[Paleopsych] NYT: Did Descartes Doom Terri Schiavo?

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Did Descartes Doom Terri Schiavo?
March 27, 2005


    IN the parade of faces talking about Terri Schiavo last week, two
    notable authorities were missing: Aristotle and Descartes. Yet their
    legacy was there.

    Beneath the political maneuvering and legal wrangling, the case
    re-enacted a clash of ideals that has run through the history of
    Western thought. And in a way, it's the essential question that has
    been asked by philosophers since the dawn of human civilization. Is
    every human life precious, no matter how disabled? Or do human beings
    have the right to self-determination and to decide when life has

    "The clash is about how we understand the human person," said Samuel
    Gregg, director of research at the Acton Institute for the Study of
    Religion and Liberty, a conservative policy group.

    The plea last week to prolong Ms. Schiavo's feeding, against the
    wishes of her husband or what courts determined to be her own
    expressed inclinations, echoed the teachings of Aristotle, who
    considered existence itself to be inviolable.

    On the other side, the argument that Ms. Schiavo's life could be
    judged as not worth living echoed Descartes, the Enlightenment
    philosopher who defined human life not as biological existence - which
    might be an inviolable gift from God - but as consciousness, about
    which people can make judgments.

    For most of history, the conflict between these schools of thought has
    allowed room for compromise, said Robert Veatch, a professor of
    medical ethics at Georgetown University who supports the right of
    patients to suspend treatment. He cited a Roman Catholic judgment from
    the Middle Ages that if a patient needed to travel 300 miles by donkey
    cart to a shrine to be healed, that was too much. "The idea that all
    life is valuable or sacred has in almost all settings been qualified
    in some way," Professor Veatch said.

    Yet this idea that all life is sacred has exerted a powerful force in
    America, said Mark A. Noll, a professor of history at Wheaton College,
    a prestigious evangelical school in Illinois, and the author of "The
    Old Religion in a New World: The History of North American
    Christianity. " It fueled the abolitionist movement of the 18th and
    19th centuries, which insisted on the humanity of slaves, against the
    prevailing views of social science. In the early 20th century, the
    same ideal stood up against eugenics, which advocated forced
    sterilization to prevent the weakest members of society from

    In both battles, Professor Noll said, people who held the sanctity of
    all human life as a religious conviction triumphed over an
    Enlightenment contention "that said 'No, we can qualify this value' "
    - meaning the value of a human life could be determined by scientific

    As late as 1927, the United States Supreme Court ruled that the
    government could sterilize mentally retarded people against their
    will. "Three generations of imbeciles are enough," Justice Oliver
    Wendell Holmes wrote in the court's decision involving a woman
    mistakenly deemed retarded.

    In this context, Professor Noll said, "the preference for life has
    been a protection against the exploitation of little people by big
    people." The conflict as it exists now began to take shape with the
    emergence of modern medicine in the late-19th and early-20th
    centuries, said Gary M. Laderman, an associate professor of religion
    at Emory University and author of "The Sacred Remains: American
    Attitudes Toward Death, 1799-1883."

    Medical breakthroughs that prolonged human life by technological means
    changed the way Americans could see death and by extension, the ways
    they defined life.

    The setting for death shifted from the home to the hospital, where
    doctors, rather than religious leaders, claimed authority. Medicine
    lionized the figure of the heroic doctor, and treated death as a kind
    of failure, Professor Laderman said. Doctors were free not to tell
    patients that they were terminally ill, claiming for themselves the
    right to determine what was appropriate. Death became a "medicalized"
    state, to be determined by human expertise. Like life, it could be
    treated as a medical option.

    By the 1960's and 1970's, medical patients began to claim this right
    for themselves, said Bruce Jennings, a senior research scholar at the
    Hastings Center, a bioethics research group that has supported patient
    rights. In this, they conspicuously followed the model of the
    political and consumer movements of the era, which shifted authority
    away from experts and institutions to individuals.

    To adopt Professor Noll's language, they redefined the little people.

    "This offered a slightly different way to frame the issue: not so much
    as a conflict between valuing life and the freedom of choice, but a
    different attitude toward technology itself," Mr. Jennings said. "On
    the one hand, there's a widespread feeling in the United States that
    everything can be cured and we don't have to die. But there's another
    fear of imprisonment by technology in a way that undermines our
    integrity and dignity. It's claiming freedom from these institutions
    or technology."

    The philosophical line in this history, then, is not straightforward,
    but includes a peculiar American twist: The evangelical revival of the
    18th and 19th centuries produced the abolition movement, which gave
    rise to the women's suffrage movement, which inspired the civil rights
    movement, which led to the patient's rights movement. But now the
    patient's rights movement faces off with many 21st-century evangelical
    Christians in the Schiavo case.

    At the same time, the scientific legacy of the Enlightenment, which
    argued that human life resided not in the body but the mind, is now
    being undermined, as modern neuroscience demystifies elements of
    thought and personality as heartless biochemical or genetic processes.
    The mind is simply prisoner to the body's DNA.

    The ideas at play over this history do not conclude with Ms. Schiavo's
    case, but feed into arguments over abortion, stem-cell research,
    assisted suicide, the death penalty and even animal rights.

    In their competing claims, these ideas are part of what defines
    America, said Courtney S. Campbell, a professor of medical ethics at
    Oregon State University who has argued for the rights of patients to
    pull the plug.

    "It goes back to the foundations of the Republic - the right to life
    and the right to liberty in the Declaration of Independence," he said.
    "It's a deep-rooted conflict that goes to the core of who we are as a
    people and as a political society, so it's not surprising that it can
    be polarizing."

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