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“I don’t believe in life insurance. When I die, I want
it to be a real tragedy.” –
Dr. Wayne Dyer (attributed)
I could swear I heard George Carlin utter that line back
in the days when his act was clean enough for television (that dates
me), but a Google search turned up only Dr. Dyer. Whoever said it,
it is clear to anyone following the Terri Schiavo case that there
are bigger tragedies than shuffling off one’s mortal coil
uninsured.
Terri Schiavo is the Florida woman at the core of a
legal battle between her husband and parents over the feeding tube
that has kept her alive for 15 years. Her husband wants the tube
gone; her parents want it to stay.
Apart from those basic facts there is little agreement
between Michael Schiavo and Bob and Mary Schindler. Associated
Press reports Schiavo’s coma was triggered by a heart attack, which
husband Michael says was brought on by an eating disorder. The
Schindlers deny their daughter had such a disorder and claim the
Florida Department of Health cleared Schiavo’s doctor of any
wrongdoing or negligence leading to her coma at age 26.
The Schindlers claim Schiavo’s doctors found mended
bones and other evidence of abuse and imply that may have triggered
the coma, which Michael Schiavo strongly denies. Michael Schiavo
believes his wife is unaware of her surroundings; the Schindlers say
she recognizes them and others and have produced photos of her
laughing with her mother. Michael claims his wife is brain dead,
while doctors hired by the Schindlers say she is not and have
recommended therapy.
Nor is there agreement on what Schiavo herself would
want, with her husband claiming she told him she was against
life-prolonging measures like feeding tubes and the Schindlers
asserting she would have wanted to live. Whatever she wanted – or
wants – a judge has stayed the removal of the feeding tube until
March 18, when, barring another courtroom victory by the Schindlers,
the process of death by starvation and dehydration will legally
begin.
I’m no doctor and won’t try to play one in the newspaper
but I feel competent to diagnose the Schiavo case as a mess, with
side complications of tragedy. Fortunately, it doesn’t have to
happen again.
In 1990, shortly after Schiavo’s coma began, Congress
enacted the “Patient Self-Determination Act” requiring virtually all
healthcare facilities to provide patients a statement of their
rights, which includes the right to make an advance directive (or
living will) in
accordance with state laws. Advance directives spell out
individuals’ desires in the event they cannot communicate and
designate a person to make decisions in circumstances not covered by
the directive.
If Terri Schiavo had an advance directive we would have
never heard of her. She may have never heard of advance directives,
but under current federal law almost everyone today will be informed
of them at one time or another.
Acting on the opportunity, however, is another matter.
Many see advance directives as something for the elderly but the
Schiavo case argues otherwise, as does my own family’s experience.
My brother-in-law died at the age of 37 in 1991. He had
signed an advance directive, leaving no questions about his wishes
when he could no longer communicate. I executed one myself before
surgery a few years later, and my wife did one at the same time.
The Schiavo case has launched debates on everything from
euthanasia to the rights of the handicapped and incapacitated.
Those questions will not die with Terri Schiavo but if there is one
universal lesson here it is the need for all adults to make their
wishes legally known and binding.
Do it is a gift to yourself and your family. Your
doctor will have the forms.
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