What can we learn from the Schiavo case?

Arthur Caplan, Ph.D. • E-mail

Terri Schiavo has now died. She died amid an incredible cacophony of arguments, pleadings, demands, threats, prayers and commentary. That she died angered many. How she died angered many others. The attention her death elicited from so many different sources angered still others. If in the wake of her passing it is possible to put some of that anger aside, perhaps we can all ask ourselves some hard questions about what has taken place here. What should each of us take away from the incredible events of the past few weeks?

First of all, no one in the United States should be without a durable power of attorney for medical decision-making. Everyone old enough to write down who they want to make medical decisions for them must do so. Every physician must ask every patient. Every hospital and nursing home must ask and record every person’s wishes. Every priest, minister, rabbi and other religious leader must remind their followers to let their loved ones know who speaks for them.

Start a dialogue
It is not enough to write your wishes down. You need to tell the person you have picked that you have chosen them and they need to consent. You need to remember to update your written wishes every few years. You need to make sure that copies of your wishes are in the hands of those most likely to come to the hospital if you are severely injured or become very sick.

Equally important are discussions about life and death. If this case has not already made you talk to your family, friends and loved ones about your views concerning medical care then do so. Now.

Not all will agree on what to do should they or someone they love become severely disabled or lose cognitive abilities. But we need to talk about these difficult matters openly, honestly, calmly and frankly.

Lawmakers overreached
It seems very clear to me that no legislator should be trying to do anything at this point at the county, state or federal level except encourage people to sign durable powers of attorney or living wills. If Congress and the legislators in Florida made anything clear over the past few years of fighting about Schiavo’s fate, it is that they have no idea what they are talking about.

After the spectacle of senators second-guessing diagnoses without benefit of any solid information, a governor introducing people as experts who lacked real credentials or hands-on experience, state legislators giving the spotlight to anyone who had any claim — no matter how blatantly screwy — about how to cure those who are severely brain injured, there is not a legislature in America that is ready to say or do anything useful about the right to stop treatment.

If legislators cannot stand inaction in the wake of what has just taken place, then let them hold hearings in which those with claims to make are carefully cross-examined and the public is given a chance to learn how conditions like permanent vegetative state and coma are diagnosed and why nearly every doctor, nurse and dietician in America knows that a feeding tube is a form of medical treatment.

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