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To Be or Not To Be

October 23, 2003

The questions and issues are profound. The response is petty, political and sadly predictable. Once again, American society confronts a morally anguishing spectacle on the too familiar right-to-die front. Since we can't agree on when human life starts, it's not surprising we're still stumped by death. When should we as caring family in an advanced but inattentive society do all that is now possible to prolong life?

More important, when should we as thoughtful people take our amazing medical technology -- and our amazingly picayune human foibles -- and get out of the way of the ugly process of dying that will inevitably claim every one of us? The Florida case of Terri Schiavo provides one more opportunity to ponder this public dilemma and perhaps private action.

Nearly 14 years ago Schiavo's heart stopped. That's unexpected at 25, though death's inevitability shouldn't be unexpected for anyone. Schiavo, like most Americans, had no living will detailing her wishes in the event of a medical emergency. So we're left with her husband saying she wouldn't want to "live" this way versus her parents saying she's "alive" and responsive. By the way, there's a lingering family feud over $plitting a medical malpractice settlement.

At bottom, all parenting is about one thing: hope. But hope for the child, not for the parents to the exclusion of all reality. Medicine can restart and regulate hearts. But not a brain deprived of oxygen. Schiavo lies in a persistent vegetative state, meaning eyes open and rolling, drooling, involuntary movements. If "fed" through hoses, cleaned and turned, this body can exist for years. Is this a life? For her? (For you?) The family disagreed. So courts decided the feeding tube could go. The parents appealed to the Legislature, which gave the governor one-time authority to reinstall the tubes. He did.

Time and technology march on. First, respirators then feeding tubes arrive. Courts decide, as temporary man-made interventions, they can be removed. Fact is, 30 years ago, before "feeding tubes," Schiavo would be dead. Be clear, this is not Mom's chicken soup or pot roast being pumped into a permanent entrance in Schiavo's stomach. It's a chemical slurry, a liquid crutch to prolong body biology. Nothing more than another impressive intervention that can prolong dying as well as living. What's your choice?

These decisions, usually eluded, are extremely difficult. They should be difficult; they're life and death. Many families and doctors forge them quietly. Such issues shouldn't be left to legislators to pounce on for a preelection parade. Would you like those faceless folks in Sacramento, who agree only on casinos and fund-raising, deciding your life and death because you never got around to specifying values and wishes to doctors and numerous loved ones?

To be sure, it's very hard to contemplate our own perhaps distant demise during the healthy, happy days of life.

But if not then, when?

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