[August 2006 journal entry, reflecting on the unfolding Terri Schiavo case]
A noticeable complexity re decisions about withholding/withdrawing artificial nutrition/hydration technologies, ventilators, antibiotics, and/or dialysis is the inescapable reality that affecting the time and manner of death is central to the decision-making process and the decision’s consequence. In other words, the reason for the withholding/withdrawing of these interventions does not have to do with the ineffectiveness or futility of the particular intervention. Each one may be effective when assessed in terms of the intervention’s specific/narrow function – e.g., nutrition/hydration may reach the body, air may reach the lungs, infection may be overcome, waste may be eliminated. The reason to withhold/withdraw, therefore, has to do more directly with the larger issues of the patient’s quality of life and of managing the patient’s dying process (i.e., ‘in league with death’). I think it takes great maturity re such considerations as ‘life’, ‘death’, ‘conflicts of interest’, ‘power’, . . . when faced with these decisions. If individuals oppose/shun this complexity and maturity, then I do not think they should employ modern/intensive medical care. I think the reactions from the religious ‘right’ in the Terri Schiavo case demonstrate the result of a one-sided use of modern/intensive medical care. ‘Playing God’ begins long before decisions about existence-sustaining technologies. I am not too confident in the maturity of those toward the ‘left’. However, there is the possibility of encouraging such maturity toward the ‘left’. I do see evidence of the needed maturity in the United States (or in Holland, for that matter) of those toward the ‘left’.
