Right to die sounds nice unless it's your turn

Kathleen Parker

10/25/2003 12:00:00 AM - Kathleen Parker

What strange times are these that we argue over whether to dehydrate to death a living human being. But thanks to medical technology that makes gods of beings unworthy, here we are.

The Florida case of Terri Schiavo, 13 years in a "vegetative" (but wakeful) state and the subject of warring factions concerning her fate, is a nightmare in anyone's wolf-stalked night. Simply distilled: Her parents want to her alive; her husband wants her dead.

Terri collapsed in 1990 from unknown causes and became severely cognitively disabled. Husband Michael has been trying for years to remove his wife's feeding tube to let her die, as he claims she would wish. Her parents have fought to keep her alive.

Until Tuesday, when the Florida Legislature and Gov. Jeb Bush intervened, Michael had prevailed. But six days after her tubes finally were removed, the Legislature gave Bush authority to override Michael's wishes and the court orders.

The feeding tubes have been put back in place and now we wait. What happens next? More skirmishes, more debates, more court challenges, more outrage, and then again, maybe not enough.

The questions posed by such cases haunt us all because we know our day is coming. The prospect is unthinkable and the answers, obviously, aren't easy.

Schiavo's case is also complicated by circumstances that are all too human. Michael long ago left his wife in spirit, pursuing another relationship and even having a child (another is on the way) with a woman he reportedly plans to marry when his wife dies.

Yet, he promised to care for Terri the rest of her life when he filed a medical-malpractice lawsuit. A jury awarded him $1.3 million, $750,000 of which was to pay for rehabilitation, which Terri never has received, according to her parents.

It is hard to fathom how we got here, but there's no turning back. As long as we're living longer and medical technology races to keep us alive through debilitating disease and injury, we're doomed to face such decisions - for our loved ones and, if we have enough foresight, for ourselves.

It is also difficult to remain emotionally detached as we ponder the rather pleasing, if mellifluously misleading, "right to die," as the Schiavo case is being defined. Hmmm. Would that be my right to die, or your right to make me die? For practice, pose this question over dinner tonight:

"Honey, if you were in a vegetative state, would you want me or your mother to decide your fate?" Just a guess, but I'll bet most married adults suddenly will see their spouses in a new light and give their moms a quick call just to check in.

Among several questions swirling around the Schiavo case is whether she would suffer during death by dehydration, which can take between 10 and 14 days. The answer seems to depend on whom you ask.

William Burke, M.D., a professor of neurology at St. Louis University, has described death by dehydration as agonizing, potentially punctuated with nosebleeds, vomiting, and hunger and thirst pangs.

Other physicians, such as George D. Lundberg, former editor of the Journal of the American Medical Association and author of "Severed Trust: Why American Medicine Hasn't Been Fixed," hold a different view.

"If all agree that the time for death has come, withholding all nutrition and fluids, orally and intravenously, is a very effective method of producing death," Lundberg writes in his book. "It is said to be reasonably painless, although it may involve discomfort from thirst and hunger. There's no reason, however, why the physician cannot provide narcotics to diminish discomfort."

I find little comfort in phrasing such as: "It is said." By whom? Surely not the dying or dead. "Reasonably painless?" That's what they said about childbirth by heavy breathing.

But we split hairs, yes? Trying to find a guilt-free way to delete people no longer fit for living according to our definition of "quality." In the absence of a living will, as is the case with Schiavo, do we really want to become the arbiters of when another's life is worth living? Stephen Hawking, I'm guessing again, would vote "no."

When there is doubt, as surely there is here, life should trump death. Otherwise, without much troubling, the right to die becomes the duty to die and, who knows, your turn may be next. Meanwhile, we'll all breathe easier, including Terri Schiavo.