As I write this essay, a woman’s body is shutting down from starvation and dehydration because of the decision made by her husband and a court order issued by Florida judge, George Greer. Terri Schiavo collapsed on 25 February, 1990, when her heart stopped momentarily, resulting in severe brain damage. Fifteen years later, her husband, Michael Schiavo, who now has two children with another woman, is insistent that his wife would not want to be kept alive. He succeeded in obtaining a court order from the Florida Supreme Court to have the small feeding tube removed. Terri’s parents, Bob and Mary Schindler, fought the court order but were unsuccessful at overturning the decision, and on 18 March, the feeding tube that supplied nourishment and hydration to the 41- year old patient was removed. Despite appeals by Governor Jeb Bush, the Florida judge refused to allow Terri Schiavo to be taken into protective custody. President George Bush and the Republican leaders of the U.S. Governor said that all legal options have been exhausted and that they would not go any further. Barring a miracle, Terri Schiavo will be starved to death.
The Schiavo case has polarised ethicists and the general public alike. Clarity can only be achieved when ideological agendas are set aside and the facts of the case are carefully and thoroughly examined. The first step is to understand Terri Schiavo’s medical condition. She is not brain-dead, but is in a permanent vegetative state (PVS). This means that her brain is severely damaged, and as far as doctors can tell, she is unaware of her surroundings, although she has emerged from a comatose state. It must be added that medical science has yet to fully understand this condition, and doctors are often reduced to resorting to educated guesses – there are no blood tests, scans or other investigations that could confirm the diagnosis. The degree of awareness exhibited by such patients, cannot be ascertained with any exactitude by doctors, and the view which categorically states that such patients have no awareness of their surroundings is at least debatable. Those who are close to Terri, including her mother, have noticed some responses when they speak to her (see video at www.Terrisfight.org).
Although patients seldom recover after being in a permanent vegetative state for 12 months, there are isolated cases of such recovery. An article by N. L. Childs and W. N. Mercer in the Journal of Neurology, Neurosurgery and Psychiatry (1985, 48: 1300-1303) reports the case of a girl who recovered sufficiently after being in a PVS for six years to communicate with simple sentences.
Terri is not dependent on any machine that artificially enables certain of her organs to function, only a small gastric tube that supplied nutrients and water. In other words, Terri is not hooked on a life-supporting machine. She is a healthy woman with a disability and merely requires to be artificially fed. She is disabled, not terminal. The gastric tube cannot be seen as an ‘extraordinary’ measure or a therapeutic measure; it is an essential means through which Terri receives the required nutrients and hydration. Although Terri is deprived of full consciousness, she must be seen as a living human being, whose judicial rights and dignity must be recognised, respected and defended. As Cardinal Keeler of Baltimore has rightly insisted, ‘Deliberately to remove them in order to hasten the patient’s death … would be a form of euthanasia, which is gravely wrong’.
The American Medical Association defines euthanasia as the ‘act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy’. This is done through ‘the medical administration of a lethal agent to a patient for the purpose of relieving the patient’s intolerable and incurable suffering’. Terri Schiavo is being euthanized by starvation and dehydration.
Her death, however, will not be ‘quick and painless’. In his article published in The Straits Times (28 March, 2005, p.20) Andy Ho describes the harrowing process that a person dying from starvation and dehydration goes through. The mouth dries out while the tongue becomes swollen and cracked. The eyes sink and the cheeks are hollowed out, while the nose bleeds and the skin becomes loose and scaly. The urine gets very concentrated, burning the bladder even as the lining of the stomach dries out resulting in vomiting. The brain cells begin to dry out as the body temperature rises uncontrollably, causing fits to occur. Before the vital organs start to fail resulting in death, the lungs also dry out and they are clogged by their own secretions causing the patient to choke on their own sputum. This is the process that Terri Schiavo is going through as her body slowly shuts down because it is deliberately deprived of food and water.
The removal of the feeding tube from Terri Schiavo is a direct violation of the commandment ‘not to kill’. No one has the right to take a human life, not even his or her own. Life is never our own possession but is always to be received from moment to moment as a gift from the Creator, and cannot be disposed of as we wish. Supporters of euthanasia have often presented the right to autonomy and self-determination as its justification. This is especially true of voluntary euthanasia, which the AMA Council defines as ‘euthanasia that is provided for a competent person on his or her informed request’. This principle is behind the ‘right-
to-die’ argument, although almost always with the qualification that it applies only to those who are terminally ill and in great pain. The question, however, is that if the right-to-life is so fundamental, why should it be confined only to this category of people? Why should this principle not apply also to those who are not terminally ill, but who feel that their lives are meaningless?
Those who supported Michael Schiavo’s decision have appealed to the quality-of-life argument. Without doubt, the quality-of-life argument in favour of euthanasia is the most harmful for life in society because it works on the basic presumption that there are certain people who have the right to judge whether the lives of other persons are worthwhile or valuable. However, as moral theologian Bernard Häring has rightly observed, their judgement ‘can not only be contemptuous, but it represents a death sentence’.
Michael Schiavo and the Florida judge have decided to execute Terri on the basis of their evaluation that she does not enjoy the quality-of-life that she should. Because of their evaluation, they are willing to subject Terri to the most inhumane execution. The people who speak so passionately and nobly about the quality of life are willing to force upon an innocent human being such an undignified death. As Cardinal Renato Martino, President of the Pontifical Council for Justice and Peace, puts it, ‘If it is true that the process has been fair, and that all legal avenues have been exhausted, how is it that this woman, who has done no wrong, will suffer a fate which society would never tolerate in the case of a convicted murderer, or anyone else convicted of the most horrendous crimes?’ Because of their verdict they were willing to submit Terri to such acts of cruelty from which even animals are protected by law. For in the State of Florida it is unlawful to keep an animal in a place while failing to supply ‘a sufficient quantity of good and wholesome food and water ’.
The case of Terri Schiavo brings much darkness to our modern society. Are we so blinded that we fail to see that we cannot inflict this sort of death on a human being without each individual and society as a whole suffering its terrible consequences?
*** Terri Schiavo died on 31 March, 13 days after her gastric tube was removed. This essay was written three days before her death.
Dr Roland Chia is Chew Hock Hin Professor of Christian Doctrine at Trinity Theological College and Theological and Research Advisor of the Ethos Institute for Public Christianity. This article was originally published in the Trumpet (TTC).