition, as her husband maintains. But is it reasonable to draw that conclusion from some offhand remarks she supposedly made years ago? Even if she wouldn't want to live this way, would she prefer -- would anyone prefer -- to die slowly from starvation and thirst? Shouldn't those insisting on her ''right to die" be insisting as well that that death be quick and painless? Instead they make comments like this one, by Brown University neurologist Stephen Mernoff in Tuesday's New York Times:
''If Terri Schiavo's feeding tube is now reinserted, the government institutions and individuals responsible will be guilty of assault and should be held accountable."
A useful prophylactic against such fanaticism is to consider what you would want if you were in Terri Schiavo's -- or Michael Schiavo's -- position.
My wife and I have been working on healthcare proxies that specify how we wish to be cared for should the worst ever come to pass. The scenarios we have been asked to consider are wrenching. For example: If you were in a coma or vegetative state and you had no hope of regaining awareness, would you wish to receive nutrients and fluids artificially? How about electric shock to keep your heart beating? A breathing tube? Kidney dialysis? Major surgery? Pain medications? Should you be given blood? Antibiotics? Invasive diagnostic tests?
What if there were a small chance you would recover fully? What if, instead of being in a coma, you had irreversible brain damage? What if you also had a terminal illness such as incurable cancer? Which medical procedures would you definitely want? Which would you not want? Which would you want only as long as there were improvement in your condition?
Even as hypotheticals, these are tough to wrestle with. Do you want your loved ones to keep you alive once your personality and intellect are gone? Would you ever want them to withhold medical care even if you weren't in pain and your condition weren't terminal? Is the sanctity of life your highest priority? Should financial cost be an issue? Some answers are clear. Others are anything but.
A decision has to be made about Terri Schiavo, and my head and heart are with those who would ''err on the side of life." But don't count me among the dogmatists. This is one case that calls for less certainty and more prayer.
Jeff Jacoby's e-mail address is email@example.com.