TCS Daily

Living and Dying In These Modern Times

By Glenn Harlan Reynolds - April 5, 2005 12:00 AM

Terri Schiavo is dead and so is John Paul II. And one effect has been to get us talking about the whens and hows of dying.

It seems that some people are against dying at all; or at least against the notion of dying all the way. As Perry de Havilland notes, one side-effect of the abortion wars has been to produce increasing vehemence among the "pro-life," and broader definitions of what counts as "life:"

"The term 'pro-life' may be a reasonable description for those who oppose killing late term foetuses but the broad political church of pro-lifers (with whom I actually share many positions) includes a section of conservatism which is so obsessed with the physical trappings of life that they have stretched the definition of human existence to the breaking point.

"The origins of this conservative faction are not hard to see. It came about in opposition to those on the socialist left who treat abortion as not so much something to be tolerated but rather a sacred sacrament which they venerate with cult-like obsessiveness and even demand it should be supported by the tax money of people who abominate the practice. In resistance to this we now see some conservatives developing an equally extreme cult to whom being 'pro-life' means treating the intentional death of a fertilised egg as tantamount to murder and demanding the removal of the customary fiduciary role of a spouse in decisions such as the Terri Schiavo case when the spouse does not follow the 'pro-life' party line. Moreover these people describe courts which do not intervene in such a civil matter as 'activist judges' who should be opposed with force by the executive if they will not buckle under and act like a, well, activist judge."

But this change in attitude, as Jonah Goldberg notes, has to do with technology: Not long ago, we couldn't keep people alive once they were seriously ill, and so we didn't have to worry about the ethics of doing so. Now we do. In fact, as Fr. Thomas J. Reese, S.J., points out, these capabilities may cause problems for the papacy itself, since it's a job that ordinarily lasts for life:

"Prior to the 19th century, this was less of a problem because role of the papacy was more limited and because doctors were more likely to kill a person with their care than keep him alive. The ability of modern medicine to keep the body alive while the mind is deteriorating will eventually present the church with a constitutional crisis. And despite church teaching that extraordinary means need not be used to keep alive a dying patient, who will have the courage to unplug the life support systems of a pope?"

Who, indeed? As it happened, John Paul II spared his flock that decision, by declining further medical care shortly before his death -- and, perhaps, delivering an implicit rebuke to the keep-the-body-alive school of thought.

But that won't make the problem go away for the rest of us, or prevent its coming up in the future for the papacy. Because the technology just keeps getting better -- but it's nowhere near good enough to solve the problem yet.

It's "better" in the sense that people who would have died quickly not so long ago can be kept going indefinitely today. It's not good enough because those people aren't really healed, just kept ticking over at the lowest possible level. If Terri Schiavo -- or John Paul II -- could have been given an injection of nanobots, or stem cells, that would have restored them to perfect health, presumably no one would have minded that. Er, except, possibly, some of those who were trying to keep the plug from being pulled. As Jim Pinkerton wrote:

"The religious right, for example, insists on using a certain level of technology to preserve life, such as feeding tubes and antibiotics. But the religious right also insists, at the same time, that not too much technology be used. The most obvious example is stem-cell research.

"What would happen, for instance, if scientists announced that they could grow a new brain from stem cells for Terri Schiavo? That is, the wizardry of medical technology would allow the unfortunate woman to regain her mental faculties. Such an announcement, admittedly hypothetical at present, would put the 'right to life' supporters of Schiavo in an awkward position. On the one hand, they would support her continued existence in a 'vegetative' state. But on the other, they would oppose stem-cell-based intervention that would lead to her genuine physical recovery. Which is to say, conservatives might be happy to see Schiavo's near-comatose state forever, but others of different beliefs might demand the true rehabilitation of their loved one."

Only some people would see a conflict here -- Leon Kass, who is anti-stem-cell research, also sees death as a "blessing" -- but for those who did it would be quite pressing. (And there would be metaphysical problems, of course -- barring a backup copy stored somewhere, somehow, the mind residing in "a new brain" grown from stem cells wouldn't be Terri Schiavo's, but that of a new person inhabiting her body. Would that count as a life "saved," or a life created? That's a topic for another column entirely, though I've touched on those issues here and here).

Like a lot of Americans, I'm somewhat ambivalent. If I were in a persistent vegetative state, as Terri Schiavo was according to the courts, I hope that someone would pull the plug on me. And I don't think that a desire not to be kept "alive" or to have loved ones kept "alive" in such a far-gone state is really part of a "culture of life" in any meaningful sense. My sister agrees -- in fact, she told me that her big worry is that her husband (the opposite of Michael Schiavo, I guess) wouldn't follow the pull-the-plug instructions in her living will.

On the other hand, I find some of the right-to-die folks a bit, well, creepy, and I'm not just talking about Jack Kevorkian. I once had a conversation with a fairly well-known bioethicist about his experience turning off the ventilator on his brain-dead father. I don't doubt that it was the right thing to do, but in his recounting he came across as somehow impressed with himself for having the "courage" to do it. Such things take a kind of courage, I guess, but they're nothing to brag about, and it came across as a sort of bragging. And there does seem a kind of eagerness to wield the power of death, sometimes, in the writings and pronouncements of many in the area. I think that the critics of a "culture of death" are picking up on this, and although they possess their own kind of creepiness (Perry de Havilland says that those willing to keep corpses animated in the name of "life" come perilously close to a sort of zombie cult) that doesn't mean that they're wrong to notice this.

Perhaps we're simply in one of those awkward in-between times, technologically. With sufficiently advanced technologies, we should be able to fix almost anything short of massive brain injury -- and one day, if mind uploading technology proves feasible, we may even have those "backup" copies available, though I suppose that will create its own, different, set of problems.

I look forward to those problems. Because amid all the ethical concerns raised by new technology, it's easy to miss the most important thing: That as these new "problems" appear, they do so in the context of societies that are richer, healthier, and better off -- enough so that they have the luxury of worrying about problems that weren't problems at all in earlier days.


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