I'm not going to get into the intricacies of the Terri Schiavo case simply because I'm not privy to even a fraction of the information available to the individuals, legal counsel and judges involved. I, like you, know nothing more than what is being reported by an often unreliable news media with a thirst for sensationalism that sometimes outweighs the quest for facts.
Instead, I'm going to focus on one single, solitary aspect of this case and this ordeal: the next of kin.
Every state in the Union has some form of 'Next of Kin' (NOK) law or designation on the books. It is used to determine the hierarchy of who is allowed to make decisions for another person if that person becomes mentally incapacitated.
Although each state's NOK designation may vary slightly, the general order is spouse, adult child, parent, adult sibling and finally legal guardian. In Terri's case, the legal NOK is indisputably her husband Michael. All decisions regarding Terri's care are to be made by him and him alone.
It is not my place to decide if Michael is good or bad or whether or not he's putting Terri's needs or his own as a top priority; all that matters is that he is the legal NOK and any decisions regarding Terri's care default to him.
Don't get me wrong; I completely understand where Terri's parents are coming from. In their eyes, Terri is, in their opinion, alive and responsive and Michael is essentially sentencing her to death.
The cold, hard fact, though, is that it is indeed Michael's decision.
Terri's case underlines the need for Advance Directives. In layman's terms, Advance Directives are simply a legal document outlining whether or not the person wishes to be resuscitated in the event of cardiac or respiratory arrest and which efforts the person would want the medial professionals to use while attempting to save or preserve the person's life. In short, they describe when everyone should just stand back and let the person die.
Terri has no Advance Directives so the decision simply falls squarely onto the shoulders of the Next of Kin. Don't get me wrong, though, I think Michael is being an irresponsible prick. If any doubts exist as to the condition of a patient or the patient's wishes regarding life support we should always, always, always err on the side of life. In other words, if there is even a slight chance that Terri is still in there somewhere, she should not have life support removed.
I have, unfortunately, been in the position to make the decision whether or not to continue the life support for my child. In my situation my wife and I, faced with the evidence that our daughter was brain dead, chose to discontinue life support. I personally know the pain and agony that Terri's parents are facing.
I have also tried to put myself in Michael's shoes, trying to make the decision for his wife that many of us have already made for ourselves; to not be trapped in our crippled and insufficient bodies for the rest of our lives but to instead be allowed to die.
It's a tough decision; Terri has hung on for over a decade in her current condition and could, according to various doctors, continue to survive indefinitely. Whether or not to continue life support would be a horrible decision to have to make.
One thing I don't understand is how a feeding tube can be considered life support. As a former Emergency Medical Technician (EMT) and former manager of a private ambulance service I am more than familiar with "Do Not Resuscitate" and "Do Not Intubate" orders limiting the extraordinary measures normally taken to save a life.
Never in my life or my career, though, have I ever considered a feeding tube as extraordinary measures. Cardiopulmonary Resuscitation (CPR) is an extraordinary measure. Using a ventilator is life support. Having a feeding tube attached is, in my mind, no different than having and IV line or receiving medication. I'm not sure when or where society and the law determined that a feeding tube is life support.
Nonetheless, this entire situation could have been prevented if only Terri had done what thousands of others have done; record her wishes in the form of an Advance Directive. This simple legal document would have spelled out exactly which measures she would like taken and under which circumstances she would have preferred to simply have been allowed to die.
I encourage every single person reading this column to at the very least discuss your wishes with your entire family and record your wishes in an Advance Directive type of legal document. Don't put your family in the position that the Schiavo family now finds themselves; spell your wishes out in a clear, concise and legally binding manner.
In the mean time, pray for Terri and the Schiavo family. No family should ever be in their position; it is a situation that has no happy ending and no good outcome. No matter what happens the rest of their lives will be spent second guessing and forever going over the 'what ifs'.
Keep them in your hearts, minds, thoughts and prayers.
Resources:
Advanced Directives Online
New York Life Insurance Company |