The lesson of Terri: Death and dying are personal matters.
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Wednesday, April 13th, 2005 The media blitz surrounding Terri Schiavo has swept me back to the bedside of my father as he lay dying of cancer -- a time of great pain for him and his family.
The issues of life and death, morality and personal choice raised in the Schiavo case touch deeply those of us with personal experiences. But the media frenzy surrounding her case raises troubling questions about the future role of politics and religion in end-of-life decisions.
Terri's story hits close to home. Experience tells us it could be our story. We each have a real and personal interest in the outcome.
Ironically, our personal interests straddle the fine line of decency, and raise many questions. What is the delicate balance between sanctity of life and quality of life? Will we meet a premature demise because the so-called "culture of death" considers our diminished capacity too high a burden, or that it falls below acceptable standards of good taste in polite society?
Conversely, we fear being cast into the jaws of medical technology and a "culture of life" that is loathe to allow death to take its natural course. Will we become vestiges of life that put our families at financial risk and deny medical resources to those for whom they could be a benefit?
If there is a lesson to be learned from this case, it is that we ought to give serious thought to what kind of life we would want or not want for ourselves, and what types of treatment would be acceptable. Then we should detail those wishes in an Advanced Medical Directive.
I read with dismay the press releases from the Vatican, which seemed to challenge the authority of a medical directive. The releases warn against the withdrawal of Schiavo's feeding tube, harking back to a statement he made in 2004 saying that food and water are "morally obligatory" for most patients in vegetative states.
The Schindler-Schiavo family is Catholic, as is Florida's Governor Jeb Bush. The Vatican's public statements on their behalf have caused some people to worry. The statements also fuel the flames of political and religious conservatism.
For the record, Catholic moral teaching since the 16th century has made provisions for patients and their families to participate in end-of-life decisions.
Types of treatment, quality of life, human dignity and burden for patient and family are weighed in these decisions. But the most revolutionary teaching came in the 1960s as the world awoke to the "...dawning of the 'Age of Aquarius.'"
Consistent with that decade's trend toward individual responsibility, the Second Vatican Council introduced the concept of "primacy of conscience." I studied this document as an undergraduate at the University of San Francisco. This was heady stuff for a "good Catholic girl" brought up on rules memorized from my dog-eared catechism and the Saturday afternoon Confessional.
The prospect of "conscience first, authority second" was revolutionary, and sobering. With exercise of conscience emerges personal responsibility.
As I reflected on the Schiavo case, I thought of this provision. Where are the guideposts for exercising good conscience when the facts -- not brain dead, Ms. Schiavo's heart beating on its own, 15 years in a coma -- leave large, troubling gaps in the picture? Lawyers tell us, "Hard facts make bad laws." Doctors add, "Good morals make good medicine." Decent, humane, and gentle decisions don't come from rulebooks but from good people: our caregivers, ourselves.
"Primacy of conscience" calls on us to consider the facts, listen to the counsel of others, and pray, if one is inclined to pray. Most importantly, it requires that we know what we value most about life and death.
The decisions might not be easy. Nobody said they would be. But being denied the right to make those decisions would be the real tragedy.
I will always remember the last day I spent with my father. It was a chilly Saturday afternoon in May, 15 years ago. I sat at his bedside in the family home in Walnut Creek. His doctors told us nothing more could be done for the cancer that had silently stolen into most parts of his body. So we had brought him home.
This Saturday I was giving my mom a much-needed break from her 24/7 care of Dad. Other friends and family members had been at the house earlier in the day, but now my father and I were alone.
He was in extreme pain despite being heavily sedated. He was crying out and struggling to get out of bed when the phone rang. I held him down with one hand and answered the phone with the other. It was his doctor. When the doctor heard Dad's screams he advised me to administer more morphine.
I did. I had to. My father deserved it.
My father died that night. Was it the heavy dose of morphine? I don't know. I do know he was finally at peace. Respect for life asks us to make tough decisions, and to try with all our might to care for the people whose lives are entrusted to us.
My decision was clear. Dad's pain was uncontrollable, and anyone in my family would have responded as I did. Regardless, I was glad to be making this decision in the care and company of a compassionate God in whom I firmly believe.
The present trend of both church and state, to use God as the watchdog, growling at the gate of conscience, is a pathetic caricature. Bullying should not guide our most personal life-and-death decisions.