Final Exam Question:

What To Do With Terri Schiavo?

David C. Stolinsky, M.D.
Mar. 21, 2005

After lengthy legal battle, judge orders brain-damaged woman to be starved and dehydrated to death.
– News item

Some time ago, I attended a funeral. I never heard a funeral described as educational, yet that’s exactly how I would describe this one. At the time, I felt only sadness. But later I realized that it taught me something, or rather it reminded me of something I should have known.

The funeral was for a medical-school teacher, a colleague of mine who had devoted her life to educating young doctors. In recent years she had been confined to a wheelchair by a crippling disease, but this had not dampened her devotion to her students.

She was a Catholic, and the church was crowded with colleagues, current and former students, and the sisters of a religious order she was close to. The priest was the brother of her former student. The service was a celebration of good life.

Years before, my colleague had adopted a baby girl. It soon became obvious that the child suffered from severe cerebral palsy, which impaired both physical and mental functions. My colleague, as always, played the cards she had been dealt as best she could. As my colleague’s disability worsened, she depended on others to help care for the child, but she never abandoned her maternal role.

At the time of the funeral, the girl was full-grown but confined to a wheelchair. Her limbs were distorted by spasticity, and she was unable to speak understandably. During the service, she uttered moans and cries. It was unclear whether she was grieving the loss of her mother, or was attempting to join in the prayers, or was merely making unintelligible sounds. I was irritated that the service was interrupted by this noise.

Later I realized that the service wasn’t intended to please me. True, funerals are meant in part to allow the mourners to grieve openly, which is healthy for both mind and spirit. But a funeral is also a reminder of what is important in life. This funeral was a celebration of a life devoted to teaching, which is important in itself. But there was more, if only I could see it.

Who, I wondered, was the most important living person there? Surely not I. Not the former students, who were devoting their lives to health care. Not the teachers, who were devoting their lives to forming young minds. Not the priest and the sisters, who were devoting their lives to serving God.

No, the most important person there was the twisted young woman in the wheelchair, uttering those seemingly meaningless sounds. Her pitiful outward appearance masked an inner light.

My question, I realized, should be restated: Who was the most important person there, and to whom – or to Whom? The sounds weren’t meaningless after all, but a reminder to us that things may not be what they seem on the surface.

When I was a child, I read a story of a king who disguised himself and went out into the city, only to find that his officials were mistreating his people. Later I read "Ivanhoe" and "Robin Hood," in which King Richard returns from the Crusades in disguise and discovers the wrongs done in his absence.

Recently I was amused to hear about a man who came to the emergency room on a Sunday with a cut hand. Unshaven, wearing dirty clothes, the man was kept waiting while the staff told jokes. On Monday they discovered he was the new chief of Emergency Medicine, who had hurt himself while working in his garden in old clothes. Needless to say, changes were made in that department.

If a new department chief can arrive dirty and disheveled, and can experience how "low-class" patients are being treated, is it possible that a more senior Chief would be concerned with the same problem?

If storybook kings can disguise themselves to discover how their people are being treated, could a real King use a similar tactic?

Might He send a messenger to appear as a homeless "bum," or as a member of an unpopular group, a person suffering from an untrendy disease, a "retarded" child, or a "useless" old person?

Perhaps His messenger could be disguised as a "cripple" disturbing our thoughts, or – yes – even as a "fetus."

If the funeral I attended was a refresher course, is it possible that life is a test? Will we get a passing grade? The test isn’t easy, but it is open-book. Right now, we are answering an important question. I believe it’s worth several points on our final exam. How will we deal with Terri Schiavo?

• This case isn’t about assisted suicide. Nobody claims Terri wants to kill herself, and nobody would choose such a slow way to do it.

• This case isn’t about euthanasia. The word means "good death," and only a sadist would think that starving and dehydrating her to death was good.

• This case isn’t about compassion. If Terri won’t be bothered by days or weeks of starvation and dehydration, she isn’t being bothered by lying in bed. But if she is suffering by having to lie in bed, then she will suffer much more by being deprived of food and water. If she's not aware, she's not suffering. If she is aware, we can't kill her.

• This case isn't about doing everything helpful, then knowing when to give up. Reportedly Terri never had an MRI or a PET scan, both of which are indicated to determine the level of brain function.

• This case isn't about humane care. Terri has contractures, evidence of lack of physical therapy. She had bedsores, evidence of neglect that is reportable to authorities.

• This case isn't about the right to refuse medical care. Terri is not on a respirator or receiving heart drugs or antibiotics. She is receiving food and water, not medicine.

• This case isn't about allowing her to die. It's about killing her.

• This case is about arrogance. I decide who isn't fit to live. Today it's Terri. Tomorrow perhaps it's those over 75 who can't care for themselves – think how much money Social Security would save. Next week it might be you.

• This case is about our worship of youth, beauty and physical fitness. So we are repelled by the old, the unbeautiful or the disabled, and don't want to look at them.

• This case is about narcissism. I wouldn’t want to live like that, so she should be put to death. I get nervous seeing her on TV, so I want her murdered. I don’t want to think about such unpleasant things, so I want her removed from my world.

Religion tells us that she is a unique human being, worthy of profound respect because she is created in God’s image.

Science tells us that she is a unique individual, with DNA unlike anyone who ever lived, or is likely ever to live.

But judges tell us that she is a worthless piece of meat, unable to contribute economically. They tell us she is a "useless mouth," a drain on the Fatherland. They tell us she is less than an animal, which must be put to sleep humanely, but is to be starved and dehydrated to death over a period of several days.

What’s more, judges tell us that she is less than an accused murderer, whose guilt must be established beyond reasonable doubt and decided by a jury. They tell us she is less than a convicted murderer, whose death sentence must be imposed by a unanimous jury, and reviewed by endless courts of appeal. And even then, they tell us that the convicted murderer must be executed humanely, like a beloved dog or cat, while she must be killed slowly and painfully.

Will we listen to religion, science – or judges? Our score on the final exam depends on our answer.

Will we consider the possibility that Terri is an angel – the word means "messenger," after all – sent to discover how we treat the "useless" among us, and then report back to the Boss?

A prior version of this article appeared in New Oxford Review. Dr. Stolinsky writes on political and social issues. He may be contacted at dstol@prodigy.net.

www.stolinsky.com