The Terri Schiavo Case -- How Far Can It Go?

As I write this, Terri is in her ninth day without food and water. As I'm sure most of you know, Terri Schiavo suffered a condition about 15 years ago, possibly related to an eating disorder or to cardiac problems brought about by an eating disorder, which resulted in the loss of oxygen to her brain for 10 minutes. The doctors and her husband maintain that Terri is in a persistant vegetative state (PVS), and thus has no chance for recovery. Her parents and immediate family say that Terri's condition could be improved with rehabilitation and that she is not in PVS but that she actively engages them with her eyes and responds to their voices.

This case has been debated heavily in the media and in the courts for over 2 years, with the most of the media attention occurring over the past four months. Now, as Terri lays in her hospice room in the final stages of life, the media has shifted its attention to trying to convince their audience that Terri does have PVS and, as a result, is in no pain, despite the fact that she is receiving a morphine drip for the pain.

Concerns have been raised over why this case should have gotten such attention from the public, most notably from elected officials at the state and federal level. What could possibly be the ramifications from this situation? Where could this case lead in the future?

Our country has always struggled with the issue of the sanctity of life. We have had a horrific track record in regards to abortion, the murder of unborn children. We have had public debate on the merits of embryonic stem cell research, a technique that also eliminates the life of unborn children. Now, we see an increasing interest in euthanasia and physician-assisted suicide.

What is the problem with this? Right now, the issue is the right of a person to decide to take their own life, with most of the current laws limited to persons who have been diagnosed with a terminal disease. However, as the case with Terri Schiavo shows, it is a short leap to move from the terminally ill to the disabled. Terri is NOT terminally ill. She has not been on life support. She was merely being offered food and water through a feeding tube, a common practice in hospitals today for thousands of patients, some of whom are NOT classified as PVS by the doctors.

Hence the danger -- if they can remove her feeding tube merely because she is disabled (not terminally ill, but brain damaged), why can't they remove the feeding tube of any disabled person? And then, once we cross that line, why not encourage the euthanasia of the disabled or the mentally retarded? In some of the countries in the Netherlands, disabled infants or those with mental retardation are routinely killed by doctors, sometimes without the parent's approval or knowledge. With the Terri Schiavo case, we see that we may not be far behind.

Consider the article that was published on Med Page today by Peggy Peck, entitled "Does Terri Schiavo feel pain?" The article goes to great pains to prove to readers that persons in a PVS state do not feel pain in a conscious sense, but only react to stimuli through a pain response called "nociception." The article states that "Pain, as well as suffering, requires consciousness, which is lacking in a person in a persistent vegetative state, says Dr. De Georgia. "

O.K. Lets assume that this statement is correct. But what is more frightening are the following statements:

"Dr. DeGeorgia says that a patient in a persistent vegetative state can experience arousal, meaning that the patient's eyes may be open and the patient may laugh, cry or appear to track someone who is in the room.

"And that is what can be confusing for people, especially relatives, he says. "For example, a patient in persistent vegetative state will grasp your hand. In fact if you put anything into the patient's hand, the hand will grasp it. But this is a very primitive reaction. A newborn baby will grasp your finger, but there is no consciousness."

"It is consciousness that determines whether one can "feel" pain in the sense that most people understand when they talk about feeling pain.

"Pain, on the other hand, is the recognition of nociception by the nervous system, which sends the impulse to regions of the brain where consciousness exists. In the case of a severely brain injured person - one in a persistent vegetative state - those areas of consciousness have been destroyed, and as result "they don't 'feel' pain.""

Did you catch the implication of the argument over consciousness that was being made here? The author says that a "newborn baby will grasp your finger, but there is no consciousness." Terri Schaivo has had her feeding tube removed because the doctors say she is in a PVS, she has "no consciousness," and she experiences no pain or suffering. But, the same article says that newborn infants have no consciousness. So, it is not a great leap of reason to assume that we could easily end the life of newborn infants in the same way, because they should not have the capacity to experience pain or suffering either.

Now do you see the implications of the Terri Schiavo case for this country? It is not about just one person. It is about the sanctity of human life. It is about not only the terminally ill, but about the disabled, the mentally retarded, and the unborn. And, it may just be about newborn infants as well.