[Paleopsych] WP Editorial: After Terri Schiavo

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Fri Apr 1 14:52:55 UTC 2005

After Terri Schiavo

[This just about represents my views, if I were to speak nicely (and not 
like Mr. Mencken). Perhaps I should.]

    Friday, April 1, 2005; Page A26

    THE DEATH yesterday of Terri Schiavo concludes a legal battle, but its
    moral quandaries live on. The Schiavo case gripped the nation because
    of the lines drawn between life and death, and the middle ground of
    dementia or coma, agonizingly hard areas to delineate. In addition,
    because of a mute understanding that this subject is too awful to
    contemplate, a discussion of Schiavo-like choices has not fully
    penetrated the public square. It will be a healthy thing if this taboo
    is permanently shattered. We may not want to discuss death, but it
    will come to all of us. And, because of medical technology, more
    people will be empowered, or perhaps some would say condemned, to make
    judgments about when life is worth living, and when not.

    A century ago, death usually came abruptly; the most frequent causes
    were pneumonia, tuberculosis, diarrhea and injuries, sudden killers
    all. Today, the average American spends two years disabled enough to
    need help with the routine activities of living; and growing numbers
    survive to be 85 and older, at which point they have a 50 percent
    chance of suffering dementia before they die. In 2000, there were 4.2
    million Americans in the 85-plus cohort, but by 2030 there will be
    nearly 9 million, according to a paper for the Rand institute by
    Joanne Lynn and David M. Adamson. We speak of people being "snatched
    from life." Death, for more and more Americans, however, is the final
    stumble in a slow decline.

    We have not adjusted to this transformation, in emotional, moral or
    economic terms. Death is often portrayed in the movies as gunfights or
    as heroic battles against diseases. Less discussed are the fading
    figures in hospices where agonizing questions about the end of life,
    pain, dementia and, yes, financial costs are confronted. We speak of
    medicine as "saving lives." But at some point, arguably, medicine
    isn't so much about saving life as managing the options for parting
    with it.

    Many Americans, and not just social conservatives, feel that life is
    always worth preserving and that wavering from this principle opens
    the door to selfish relatives who don't want the burden of caring for
    the vulnerable. It's an honorable outlook -- also a natural one. Many
    believe on religious grounds that life is sacrosanct. With the
    survival instinct hard-wired into human nature, others find it
    difficult to contemplate the extinction of the self. Yet there has to
    be space in a free society for others to differ: to draw up living
    wills that specify limits to life-prolonging medical interventions,
    and perhaps also to opt for assisted suicide.

    It isn't possible for government to withdraw from this sphere
    altogether. The Terri Schiavo case featured two claims to speak on her
    behalf; inevitably Florida's legal system had to adjudicate between
    them and to decide what standard of evidence was necessary to
    establish that Mrs. Schiavo herself would have chosen to die. Equally,
    laws permitting assisted suicide, such as the one in Oregon, require
    government to create and enforce tight limits on its use. But it's
    clear that, on a matter as imponderable as this one, the federal role
    should be minimized. Thanks to Terri Schiavo, a national conversation
    is, we hope, beginning.

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