c. 2005 Religion News Service
(UNDATED) As a founding member of the New York State Task Force on Life and the Law, I was not surprised by the 15-year Terri Schiavo case that ended with her death Thursday.
The task force has been dealing with critical bioethical issues since the group’s founding in 1985. Gov. Mario Cuomo established the task force, and we have continued our work under Gov. George Pataki.
Those issues include the right of patients to refuse resuscitation in a hospital, the creation of a proxy medical power of attorney _ specific instructions that are superior to vaguely worded living wills _ the legal definition of death, surrogate parenting, organ transplants, and, of course, the withdrawal and withholding of life support from patients.
The past 20 years have been a humbling experience for task force members who include clergy, physicians, nurses, lawyers, philosophers, ethicists, social workers and hospital administrators. Because the issues transcend religious, racial and ethnic boundaries, I have devoted many weekly commentaries to bioethical questions.
The birth of a human is always problematical, but it directly involves only three people: the child and its parents. Most deaths, including Terri’s, are more difficult than births since they usually involve many more individuals.
The Schiavo case is remarkable not for the issues it raises, but rather for why it took so long for those issues to erupt upon the public stage with its confusion, anger, distrust and complexity.
All rabbis, priests and ministers know firsthand that questions involving withdrawal and withholding of life support from patients is a common daily occurrence throughout America. Nor is the family dispute so evident in the Schiavo-Schindler drama a rarity. Families usually have strong differences, often bitterly expressed, when loved ones _ parents, spouses, children or siblings _ lose capacity, that is, are unable to make medical decisions for themselves.
What are my feelings after watching the Schiavo case reach its sad and inevitable conclusion? “You ain’t seen nothin’ yet!”
New, even more complicated issues and controversies are certain to arise involving families, the medical profession, religions, insurance companies, and _ always lurking as the 900-pound gorilla in every hospital and hospice room _ the local, state and federal governments.
Because health facilities and their personnel are finite, medical rationing and triage will soon become major issues in American life. Who will make the choice between saving the life of a 9-year-old or a 90-year-old in a short-staffed emergency room situation that lacks both the time and the talent to successfully treat both patients?
Will only rich and prominent people, including members of Congress, be the principal beneficiaries of excellent medical care in the U.S., a nation where millions of citizens lack any health insurance?
Who is entitled to receive transplanted organs like kidneys, hearts and lungs? Will these precious scarce organs go only to the politically powerful and the wealthy, or will they be distributed on an equitable basis where the homeless person’s need for a renal transplant is as compelling as a senator’s? Will an orderly queue be established and maintained for organ transplants or will “influential” persons receive preferential treatment based on socioeconomic status?
And I haven’t begun to discuss the ethical questions raised by stem cell research and its hopeful promises of treating dread diseases. In a nation where stem cells and trained health care personnel are in short supply, how will those cells be allocated to a vast, demanding public?
The late Dr. David Axelrod, the task force’s first chair, once told me that Americans mistakenly believe they can have on instant demand all the medications, tests, attending physicians, nurses and therapists they require; the latest medical facilities, machines and treatments all the time, available everywhere, and at little or no cost.
But he warned: “Such a belief is a dangerous myth raising false expectations. Everything in medicine is finite, costly and limited.”
As a nation, we need to create a fair legal bioethics system now before America is torn apart as we first debate and then, knowing human behavior as we do, we violently assault one another in the quest not for spices and salt to preserve our food as in the past, and not for oil as we do today to preserve our profligate lifestyle.
The next violent battles will be to obtain the limited medical resources needed to stem the arrival of the Angel of Death who awaits us all.
The Schiavo case is the opening battle of our next civil war.
MO/PH END RNS
(Rabbi Rudin, the American Jewish Committee’s Senior Interreligious Adviser, is Distinguished Visiting Professor at Saint Leo University.)
