The Schiavo case

TerriSchiavoCase230x150.jpgA number of friends have asked me why I have not blogged on the Terri Schiavo case, to which I have stolen Eugene Volokh‘s reply that “I know nothing about the Schiavo matter, and — despite that — have no opinion.”
As we have seen with the Enron case, when a case becomes as sensationalized in the MSM as the Schiavo case has over the past several weeks, battle lines get drawn politically, increasingly shrill views compete for the public’s limited attention, and wise perspectives tend to get lost in the shuffle. Bloggers can find thoughtful views — such as those of Professors Bainbridge and Ribstein — but, let’s face it, the vast majority of the public do not read blogs.
At any rate, I wanted to pass along a couple of informative articles on the Schiavo case that will appear in next month’s New England Journal of Medicine. Timothy Quill, M.D. is a nationally-recognized expert in palliative care and end-of-life issues who is a professor of medicine, psychiatry, and medical humanities at the University of Rochester, School of Medicine and Dentistry. In this article, Dr. Quill dispassionately reviews what has occurred in the Schiavo case, and then makes the following observation:

In considering this profound decision, the central issue is not what family members would want for themselves or what they want for their incapacitated loved one, but rather what the patient would want for himself or herself. The New Jersey Supreme Court that decided the case of Karen Ann Quinlan got the question of substituted judgment right:

If the patient could wake up for 15 minutes and understand
his or her condition fully, and then had to return to it, what would he or she tell you to do?

If the data about the patient?s wishes are not clear, then in the absence of public policy or family consensus, we should err on the side of continued treatment even in cases of a persistent vegetative state in which there is no hope of recovery. But if the evidence is clear, as the courts have found in the case of Terri Schiavo, then enforcing life-prolonging treatment against what is agreed to be the patient?s will is both unethical and illegal.

In the same issue, George P. Annas, J.D., the Edward R. Utley Professor and Chair Department of Health Law, Bioethics & Human Rights at Boston University School of Public Health, pens this article in which he reviews the legal precedent relating to the Schiavo case and criticizes Congress for ignoring it. In so doing, Professor Annas observes the following:

There is (and should be) no special law regarding the refusal of treatment that is tailored to specific diseases or prognoses, and the persistent vegetative state is no exception. “Erring on the side of life” in this context often results in violating a person?s body
and human dignity in a way few would want for themselves. In such situations, erring on the side of liberty ? specifically, the patient?s right to decide on treatment ? is more consistent with American values and our constitutional traditions.

Hat tip to the HealthLawProf blog for the links to these articles.

3 thoughts on “The Schiavo case

  1. In Cruzan, we were presented (eventually) with clear evidence about Nancy’s wishes.
    Many people think the evidence is less clear in this case.
    Some people (Chronicle editorial board!) want to attribute base motives to the political actors in this case. I’d only suggest that if one truly believes the evidence on Terri Schiavo’s wishes is not compelling and truly believes in the sanctity of life and individual liberty, there’s certainly a case to be made for intervention.
    I’m not going to argue that case one way or the other here, as I appreciate the dispassionate way that you’ve chosen to present this, and don’t want to hijack a comment thread.

  2. Kevin, my sense of the biggest problem in the Schiavo type of cases is that the result of a loss (i.e., the probable termination of human life) is uncomfortable for almost everyone and untenable to many folks. Call it the ultimate finality of result.
    However, resolution of disputes in our legal system necessarily requires that type of result. The process is certainly not perfect, but I have yet to find a better dispute resolution process. I am certain that Congressional intervention is not the answer.

  3. Great post. I haven’t been following this too closely, partly because I’m with the Eskimos — put me out on the iceberg when I become a burden — and that is not a popular view in this day and age. The “substituted judgment” test is interesting — I had forgotten it, even though I read the Quinlan case years ago.

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