Despite John Welch’s admirable asserted desire to keep the Schiavo thread on the topic of “what does LDS theology tell us about end of life care options?,” much of the discussion has predictably become a political slugfest. So be it. However, it hasn’t been, in my mind, a particularly useful political discussion. And a primary reason is because so much of the Schiavo case depends on the particular evidentiary nuances of that case. What did she tell her husband, who is he sleeping with, blah blah blah. Evidentiary questions are boring. So let’s filter them out and see where people stand on the broader issues of right to life (assuming state responsibility to enforce any right) and family wishes in general. In particular, let’s try to figure out exactly what rights are at stake in the Schiavo case. Is it Ms. Schiavo’s right to live? If so, then what do her parent’s wishes have to do with it? Is it her parents’ right to keep a child alive? These are the interesting questions.
To do away with the sticky evidentiary issues, we’ll work with some hypotheticals which are hopefully clean enough to allow examination of some of the underlying issues without getting stuck in too many blind alleys.
Hypothetical number 1
Mr. Smith is terminally ill. He unambiguously signs a form saying “if I go into a vegetative state, discontinue care.” He is of sound mind at the time he signs. His family agrees with his decision.
He then goes into a vegetative state. The doctor believes that life can be prolonged indefinitely. The family wishes to end care.
Should the state keep Mr. Smith on medical care? Why or why not?
. . .
. . .
[If you believe that the state should keep Mr. Smith alive, then you ascribe to an “irrrevocable right to life” position.
If you believe that the state should not continue care, then you believe that the right to life is revocable, either by Mr. Smith’s actions, by his family’s actions, or both.]*
If you answered “No” to hypothetical number 1, then please try out hypothetical number 2.
Hypothetical number 2
Mr. Jones is terminally ill. He unambiguously signs a form saying “if I go into a vegetative state, pull the plug.” He is of sound mind at the time he signs. Different from the first case, Mr. Jones’s parents strongly disagree with his decision. (To keep the hypothetical clean, we’ll posit that his parents are his only family members).
Mr. Jones then goes into a vegetative state. The doctor believes that life can be prolonged indefinitely.
Should the state keep Mr. Jones on medical care? Why or why not?
. . .
. . .
[This hypothetical is designed to further split the group which believes that the right to life is revocable. It directly pits the wishes of a family member — parents, in this case — against the wishes of the ill person. If you answered “no” then you believe that the right to life is revocable by the ill person. If you answered “yes” then you believe that the right to life is not revocable by the ill person.]
How these categories play in Schiavo
If you believe in an irrevocable right to life, then you believe that the state must keep Ms. Schiavo on medical care.
If you believe in a revocable right to life, but one which can only be revoked by family members’ consent (you answered “Yes” to hypothetical number 2), then you believe that the state must keep Ms. Schiavo on medical care. (Because absent family consent, no valid revocation can occur).
If you answered “No” to both #1 and #2, then you believe in a revocable right executable by the ill person. In other words, you believe that Ms. Schiavo has every right to decide to end medical care herself.
If you believe in a revocable right to life, executable by the ill person, but you also believe that medical care should be continued for Ms. Schiavo in particular, then you must believe that she simply has not executed a valid revocation of her right to life. That position is an evidentiary one, and is based on the lack of sufficient evidence to support a finding of revocation.
If you are in that evidentiary camp, your position could change depending on changing evidence of a valid revocation. For example, if Mr. Schiavo suddenly found a safe deposit box tomorrow which contained a living will for Ms. Schiavo, which was unambiguously valid and executed, and which said “if I go into a vegetative state, discontinue care” then you would, at that point, change your position to support discontinuing care.
*I am deliberately ignoring the question of whether the right to life is state enforceable. We will assume for this hypothetical that if the right exists, it is enforceable.