Terri Schiavo: killing or letting die or letting live?



e-Review Florida United Methodist News Service
      
 

Terri Schiavo: killing or letting die or letting live?

March 28, 2005    News media contact:  Tita Parham*    
800-282-8011   
tparham@flumc.org     Orlando  {0270}

NOTE:  A headshot of Whitaker is available at http://www.flumc.info/photo_gallery2.shtml.




An e-Review Commentary
By Bishop Timothy W. Whitaker**




The tragic ordeal of Mrs. Terri Schiavo causes most of us to engage in moral reflection on that borderland of human existence where there has to be a decision about killing, letting die or letting live.

A fundamental moral principle consistent with faith in God revealed in Jesus Christ is to always care rather than kill. In 1991 the Ramsey Colloquium of the Institute on Religion and Public Life (named after the late Paul Ramsey, a United Methodist ethicist) issued a declaration titled "Always to Care, Never to Kill." The declaration says, "In relating to the sick, the suffering, the incompetent, the disabled, and the dying, we must learn again the wisdom that teaches us always to care, never to kill. Although it may sometimes appear to be an act of compassion, killing is never a means of caring."

On the basis of "always to care, never to kill" we would never give moral approval of physician-assisted suicide or active euthanasia. Approval of techniques to terminate the lives of the dying would distort the purpose of physicians to care for persons and open the way to destroy the lives of the disabled.

The principle of always caring does not prohibit letting the terminally ill die in dignity and comfort. The hospice movement is based upon the moral assumption that it is permissible to let the dying die as long as they receive caring while they are dying. The statement on "Faithful Care of the Dying" in the Social Principles of The United Methodist Church expresses the moral wisdom of limiting the use of medical technologies in caring for the dying: "The use of medical technologies to prolong terminal illness requires responsible judgment about when life-sustaining treatments truly support the goal of life, and when they have reached their limits. There is no moral or religious obligation to use these when they impose undue burdens or only extend the process of dying. Dying persons and their families thus have the liberty to discontinue treatment when they cease to be of benefit to the patient."

The extreme case of Mrs. Schiavo demonstrates how difficult it can be to distinguish between killing and letting die or to choose between letting die and letting live.

One concern is how to assess the technique of feeding a person through a tube. Without the feeding tube Mrs. Schiavo would have died years ago. There is a difference between eating and being fed by the insertion of a tube into one's stomach. Mrs. Schiavo has been unable to eat ever since she entered the "persistent vegetative state."

Some think that providing a feeding tube to a person in a "persistent vegetative state" is an extraordinary medical intervention and that removing the tube is not killing, but letting die. On the other hand, there are those who say that providing fluids and food is not an extraordinary medical intervention, but a necessary means of caring. There are many disabled persons who live by means of a feeding tube. Therefore, they say that to deprive a person of fluids and food would be killing not letting die.

Another concern is how to characterize Mrs. Schiavo's condition. It is morally permissible to allow the terminally ill to die, but can Mrs. Schiavo be described as one who is terminally ill? As long as she received fluids and food she would continue to live. It is more accurate to describe her as a person who is severely disabled rather than one who is terminally ill.

To make matters even more complex, there is the concern of how to define "life." The simplest rule is that life is life: as long as a person is alive, regardless of whether or not one's brain is dead, or the cortex of the brain is dead, then that person should be allowed to live and she should receive care.

Jews and Christians who consider the body an essential dimension of being human should not place too much value upon one's capacity for consciousness; to do so would imply a spiritualistic view of a human being and pose a potential threat to the lives of the mentally incompetent. Yet, even very conservative Jewish and Christian bio-ethicists think that brain death should be viewed differently than other kinds of disabilities since the cortex of the brain is the means through which a person expresses herself.

Moreover, to make "life" per se an absolute category is to obscure the value that should be placed upon "a way of life," i.e. an ability to interact with the rest of the world and to relate to others. Indeed, there is a spiritual danger in hypostatizing life, i.e. viewing life as something that subsists in itself and thus makes moral claims upon us, rather than viewing life as a gift of God offered to us under the conditions of creaturely limits. It is not "life" itself, but God's purposes for human beings that make the ultimate moral claims upon us. Similarly, I would argue that the Christian protest against the violence of abortion should not be based upon a "right to life," but upon God's peaceable purposes and God's call for us to care for the most vulnerable.

To continue to acknowledge the complexity of a case such as Mrs. Schiavo's, there is also the concern about the value of the person in a "persistent vegetative state" to her loved ones. A person who is in a "persistent vegetative state" is not a vegetable, especially not to those who know her and love her. The love that Mrs. Schiavo's parents and siblings have toward her and the care they display toward her is of immense value. It should be humbly acknowledged that no one — no physician, no ethicist, no judge, nor any other human being — can absolutely know the effect that the power of love has upon someone even as severely disabled as Mrs. Schiavo. Moreover, the love displayed by members of a family, friends, and professionals and volunteers in a hospice adds immensely to the moral dignity of our society. To Christians this kind of display of love is a witness to the love of God revealed in Jesus Christ and poured into our hearts by the Holy Spirit. Moral reflection should include consideration of the value of the love of caregivers as well as the condition of the one receiving care.

It seems to me that, all things considered, in the case of Mrs. Schiavo, it would be better to allow her to live. I would not go so far as to say that removing her tube is killing her. Since she is brain-dead it is understandable why some think it would be merciful to let her die and to entrust her to the care of the living God whose purposes for us transcend this life. Here motives of the decision-makers are very important: it makes a difference whether or not our motive is to release someone from being bound to her severely impaired body or to get rid of her because she is a burden. Yet, I believe it would be better to let her live because she is the beneficiary of abundant love.

The decision is excruciating because of the complexity of the case. In my view there is not much room for moral condemnation on either side of the decision between letting die and letting live. Nevertheless, one must judge, and I would decide for preserving her life primarily because of the high value placed upon the self-giving love of those who want to care for her.

Of course, the case of Mrs. Schiavo is a legal one, as well as a moral one. The judges have ruled in accordance with the law of Florida that Mrs. Schiavo should be allowed to die because her spouse is a witness to her intention. The problem with the existing law is that (as far as I know) it does not contain a provision that would allow the court to render a judgment about whether the spouse should be the only witness where there is no written will or if the spouse's witness is compromised by a conflict of interest, such as living with another person with whom he is rearing children. The existing law does not permit consideration of the testimony or the moral claims of other members of the family who are willing to provide the love and care the disabled person needs. If I understand the law correctly, it seems to me there is a moral basis for modifying the existing law.

In our society the usual assumption is that consideration of whether or when to withhold life support to a person depends upon that person's own preference. Surely, it matters whether or not we would want to live with medical support if we were brain-dead. However, limiting moral considerations to only the intention of the person is an individualistic perspective that does not take into consideration the ability and willingness of others to love and to care. At worst, such individualism in moral deliberation and law can be an endorsement of absolute individual autonomy and self-determination and thus of moral decisions and law that could permit physician-assisted suicide and active euthanasia. It is important to society, and especially to Christians in society, to also introduce communitarian values into our moral deliberations as the basis of both decision-making and legislating.

We are grateful that we live in a nation where we are given freedom. As Christians we are especially grateful for the spiritual freedom given to those of us who are justified by grace through faith in Jesus Christ. The freedom we have received is not given to us for the sake of self-determination, but for the sake of service. The apostle Paul wrote, "you were called to be free; do not use your freedom as an opening for self-indulgence, but be servants to one another in love, since the whole of the Law is summarized in one commandment: You must love your neighbor as yourself (Galatians 5:13-14, The New Jerusalem Bible)."

Serving others in love is possible only by participating in the love of God. On Easter Christians heard again the proclamation that because of the resurrection of Jesus Christ God's love is stronger than death. Unless this proclamation is just a pious sentiment it creates a people whose practices are different than those of the world. The church's mission is not to be the chaplain to a culture of death, but to be a witness to the love of God in the world. Rather than assisting people to make living wills, wouldn't it be more fitting for the church to tell the stories of those who have found new life in giving loving service to the disabled? Their stories show us how to practice a way of life of participating in the love of the Triune God, which is eternal life.

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This article relates to Christian Faith/Church and Society.

*Parham managing editor of e-Review Florida United Methodist News Service.
**Whitaker is bishop of the Florida Conference.




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