Thursday, February 05, 2004

Dead Woman Waking

I thank thee, O Father, Lord of heaven and earth, that Thou hast hid these things from the wise and prudent, and hast revealed them unto babes…

Last fall, in September 2003, during a night class that I teach – and not long after a Florida judge had granted Michael Schiavo permission to have the feeding tube sustaining his wife, Terri, removed - we were going over a model paper in support of the death penalty, as preparation for their own research project which is argumentative in form. During our discussion of the points raised in this paper, a young woman in the front row, a lovely blond flower about nineteen years old, offered the opinion that we ought to kill murderers in the same way they killed their victims. Murmurs of approval rose from several girls sitting near her and rippled through the class. The young men mostly just smiled. I confessed to being unaware that I had so many bloodthirsty females in one class. The ladies laughed (they were all quite young, from teens to twenties, one perhaps in her thirties). I then wondered aloud if perhaps we ought not approach an execution as a duty to justice, rather than an opportunity for orgiastic bloodletting, lest it make us too much like the man we are killing, lest by imitating him we become him, or violate the constitution's humane prohibition against cruel and unusual punishment, it not being the state's function to publicly enact our private fantasies of revenge. What did they think?

I looked directly at the blond flower and her support group. Their smiles sobered, and I took the ensuing silence as a tacit, though not happy, sign of acquiescence. But you never know.

The following afternoon, in another class afflicted with the same assignment, I went around the room trying to find out who among them had found a topic. One young lady had chosen euthanasia. Was she for it or against it? Against it. The passive form, the active, or both? Umm, she hadn't read about that yet. It's remarkable how little they know about subjects on which their opinions are vehement. (A girl in yet another class, who works in the medical field, wanted to write a paper arguing in favor of fetal rights. That is, if a boyfriend, say, kicks his pregnant girlfriend in the belly and kills the baby, she thought the boyfriend ought to be prosecuted for murder. Yet this same girl is in favor of abortion rights. "Pro-choice," in her words.)

I gave our euthanasia girl a couple of examples to illustrate the difference between active and passive, then asked, out of sheer curiosity, if she or any of the others had heard of the Terri Schiavo case. None had. This struck me as odd, I said, since it was happening right down the road in St. Pete. Oh yes! A couple of them had heard of it, but were not familiar with the details. So I laid those details out. This was a sometimes raucous class - not purposely obnoxious, just boisterous. A couple of them were genuinely funny, and the others fed off it, so I had to keep my boot on their necks. But now they were newly silent.

"They're going to starve her to death," said the euthanasia girl ,Jennifer, which shows that you need not be well read to have an unerring nose for the truth. And they seemed genuinely aghast when I told them it was written into Florida law that nutrition and hydration were to be considered "extraordinary" and unnatural means of prolonging life. I suggested to Jennifer that she might want to look up the story of Nancy Cruzan to see how a similar case had played out, and that of Karen Ann Quinlan to see how wrong a medical certainty can be. Her appetite seemed whetted, but, again, you never know. In the end, it’s a lot of work they’d rather not have to do.

Then I met again the next Tuesday with that class of girls (and boys) high on the death penalty, and repeated the process once more, searching out topics. When I got to a girl in the back, she too had chosen euthanasia. For or against? "For," she said emphatically, "active euthanasia." She had done some reading, so I went straight to the issue, and asked if she was familiar with the Schiavo case. Not real familiar, she admitted, but she'd heard of it. Once again I explained the circumstances, and then asked (Sarah, I think), "So… should they kill her?"

Believe it or not this phrasing, this mere statement of fact, shocks. It shocks because they're not thinking in terms of killing, but of "letting her go," of doing some mercy. Sarah's eyes widened a little.

Some fellow piped up: "How much is it costing to keep her alive?"

I told him I had no idea, but presumed a great deal.

"Then pull the plug," he said flippantly, grinning widely.

"It's not a plug. It's a feeding tube."

"Same thing," he said.

"So if people are expensive we can kill them?" I asked.

"Sure," he said, "everything's about money anyway." He garnered some light laughter, but no one took him seriously, including me. I turned back to Sarah.


"Is she in the process of dying?" she asked. She had done some reading.

"I don’t think so," I said, "she appears to be in the process of living, with the help of a feeding tube." When I mentioned the added detail that certain therapists were of the opinion that she could learn to take food from a spoon (a fact I consider irrelevant), but that the judge had denied them the opportunity in his apparent determination that the tube be pulled sometime in October, her eyes began darting about, looking for another way.

"But if removing the tube would stop her suffering..."

"She's not suffering," I said. “As far as I can tell. I've never seen anyone suffer less," adding that, by the term most beloved of those who would speed her on her way - that she existed in a permanent, "vegetative state" - her capacity for suffering was far removed from our own.

I let her indecision become lost in the noise of remarks offered by others, and she seemed glad of the reprieve. I think (and I'm guessing again, but it's well-educated) she still wanted Mrs. Schiavo "let go," but would have to work on another way to justify calling it that.

There was more, a brief discussion of Christopher Reeves’ case, for example, and how it might differ from Terri’s, though where it ended I can’t remember. In the one class I sensed much sympathy for Terri, in the other not so much.

This went on for a couple of weeks, the same discussion ensuing with a number of students. One was a grown woman who works in the nursing profession, wore her uniform to class, and who was all in favor of disconnecting Mrs. Schiavo’s feeding tube. As I questioned and she answered, my thoughts returning for some reason to Christopher Reeve, a measure of light came to me in the form of a question: suppose tomorrow Mr. Reeve declared himself sick of it all and asked his wife, or a friend, or a doctor, or you, madam nurse, to yank that tube from his neck. What would you do?

She seemed taken aback. Reeve had not been part of the conversation. Where had he come from? She blinked rapidly, her back stiffened, and she stared past me into some distance where her thoughts could gather.

Please, ma’am, I pressed after a moment. He wants his ventilator turned off. Will you do it or not?

“No,” she finally replied.

“And why not?”

She couldn’t answer. So I offered assistance. “Because it would be murder?”

“I think so. Yes.”

But, I reminded her, she’d been arguing for Terri Schiavo’s “right to die” – more precisely, for Michael Schiavo to exercise it on her behalf - though Terri herself had expressed no such desire. Mr. Reeve would now like to exercise his. How would it be murder?

She thought some more.

“Is it because he’s conscious and has all his wits about him?”

“Yes,” she admitted, though I’m not sure she would have without the prompt.

“So even though Reeve has asked for it, to accede to his wish would be murder. And even though Terri has asked for nothing, to accede to Michael’s wish for her would not be murder.”

She nodded, but with ebbing enthusiasm.

Whatever had happened to the freedom of choice, I asked, the principle upon which she’d founded her argument? Reeve is not allowed the use of it, while Terri would have it thrust upon her.

She said she’d have to think about it. I then asked her to be honest. Was it not her opinion that Terri Schiavo was, because of the severity of her mental disability, as good as dead, and that to disconnect her feeding tube would be an act of “letting go,” of her natural dying?

And, in saying yes, she was indeed honest.

Though some might say that these are callow college kids, their minds ill-formed, their judgements arrived at through instinct and prejudice, I recount these classroom scenarios because, after perusing the works of those normally considered “experts” in these affairs, I find that the students, whether for or against euthanasia, end up in the same place as the experts but with less circuitry of thought. They arrive more directly. They are less sophisticated, less pretentious, and unencumbered by post-graduate letters trailing after their names. They are, so to speak, even in their vehement certainty, more innocent, and capable of change. I’ve seen it happen. Uncomfortable as the fact may be, these life and death issues are those upon which we are all called to be experts, for we are all affected by them; and these are times, in the age of “choice,” when every man would be his own Pope. It would be easier if there were only one to which we all swore allegiance, but I don’t see it in the offing.

Among the experts a consensus has formed, and, since 1990, when the Supreme Court ruled in the case of Nancy Cruzan that food and water may be withdrawn from hopelessly vegetative patients, a fairly consistent ethical policy with regard to these “end of life” decisions has come to rest in our hospitals and nursing homes across the nation.

Yes, we must admit that many, unlike Terri Schiavo, have died behind the scenes without fanfare or protest. The policy spoken of must be the one referred to by Wesley Smith when he wrote in First Things that “all fifty states now permit profoundly cognitively disabled people to be dehydrated to death by withholding or withdrawing tube-supplied nutrition and hydration, as long as their families consent. Such action is not taken because supplying food and water is medically inappropriate, but because of judgments about the quality of these patients’ lives.” It is a policy embraced by Arthur Caplan, a prominent ethicist with letters after his name from the University of Pennsylvania, who enthuses that “the good news is that the U.S. Supreme Court looked at these issues a decade ago in the case of Missouri’s Nancy Cruzan and affirmed the right to stop medically supplied food and nutrition to patients in permanent comas. There is every reason to think that the newly enacted Florida law is unconstitutional and will be overturned.” (He is referring to Terri’s Law, enacted by the Florida legislature in emergency session to save her life.)

Two experts, highly educated, thoughtful (we must presume), with two different takes on the same decision that gave birth to the current policy. And both have arrived at one of two positions, the same two positions claimed by my students - let her live or let her go - and, as far as I can tell, for the very same reasons. Mr. Smith makes the quality of life argument, believing that those who would let Terri go see no value in her continued existence. He believes we have entered “the surreal world of ‘personhood theory,’ under which people diagnosed with permanent loss of consciousness or the ability to meaningfully think and communicate with the world are denigrated as ‘nonpersons.’ “ It’s hard not to agree with him when Dr. Caplan says, from the other side, that “Bob and Mary Schindler, Terri’s mother and father, say they don’t trust Michael and believe that Terri would want to continue living even though she is almost completely incapable of any thought, feeling or mental activity.” [italics mine.]

I emphasize his words because Dr. Caplan tends not to. That Terri’s mental life might make her unworthy of “mere” life rides beneath the surface as a supposition shared by those of clear mind, when it is in fact the very question begging an answer. Instead, Dr. Caplan tends to frame the matter in terms of patients’ rights, of one’s “right” to die, of the dignity conferred therein on the sick and dying, and of the usurpation of judicial authority by Jeb Bush and the Florida legislature in their “bone-headed” decision to save Terri’s life. “The right to control your medical care is one of the most fundamental rights you have,” he claims, for “the Florida Legislature and the Governor have called into question the right to die of every single person in the state who does not have a living will or advanced directive,” and therefore urges all Floridians to “sharpen your pencils lest the legislature decides that you, too, cannot have the plug pulled.” That last remark should remind the reader of a frivolity uttered by a shallow male student.

So, is Wesley Smith right in his belief that those who side with Dr. Caplan have callously relegated Terri, like the unborn, to that shadowy underworld of “nonpersons” whose lives merit no legal protection because they are not people in the proper sense, some of whom ought to die because, really, they are already as good as dead? Or do the Caplans of the world hold the sincere conviction that people like Terri, having been judged to be without hope of recovery, are victims of a fatal malady, and that therefore her feeding tube is just another form of extraordinary treatment, an attempt to preserve life at all costs and beyond all reason, interfering with what would otherwise be a natural dying process, and with her "right” to this process, even though exercised by a second party harboring no personal agenda, her husband Michael? Does he (Caplan, that is), like our college student, really see no difference between the tube and the plug?

Certainly, Terri would die without the tube. But what exactly constitutes her “fatal condition”, the thing that is killing her? Is it her “vegetative state”, or her inability to swallow? Dr. Caplan cannot say the former or he would be guilty of what Smith charges him with: of holding that those suffering a severe mental disability for which there is no hope of remediation become eligible for execution, and I doubt he would concede that execution plays any part in the matter. He must therefore hold to the latter, that her inability to swallow amounts to a fatal condition which, if left to its natural progression, would result in death, in defiance of which her tube is merely an artificial frustration.

There is some evidence that this accurately renders his line of thought, for in response to some remarks made by the Pope on March 20th 2004 before an International Congress pondering the issue of “life-sustaining treatment and the vegetative state” – to wit, that assisted nutrition and hydration are means of treatment to be considered ‘natural’, not ‘medical’, ‘ordinary and proportionate’, not ‘extraordinary and extreme’ - Caplan, somewhat incensed, observes that “the Pope proclaimed that feeding tubes should never be withdrawn from any patient and that health-care providers are morally obligated to provide nutrition and hydration regardless of a patient's wishes.” (His use of the pejorative “never”, a word the Pope never uses, and his setting of the Pontiff in opposition to a “patient’s wishes”, seriously distort what was actually said.). Turning quickly to the notion of “rights”, he then asserts that the Pope’s statement “threatens to undermine a powerful social consensus in the United States about your right to refuse medical treatment,” for “the Pope’s position is directly at odds with current clinical practice in U.S. hospitals.” And that includes Catholic hospitals. (A typical recent headline ran: “Pope’s edict on life stuns Catholic caregivers,” which should give us some idea of what’s been going on.) He then moves to the nature of that treatment itself: “Patients refuse life-sustaining treatment all the time in American hospitals. Jehovah’s Witnesses say no to life-saving blood transfusions and their subsequent deaths are not treated as suicides. Dying patients request that ventilators and dialysis machines be turned off and no one considers doctors' decisions to honor these requests cruel or a form of euthanasia. So why make a special case about receiving chemicals through feeding tubes?”

Why indeed? Patients on dialysis are suffering from a terminal ailment – kidney failure. A patient on a ventilator might be suffering from any number of things, the most prominent of which is an inability to breathe. (That a Jehovah’s Witness refusing a blood transfusion is not treated as suicide begs the question of whether it ought to be so treated.) When there comes a time that the dialysis machine or the ventilator no longer provides relief to the patient, that is, when its deployment is merely a holding action in a losing battle of attrition against the onset of death, I can assure Dr. Caplan that it is settled Catholic, and hence papal, teaching that the patient has the right to say “no more.” So he must see Terri’s inability to swallow as a terminal condition akin to kidney failure or paralysis of an involuntary function such as breathing, and her feeding tube as a perfect parallel to such devices as dialysis machines or ventilators.

Which brings us to the question: is Terri’s inability to swallow in fact a terminal condition? (That her vegetative state is not this condition can be sworn to by any and all medical experts. They will readily admit that she could live a long time in her present state, as Nancy Cruzan before her might have had her tube not been taken away.) And so I’d like to return to the case of Christopher Reeve, which I find instructive, for I have seen no pained editorials in the press, nor heard any incredulous chorus of experts, bemoaning the fact that he seems to prefer living to dying. In short, is Terri’s inability to swallow the same thing as Reeve’s inability to breathe? How does each situation differ from, or resemble, the other?

The most obvious difference is that one is conscious, the other barely so (or so we are told). The most obvious similarity? One is being kept alive by a tube that forces air into his lungs, the other by a tube that forces food into her digestive system. Are they (these latter two) in fact the same? On the assumption that we already know the other side’s answer, let me give mine: no they are not. One is an involuntary function, the other voluntary. One is a fatal condition, the other is not. Under normal circumstances, I cannot breathe for you, but I can feed you. Some will not admit this difference, but I don’t see how it can be other than of the essence. If it is not, the argument on Terri’s behalf is lost, and we must delay Michael’s request no longer. Mrs. Schiavo's feeding tube is no different than a spoon held to her lips, as of that to a baby’s, and that's why I believe that the possibility she might be taught to take food from a spoon is a matter of no relevance. I think (and many will not like this) that a stronger case can be made for letting Mr. Reeve go than for Mrs. Schiavo. I will elaborate in a moment, but the only thing that gives us pause is Reeve's awareness. If he were lying in permanent coma, interested parties would be lining up, and the courts swinging into action, to "relieve" him of his burden, possibly even against his wife’s wishes. Is his life more valuable than Schiavo's? Before we answer, we might want to ask her parents.

Some might object that the spoon to the baby’s lips is impermanent, while the feeding tube is not. But we must remember that Reeve, too, must be fed by an outside agency. Let us then suppose that he could breathe on his own, like Terri, yet needed to be fed by spoon – permanently. Who among us would take away his spoon? But, come the protests, he would still be able to swallow while Terri cannot. All right, then let us suppose he cannot swallow and must be fed by a tube. Now, will you take away his tube? If the answer is no, then I ask a further question: if Reeve lapses into a state of unconsciousness, of coma, but one medically determined to be not fatal in itself, a state that might persist for years, would you then be otherwise inclined?

Those answering in the affirmative refuse to draw a distinction between the ventilator and the tube. But I maintain that the accurate parallel is not between the two forms of technology, but between Reeve’s nervous system and Terri’s digestive system, the latter of which works while the former does not. By a fatal condition I mean one that will not suffer amelioration by treatment. Such a circumstance does not describe Terri’s case. The tube indeed treats her condition quite well. Allowed food and hydration, she lives.

But, allowed air, so does Reeve. The ventilator treats his condition quite well. Allowed air, he lives. The accurate parallel is not that between his nervous system and her digestive system, but between the nervous systems of both, for it was damage to her nervous system that caused the inability to swallow. His tube and hers both force an element necessary to survival into the patient’s system.

And so far, I would say, so good, with one crucial difference: take away Reeve’s tube and he will at once stop breathing; take away Terri’s, and her digestive system will not at once shut down. It will continue working until all the food is gone. In fact, it will begin to digest her own tissues until starvation is complete. Reeve’s lungs would have no such residual activity.

Many will think this distinction too finely wrought. It’s difficulty, among those who are sincere in finding it so, can be gleaned from a correspondence I had with a gentleman at a website where the issue was under debate. He asked the very question we have been trying to answer: “If a patient in a Persistent Vegetative State is unable to swallow and can only be nourished through surgical intervention, doesn't this patient - like Reeve - indeed have a ‘fatal condition’?" And my answer was as given above, but apparently unconvincing. His essential problem was this: “It is precisely the question of whether Assisted Nutrition and Hydration may be considered a minimal, obligatory treatment or a futile medical procedure (when it is not just a convenience, but a requirement because the patient cannot swallow) that I am still undecided upon.” Assuming (with good reason) that he is Catholic, I likewise assume that the Pope’s recent remarks have now resolved his doubt. And yet I wonder if he would have had any doubt were Terri Schiavo fully conscious.

Even as I say that a stronger case can be made for letting Reeve go than for Schiavo, I do so with strict qualifications. Another correspondent, a lady, asked: “"But does it matter when the decision is made? Would it have been different to have refused the tube in the beginning - If he can't make it on his own, he can't make it and we must let him go - versus deciding 10 years after the fact that he is tired of the whole process and wants to disconnect?" The decision even to begin certain kinds of treatment sometimes seems questionable, but I imagine that in the crisis of the moment the doctors cannot know for certain what the prognosis might be. So they attach a ventilator to preserve life until they can determine what hope might remain. I should think this is their duty. Eventually they discover that Christopher Reeve will never again breathe on his own. But this discovery does not then entitle anyone to flip the switch to the "off" position. When Christopher Reeve awoke from his accident, he found himself reborn, so to speak, into a new life, one that he did not ask for, but that we gave him, and though we gave it, it is not ours to take away. It seems to me that once a treatment is initiated, we have entered into a morally binding contract with the patient, and further, that if this patient is capable of making his wishes known, it should now be up to him to decide when enough is enough. He may not ask you to hurry him along - by requesting, for example, a fatal injection - but I don't see how his right to be free of a burdensome, life-prolonging treatment, a device which is literally interfering with his dying, can be denied him. Since depression often follows hard upon severe disability, due passage of time may be required, his soundness of mind to be judged by those closest to him, but it is a fact that sometimes people know when it is their time to go to God, and I, for one, would not gainsay him.

But wouldn’t this apply to Terri as well? Supposing she were fully awake and requested that the tube be removed? Shouldn’t we heed her wish, her right to die?

I say no, basing my answer on the immemorial principle that we may not do evil that good may come. I wish it were a principle we could all agree on, but I don’t think we can anymore. We may not, by act or omission, purposely intend the death of another for whatever reason. We may allow nature to "take its course" if there is no hope of recovery (from a terminal condition), rendering the course of treatment excessively burdensome to the patient and, in effect, merely prolonging his suffering with no hope of improvement. This is not to intend his death. Death is coming on its own and in its own time. We are not committing murder; nature is (metaphorically). Nor are we doing the same by omission because, whatever we do or fail to do, we cannot win. This does not describe Terry Schiavo's case. Her case is, in my opinion (and I intend no cruel wordplay), a no-brainer. She is not dying, but living. She needs to be fed and that is all. This is a thing we do for each other. Her only problem (society's problem, actually) is that she is severely mentally retarded. She is not participating in the life of the world as others would like. Being alive is not enough. Her life is now "not worth living." That is the opinion of the world. That you are human and in existence no longer grants you an inherent and infinitely precious worth. This is the position many would convince the world to abandon, and I wish them great luck.

Now if Terri’s heart condition kicks up again, things could change. A case could be made for withdrawing the tube if it became part of the treatment in her fight against a heart failure that will not relent. But that is not the case at the moment.

But if we allow such a request to be granted in Reeve’s case, wouldn’t we be contradicting our prior principle that we may not intend the death of another? I don't think so. What would we be intending if we acceded to his wish? Would we not be intending that, as the machine went off, his breathing, like that of Karen Quinlan, went on, that he live? Of course we would. And in the event he did not go on breathing, we would be allowing the dying process (nature) to finish its course, accompanied by the hope that Mr. Reeve find rest in the arms of God.

But, apart from his request, he remains untouchable. In Terri’s case, we would be embracing an action, with full and complete consent of the will, that we know for a certainty and beyond all doubt will end in her death. We cannot hope that she will go on eating.

As to the manner of death in each case, the difference is that in the one the choice belongs to the patient, and in the other it does not. Or perhaps I should say that it's being taken from her. That her life is hers no matter what others think of it is a guiding principle in rapid decline. I don't know how it will be retrieved.

Now let us suppose one further thing – that I am wrong in this comparison of the two cases, most especially in that comparison of the nature of Reeve’s ‘fatal condition’ with that of Terri, and of his ventilator with her tube. Where would that leave us as regards the essential difference between them? I say it would leave us back where we started, among certain untutored college students who say that the difference between his awareness and hers makes all the difference in the world as to whether or not one ought to be allowed to live or made to die. We are back with Wesley Smith’s charge that those who choose the latter course do so based on an artificial distinction about one’s worth, about one’s personhood, about one’s “quality of life.” The witness of those students, and of the degreed Dr. Caplans, only serve to remind us of the effect on our judgement when one patient is fully conscious and of undiminished faculties and the other is not. It is the same line of thinking that allows so many babies to be aborted – they are undeveloped, their capacity for a properly sensate, fully human experience not yet present and, until they cross some very poorly defined line, deemed to be at the mercy of others in a position to judge. That they do experience life at an age-appropriate level, that life itself is a continuum along which one must inhabit the earlier stages if he is ever to achieve the later, that, in short, you can't get here without first having been there, does not seem to sway the opinions of many. Terry Schiavo has undergone a developmental reversal; she has, in a sense, turned around and crawled back into the womb, and is once again at the mercy of those "in a position to judge." Her umbilical cord is a feeding tube, and unless the grace of God performs some great work, it will one day be cut. That other womb, the law of our land and the protections it might afford, is no longer one of safety and sustenance. It is her enemy.

Regarding the alacrity with which so many these days are willing to make popes of the several justices of our courts – whether of Florida’s Sixth Judicial or the United States’ Supreme – I must say that it is a phenomenon that puzzles. Should the courts’ agenda change, where will they look for an anti-pope? Perhaps they will rediscover the attractions of democracy, of governors and legislatures. And for those of us who do see the attraction, there is another phenomenon that baffles:

If a man is convicted of murder, he can then be sentenced to death by a judge. The governor of the state, for whatever reason he deems sufficient, can later commute that sentence or even grant clemency, and no judge may second-guess him. Like the murderer, Terri Schiavo went on trial for her life, but not before a jury of her peers and having committed no crime. She is the defendant in a bizarre murder trial in which she is both the accused and the victim, but can neither take the stand on her own behalf nor confront her accusers. She was found guilty as charged of...what, exactly? I'll leave to readers the unearthing of the mot juste that would describe her offense. And now she has been sentenced to death. What evades understanding is why Governor Bush lacks the authority to grant clemency in the former case but not the latter. It must be some subtlety of the law that servants of the servile state can't grasp. What kind of society, some of us would like to know, allows clemency for the guilty but not the innocent? What kind of society brings an innocent person to trial in the first place? What diabolical kingdom compels a woman to be tried, not for crimes against her fellows or against the crown, but for her very humanity?

As in the case of abortion, Terri's murder will be perpetrated beyond public view, and there might seem to be a defining difference between them, which is that, unlike the baby in the womb whose dependence and invisibility incur a fatal anonymity, our black-robed vicars of moral clarity are in this case permitting the execution of a fellow being who is fully in the open and utterly independent of the person who will do the killing. But I don't think it's really a difference at all. We've simply moved outside the womb where, like Justice Blackmun in Roe v. Wade, judges sometimes have trouble telling who is human and who is not, and, faithful to the logic of previous ruminations, end up erring on the side of not. If you don't know what it is, you can kill it. We pretend not to see what is before our eyes. We live in an age when the denial of the obvious has become a virtue. We've finally found an area where even men can exercise their freedom of "choice," men like Michael Schiavo.

Here's another thing I don't get. It's an irony, I suppose, for those who are into appreciating such things. If a murderer on death row were found to be suffering his execution by means of starvation - by our withholding from him food and drink - the ensuing uproar would occupy the national headlines, and the shouted outrage of the television news, until the injustice had been repaired and the warden and his foot soldiers brought to bar and thrown in prison. What would be cruel and unusual punishment for the murderer will be good enough for Terri.

That's the world we live in now. We agonize over punishing the guilty, while throwing the innocent into Astarte's fire. And it's all legal. Where's Sister Prejean when we need her? Terri Schiavo, being innocent of any crime save possession of a "life not worth living," lacks star power. She doesn't draw the crowds. She has no bad-girl swagger. There's no glamour here, just a dead woman waking.

The quality of life crowd thinks she's as good as dead, not really there. But I had a student once, a very young man, who had suffered a terrible head injury in a recreational vehicle accident, one of those three-wheelers I believe. He spent some time in a coma. He attended my class in a wheelchair. His speech was slurred, his physical movements bordering on the spastic. He had an awful time writing in class, but gutted it out. On first meeting, I imagine many thought him sub-intelligent (I know his classmates did), until they learned to decipher his words and realized quite the opposite. He made an A. A real A, not a gift. We judge so easily and quickly by appearances.

You see, I know Terry Schiavo's in there. We’ve all heard the philosopher’s words, that the "soul is the form of the body." The soul is intact, but the body gravely injured. The soul has lost access to the instrument of its expression, but it's in there. And I think that before a judge or a husband kills her, they ought to have to prove me wrong.

There is one other thing I'd like to see, just once, the very thing so many have given up on even the possibility of, but which has been known to attend our human frailty from time to time: a miracle. I'd like to see God bring a Terry Schiavo out of her persistent vegetative state so that the world would know what's hiding behind it. But I guess I shouldn't always be seeking after a sign.

*Arthur Caplan’s articles for can be found at the following addresses:
*The Pope’s remarks at the following address:
Wesley Smith’s article at:

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