Thursday, March 17, 2005

Husband and Wife

"And a man shall leave his mother,
and a woman leave her home,
They shall travel on to where
The two shall be as one."--Paul Stookey

The irony of the House vote to allow the parents of Terry Sciavo to intervene in her care via the Federal courts, is that it undermines precisely the "sanctity of marriage" that supposedly won for the GOP in November. Not that this is noticeable on the face of the matter, of course; but it is true.

The legal issue in the Sciavo case, as I understand, has always been a simple one: who decides when Terry Sciavo cannot decide for herself? Her parents? Or her husband? As expressed in the words of "The Wedding Song," and as generally enshrined in the law of 50 states, upon marriage a woman and a man become adults, and become responsible for each other's care. This is generally considered under the rubric "the sanctity of marriage." The husband is held liable for, and responsible for, the wife's care, and vice versa. Terry Sciavo's husband has, unfortunately, had to fight her parents to assert that right, largely because they don't like his decision. As lawyers say, hard cases make bad law. This is a hard case; and the law the House of Representatives has approved, is bad law.

But bad law is not the only issue here. The real issue is one of treatment, is one of "euthanasia." The real question here is: is this how we treat human beings?

It isn't a simple question. I started thinking about it when I read this post, by Majikthise. What I didn't even realize was that Ms. Sciavo's "cerebral cortex [has] been destroyed and replaced by fluid." Which puts her, clearly, in a persistent vegetative state. And the courts have found that this is not a condition she would want to endure. So I suppose we should all feel comfortable with that; comfortable enough to let her starve to death.

But the uncomfortable questions are not so easily dispelled. How did Terry Sciavo come to be in this state? Is it humane medical practice to keep people alive in such a condition? Is it humane medical practice to kill them? Hard cases make bad law. And we are making a lot of hard cases these days.

We are making hard cases because, as the Last Whole Earth Catalog put it, "We are as gods." Except we aren't getting good at it. This whole issue of "life" and "death" seems to have us bamboozled, still. The underlying issue here, it seems to me, is a simple one, but a very Western one. We are still caught on the horns of the "mind/body" split.

This one is so fundamental to Western thought that thinking about it is very hard, indeed. But the mind/body hypothesis says that "we" are mind, and only tangentially "body." Our "soul," our "essence," is somehow contained in this "vessel," this "container." And when the vessel is damaged beyond repair, it seems only "humane" to us to release the "soul," or "essence," if you prefer, from it's prison. "She wouldn't want to live like this," we say, presuming that "she" is somehow no longer "here," because we cannot communicate with her. And so we consider it more humane to starve her to death, than to keep her alive.

It isn't easy, and I don't mean to draw a bright line or even infer the answer is clear, if obscured by poor reasoning. It isn't clear, and the reasoning commonly used isn't poor, for the most part. What it is, is difficult. What we have to decide is: when is a human being no longer a human being? When is it justifiable, in other words, to kill someone, whether killing means actively ending their life, or passively withdrawing the means for their life?

We don't do this with infants, even infants who are brain damaged. Withdrawing the feeding tube form Terri Sciavo is no different than leaving an infant on a rock to die of "exposure." Both will simply starve to death, because they are unable to feed themselves. On the other end of the scale, we have nursing homes where we care for people who can no longer shop for their own groceries, cook their own meals, in some cases feed themselves or even clean up after themselves. But we don't starve them to death. We may be inhumane to them in other ways, but we don't starve them to death.

In general, we don't starve humans to death at all. We intervene in hunger strikes, or even acquiesce to the demands of the striker. We intervene in countries where people starve, or use it as a motivation to intervene. Starvation is cruel and unusual and a punishment we don't wish on our worst enemy. It's inhumane. So, does the lack of a cerebral cortex mean Terri Sciavo is no longer human?

She is suffering, we say. Or she wouldn't want to suffer. But we intervene to prevent suicides, whenever we can. We alleviate suffering as much as we can, but we also accept it as part of life. This kind of suffering is different; without medical technology, it would be impossible. The cutting ethical question, the one no one really wants to answer, is: who is suffering more? The patient? Or the family who wants to "pull the plug"?

That's the nettlesome issue with "euthanasia." For whom is the death "easy"? Don't rule out that it is easy for the family, even if the patient is cogent and can ask for the end to be hastened. The patient may be less selfish than the family, in that case. How do we tell?

We give husbands and wives a great deal of privilege over their spouses, and we should do so. The House should not intervene in this matter. But should the courts support such an action? They do now; but is the jurisprudence of that theory sound? Is the ethical base for it so clear? Is the body merely the receptacle that, when damaged enough, releases the soul? Is that what death is, and we should not stand in the way of it? This is the philosphical (and theological) question our medical technology forces us to face.

It's time we got down to it.

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