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The
Vegetative State: |
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A Fate Worse Than Death |
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Imagine yourself being out of your body and in between two worlds - a state of limbo. You are aware of what's going around your
body but you can't move or speak. You feel pain but you can't tell anyone about it. You are either in a coma or what is known as
a persistent vegetative
state. No matter what you call it, it is certainly a fate worse than death. This is because it is neither life
nor death.
In 1990, Terri Schiavo suffered major brain damage when her heart failed which cut oxygen to her brain. She entered the
unfortunate condition of a persistent vegetative state. Her eyes are open and she goes through periods of sleep and wakefulness. But that part of her brain that controls most motor functions has been destroyed. She can breathe on her own, but cannot eat,
thus she is kept alive with a feeding tube.
The legal fight over Terri Schiavo began almost immediately in 1990. Court-appointed doctors declared that Terri would never
recover from the brain damage, and for the last 13 years, she's needed feeding and hydration tubes to stay alive. That's against her stated wishes, says Terri's husband Michael. He's been battling her parents in court, seeking to allow her to die.
For all of the medical knowledge, legal wrangling and family anguish expended in the past 10 years over the fate of Terri
Schiavo, the most pivotal question remains unanswered: Would the 39-year-old Florida woman want to go on living in her current
vegetative state?
That mystery could have been solved with a simple piece of paper -- a living will
(see the bottom of this web page for more info) written by Schiavo making clear how she would
want to be treated medically if she no longer could communicate. Lacking that, her husband, her parents and a succession of
strangers -- judges, the Florida Legislature and Gov. Jeb Bush -- have intervened to decide whether she should live or die 13
years after collapsing in her home. This should be an important lesson for anyone who does not want to be kept artificially in
limbo for decades.
Most people die what may be called a bad death. One study found that:
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"More often than not, patients died in pain, their
desires concerning treatment neglected, after spending 10 days or more in an intensive care unit."
(1) |
The word euthanasia originated from the Greek language:
eu means good and thanatos means death. One meaning given
to the word is:
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"the intentional termination of life by another at the explicit request of the person who dies." |
The term euthanasia normally implies that the act must be initiated by the person who wishes to commit suicide. However, some people
define euthanasia to include both voluntary and involuntary termination of life. Like so many moral/ethical/religious terms,
euthanasia has many meanings. The result is mass confusion.
It is important to differentiate among a number of vaguely related terms:
Passive Euthanasia: Hastening the death of a person by altering some form of support and letting nature take its course. For
example:
| (1) |
Removing life support equipment
(e.g. turning off a respirator) |
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| (2) |
Stopping medical procedures, medications
etc. |
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| (3) |
Stopping food and water and allowing the person to dehydrate or starve to
death |
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| (4) |
Not delivering CPR
(cardio-pulmonary resuscitation) and allowing a person, whose heart has stopped, to
die |
These procedures are performed on terminally ill, suffering persons so that natural death will occur sooner. It is also done on
persons in a persistent vegetative state.
The option of dying by starvation or Patient Refusal of Nutrition and
Hydration (PRNH), as it is referred to, appears to be a compromise which allows terminally ill people to end their lives and still have ministrations from hospice and from a doctor.
Hospice nurses know that this is a painless and gentle death which obviates the necessity of a more drastic end.
Most hospice reports of dying patients are within one or two weeks from dehydration.
But until voluntary physician-assisted euthanasia is legalized in the US as it is in the state of Oregon, this crude method will have to do.
PRNH is a choice; it is relatively gentle and painless in most reported cases. It is certain, and loved ones can be there. Hospice
workers and doctors will regard this as acceptable and treat the patient with compassion. It is not offensive to most religious
groups. But it is not swift; the patient must be close to death, and medical and nursing help should be available. It may not be
an option for everyone.
Terri Schiavo's husband petitioned a Florida court to have the feeding device removed, a step that would lead to her death within a few
weeks. But her parents strongly objected. What would Terri Shiavo want? Her husband says she would want to be allowed to die. But
she left no written instructions. After a hearing, a judge agreed that given her medical condition, her husband had the legal right
to have the feeding tube removed. The decision was supported by years of court rulings, as well as a Florida law.
That's when the game of political ping-pong began. Her parents didn't want to see her die. And
Governor Jeb Bush came to their rescue. Governor Bush
ordered that a severely brain-damaged woman be placed back on life support, at the request of her
parents, although the woman's husband won a court order to have his wife removed from life support six days ago. This happened
after Governor Bush tried to stop the feeding tube from being removed, was rebuffed by the courts, then got his state legislature to grant him explicit authority to order the tube reinserted. The highly unusual statute, dubbed
Terri's Law by Florida lawmakers,
gave Bush the authority to order Terri Schiavo, specifically, to have her feeding tube be reinserted. Jeb Bush's intercession to put
the feeding tube back into Terri Schiavo in Florida, places the government formally in the new role of doctor to the nation. The
husband of the severely brain-damaged woman challenged the legality of a hastily passed state law empowering
Governor Bush to keep her alive. In a court filing, lawyers for Michael Schiavo contended that the law violates Terri Schiavo's right to privacy and
the separation of power provisions of the Florida Constitution.
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"It argues that her constitutional right to refuse medical treatment was, in essence, cast aside by a statute that allows the
governor to do that under any whim and without any standards and without any review," said George
Felos, who represents
Michael Schiavo, after filing the document. |
Her parents have said that their daughter had no such wishes and is not in a permanent vegetative state despite what all court-ordered physicians claim. Her parents state that she is responsive and could
improve with therapy. But this is only wishful thinking and flies in the
face of all medical understanding of the persistent vegetative state..
The legal battle over her fate is one of the nation's longest and most contentious right-to-die cases. Florida courts have
repeatedly affirmed Michael Schiavo's legal right to remove his wife's feeding tube. The state Supreme Court has twice refused to
hear the case; the U.S. Supreme Court also refused to hear it.
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"This dangerous abuse of power by the governor and Florida lawmakers should concern everyone who may face difficult and
agonizing decisions involving the medical condition of a family member,"
said Howard Simon, executive director of the American Civil Liberties Union of Florida. |
Terri Schiavo's well-intentioned parents are missing the point
altogether. And it's tough to be critical of them. Anyone who has had to watch a loved one
die understands their emotions. But they have helped make their daughter a pawn in a great cynical chess game, shuttled from
hospital to hospice and back to hospital, having a feeding tube inserted, removed, and reinserted, depending on the state of the
law on any given day.
The politicians, you can be certain, have other motives. The speaker of the Florida House sees the issue as his ticket to the
U.S. Senate. And right-to-life activists see the Schiavo matter as their wedge to push their own
political agenda. Terri Schiavo is merely this week's photo op. And she'll be forgotten by her new allies as soon as they move on to their next battle.
The great untold story is that what's happening to Schiavo occurs hundreds of times a day in hospitals, nursing homes, and
bedrooms all over this country. People get very sick. And after agonizing talks with doctors and friends, often after prayer,
families make the painful decision about whether to continue artificial means to keep a loved one alive. Sometimes, the choice is
to do everything possible. Many other times, the choice is to let someone die.
The Schiavo case is not, as some critics suggest, about state-sponsored killing. An ethical, legal, and theological gulf exists
between allowing someone to die and acting to hasten their death.
In a perfect world, everyone would prepare a living will, in which everyone would explicitly say whether they want to be kept alive
through extraordinary measures. But in this imperfect world, many people don't, and someone has to make the painful decision.
In the absence of a living will, the choice should be made by the family, not the state. If the family cannot agree, the courts can
resolve the matter. That's not a great option. But do we really want politicians -- with their own agendas and ambitions -- deciding
who lives and who dies? Make no mistake. That is what Florida has done.
The president of the Florida Senate, James E. King, got it right:
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"I really do hope we've done the right thing. I keep thinking, what
if Terri didn't want this to happen at all," he said. "May God have mercy on all of us." |
The tragedy is he didn't figure that out until
after he turned Schiavo's life over to Jeb Bush.
The Right-to-life movement has an honorable mission to protect the sacredness of life. But for some strange reason, they do not
view death as a part of life. This attitude leads to the false and dangerous belief that life should be prolonged as long
as possible, even artificially, no matter what the quality of life or how much suffering exists.
There are two main arguments offered by Christians, and those of other faiths, that advise against an individual seeking suicide,
for whatever reason:
| (1) |
Life is a gift from God, and that each individual is the steward of that life. Thus, only God can start a life, and only God
should be allowed to end one. |
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| (2) |
An individual who commits suicide is committing sin. |
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| (3) |
God does not send us any experience that we cannot handle. God supports people in suffering. To actively seek an end to
one's life would represent a lack of trust in God's promise. |
Of course, there is a significant and growing percentage of religious and non-religious people who do not accept these
theologically based arguments. They might argue:
| (1) |
Each person has autonomy over their own life. |
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| (2) |
Persons whose quality of life is nonexistent should have the right to decide to commit suicide, and to seek assistance if
necessary. |
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| (3) |
Sometimes a terminal illness is so painful that it causes life to be an unbearable burden; death can represent a relief of
intolerable pain. |
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| (4) |
People
facing a terminal illness may not want to deplete their resources
to fight the inevitable when they can instead have these resources
remain with the family after they die. |
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People
facing a terminal illness may not want to put themselves or their
family through the horrible ordeal of a long and agonizing death. |
An active political question is whether individuals should be allowed to choose suicide, or whether they should be forced to follow
the theological beliefs of the dominant religion.
The Bible contains a number of references to men seeking suicide, either by taking direct action or by begging God to kill them
on the spot.
Jesus voluntarily chose to have himself killed.
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"I lay down my life. No one takes it from me, but I lay it down of my own accord."
(John 10:17-18) |
Jesus have up his life for
his sheep. Jesus wanted to die. God wanted him to die. Jesus was given the opportunity to choose life but instead he preferred death. He entered Jerusalem knowing it would result in his death. He freely choose to do what he knew would condemn him to death and he willingly accepted it. Even when he was on the cross, when people taunted him to save himself, he could have called down legions of angels to rescue
him but he chose not to. True, Jesus' death can be equated to that of a soldier falling on a grenade to save his comrades. But this analogy falls short because it was God
(Jesus) who permitted the situation to happen in from the very
beginning. In other words, it was Jesus who threw the grenade in the first place - only to fall on it.
Jesus foretold his own capture, torture and death. Then he voluntarily walked to his captors with the intent of dying at their hands. There was not even inaction on his part. Pontius Pilate did everything he could to free
him. Even Pontius Pilate could see his innocence "I have not found him guilty of any of the crimes you accuse him of. There is nothing this man has done to deserve death."
(Luke 23:14-15) So, the only conclusion that can be drawn is that Christianity is based on
a voluntary suicide - the voluntary euthanasia of Jesus.
Other Bible passages do not appear to consider suicide to be a great moral
sin either. The act of committing suicide or of asking God to kill them are simply reported in
the Bible in a factual manner. The Bible does not interpret these acts as sinful. They seem to be regarded simply as straightforward personal decisions. However, the Christian church has traditionally deviated
from the Biblical message and has considered suicide to be a great moral sin. Some denominations have even refused to bury people who have committed suicide. Here are other Bible verses referencing
suicide:
| (1) |
Samson
(Judges 16:29-30), blinded and humiliated by his enemies, collapsed the temple upon himself, killing thousands of others in the process. |
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| (2) |
Saul
(1 Samuel 31:4-6) fell on his sword during battle because he feared the abuse he would receive at the hands of the enemy. Saul's
armor bearer immediately followed his lead and did the same. |
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| (3) |
Moses
(Numbers 11:12-15) was in despair because of the complaints of the Israelites whom he was leading. The burden of
leadership was too heavy for him to bear. He asked God "If You treat me like this, please kill me here and now..." |
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| (4) |
Elijah
(1 King 18:40 and 19:4) fled for this life to Beersheba, went into the wilderness, and "prayed that he might die." He said, "It is enough! Now, Lord, take my life, for I am no better than my fathers!" |
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| (5) |
Jonah
(Jonah 4:1-11) was so angry at God's display of mercy toward Nineveh that he asked God to kill him, "for it is better for me to die than to live!" He repeated the same request to God on the next day. |
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| (6) |
Paul
(Philippians 1:20-26) contemplated whether it is better to live or die. He is hard pressed to decide between the two,
"having a desire to depart and be with Christ, which is far better. Nevertheless to remain in the flesh is more needful for you...yet
what I shall choose I cannot tell." One commentator writes of this passage that Paul "does not know whether he prefers life with
labor or death with gain...in a life-and-death situation, he scarcely knows which alternative is to be preferred." He does choose life. |
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| (7) |
Abimelech
(Judges 9:52-54) asked his armor bearer to run him through with the sword because he feared the humiliation of being killed by a woman. |
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Ahithophel
(2 Samuel 17), hung himself after experiencing public humiliation when his advice was rejected. |
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Zimri
(1 Kings 16) set fire to the tower he was in because he feared falling into enemy hands. |
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Judas
(Matthew 27:5) submitted to remorse and regret after betraying Jesus, and hung himself.
But this verse is an apparent contradiction of Acts 1:18 where it states
that Judas fell and burst open in the middle and all his entrails gushed
out. It is likely that he did not simply fall down, but rather fell from a height great enough to split his body open. Most religious liberals would assume that these two very different accounts of the death were simply the result of different traditional stories related independently by the anonymous authors of Matthew and Acts. Some conservative Christians have attempted to harmonize the two stories by concluding that Judas hanged himself from a tree which hung over a ravine. The rope broke and he fell to the rocks below, splitting open his body. |
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| (11) |
God stated in
Exodus 20:13 "Thou shalt not kill." Some people believe this verse applies to suicide. But this verse obviously cannot be interpreted so broadly and so literally. People continually kill plants and animals for food. God
even condones capital punishment as the Bible testifies. Otherwise, Jesus would have been given 10 to 20 years with time off for good behavior. "Thou shalt not kill" has generally been interpreted to mean that one should not murder a human being, except in cases of self-defense, capital punishment,
self-sacrifice or warfare. |
Living wills, Advance Directives, Power of Attorney
God forbid that you should ever become comatose or vegetative. But if you do and want to be allowed to die and not be
kept artificially alive for decades - you will need the following
documents listed below. Some you can just download. Someday, you may be glad you did.
What are Advance Directives?
Advance Directive is a general term that refers to your oral and written instructions about your future medical care, in the event
that you become unable to speak for yourself. Each state regulates the use of advance directives differently. There are two types
of advance directives: (1) a Living Will and (2) a Durable Power of
Attorney for Health Care. There is also a document called a Do Not
Resuscitate order. These will be explained below.
Why Do I Need an Advance Directive?
Advance Directives give you a voice in decisions about your medical care when you are unconscious or too ill to communicate.
As long as you are able to express your own decisions, your advance directives will not be used and you can accept or refuse
any medical treatment. But if you become seriously ill, you may lose the ability to participate in decisions about your own
treatment.
What is a Living Will?
A living will is a type of advance directive in which you put in writing your wishes about medical treatment should you be unable
to communicate at the end of life. Your state law may define when the living will goes into effect, and may limit the treatments to
which the living will applies. Your right to accept or refuse treatment is protected by constitutional and common law.
You can download your
state's Living Will form here. (Note:
The form costs around $25.)
U.S. Living Will Registry
offers an excellent service where they electronically store your advance directives and makes them available directly to
your health care providers anywhere across the country by telephone and internet through an
automated computer-facsimile system. This is handy because there may be
situations where you enter a hospital and your advance directives are not
known or available. This service will make certain your wishes are
granted.
What is a Durable Power of Attorney for Health
Care?
A durable power of attorney for health care is a document that enables you to appoint someone you trust to make decisions about your
medical care if you cannot make those decisions yourself. This type of advance directive may also be called a
health care proxy or appointment of a health care agent. The person you appoint may be called your health care agent, surrogate,
attorney-in-fact, or proxy. In many states, the person you appoint through a medical power of attorney is authorized to speak for you any time you are unable to make your own medical decisions, not only at the end of life.
You can download
your state's Durable Power of Attorney for Health Care form here.
(Note: The form costs around $25)
What is a Do Not Resuscitate (DNR)
Order?
A Do Not Resuscitate order is another kind of advance directive. A DNR is a request not to have cardiopulmonary
resuscitation (CPR) if your heart stops or if you stop breathing. (Unless given other instructions, hospital staff will try to help all
patients whose heart has stopped or who have stopped breathing.) You can use an advance directive form or tell your doctor that
you don't want to be resuscitated. In this case, a DNR order is put in your medical chart by your doctor. DNR orders are
accepted by doctors and hospitals in all states. DNRs can be obtained by your or any doctor.
Have Medic Alert
Make Your DNR More Prominent
For people who do not want to be hooked up to a machine and those who want to refuse resuscitation, there are ways to prevent it from happening. Most states allow people to have a DNR
(Do Not Resuscitate) order. That means that if you are in a supermarket, for example, and your heart stops beating, you will not be resuscitated. But this will
only happen if you have a DNR that is easily identified by medics. The problem with DNRs is that medics do not look for them whether you keep your DNR in your wallet or on your fridge. Fortunately, DNR identification
jewelry can be obtained through the non-profit 45-year-old MedicAlert Foundation. Once
you have filled out your DNR document, you send MedicAlert the last sheet of your
DNR. For a small fee, you can join MedicAlert. Then they will inform you about the choice of necklace or bracelet that clearly states your wishes to
Do Not Resuscitate. In some states, this jewelry and/or official papers
(which you might not have on your person) are the ONLY methods honored by emergency medics. If such a notification is not present, you
WILL be resuscitated - meaning you will be denied your
paradise.
A tremendous number of NDEs I read about involve the person coming back
and being extremely upset that they were resuscitated. Often it leads to
severe depression. 4% of experiencers commit suicide. Being revived from
death is just another instance of others deciding whether you should live or die.
Don't Forget
About Organ Donation!
There is probably no better gift
than the gift of life. But the number of people requiring a life-saving
organ transplant continues to rise faster than the number of available donors. Approximately 300 new transplant candidates are added to the waiting list each month. Countless
numbers of needy children have died waiting for a life-saving organ transplant. And the sad part
is that it is entirely unnecessary. It is so simple to have your organs
donated when you die. The irony is that adults who want to die are often forced to
live; but children who want to live are forced to die because not enough
people donate their organs. We can't take our organs with us! And we pass
up such a great blessing to someone else if we neglect such a tremendous
opportunity. Unfortunately, the vast majority of people
who die do so without thinking about or knowing how valuable their body could be to someone else.
What is the price for giving someone life when they so desperately want
it? So, make your life review even better. Donate your organs and give a
child a new lease on life.
Visit the National Organ and Tissue Donation/Transplantation website
to see how.
Also read more about the case for assisted suicide and active voluntary euthanasia and
why someday you may beg for it.
It's all about taking control
of your own life and death. Don't let someone else do it for you. Take
action now.
Click here to send
a message to Governor Jeb Bush and tell him obey the Florida courts
and let the wishes of Terri's husband.
Click here to send
a message to Attorney General John Ashcroft to cease
and desist in single-handedly nullifying the will of the people of Oregon
to invalidate their two statewide elections and a U.S. District Judge's
ruling - affirming their right to a dignified and humane deaths through
Death with Dignity laws.
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