The Schiavo
Case: Right-to-Life vs Right-to-Die
By Dr. Rizwana Rahim
Chicago, IL
If it were in the Netherlands, Belgium or Switzerland,
it would be legal and common -- not news, and
if it were in other countries where health care
is unevenly accessible or distributed, if available
at all, it would be unimaginable.
Even though each country has its own Schiavos,
this is our Theresa (‘Terri’) Marie
Schindler Schiavo, born on December 3, 1963 near
Philadelphia, the first of three children of Robert
and Mary Schindler, and wife of Michael since
1984, and after her cardiac arrest on 25 February
1990 and the resulting brain, in different stages
of unconsciousness and long considered in a ‘persistent
vegetative state’ (PVP), in a Florida hospice.
She died shortly after 9 AM (EST) on March 31,
2005, nearly two weeks after the feeding tube
was removed from her.
The case has been extensively covered in the media:
the bitterness between Terri’s husband (who
wanted her feeding tube removed) and her parents
(who wanted to keep her alive, no matter); disputes
over insurance money after Terri’s condition;
the motives for and accusations of cruelty, selfishness
and adultery against Michael who has a girlfriend
with whom he has had two children; Michael, as
her legal custodian, wishing to honor her wish,
according to him, to end the life-support after
many unsuccessful attempts over the years; the
acrimony between Michael and his in-laws; many
court rulings and appeals (all the way to the
US Supreme Court); involvement of FL State Governor
(Jeb Bush), the State and US legislature and the
bills passed; and many extremists pro-and-con
pro-life groups. All boiling down to the fact
that: Terri, without any life-support (including
feeding tube), ordered removed over a week ago,
finally breathed her last 13 days after the life
support system was removed from her.
The fact that Terri was kept ‘alive’
for the last 15 years is a testimony to the will
and the technology to perform medical miracles
-- the right-to-life resolve making demands of
the technological sophistication. In the US, there
are thousands (30-40,000 according to some reports)
in similar PVP, with hardly any fuss, but Schiavo’s
case is now mired in a raging right-to-die debate,
more precisely, the-right-to-die ‘in dignity’.
The right-to-die in dignity does not necessarily
mean euthanasia, mercy killing, assisted suicide,
or deliberate ending of life of a person suffering
from an incurable disease or a state that’s
near impossible (given the medical resources available)
to revert to normal life. And, to some, this distinction
is not minor or academic.
Why is Schiavo’s medical situation not just
a matter of her family and her doctors alone ?
Why have the government, the courts, the church/religious
establishments, the bio-ethicists, and the public
groups gotten so deeply involved, in such an intense
emotionally charged manner? No two physicians,
members of the same family (including Schiavo’s),
same political or cultural group seem to think
alike. The public opinion is anguished and torn.
The fissures run deep. This is not just in the
US, but across the world.
In the US, the thoughts have suddenly turned to
personal evaluation of the end-of-life issues,
living wills on how one would choose to die. Elsewhere
in the world, the opinions run the entire gamut,
for instance:
In South Africa, with a crushing number of AIDS
victims, it’d be a matter of spreading the
limited resources, rather than spending them on
one person. In India, the doctors are legally
prohibited from denying a life-saving treatment,
and all treatment deemed appropriate, but the
reality (based on personal resources) may be entirely
different. In Russia, euthanasia is illegal, but
the reality seems more sympathetic. In Belgium,
euthanasia has been legal since 2002. Same is
the case in the Netherlands, where physician-assisted
suicide is also legal. In these two countries
alone, there are on the average 2,500 cases a
year. Assisted suicide has not been illegal or
a crime in Switzerland for nearly 60 years.
In Britain, there are laws against euthanasia
and assisted suicides, but a few have been successfully
challenged. And, what is scheduled to be effective
later this year includes restrictions, such as
“unreasonable persistence” in treating
the terminally-ill, and “when medical acts
appear useless, disproportionate, or serve no
other purpose than the artificial support of life,
they can be suspended or not undertaken.”
In France, the law specifies that artificial means
of sustaining life (like feeding tubes etc.) can
legally be withdrawn. In Spain, the doctors would
not be permitted to stop the life sustaining measures
either. The Spanish law is based on the story
of the paralyzed Ramon Sampedro, as told in the
Oscar-winning foreign film “The Sea Inside.”
While the Catholic church remains opposed to euthanasia,
right-to-die and anything that abridges the life
and its sanctity, many countries in Europe overwhelmingly
support (about 80% according to some polls) the
idea of euthanasia and assisted suicide. Other
religions have different opinions, for instance:
The Jewish law and tradition regard human life
as sacred, and forbid doing anything that might
shorten life. Active euthanasia is regarded as
murder, without any exception, and it makes no
difference if the terminally ill wants to die.
Saving someone from pain is, according to the
Jewish tradition, not a reason to kill them; nor
is it lawful to kill oneself to save oneself from
pain. However it does not require doctors to extend
the state of dying.
Muslims are also against euthanasia and suicide:
“Do not take life, which Allah made sacred,
other than in the course of justice.” (Qur’an
17.33). “If anyone kills a person - unless
it be for murder or spreading mischief in the
land - it would be as if he killed the whole people.”
(Qur’an 5.32); “When their time comes
they cannot delay it for a single hour nor can
they bring it forward by a single hour.”
(Qur’an 16.61); “And no person can
ever die except by Allah’s leave and at
an appointed term.” (Qur’an 3.145);
“Take not life which Allah made sacred otherwise
than in the course of justice” (Qur’an
6:151 and 17:33). “Do not kill (or destroy)
yourselves, for verily Allah has been to you most
Merciful” (Qur’an 4:29). To warn against
suicide Prophet Mohammad said,”Whoever kills
himself with an iron instrument will be carrying
it forever in hell. Whoever takes poison and kills
himself will forever keep sipping that poison
in hell. Whoever jumps off a mountain and kills
himself will forever keep falling down in the
depths of hell.”
The Islamic Code of Medical Ethics endorsed by
the First International Conference on Islamic
Medicine (Islamic Organization of Medical Sciences,
Kuwait, 1981, p.65) includes: “Mercy killing,
like suicide, finds no support except in the atheistic
way of thinking that believes that our life on
this earth is followed by void. The claim of killing
for painful hopeless illness is also refuted,
for there is no human pain that cannot be largely
conquered by medication or by suitable neurosurgery...”.
On pain, suffering and endurance, Islam has special
consideration: “Those who patiently preserve
will truly receive a reward without measure”
(Qur’an 39:10). “And bear in patience
whatever (ill) maybe fall you: this, behold, is
something to set one’s heart upon”
(Qur’an 31:17). Prophet Mohammad taught
“When the believer is afflicted with pain,
even that of a prick of a thorn or more, God forgives
his sins, and his wrongdoings are discarded as
a tree sheds off its leaves.”
Some on the extreme right have contrasted this
with the stem cell battle: Terri is like a 64-cell
blastocyst (containing stem cells) but without
any potential, and interfering with it (stopping
its normal growth) is murder.
Terri has now become a metaphor straddling the
struggle between the right-to-life and the right-to-die,
a religio-cultural battle. During the Good Friday-Easter
weekend (when Jesus was crucified and resurrected)
very few other things would have been more appropriate
for consideration.
Schiavo is dead but this debate will go on.
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