Intellectuelle

But then the autopsy showed she was indeed brain dead.

My problem as a Christian with the feeding frenzy surrounding Terry Schiavo are two:

1) She had been on artificial life support for 15 years. If I had lived like that for 15 years; I would expect my wife to pull the plug - indeed demand it if I could. This shows us all the need for a living will.

My "sanctity of life" positions actually revolve around a secular paper, Why Abortion is Immoral? by Don Marquis. This allows for active euthanasia. No where in the Bible does it require I live on life support for 15 years not being able to do God's work - while burning through the resourses and strengths of my family.

2) Why would Christians come to defense of the parents over the husband? Doesn't becoming two parts of one organism (one-flesh) - after leaving ones parents to join with your spouse - imply we have to trust the husband's understanding of his wife's wishes over her parents. If he is wrong he will answer to God.

I understand the very slippery slopes in euthanasia.

The Schiavo autopsy report is a perfect example of the effect that one's worldview has on interpreting facts. The autopsy report stated that "The frontal temporal and temporal poles and insular-cortex demonstrated relative preservation." (The actual report is available on-line.) In other words, the areas controlling higher level, cognitive thinking were not severely damaged. What was severely damaged was the area controlling her motor skills--her ability to move and communicate--much like a person with severe cerebral palsy. However, running this information through one worldview filter you get 'brain dead', through another 'brain damaged'. There is a world of difference between these two.
Worldviews effect not only the interpretation of the facts, but even which facts we receive. The information most receive comes filtered to them by the major media outlets. And we filter facts, ourselves, by the choices we make as to where we go (or don't go) to obtain those facts.

Just curious, Debra. Are you a physician? I would like to know how you are able to interpret the results of the autopsy. It seems to me that only an expert in the area of brain function could possibly interpret the results correctly. I don't think worldview is the issue, but expertise is definitely required when interpreting something as serious as results of an autopsy. Maybe you are such a person, I am not doubting your credentials, just asking a question.

I'm not sure if I believe in "brain death" at all. Read this blog-article (by a well-known English journalist):

http://www.melaniephillips.com/diary/archives/001309.html

She quotes from one article in Critical Care Medicine and another in the Journal of Medical Ethics:

"The concept of brain death has long been recognized, however, to be plagued with serious inconsistencies and contradictions. Indeed, the concept fails to correspond to any coherent biological or philosophical understanding of death."

"There were never sound empirical grounds for criteria of death based on the loss of testable brain function while the body remains alive. One difficulty is the near impossibility of diagnosing—with the necessary certainty—the 'irreversible cessation of all functions of the entire brain, including the brain stem' while the rest of the body remains alive. The Harvard tests—essentially of brain stem mediated reflexes and ventilator dependence in patients whose coma appeared irremediable—clearly lacked the power to make that diagnosis. The many protocols now in use worldwide fail similarly. Indeed, their very number proclaims the fact that the syndromes they diagnose cannot be one and the same true entity."

No, I have a background in science, not medicine. It would be pointless to try to argue whether or not I have sufficient knowledge to interpret that portion of the autopsy report. I was reporting the interpretation of Dr. William Hammesfahr, a physician who specializes in helping the brain injured. Looking at the autopsy report you will also find a neuropathologist, Dr. Stephen Nelson, conceding that there is no way of determining through an autopsy whether or not a person was in a persistent vegetative state.
My point, though, wasn't to rehash the Schiavo case but to point out that, as Sarah has been stating, the interpretation of facts does not occur in a vacuum. Our worldview (or our personal views) determines where we go for information, who we believe and how we intertepret the information. Presented with conflicting data or conflicting interpretations of the same set of data, we will chose to believe the interpretation that best fits our worldview/personal view.

Debra, you are the first person I've run into, anywhere, who read Terry Schiavo's autopsy report. (I read it, too; it's readily available online). Seems like most reporters and editorial/opinion writers drew broad conclusions about the report apparently w/o reading it, and then quoted one another in the media echo chamber... or maybe they just ignored the parts that Debra cites.

jch--I could have used you when I was blogging the Schiavo ordeal. I totally agree with your conclusions (and will address them on a broader scope--sanctity of life, technology, etc. in the first post of the quiver full series I'm going to do here).

In Christian circles, we are in the minority, though. Frankly, I would wager that you, me and my mom (alicia rose) are going to be the only people in this thread who favored Terri being allowed to die (that wording is probably going to get me into trouble but that's how I see it). The real test is if people will still want to read my posts here knowing how I view this situation--I managed to keep my blog readership but I know there were some casualties, who viewed my stance as akin to supporting abortion--something I would never do.

One thing that really bugged me is that Terri's husband was more villified than women who choose abortion. There's all this compassion for a woman who kills her baby but outright hatred toward a man placed in an excruciating situation that was nowhere near as clearcut as abortion.

Sarah, while I disagree with your position on the Schiavo case, I agree with the philosophical point you are making about neutrality.

"Seems like most reporters and editorial/opinion writers drew broad conclusions about the report apparently w/o reading it, and then quoted one another in the media echo chamber... or maybe they just ignored the parts that Debra cites."

Maybe they read it while not being aware of their conceptual filters and grids. It could be the case that their conceptual system caused blind spots such that their interpretations were skewed. Then, some reporters read other reporters who share the same filters and templates with the result that their grids are self-validated. Then they pat themselves on the back for being objective, scientific, thorough and diligent in investigation.

If we read others who have the same blind spots that we have, we will not become conscious of our presuppositions. There is a sense in which we, especially those in the media, are engaged in merely affirming the consequent (a logical fallacy [If P, then Q. Q, therefore P.]. We are not aware of the vicious circularity that occurs in such a reasoning process. We can read certain things and think that we are engaged in an objective, scientific investigation without realizing that we are imposing our preconceptions on the "facts."

The modernistic objectivists disdain premodern perspectivism. They say, "There is no need for the transcendent to get understanding. In our autonomy, we can see the plain "facts" of the case without the need of divine intervention and illumination on the matter! There is no need for our views to be informed by traditional arguments, even in ethical considerations. You Christians are premoderns! Get with it already and look at the plain facts for a change!"

There's a story about three umpires sitting in a bar discussing how they make calls in baseball. The first umpire said, "I call them as I see them." (Premodern critical realism) The second umpire said, "I call em as they are!" (Modern naive realism) The third umpire said, "They ain't nuthin til I call em!" (Postmodern anti-realism)

Sarah's entry is a premodern (or critical realist) effort to get the modernists (or the naive realists) to become aware of a degree of bias in their perspective. It's not that we cannot obtain a degree of objectivity in our perspective through rigorous testing (contrary to the claims of postmodernist anti-realists), but it's an acknowledgement that our interpretations are built on certain subterranean metaphysical beliefs.

We need to be more epistemologically self-aware when we approah certain data. The secularists are not self-aware (conscious of their presuppositions), and Christians need to be equipped to point that out. The secularists approach ethical decisions with a modernistic naive realism. There's a sense in which the secularist is a kind of religious fundamentalist, hence the prejudice and bigotry against other perspectives, particularly with respect to Christianity.

jchfleetguy Why would Christians come to defense of the parents over the husband? Doesn't becoming two parts of one organism (one-flesh) - after leaving ones parents to join with your spouse - imply we have to trust the husband's understanding of his wife's wishes over her parents. If he is wrong he will answer to God.

Michael Shiavo may have legally been Terri's husband but he severed his moral claims when he took up a "one-flesh" union with his common law wife.

(For the record, though, I don't think the parents were the ones that should have made the decision either. An impartial guardian ad litem should have been permantley appointed to make decisions for Terri.)

Marla,

My position on the Schiavo case (and I'm relatively sure that Sarah feels the same) is not that the woman should have been forced to be kept alive at all cost, but rather that the wrong person was making that decision for her.

After Terri fell into a coma, Michael Schiavo sued in order to get money for "long-term" care for his wife. It was only later -- when he didn't get as much money as he had hoped -- that he suddenly remembered Terri saying that she didn't want to be kept on alive if she had fallen into such a state.

And let's be perfectly clear. Most of the reason that Michael Shiavo is vilified is because he is an adulterous cretin. If he had simply been a husband making a hard decision about a woman he loves -- as happens every day in America -- it would have been a different story. But you can't move in with another woman, have two children by her, and then expect people to have sympathy for you when you want to remove a feeding tube from your "wife."

My concern is that there will be more and more cases like the Schiavo case that will divide even those who are against abortion. Things have gotten very complicated, due in part to the rapid advances in technology. But also due to the deluge of information. Increasing technology intimidates us into believing that things like autopsy reports can only be understood by experts in medicine. (And there are more and more things that are too complicated for a person without expertise to keep up with.) Increasing information and complexity make it necessary for all of us to 'filter' and find trustworthy (in our view) sources.
If we don't want to be totally lost to the truth of what is going on we had either better educate ourselves so that we can interpret the raw data or find sources that we believe can accurately interpret the data. My experience with listening to fellow Believers that do not share my viewpoint on the Schiavo case is not so much a difference in worldviews regarding the sanctity of life (although I've found some of that, too), but a difference in information on the case. I'm not suggesting those supporting removing her feeding tube necessarily have less information, but I have found they definitely have different information.
So back to the problem of getting and interpreting the massive amounts of information we have coming at us. We must find reliable sources of truth and we must educate ourselves and our children as much as possible to become discerners of truth. This is a serious issue--especially since it is now effecting matters of life and death.

No, Marla, I wouldn't turn away from either Intellectuelle or anything else you had to say because of a difference of opinion--even on something this important. I respect your opinions. The job of getting at the truth is way too big for any one person and our Lord didn't intend for us to work alone. It is only together, prayerfully, working together, listening to each other that we will discover the Truth.

Joe, I was under the impression that Michael didn't get his girlfriend until after Terri had been in PVS for three years. And, btw, King David was a polygamous adulterous cretin (God even let him keep the wife he got by murdering her husband). If we're going to think about Michael, let's pray for his salvation rather than condemning him. There but for the grace of God go all of us...

Another problem I had with evaluating this case is that "the facts" were never clear. Different sources provided different information and interpretation of that information. Isn't this at the heart of Sarah's message?

I can't have this discussion unless I see purported facts referenced. It also seems to me there is too much inference going on. Especially in the motives department. I'm especially good (i.e. sinfully wretched) at judging others' motives and need to repent often of errors in discernment so how anyone judge Michael's motives without knowing him? It's much clearer cut to judge the motives of those who didn't know Terri but were using her (ironically, much like Ms. Roe in Roe v. Wade) to achieve an ideological agenda that may or may not be misguided.

I have a question for you Joe. What do you do with the information in interviews with Michael Schiavo that portray him as having very different motives than those you attribute to him. For instance this article http://www.msnbc.msn.com/id/7287950/
Is it all lies because it comes from the secular media? I don't think that is a healthy attitude to take. Who can judge the attitude of this man's heart?

In another article Michael says that Teri's parents were in denial when it came to facing her death. They could not let go of her and that is why he fought to see her released. Is there any possibility that was true?

Is our worldview so narrow that we cannot open ourselves up to the idea that some things are not as they appear. Perhaps the lens of our faith is clouded over by biases that don't belong there.

It is easier to just be black and white, right and wrong about everything, but some things are not that clear cut. This is a complex issue and there are no easy answers.

Debra, I totally agree with your point about the information gathering dilemma, and I'm glad that you won't hold my position in the Schiavo case against me. I also am not judging other Christians by their position on this, though I am troubled by some of the attitudes. My attitude stinks a lot of the time, too, though, so I know I need to be forgiving :)

Joe, I was under the impression that Michael didn't get his girlfriend until after Terri had been in PVS for three years.

I think that sentence raises a number of relevant points. For starters, why did Michael wait so long to bring it to everyone’s attention that Terri didn’t want to be kept in a PVS state? Why didn’t he mention is during the three years prior to his taking a second wife...ur...girlfriend? Second, the very fact that he took up a girlfriend shows that he lacked the commitment to his wife to make life-and-death decisions for her. I’m not condeming him for being unfaithful. But when he did he should have recused himself from the role of Terri’s guardian.

And, btw, King David was a polygamous adulterous cretin (God even let him keep the wife he got by murdering her husband). If we're going to think about Michael, let's pray for his salvation rather than condemning him. There but for the grace of God go all of us...

I don’t personally condemn Michael nor do I particular care what he does in his personal life. That is between him and God. But I am concerned about the precedent it sets when a man can form a pseudo-polygamous relationship and still be perceived as being capable of acting in the interest of his “wife.” I think this is more a marital rights issue (respecting marital bonds) than an end-of-life issue (removing a feeding tube).

Another problem I had with evaluating this case is that "the facts" were never clear. Different sources provided different information and interpretation of that information. Isn't this at the heart of Sarah's message?

I will be the first to admit that all of the facts in the case were murky. But the primary question is whether Michael was the best person to be acting on behalf of Terri. I think that his actions clearly indicate that he was not the best choice to act as her guardian.

I can't have this discussion unless I see purported facts referenced.

Personally, I think that his lack of integrity speaks for itself. Everyone agrees that he was unfaithful to his wife. That is not secret. But the fact that he was duplicitous about Terri’s wishes is the real cause for concern. Here, for example, is a statement Michael made in 2003:

After more than seven years of desperately searching for a cure for Terri, the death of my own mother helped me realize that I was fooling myself. More important, I was hiding behind my hope, and selfishly ignoring Terri's wishes. I wanted my wife to be with me so much that I denied her true condition. Terri told me on several occasions before this happened that she would not want to live in her current condition. If we had been older, I am sure she would have signed a living will making it clear that she did not to be kept alive on tubes and machines. She never had the chance. That left me to carry out her wishes. It has been hard. In fact, it is the hardest thing I have ever done. In the end, I did what I believe Terri would have wanted me to do. Some people do not agree with the decisions the court made to remove Terri's feeding tube. I struggle to accept it myself. But I know in my heart that it is right, and it is what Terri wants.

Michael admits that he intentionally ignored “Terri’s wishes.” Now, however, he has a change of heart and realizes that what she would have wanted was to die. He could be completely sincere in this statement. But his failure to tell the truth combined with his infidelity raises a clear cause for concern. This statement alone should have raised questions about his fitness for guardianship.

I have a question for you Joe. What do you do with the information in interviews with Michael Schiavo that portray him as having very different motives than those you attribute to him.

I say we ignore the motives and look at the actions. Michael never mentioned that Terri would have wanted to die until after he had taken up with another woman and had started a family with her. Whether his motives are pure or evil makes no difference. All that matters is that when a clear conflict of interest arises, an impartial guardian needs to be appointed.

In another article Michael says that Teri's parents were in denial when it came to facing her death. They could not let go of her and that is why he fought to see her released. Is there any possibility that was true?

I certainly believe it is true that Terri’s parents were in denial about her condition. And as I said before, I don’t think they were fit to be guardians either.

It is easier to just be black and white, right and wrong about everything, but some things are not that clear cut. This is a complex issue and there are no easy answers.

I don’t think the issue is as complex as some people make it out to be. The simple fact is that it is moral, in my opinion, to remove a feeding tube from a person who is PVS and has no chance for recovery and has explicitly stated that this was their wish. The only question is whether an adulterous husband who previously lied about what his wife’s wishes were can have a “change of heart” and still be considered credible enough to make such a decision on her behalf.

Joe, I see where you're coming from, but it (Michael's motives/actions) still isn't a two and two makes four scenario to me. The fact that he met someone while his wife was in this condition does muddy it up, and I wish he had made the decision (or attempted the therapy she was supposedly denied, if that's true) before that happened, but he's not a Christian so I wouldn't expect him (if he thought his wife would never recover) to stop himself from getting involved with someone else when that someone happened to come along.

Ironically, that quote is actually a big part of why I actually think his motives were right--especially because I have experienced the death of a parent and know how transforming it is. I believe him--maybe I'm just a sucka, tho ;)

I think this one where we'll just have to call a truce because there are too many unknowns, or at least that's how I see it.

Apart from Michael, though, I think that whoever was in the position to make the decision would have been right to remove the tube. And that's what I want to address in my sanctity of life post, for which I am eager to get your and Sarah's feedback. But I'm way behind on real life right now so it will have to wait.

All of these comments are VERY interesting. Joe was apparently really bored at work today while I was working very very hard, because i had no time to respond to the comments. (Just kidding Joe!!)

I went back over my post today, and I don't see where I've even stated a position on the Schiavo case, it simply served as a case study on the concept of neutrality. However, I do know Dr. Cheshire and I do happen to believe that her life should not have ended the way it did, but no where in this paper do I actually espouse a position...rather, I critique the wisdom and rationality of the Cheshire's critics. I suggest that a non-Christian neurologist could have landed in the same place as Cheshire, but I didn't intend for that to necessarily reflect my views.

But Joe did speak well for me earlier in a post - I do not believe that we should prolong life at all costs. Sometimes we do need to "pull the plug." But we also need to recall that Terri wasn't being "kept alive," she was actively killed...unless we are to believe that nutrition and hydration are medical treatments. And in that case, a baby bottle is in a very real sense, a feeding tube.

Aside from my actual point, that Cheshire was dismissed not on his positions, but on account of his worldview, I want to point out that this case had as much to do with us as it did with Terri. I don't believe that as image bearers we are called to destroy innocent life, but rather we are called to protect it.

Psalm 113 says that God cares for the poor, for the weary, the needy, and the barren. These are the most vulnerable and need the most protection.

Thanks guys - we're all still friends!
Sarah :)

Sarah, this sentence clued me in to your position:

" Another neurologist could have come to the same conclusions as Dr. Cheshire in that one need not be a Christian to have compassion and concern for the most vulnerable in our culture, but I believe one needs to be a Christian to have the fuller understanding why we should care for the vulnerable."

Definitely still friends :)

I blogged on this topic extensively when it was happening, so I don't want to rehash it here but it's interesting that you and Joe have different views on this.

He said: "The simple fact is that it is moral, in my opinion, to remove a feeding tube from a person who is PVS and has no chance for recovery and has explicitly stated that this was their wish. "

You said: "But we also need to recall that Terri wasn't being 'kept alive,' she was actively killed...unless we are to believe that nutrition and hydration are medical treatments. And in that case, a baby bottle is in a very real sense, a feeding tube.'

Byyour logic--that a feeding tube is not artificial life support (i.e. a plug to pull) and is actually equivalent to a baby bottle (merely a means of providing nourishment)--it would be murder to remove the tube under any circumstances.

This is another place where the "pro-life" position breaks down for me. When a baby is given food, she grows and thrives to the point where she won't need the bottle anymore. In Terri's case, it was the reverse situation.

Joe

I think your position about a medical decision maker outside of the husband or the parents was a good LEGAL one - especially after the controversy started.

My real point was why this became a "Christian" zoo - and why Christians took the sides they took. It was a legal issue; not really a Kingdom one. When I posted earlier I didn't tie back directly to Sarah's post; but the sentence that "set me off" was this:

I believe one needs to be a Christian to have the fuller understanding why we should care for the vulnerable.

This is absolutely true - but absolutely did not come across to the "public" as a result of the circus that happened. It come across not as Christians having a deeper understanding - but as Christians bellying up to the microphone.

Marla: You said -

"In Christian circles, we are in the minority, though. Frankly, I would wager that you, me and my mom (alicia rose) are going to be the only people in this thread who favored Terri being allowed to die (that wording is probably going to get me into trouble but that's how I see it). The real test is if people will still want to read my posts here knowing how I view this situation--I managed to keep my blog readership but I know there were some casualties, who viewed my stance as akin to supporting abortion--something I would never do. "

I support you. My wife and I couldn't get past the fact that Mrs. Schivo was being kept alive by technology. Technology that, btw, didnt exist a century ago. I am decidedly pro-life and, as someone with a disabled child, care alot about the vulnerable in our society. I think the removal of medically assistive technology is not always an evil, and can even be a blessing. I know for me, there are many things I can think of that are worse than death. Being nourished and hydrated by tube is one of them.

You haven't lost this reader.

Think about the precedents being set by the Schiavo case. Right now, in in the UK, a man with a neurological degenerative disease, who definitely wants tube feeding when it becomes necessary, has been fighting in court to ensure his wishes will be followed. The General Medical Council and the UK government are appealing!

Read the following article:

http://www.weeklystandard.com/Content/Public/Articles/000/000/005/645igjun.asp

Quote: "It would be a mistake to assume that Americans are safe from having life-sustaining treatment rationed like this just because we don't have a national health service. Burke is fighting a broader movement in the bioethics field, "Futile Care Theory," that is also gaining traction here. Futile care theory is a one-way street when it comes to patient autonomy and end-of-life care. Futilitarians assert that patients have an absolute right to refuse life-sustaining treatment but are not similarly entitled to insist that their lives be maintained."

"In another Houston case, one with ironic echoes of Terri Schiavo, the wife of Spiro Nikolouzos wants tube-feeding for her persistently unconscious husband, based on his previously stated desire to live. But unlike Schiavo's, Nikolouzos's personal wishes are not deemed determinative.... For the moment, Nikolouzos is being allowed to stay alive. But the final decision about the matter isn't his wife's: Under futilitarian Texas law, it belongs to committees of bioethicists and doctors."

Culture of Death.

Atlantic, culture of death? As Fattripleone pointed out, a hundred years ago, Terri wouldn't have lived through her brain damage. Technology is extending life beyond anything we've ever known--that doesn't mean it's always right. Hence, the need for bioethicists. And MUCH prayer. Yes, it's better to err on the side of life. But how do we define it at its end, as opposed to its beginning? With abortion, a life has just begun. When we are on the opposite end, how do discern between sustaining life and prolonging death? These are questions I intend to explore more fully but right now I don't see any clear answers, so it's a case by case situation.

I think the 'being kept alive by technology' is the sticking point, here, for most. I was very much for the parents having the right to remove their daughter, Karen Quinlan from artificial life support. I am very much against the consideration of nutrition and water (no matter how they are administered) as 'life support' and 'medical treatment'. What especially disturbed me in the case of Schiavo, is that it was never clearly established that she couldn't take water and soft foods by mouth. The feeding tube is often used as a convenience for severly handicapped individuals. She did not have a suction tube in her mouth to suction saliva, as she was capable of swallowing it herself. A former nurse in a sworn statement stated that she had given Ms. Schiavo water and jello by mouth. No swallow tests were conducted and Judge Greer refused to order one to be conducted. Part of his order was not only that her feeding tube be removed but that no fluids or nutritions be administered by mouth, either. (Not even a moist rag to cracked lips.) Death by dehydration is a horrible, excrutiating death. Read accounts of Nazi prisoners who feared that death worse than any other. Look it up in medical texts. Research all the statements I have made here.
Once again we have the problem of 'bias'. Just as the testimony of Christians is discounted as biased due to their Christian worldview, so any information coming from those seeking to save Terri's life will be considered bias---and so it may be. But there are facts out there. We may have one set of facts presented by one side and another by the opposition. But somewhere out there, aside from the opinions of either side, there are cold, hard facts. I think if pro-life Believers could all look at the complete set of facts in the Schiavo case we would find ourselves in agreement.

Marla, it is true that Schiavo probably could not have survived the initial brain damage without modern technology--but that is also the case for many trauma patients and or stroke and heart attack victims. A large percentage of those saved in ER or even at accident sites would not have had a chance even a few decades ago. That's beside the point. I am not a big fan of modern medical practices--but the area of trauma care is where I am most supportive of and thankful for medical advances and technology. It is good that we have the technology to stabilize people who have suffered traumatic injury or medical emergencies.

But how do we define it at its end

Even I could defend the ending of artificial administration of food and water for a terminally ill person with a clearly stated, written documentation of their desire not to sustained in that manner at the end of life. But in all other cases we should err on the side of life. The fact remains that it was not clearly established and agreed upon by all experts that Ms. Schiavo was terminal or 'at the end' of her life.

Sorry about three posts in a row, but I just have to add one thing I forgot to mention. Even for the case I stated in which I could support removal of the artificial administration of hydration and nutrition, it would be imperative to provide as much hydration and nutrition as they could take by mouth, keep their mouth moistened, etc...This might prolong the dying process a bit, but would ensure their humane treatment.

An interesting reaction to the Schiavo case gave me another perspective. A young married woman with two small children told me the case "scares her." She has a borderline abusive husband. It scares her that the state of Florida allows a husband who has abandoned the marriage (may I say that, since he was cohabiting and fathering children with another woman?)to have official life-or-death influence over the wife.

In the law, "conflict of interest" usually prevents anyone from acting as a fiduciary (such as a guardian) for another.

For an unbiased source of facts, try abstractappeal.com, by Matt Conigliari, a Florida attorney. What I read there helped me understand Judge Greer's decision. I don't think he imposed a worldview on the case, as many believe; I think the Florida statute almost compelled the result. And according to his opinion, he discounted the testimony of Michael Schiavo and the parents, and relied primarily instead on Schiavo's brother and sister-in-law, whom he found to be relatively unbiased.

Still, I think the result is ghastly. That's my worldview speaking . . . .

""The frontal temporal and temporal poles and insular-cortex demonstrated relative preservation."

Just to respond to Alicia Rose's first comment. I'm qualified in biomedical science. The above statement is one I can interpret - and one a number of people with medical knowledge who do not specialise in neurology could interpret.
Key areas of the brain were functional - as a commenter has already correctly discussed.
What the autopsy does not, and cannot indicate, is living function. PVS diagnoses cannot be made from examination of dead neurological tissue. That is also a medically recognised fact, and one not controverted by the autopsy.
The worldview aspect is important. I recall reading Dr. Cheshire's report and there was no reason to discredit it, although it was discredited - not on the basis that he provided a specialist opinion but because he is a Christian. I would point out that when a spcialist medical opinion is presented it is disregarded by some who have called loudly for just that - a specialist medical opinion - because it does not fit their worldview. Thus it is not rejected on medical grounds, but on the underlying worldview which motivates their position.
Marla - worldview is at play here. I recall you making a comment in a previous discussion that you were not interested in information from people with "vested interests". That excludes everyone, including you, because there is no neutrality here.
One of the interesting aspects of this is that world view cannot be excluded. Many people brought their own personal issues and experiences into the debate - ther own bereavements, even though those bereavements did not involve questions regarding PVS diagnoses, feeding tubes, or the absence of living wills. In short - some transferred their own unresolved loss issues to the Terri Schiavo case. This only highlights that we need to be clear about what is informing our worldview - are we coming with clarity or are we transferring unrelated and unconnected matters into an issue because of deeper unresolved memories and dissonance.
There were those who argued that it sould be only a rational and factual debate - yet when I engaged in such discussion they searched me on Google, found I am a Christian, and proceeded to bring my Christianity into the discussion even though I had not. At the same time, the facts were not heeded. Let's not be so naive as to think that there is a neutral rational aspect to such this case. And as Joe said, it is not as complicated as some would like to make it.
I do not have time to provide links - and see no need to as this is Sarah's post and I am responding to her central premise.

"Key areas of the brain were functional - as a commenter has already correctly discussed.
What the autopsy does not, and cannot indicate, is living function. PVS diagnoses cannot be made from examination of dead neurological tissue. That is also a medically recognised fact, and one not controverted by the autopsy."

I didn't word that as well as I could have. Key areas of the brain were preserved - so there is no reason to posit those areas were not functional. What cannot be indicated by the autopsy is the total function the person had while alive, i.e. the physical responses to neurological signalling. And as I said, PVS diagnoses are made not on the basis of examining dead tissue. Neither are they made purely from medical data without observation of the patient when they are alive.
It is medically incorrect and unethical to take the autopsy finding and say that she was "brain dead", or that she was PVS. Unethical because the autopsy data cannot substantiate those claims.

"It is medically incorrect and unethical to take the authopsy finding and say that she was 'brain dead,' or that she was PVS. Unethical because the autopsy data cannot substantiate those claims."

Yes. In fact, in their reports, both the medical examiner and the neurologist affirmatively stated that PVS cannot be diagnosed in the deceased, only in the living -- and even then, with difficulty and potential for disagreement.

I sure never saw that reported anywhere.

It's pointless to continue debating the facts since they are different depending on which sources are consulted. If we're only willing to look at what the doctors on "our side" say, then we're as guilty of bias as the other side.

On a spiritual level, I believe that either her soul went home at the time of the accident or it was finally and mercifully released when the feeding tube was removed--any pain she suffered in death was nothing compared to her trapped existence (if "she" was still in her body).

BUT I could be wrong. Unlike everyone else who "knows" that the right thing was to keep her feeding tube in place.

The odd thing is how these same people have no problem with feeding tubes being removed from people in similar (and even less grave) conditions if the person wished that the tube be removed. By their logic, how is that not euthanasia? The fact that a person wished to be killed rather than kept alive by "a mere piece of medical equipment" suddenly makes killing them okay? I don't get this at all. If the tube is all that stands between the person and death, either removing the tube is always euthanasia or it's not. This dualistic type of thinking smacks of relativism.

Marla, you said: "The odd thing is how these same people have no problem with feeding tubes being removed from people in similar (and even less grave) conditions if the person wished that the tube be removed."

I'm glad you brought that up, because in fact, I have questioned why its ok to remove feeding tubes just because this is a person's wishes. I agree - it smacks of relativism. I'm all for consistency.

:-)

Marla -

Not sure you were addressing my comment, but just to clarify: the autopsy report and attached neurology report were the source for my comment. These doctors were hired by Michael Schiavo (I think), and probably were pretty objective since Terry was already dead. So I cited them not b/c they were on a side, but b/c they apparently weren't.

But I agree, you can find some fact or opinion to support any side/all sides in the Schiavo case.

Second question: Are we essentially asking whether anyone should ever refuse life-sustaining treatment for themselves?

This true incident has me pondering all of the above:

Baby X was deprived of oxygen at birth. He has no gag reflex and can't swallow. He now has a trach and a feeding tube. His eyes lack focus and he has no body tone -- but he's very cute (I saw him at a fundraiser). Dad is a pastor and the entire (small) church family adores Baby X; they also believe the Baby X experience has given them a new appreciation for life, suffering, overcoming, and God's sovereignty. There is much joy.

Did Baby X's soul depart at birth, as per Marla's theory? Does a living Baby X have a role even if he is not sentient?

My own thoughts would be "no" and "yes." But I can see both sides. Thoughts?

Just wanted to make sure my earlier comments were not mistakenly taken to mean that I supported removal of feeding tubes simply on the basis of prior written consent. What I addressed was the removal of artificial feeding tubes for dying patients who had requested that, who could then be given as much nutrition and hydration as they could safely be given by mouth, and at least have moisture applied to their mouths. I was trying to the make the point that I was in agreement with those that stated extreme medical intervention for those who are dying could be ethically refused without constituting active euthanasia. This is very different from denying all forms of nutrition of hydration, or attempts to administer them by any means, to a severely disabled person.
I suppose there were some who's main objection to the removal of Schiavo's feeding tube was simply the lack of prior written consent, but most I heard objected to it on the grounds that it was not clearly established that she was dying. Denying food and water to a living human being who is not dying is active euthanasia--whether they have given prior consent or not.

I leave the debate on whether active euthanasia is ever a moral or ethical choice for Christians to others.

Unlike everyone else who "knows" that the right thing was to keep her feeding tube in place.

There also must have been those who "knew" that the
right thing was to remove it---because that's what they did.

There's nothing wrong with looking at a set of facts and drawing a conclusion. The critical thing is to seek out those facts and determine, to the best of our ability, which are true. We cannot possibly do that with all the issues out there---but there are some cases where it is vital that we do are very best to come to a correct, objective conclusion. The autopsy stated that the areas that we are taught in high school biology class control our higher level, cognitive thinking and reasoning appeared relatively undamaged. That's just one fact. But from that fact alone I could "know" that it was wrong to stop feeding her and giving her water.

But from that fact alone I could "know" that it was wrong to stop feeding her and giving her water.
To tie this all back to the originally posted topic--and to be more accurate--I should have said:

"But from that fact, alone, I could, based on my 'worldview', "know" that it was wrong to stop feeding her and giving her water."

Below are two links. The first is from an article in Touchstone magazine, which discusses Terri Schiavo and makes some interesting comparisons to Christopher Reeve.

The second outlines the Catholic position on end of life issues. Quote:

"Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of 'over-zealous' treatment. Here one does not will to cause death; one's inability to impede it is merely accepted....However, when the withdrawal of nutrition and hydration is intended to kill the person, or will be the immediate and direct cause of doing so, quite apart from any disease or failure of their bodies, then to withdraw food and water would be an act of euthanasia, a grave sin against the natural law and the law of God."

http://www.touchstonemag.com/archives/article.php?id=18-02-040-f

http://www.ewtn.com/expert/answers/end_of_life_decisions.htm

"On a spiritual level, I believe that either her soul went home at the time of the accident or it was finally and mercifully released when the feeding tube was removed--any pain she suffered in death was nothing compared to her trapped existence (if "she" was still in her body)."

What a load of gobbledygook Marla.
Trapped existence?
Based on what exactly?

It is not about having doctors on "our side" - it is that important medical reports need to be considered. And at the very least, if there is significant doubt (which there is) one errs in favour of life. But we've had this discussion before.
However - I for one am not going to discard my own training in assessing the reports of specialists because you have an unsubstantiated opinion.

Warning: inflammatory comments will be deleted. Please practice the Biblical injunction to speak [what you think is] the truth in love.

Marla my comment is not intended to be inflammatory. I'll rephrase it for you as "gobbledygook" may not be the right word.

I think your comment is purely opinion - and no substantiated basis is provided. It reads to me as confused. The statements you made require medical diagnoses. Yet you seem to discard medical diagnoses. That leaves unsubstantiated opinion.

This is not meant to be unloving - but to point out that I would rather look at the medical reports than take an opinion that is not substantiated when it concerns the life or death of another person.

"But from that fact, alone, I could, based on my 'worldview', "know" that it was wrong to stop feeding her and giving her water."

Hi Debra,
Yes, geting back to the original post - I agree that we look at the reports (the data) and that is also what informs our worldview. In this case it is a question of whether or not one's worldview includes approval of euthanasia. And for some I expect that their own personal issues, unrelated to the Schiavo case, that may inform their position in favour of euthanasia.

To borrow from Nancy Pearcey, there is the possibility of falling into an artificual divide - a split between "spiritual" and "factual" -when in fact a Christian worldview is best exemplified by incorporating both.

On that basis, given that at the least, as a common denominator in the debate, there is significant doubt, it then falls to whether one's worldview incorporates the sanctity of life or is pro-euthanasia. It is not about lining up doctors on "our side", but about looking at all the reports and drawing conclusions. Having said that, purely on a factual basis, not all reports carry the same weight. Dr. Cheshire's report was very important - and in itself raises very serious questions about the way the legal decision concerning Terri Schiavo was reached.

In the same way, my worldview does not discount the eye-witness reports of her final hours, the hospice's report that she was administered morphine for pain, and the medical consequences of two weeks of dehydration and starvation. My worldview calls that suffering. Given that it was euthanasia, I experience what is called moral repugnance (in ethical terms) at what was done.

Worldview, and how it is informed, is the issue.

Marla,
I'm sorry for using the word "gobbledgook". I realise it has upset you which was not what I wanted. If you wish to delete that particular comment I have no objections - if you wish to keep it here I have no objections to that either. Whatever you are Ok with.

Here is an interesting Australian version of the feeding tube issue.