quality vs quantity
This Terri Schiavo thing really bothers me. One of our friends blog was on the topic yesterday and I posted, read other responses. Terri is a young woman who suffered a brain injury several years ago, now is unable to walk, talk or eat, is tube fed. Her husband claims she did not want to be kept alive by artificial means and has been trying to have her tube removed for years, parents are contesting saying she is responsive and not vegetative and should not be actively killed.
You know I am totally opining on this, I am not related to her, have not met her or her husband, I just am examining the situation and responses I have heard to it.
Peoples' emotions run high when right to life issues rear. Most people have had at least someone close to them suffer or die, which has a lasting effect on you. The question in my mind is, why assume Terri is suffering?
She is responsive, laughs, smiles, looks at people, recognizes familiar faces, etc. She sits unassisted, is dressed, apppears to enjoy music and to be close to her family. What defines suffering? She exhibits no sign of pain, is not crying, moaning, wincing, squeezing her eyes, or any other verbal or non verbal sign of pain. My father died of cancer, and was in pain, I would not wish that on anyone, but Terri isn't in pain.
She is dependent on others for her physical care, does this mean she is suffering? Babies don't suffer due to that. When we are injured we get cared for, is that suffering? Older people need help sometimes due to frail frame, are they suffering? I don't know but that would be an individual call and not an automatic assumption. In and of itself there is no indication that needing help is a cause of suffering.
I worked in a home for severely disabled adults with medical needs, I am an RN. All of these clients were significantly worse off than Terri, yet none of them appear to be suffering. They knew no other life so one could argue that Terri was suffering because she could no longer do the same things she had done before. Of course, by this logic then, old people are also suffering because of loss of function. I learned alot in that home. The clients went out into the community, they had distinct personalities, only one could walk and talk, the rest were "vegetative", yet they all were distinct people, and they lived a life, not some vague existence. They had favorite TV shows, preferred care givers, food preferences, sleep preferences, ways of communicating (eye contact, laughing, frowning, hand movements, etc). In nursing school alot was made of the question quantity vs quality, we were very inculturated in the push to promote quality of life issues, end of life issues, etc. I think the question is very murky.
Don't get me wrong, everyone should have the chance to make the decision about end of life issues, Terri did not leave a living will, all we have is her husband say so. The problem is the fluidity of what constitutes quality of life, disability, etc. No one would wish someone to live in pain, and she is not in pain. Now that she has persisted for over a decade, is in exellent health other than the physical limitations and does not appear to be in any discomfort, withdrawing food is actively killing her. The time to have done so would have been back when the injury first happened. You don't come along a decade or two later and say, oops, should not have done that.
How does one decide if a life is meaningful? Is it only what one can produce or contribute to the world at large? I think that attitude devalues life more than anything. None of the clients I worked with contributed anything to society, and were quite a drain financially. Does that mean their life was worthless? I don't think so. Our value is not dependent upon what we produce, it is dependant on the fact that God saw fit to create us. We don't lessen in value when we are less than perfect, and the value of our life does not diminish because of a brain injury or disability.
Why do we in this society assume that someone who is physically or mentally disabled must be unhappy with their condition? I worked in an Alzheimer's unit for a few years, most of the residents were very happy (they didn't have a clue where they were but they didn't seemed bothered by it, mostly, short term memory loss can be a blessing), it was their family who were suffering. Toward the end as their physical health declined they were very ill, but that happens to many people for a variety of reasons, we all will die. There is no reason to say that their death is any better or worse than another. We don't want to watch someone decline but to assume that because it causes us grief, it must also be causing them grief is faulty logic.
We can't kill the physically and mentally impaired off to make us more comfortable. That is what it seems is happening. The attitude that someone might be unhappy or uncomfortable, even down the road, because of a condition that probably will not improve, is enough to ask them to end their life seems harsh. I have also known of people who ended their life due to chronic debilitating disease which was causing them to suffer. I just don't think anyone should make that decision for anyone else.
You know I am totally opining on this, I am not related to her, have not met her or her husband, I just am examining the situation and responses I have heard to it.
Peoples' emotions run high when right to life issues rear. Most people have had at least someone close to them suffer or die, which has a lasting effect on you. The question in my mind is, why assume Terri is suffering?
She is responsive, laughs, smiles, looks at people, recognizes familiar faces, etc. She sits unassisted, is dressed, apppears to enjoy music and to be close to her family. What defines suffering? She exhibits no sign of pain, is not crying, moaning, wincing, squeezing her eyes, or any other verbal or non verbal sign of pain. My father died of cancer, and was in pain, I would not wish that on anyone, but Terri isn't in pain.
She is dependent on others for her physical care, does this mean she is suffering? Babies don't suffer due to that. When we are injured we get cared for, is that suffering? Older people need help sometimes due to frail frame, are they suffering? I don't know but that would be an individual call and not an automatic assumption. In and of itself there is no indication that needing help is a cause of suffering.
I worked in a home for severely disabled adults with medical needs, I am an RN. All of these clients were significantly worse off than Terri, yet none of them appear to be suffering. They knew no other life so one could argue that Terri was suffering because she could no longer do the same things she had done before. Of course, by this logic then, old people are also suffering because of loss of function. I learned alot in that home. The clients went out into the community, they had distinct personalities, only one could walk and talk, the rest were "vegetative", yet they all were distinct people, and they lived a life, not some vague existence. They had favorite TV shows, preferred care givers, food preferences, sleep preferences, ways of communicating (eye contact, laughing, frowning, hand movements, etc). In nursing school alot was made of the question quantity vs quality, we were very inculturated in the push to promote quality of life issues, end of life issues, etc. I think the question is very murky.
Don't get me wrong, everyone should have the chance to make the decision about end of life issues, Terri did not leave a living will, all we have is her husband say so. The problem is the fluidity of what constitutes quality of life, disability, etc. No one would wish someone to live in pain, and she is not in pain. Now that she has persisted for over a decade, is in exellent health other than the physical limitations and does not appear to be in any discomfort, withdrawing food is actively killing her. The time to have done so would have been back when the injury first happened. You don't come along a decade or two later and say, oops, should not have done that.
How does one decide if a life is meaningful? Is it only what one can produce or contribute to the world at large? I think that attitude devalues life more than anything. None of the clients I worked with contributed anything to society, and were quite a drain financially. Does that mean their life was worthless? I don't think so. Our value is not dependent upon what we produce, it is dependant on the fact that God saw fit to create us. We don't lessen in value when we are less than perfect, and the value of our life does not diminish because of a brain injury or disability.
Why do we in this society assume that someone who is physically or mentally disabled must be unhappy with their condition? I worked in an Alzheimer's unit for a few years, most of the residents were very happy (they didn't have a clue where they were but they didn't seemed bothered by it, mostly, short term memory loss can be a blessing), it was their family who were suffering. Toward the end as their physical health declined they were very ill, but that happens to many people for a variety of reasons, we all will die. There is no reason to say that their death is any better or worse than another. We don't want to watch someone decline but to assume that because it causes us grief, it must also be causing them grief is faulty logic.
We can't kill the physically and mentally impaired off to make us more comfortable. That is what it seems is happening. The attitude that someone might be unhappy or uncomfortable, even down the road, because of a condition that probably will not improve, is enough to ask them to end their life seems harsh. I have also known of people who ended their life due to chronic debilitating disease which was causing them to suffer. I just don't think anyone should make that decision for anyone else.
posted by madmom at 1:16 PM
4 Comments:
Wonderful, well written post. I agree about what is happening with Terri. I think that maybe our value should be measured by how much we are loved. Of course that means we are all of great value, since God loves us all so much he sacrificed his Son for us.
Thank you Patty Jo. I guess what bugs me is the automatic assumption by so many people that a life where one is disabled is not a life worth living. There are so many other factors in Terri's case but that is the crux, why is her life not worth living? Who decides and why? Since she can't speak for herself and she is not apparently in pain, why not err on the side of caution and let her live?
There is another thing to consider and it cuts both ways. What would you decide to do AFTER THE FACT, if your 'quality of life' was severely compromised?
If you sign a living will with certain stipulations, then those living really have no choice but to follow it. However, I wonder, if I filled out a living will and later found myself in a semi-living state - would I still want my life terminated? Or would I want to cling to life?
My mother had a massive stroke and had already signed a living will and the DNR documents. We allowed her to pass per her wishes (at least her wishes when she filled out the will). By the same token my grandmother had also had a massive stroke and didn't have any kind of instructions. She was fed via the tube for about 5 years. She was never in pain, she enjoyed having people around, having her hair done, etc. We all enjoyed the extra 5 years that we got with her (although she certainly wasn't the same person that she was prior to the stroke).
It's a hard, hard question, but when no instructions are given, I believe we have to error on the side of life. Just one ArchAngel's opinion.
Well, that's the dilemna, isn't it?
1-I know there are people who are absolutely adamantly determined they do not want to be kept alive by artificial means when they would otherwise die, I have no problem with that, it is their choice to let nature take it's course.
2-There are terminally ill people who are dying anyway that don't want extraordinary measures taken to keep alive a dying body, or delay the moment of death, that makes perfect sense and is not a moral dilemmna.
3-There are people who would rather die than be crippled or maimed. Again that is their choice and is between them and their maker, but I don't think anyone should help them off themselves, or decide for them that their life is not worth living.
There is a big difference between not rescusitating a dying person, and killing a living one. Terri is not dying, is not likely to die other than by the usual course of events. The only way she can die is by being killed. To DNR or not is might have been relevant 15 years ago, but right now she isn't dying. I agree, why not err on the side of caution and let her live?
The people who are inflamed about her "right" to die may have seen family members suffer painful deaths and have strong emotions because of that. Terri is not a terminally ill person and the only justification for causing her death is that one feels that her existance is not worth living. No one can make that call for another. No one can predict the future.
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