Thursday, September 25, 2003

A Question

Overheard while leaving school the other night, the following conversation between a girl student and her cell phone. She was between eighteen and twenty-two, if I had to guess. She emerged from a building and fell in behind me on the sidewalk. She was kind of cute with a loud, brassy voice that either didn't care, or actually desired, that others might listen in:

"Yeah, I just got outta class. Huh? What? It's already started? Thanks for getting wasted without me. Couldn't wait till I got there to get drunk, could you? Well, is there any left? I don't wanna have to stop at the store...don't have much money on me. Yeah, I can hear Justin in the background. What? Oh you're kidding. Now I'm starting to get pissed off...You're shitting me..."

Then our paths diverged. I often worry about the future of our country.

Last week during a night class, 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 - I don't recall exactly which one - a young woman in the front row, a lovely blond flower, 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 are all quite young, from teens to twenties, one perhaps in her thirties). I then wondered aloud (in the form of a question) 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 fantasies of private 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.

Yesterday 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 boy- friend 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 Terry Schiavo case. None had. This struck me as odd, I said, since it's 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 is a sometimes raucous class - not purposely obnoxious, just boisterous. A couple of them are genuinely funny, and the others feed off it. I have 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 (her name is Jennifer, like so many), which shows that you need not be well-read to have an unerring nose for the truth. I nodded. And they seemed almost genuinely shocked 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. Anyway, the conversation went on (we discussed Christopher Reeve, for example) and I suggested to Jennifer that she might want to look up the story of Nancy Cruzan to see how a similar case 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. I'm always guessing.

Then I met again this evening 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. I explained to the class 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?"
"A lot," I said.

"Then pull the plug," he said flippantly, grinning widely. He was enjoying himself.

"It's not a plug," I said, "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.

"No," I said, "she's 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. "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 the rest of us.

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 callling it that.

There was more, but I think that's enough for now. In the one class I sensed much sympathy for Terry, in the other not so much.

Speaking of Christopher Reeve, a question has occurred to me. Suppose tomorrow he became sick of it all, and asked his wife, or a friend, to yank that breathing tube from his neck. What should they do?

Reader comments:

Very interesting!
Posted by KTC email at September 26, 2003 08:39 AM

Sometimes it amazes me how easily this generation can remove themselves from real life and death. Even knowing Terri's name and her situation, there are still those who are fine with the idea of starving her to death. It's so simple for them to de-humanize anybody they don't know personally.
I was teaching one advertising course at the University of Nebraska-Lincoln on Sept. 11, 2001. My class met at 1 p.m., and only one student called to see if it was cancelled. I told her I was following the Dean's policy of taking a vote -- if the majority wanted to stay for class, we would. If they wanted time to mourn, we'd take the day off.
Every single student showed up. I opened with some remarks about the terrorist attacks and my own feelings that advertising had to be the silliest subject matter in the world when thousands of people were dead or dying. I cautioned them that if they chose advertising as their profession, they would have to face this throughout their lives -- the deadline for a soda pop commercial coinciding with the death of a loved one, or a campaign for tennis shoes while their beloved child lay ill. I reminded them that they had to choose their careers wisely and know that the ones that "look like fun" like advertising sometimes seem completely ridiculous when marriage and divorce, birth and death, and other serious issues come into play. And then I told them they could vote, whether to stay and do the week's subject matter with me, or go off to think about things, to pray for the dead or wounded or bereved, to donate blood, etc.
Every single student voted to stay and learn about newspaper advertising. I buckled down and did my job as asked, but it sure made me wonder. Aren't we doing something wrong when people can react this way?
Posted by Sparki email at September 26, 2003 02:16 PM

Thanks, Sparki. You sound like a wise teacher. But I notice that neither you nor Kathy answered the question.
Posted by William Luse email at September 26, 2003 02:42 PM

If Mr. Reeve went to Florida, would his breathing tube be an extraordinary and unnatural means of prolonging his life? In light of the Terry Shiavo case, and according to the suffering/expensive/unnatural/quality of life arguments for active euthanasia, why should anyone ask Christopher Reeve his opinion before yanking the breathing tube from his neck? Shouldn't his wife -- especially if it is difficult for her to witness his present state -- be allowed to "pull the plug" as an act of mercy?
Posted by Micki email at September 27, 2003 03:11 AM

Thanks again, but I'm still waiting for someone to just say yes or no and explain why.
Posted by William Luse email at September 27, 2003 04:31 AM

They should refuse to pull it. He has the same right to life that he would deny those embryos he would like to see 'harvested' for stem cells that might restore his function. I don't support euthanasia in any form, and I think that most members of the Hemlock Society are outright sociopaths. There is, however, a time to get out of the way of God and allow death to occur - but each case should be very carefully and prayerfully examined. My mother-in-law had been declining for years due to a series of small strokes, and broke her hip. While she was in a skilled nursing facililty for rehab from her fracture, she suffered a massive brain hemorrhage. She was put on a ventilator and every effort was made to keep her going, but it became obvious that even the ventilator and full support would not keep her body and soul together for very long. Her children were all able to fly to her bedside from various parts of the country, her beloved husband was able to hold her in his arms, and their parish priest brought the sacraments. She died surrounded by love and prayer. Without technology, she probably would have died a few days earlier but alone. With aggressive technology, she might have stayed alive for a few more hours or days. But the outcome was never in doubt. I also strongly believe that women should be supported in the choice to carry pregnancies where there is no hope of extra-uterine life for the baby. Too many moms are encouraged to take these babies off of placental life-support because the outcome is certain to be death within a very short time of birth (if not before).
Posted by alicia email at September 27, 2003 08:35 AM

Thanks, Alicia. Your first paragraph is pretty plain spoken, with your point about stem cell harvesting well taken. He certainly has the same right to life as the rest of us, but that phrase calls up images of beings whose lives are under assault without their consent. What bothers me about the Reeves case is that the ventilator that (apparently) keeps him breathing may very well be "getting in God's way." I assume that's why they put him on it in the first place, because he couldn't do it on his own. Presumably, if that tube were removed, he'd die of a pre-existing medical condition. This is not the case with Schiavo, though many see no difference between the feeding tube and the ventilator. I think there is a difference, but I'd rather hear someone else say what it is.
Posted by William Luse email at September 28, 2003 02:34 AM

Consent to murder is why suicide is called selbstmord (self-murder). The consent of the victim does not change the fundamental nature of the act.
But to answer your question, the difference is that the former victim of epivalothanasia dies of starvation and dehydration—if he survives the assaults of opportunistic diseases, while the latter victim dies like a fish gasping for air after he is heartlessly tossed to the floor to die.
The question reminds me of one posed to me several years ago by a priest of the Society of St. Pius V. Like the Society of St. Peter, its priests had left the Society of St. Pius X, but unfortunately to move closer to Oyster Bay Cove (NY), not Rome.
I was soliciting his support, on behalf of CURE, for a Catholic woman about to be starved to death with the active support of her bishop—again this was years before the attack on Terri.
The relevant portion of our abbreviated conversation:
Father: The feeding tube may be removed since it constitutes "extraordinary means."
Earl: But, Father, everyone needs food and water to live.
Father: Does everyone need to breathe oxygen to live?
Earl: Of course, Father.
Father: Then what would you call it if I were to pull the plug on a ventilator needed to sustain life?
Earl: I would call that murder, too, Father.
And at CURE we still do.
Earl E. Appleby, Jr., DirectorCitizens United Resisting Euthanasia (CURE)
Posted by Earl E. Appleby, Jr. email at September 28, 2003 07:12 PM

I understand your points, Mr. Appleby, but I don't think you've addressed the distinction between the two situations. That Reeve, if the tube were pulled, would die "like a fish gasping for air after he is heartlessly tossed to the floor," loads my hypothetical with an animus not in the original. Suppose he asked for it. He would then die of a pre-existing medical condition not inherent in the Schiavo case. His breathing tube is a form of ongoing treatment for a condition quite possibly fatal. Patients have the right to refuse such treatment when there is no hope of recovery. I was wondering why you would not allow Reeve to exercise that right.
Posted by William Luse email at September 28, 2003 07:36 PM

There was an interesting story on the front page of Sunday's Boston Globe along these lines. I will see if I can find it and post it.
Posted by alicia email at September 29, 2003 11:21 AM

Okay, I'll try to answer. I guess I got caught up in the indifference issue before.
Assuming that somebody like Christopher Reeve asked for help in removing the breathing apparatus, I would find it hard to trust his feelings about the issue. I would likely assume that he is depressed and frustrated, and so I would urge him to explore that possiblity, get some professional help maybe.
I believe we are all given an urge to live, a gift from God. For the mentally healthy person who is in communion with the Lord, this urge lends us to choose wisely on earth to protect our fleshly lives (e.g., not driving recklessly) as well as our eternal spiritual lives (e.g., participating in the Sacraments). Excluding the person who is a position to experience martyrdom, anybody who is eager to dispose of their lives could therefore be deficient in some way, mentally or spiritually, and the sensible thing to do would be to try to address the deficiency and make sure the person is "whole" again before any such life-and-death decisions are made.
I'm still not doing a good job answering your question. I guess it's a matter of determining whether the request is valid or the result of depression. And I'm not exactly sure how that conclusion would be made, but until it is, I would err on the side of life and refuse to help him until he had made sure that depression (or whatever) was not causing him poor judgement.
If a depressed person asked me to load his pistol for him to kill himself, I would feel a moral obligation to refuse and try to help the person get the help he needs. If a depressed disabled person asked me to remove him from life support, I would feel the same moral obligation.
But a person who is really ready to go -- physically and spiritually -- is different. My husband's grandmother died last year at about this time. She had a series of strokes and was not visibly conscious, on an IV and a breathing machine. When her children and all the grandchildren who lived locally were at her bedside, the doctor informed them that the breathing machine was the only thing keeping her alive and the family should decide about whether to keep it on or not. He left, and they sat there dumbfounded, not even knowing how to begin such a decision-process. They waited in silence a few moments, each praying for guidance. Before anybody could speak, Grandma slipped away, despite the machinery. All her kids were there, they'd all had a chance to say good bye. She was confident that she was in good standing with the Lord. Her body was done. No machine could have stopped that.
I think it would be entirely different for somebody whose time had not yet come.
Posted by Sparki email at September 29, 2003 11:35 AM

Sparki, Spiritually and mentally, Reeves is clearly not yet "ready to go," though physically he may have been ready until the moment they attached the tube. Severe disability tends by its nature to depress people. So let's assume, as does the hypothetical, that Reeves' request has (after much reflection on his part) been judged valid. He asks you - in the presence of others, the secrecy of shame playing no part - to disconnect his life support. Would you do it?
Posted by William Luse email at September 29, 2003 04:06 PM

Boy, I've been thinking about this all day, and I don't think I could. I haven't been Catholic very long, but long enough to understand that suffering on earth is supposed to help us and others. So easy to say when one is not suffering personally, but I would have to look the man in the eye and say, "I know you embrace the idea of death, and I will do everything I can to help you prepare spiritually for the journey, but I'm not going to provide the hand that leads to your death. When it's time for you to go, no machine will stop you from living. For now, there must be something for you to do -- some prayers to pray, some words to speak or write, some person to comfort or encourage. I can help you find the task (or tasks) and fulfill it (or them). But I can't hurry your death by my actions."
Having said it, though, I'm not 100% sure of my position. It's not easy to judge these things when one has never been in the circumstance.
Posted by Sparki email at September 29, 2003 05:02 PM

As always, a great discussion. Ditto Sparki's last comment, and I really don't have much to add. So, Bill, when are you going to show your hand?
Posted by Jeff Culbreath email at September 29, 2003 06:25 PM

Okay, I just got here, and I haven't been thinking about this all day, but here is my thought. No, I would not do it. There may not be a real difference (only a perceived one) but the usual choice to shut off a respirator or remove a breathing tube is made when a person is having no brain activity, no ability so sustain life without profound artificial help. I mean to say that they are beyond merely comatose, requiring assistance receiving required sustenance or food and hydration. Christopher Reeve, although kept alive with a breathing tube, is in possession of his faculties is conscious. Although this may be only an artificial distinction, it does not seem so to me.Terry, and others in a persistent vegetative state, are able to breath and do have some maintenance level brain function.... Not upper level consciousness, but some brain activity, some possibility of life.Okay, now I will be thinking about this all night.
Posted by Denise email at September 29, 2003 06:43 PM

***Sparki's problem is that she's a good woman who desires so much to do the right thing (I guess I shouldn't call that a problem) that, under certain circumstances, she might end up doing nothing. But, if her conscience is in doubt, that is exactly the course she should follow. Her last line does present a problem which I will deal with in time.***Denise attempts to make some crucial distinctions, one of which she fears might be "artificial," and I will deal with that (or attempt to) as well.***I like the way Jeff asks me when I'm going "to show my hand" (without showing his). Well, I'll need a couple of days. Of course, I said that with the "Just Punishment" post and it took about four. I'm suffering beneath a workload hell at the moment, but I will get to it. Meanwhile, any others who wish to contribute, or further refine a previous comment, are welcome to do so.
Posted by William Luse email at September 30, 2003 01:32 AM

OK, so now I'm thinking about this.
Something is rattling around in my head--no, don't say it must be my pea sized brain. 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? I'm not sure what I think the answer is to this, but it is niggling at me.
In some ways it almost seems like the abortion "pro choice" decision. It's not that I would deny that there are choices to be made. I just think in most instances the choice to be made came earlier in the process. For a pregnant teenager, the real choice is sex (and its consequences) and no sex. When you choose the first, you choose the consequences down the line.
This may be totally off track, but somehow it seems to make some difference.......
Posted by Terry email at September 30, 2003 07:32 AM

It does, and I'll talk about it if I can just find a few free hours when work, yardwork, car maintenance, and my daughter's computer problems don't get in the way.
Posted by William Luse email at September 30, 2003 12:27 PM

Right now (October 15) I'd kick a chair out from under Michael Schiavo and I seriously doubt I'd think twice about it.
Posted by smockmomma email at October 16, 2003 12:30 AM

When I say "I feel your pain," I actually mean it.
Posted by William Luse email at October 16, 2003 01:07 AM

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