Life, Politics, and Terry Schiavo

A co-worker came into my office this afternoon with the specific intention of asking me my views on the Terry Schiavo case. She knows that I'm a libertarian and was wondering whether I had a strong position, based on my ideology. Perhaps the fact that she didn't ask me how I felt theologically is an indication of my pathetically low level of external religiosity — then again, 'tis harder to find a libertarian than a Christian, which may make the former a more interesting—though less important—identity. ('Tis harder still to find a Christian libertarian!) My views boil down as follows:

On the less interesting question of Congress's (and President Bush's) attempt to force Ms. Schaivo's hospice to reinsert her feeding tube: it appears that such action was not only unconstitutional but laughably so. The Republicans have spent the past four years demonstrating that they truly have no concern for small government or states' rights, so this should come as no surprise. The US Supreme Court would be wise to tell the other two branches to butt out of a state-level issue.

Of course, this would not be an issue at all if Ms. Schaivo had completed a living will, laying out exactly what she wanted done in such extreme circustances as this. I certainly do not blame her: most 20- or 30-somethings, including myself, do not spend large amounts of time pondering end-of-life issues and thus, have not completed such paperwork.

Barring any official documentation, my external (read: untrained) legal eye leads me to believe that her husband is her legal guardian and thus, would have the right make the final call. He says that she would not want to remain in a persistent vegetative state, and thus, has been lobbying to remove her from life support.

On the other hand, since we do not have that official paperwork, the nagging questions remain: How can we be sure? Does he have ulterior motives? Even though Ms. Schiavo's husband is her legal guardian, such guardianship is not sovereign when it comes to matters of life and death. (After all, just because a parent serves as a de facto legal guardian over his/her child does not give that parent powers of life-and-death over that child.)

This brings us to the three most important questions in this debate: Is Ms. Schiavo alive? If so, how much obligation does the state have to keep her alive? What obligations would we have if we were in her situation?

It is clear that Ms. Schiavo is physically alive; she is metabolising. However, from what I have heard and read, it is unclear whether she is conscious (and as journalist Ronald Bailey has noted, one has yet to invent a "consciousness detector") — consciousness being the litmus test for determining whether someone is fully or "truly" alive. Then again, is consciousness a legitimate test for this matter? More provocatively, is consciousness a legitimate method for determining the whereabouts of one's soul? I duck these questions because at this point, I simply have no answer.

If Ms. Schiavo is alive, then how much obligation does the state have to keep her so? According to Slate's Daniel Engber, Florida's Medicaid system is paying for at least part of her care, which comes in at $80,000.00 per anum. Do Members of Congress consistently believe that taxpayers have an obligation to keep alive any citizen, who (a) has no official documentation as to his/her end-of-life wishes and (b) has no assets by which to pay for indefinite life support? If another person brought a similar case to the public's attention, and Congress did nothing to act, then its moral consistency should be called into question (and its use of Ms. Schiavo as a political football would be even more obvious than it already is).

Finally, what are our obligations if we find ourselves in a similar situation? One can believe that for practical reasons, the state should not criminalize suicide, while also holding the view that suicide is morally wrong. However, is it just as immoral to refuse care at the end of life? To tell a physician that one is unwilling to go another round of chemotherapy? To tell one's family members that he/she just wants to spend his/her last days at home or in a hospice? When we refuse treatment or, more basically, life support, are we just as guilty as the one who hangs him-/herself?

For some reason, most people make a distinction between suicide and refusing treatment. Perhaps it is because the former is an active taking of one's life, while the latter leaves open some small space for a miracle. After all, suicide is inherently intentional; refusing treatment is seemingly more passive, more watchful, and perhaps more hopeful.

Unfortunately, I don't have any solid answers for my co-worker. I haven't examined these issues as much as I should. I've been preoccupied by other pursuits!