the daily snivel

  Indiana Jones and the Culture of Life

I've been reading, quite unhappily, about the tragedy that has befallen Terri Schiavo, a 41-year-old Florida woman who has been in a persistent vegetative state for 14 years. Almost 40 percent of her brain has been replaced with cerebral-spinal fluid (CSF), which is to say that much of her brain is now liquid. She is incapable of consciousness, awareness, or speech. She is incontinent and only able to survive by virtue of a feeding tube that provides nourishment. Her husband has power of attorney and is convinced that she would no longer wish to be kept alive, but her parents insist that she should be kept alive, hoping she will improve one day, and a legal battle has raged in the courts for years. Finally, this week, a judge ordered that Michael Schiavo, Terri's husband, could have the feeding tube removed. The US House of Representatives went so far as to attempt to subpoena Michael and Terri to "testify" before Congress, a stalling technique that would have prevented the feeding tube from being removed because of a rule providing that harming or preventing a person called to testify from testifying would result in a federal charge of contempt of Congress. This despite the fact that Terri Schiavo cannot speak and is not ambulatory.

Now the party of "small government" and "states' rights" is seeking to pass emergency legislation that would allow Ms. Schiavo's parents to apply to federal court to keep her alive, throwing out precedent from the state courts and stacking the deck against Michael Schiavo as the cynical right appeals to its "pro-life" base by intervening in the sad case of a family that is not at peace, and desperate parents clinging to the false hope that brains can grow back.

What I don't see is the outrage over several other cases where feeding tubes have been ordered removed:

Sun Hudson, a six-month-old boy with a fatal congenital disease, died Thursday after a Texas hospital, over his mother's objections, withdrew his feeding tube. The child was apparently certain to die, but was conscious. The hospital simply decided that it had better things to do than keeping the child alive, and the Texas courts upheld that decision after the penniless mother failed, during the 10-day window provided for by Texas law, to find another institution willing to take the child.

Where, I would ask, is the outrage? In particular, where is the outrage from those like Tom DeLay, who referred to the withdrawal of Terry Schiavo's life support as "murder"? If it's appropriate to Federalize the Schiavo case, what about the people being terminated simply because their cases are hopeless and their bank accounts empty?

Sun Hudson is dead, but 68-year-old Spiro Nikolouzos is still alive, thanks to an emergency appeals court order issued yesterday. However, his life support could be cut off at any moment. A nursing home is willing to take him if his family can show that he will be covered by Medicaid after his Medicare runs out. Otherwise, the hospital gets to pull the plug.

The Texas cases contrast with the Schiavo case in two ways:

1. Schiavo is in a persistent vegetative state, but isn't terminal. The two Texas patients were terminal but not vegetative. It seems to me that the distinction between a patient who is aware and a patient who isn't aware is the morally relevant one, while the disctinction between a death that is sure to occur soon and a death that is sure to occur eventually is morally irrelevant. (Try pleading as a defense to a murder charge that the victim had a terminal ailment.)

2. Terry Schiavo's husband has decided that she would have wanted to die, and the courts have upheld his view against the view of her parents. The mother of Sun Hudson wanted her child to live, and the wife and children of Spiro Nikolouzos want him to live. So while the Schiavo case is an intra-family dispute, the two Texas cases pit the families against health-care institutions motivated at least in part by financial considerations.

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But the notion of letting the health-care providers decide, after doing a careful biopsy of the patient's wallet, strikes me as pretty damned outrageous. And it seems to me that the Right-to-Lifers ought to agree, though apparently anti-abortion groups had no problem with it when Gov. George W. Bush signed the Texas Futile Care Law.

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What I can't figure out is how someone could be genuinely outraged about the Schiavo case but not about the Hudson and Nikolouzos cases. Perhaps Mr. Bush, who says he thinks there should be a "presumption in favor of life," can explain that to us.

Let's be clear on this. When Bush was Governor of Texas, he signed a law into being that allowed health care providers to end life support measures if recipients were unable to pay and recovery was medically determined to be unlikely. There was no outrage then, nor does there seem to be any now, or whenever poor people cannot afford to keep their families on life support indefinitely, even if those family members are infants. Meanwhile, Congress is also insisting that the budget will not go ahead until legislators slash funding to medicare which practically guarantees that more such cases will end in the cessation of interventions to keep people alive. At the same time, this celebration of the culture of life has reached the pitch that Mr. Schiavo and the judge who ruled in his favour are not receiving death threats from those life-loving evangelicals.

So what's left behind the chilling power grab from the judicial branch of government in the Schiavo case except crass opportunism?

ABC News has obtained talking points circulated among Republican senators explaining why they should vote to intervene in the Schiavo case. Among them: "This is an important moral issue and the pro-life base will be excited..." and "This is a great political issue... this is a tough issue for Democrats."

Not to mention that Tom DeLay, who has taken such a personal interest in this case that he's actively expressing contempt for Michael Schiavo, is also benefitting from the distracting this brings from the mounting ethical problems that are threatening to bring down his career if they stay in the spotlight any longer.

Me, I think this is a sad case. If my higher brain centres were replaced with liquid, and I couldn't feed myself, speak, think, remember, be aware of the outside world, or even go to the bathroom, I wouldn't be wished to be kept in that state indefinitely. To do so now in the case of Terri Schiavo only satisfies the short-term political interests of a hypocritical and cynical elite who have no interest in making health care universally accessible (and who might thus ensure that people like Sun Hudson and Spiro Nikolouzos aren't forced off life support because no one has the money to sustain them). And I think it's positively ghoulish and hypocritical for the government to expend such energy to interfere now, when people in the US and around the world are dying senselessly from poverty, aggressive war, and treatable illness.

Let the poor woman leave this world with what little dignity remains after this feeding frenzy.

An update from Digby as the House and Senate vote in favour of the Frankenstein-ian bill to "save" Terri Schiavo:

By now most people who read liberal blogs are aware that George W. Bush signed a law in Texas that expressly gave hospitals the right to remove life support if the patient could not pay and there was no hope of revival, regardless of the patient's family's wishes. It is called the Texas Futile Care Law. Under this law, a baby was removed from life support against his mother's wishes in Texas just this week. A 68 year old man was given a temporary reprieve by the Texas courts just yesterday.

Those of us who read liberal blogs are also aware that Republicans have voted en masse to pull the plug (no pun intended) on medicaid funding that pays for the kind of care that someone like Terry Schiavo and many others who are not so severely brain damaged need all across this country.

Those of us who read liberal blogs also understand that that the tort reform that is being contemplated by the Republican congress would preclude malpractice claims like that which has paid for Terry Schiavo's care thus far.

Those of us who read liberal blogs are aware that the bankruptcy bill will make it even more difficult for families who suffer a catastrophic illness like Terry Schivos because they will not be able to declare chapter 7 bankruptcy and get a fresh start when the gargantuan medical bills become overwhelming.

And those of us who read liberal blogs also know that this grandstanding by the congress is a purely political move designed to appease the religious right and that the legal maneuverings being employed would be anathema to any true small government conservative.

Those who don't read liberal blogs, on the other hand, are seeing a spectacle on television in which the news anchors repeatedly say that the congress is "stepping in to save Terry Schiavo" mimicking the unctuous words of Tom Delay as they grovel and leer at the family and nod sympathetically at the sanctimonious phonies who are using this issue for their political gain.