Future Of End-Of-Life Laws Unclear In Legislature

TAMPA, Fla. -- "Terri's Law" was actually an appropriate label for the measure passed by the Florida Legislature last fall to save the life of brain-damaged woman Terri Schiavo.

Lawmakers in special session crafted the bill so narrowly as to apply only to Schiavo's unique situation. At the urging of her parents, they gave Gov. Jeb Bush authority to order a feeding tube reinserted into her stomach, six days after her husband had it removed with court permission.

The unprecedented government intervention into a right-to-die case attracted national attention, aroused strong emotions on both sides and brought to the forefront a public discussion of how to treat incapacitated people who leave no written end-of-life plans.

But how much the Florida Legislature will delve into end-of-life issues again when the regular session begins March 2 remains to be seen. There is disagreement in Tallahassee about what, if anything, needs to be done.

The House Judiciary Committee took the first step Feb. 3, proposing a bill that would keep incapacitated people alive regardless of their family's wishes if there are no advance directives.

The committee didn't vote immediately because several members expressed misgivings about details. The panel will take up the issue again in the coming weeks, though, and it could quickly get to the House floor.

Opponents, such as Rep. Dan Gelber, say it inserts the government into a decision better made by families. He questioned how the bill would affect the parents of children who are too young to legally express in writing what they would want.

"For us to be making these decisions for families is patently absurd," said Gelber, D-Miami Beach, one of several Democrats who said he was prepared to vote against the bill. "These are intensely personal family decisions, and they should remain that way. We should not be involved and neither should the governor."

Gelber said many of his colleagues are under political pressure to address issues related to the Schiavo situation. He thinks their efforts would be better spent on other matters.

"We've spent more time trying to provide health care to a woman who doesn't want it than to 100,000 kids on the KidCare waiting list who need it," he said.

Supporters say if people didn't want to be kept alive with a feeding tube they should say so in a written directive.

If not, "we're going to err on the side of life," said the bill's sponsor, Rep. Jeff Kottkamp, R-Cape Coral.

The Senate is unlikely to move as quickly and may not even consider the issue at all. Senate President Jim King has already expressed his reluctance to deal with it this year.

Moreover, the Jacksonville Republican said he now regrets voting for the bill that allowed Bush to intervene to keep Schiavo fed and hydrated, calling it "probably one of the worst votes that I've ever done."

King has long supported a Florida law that allows surrogates such as spouses and relatives to decide whether to keep alive people in a vegetative state who haven't specified their own wishes.

He told the St. Petersburg Times editorial board recently that he bowed to the intense public pressure to help Schiavo at the time and was worried about being blamed for her death if he didn't go along with the effort.

"After the vote there were far more people critical of what we had done and very vehemently angry at what we had done than there were people supporting it," King said. He said there was "no question" he would not vote that way today, "and if it comes up again I will not do it."

Senate Majority Leader Dennis Jones, R-Treasure Island, shares King's views. He said was just confronted with an end-of-life decision recently when he decided to remove his mother's feeding tube.

"It's a very tough decision but quite frankly we were put in a situation in that special session where we felt we didn't have any other thing to do," he said. "If I had to do it over, I most likely would not take the same vote myself."

Bush, who continues to defend his decision to sign the bill written specifically to keep Schiavo alive, said he supports the Legislature looking at the broader issue of how to deal with end-of-life decisions when someone doesn't have a living will.

Florida courts have for years affirmed Michael Schiavo's efforts to remove his wife's feeding tube. He convinced a circuit judge that Terri once made statements that she would not want to be kept alive artificially.

Michael Schiavo sued Bush immediately after the Legislature acted, asserting that the law violated Terri Schiavo's right to privacy and separation-of-power provisions of the Florida Constitution. That lawsuit is pending in circuit court in Clearwater, held up by procedural issues.

Terri Schiavo's parents have fought her husband all the way. They doubt she had any such end-of-life wishes and believe she could be rehabilitated and even learn to eat on her own with therapy.

Meanwhile, the 40-year-old woman continues to live in a Clearwater nursing home in what some doctors call a "persistent vegetative state," which has been her condition since she collapsed in 1990.

No two ways about it, this is a tough issue either way you go. In the Schiavo case, since the husband wants to move on with his life and legitimize his relationship with his current squeeze and the children he has fathered by her, I don't understand why he won't divorce her or, at the very minimum, relinquish all guardianship rights to the family. I think Michael has a lot to answer for in this case because there is no reason to maintain guardianship rights over someone he wants to see dead and the family doesn't. Nonetheless, that's a different issue.

In general, however, I think that this issue will be with us for a long time to come. IMO, it is one thing to make an off-hand comment when we are young that we wouldn't want to live as Terry is currently living but, by the same token, our choices are often different when actually faced with the real situation. I don't believe that ANY legislative body will be able to craft a cokkie-cutter law that will apply in all cases. Therein lies the rub. Because of religious and other differences, each of these cases, IMO, will always have to be treated on a case-by-case basis.

“I'm making a prediction that organs may be the reason they want to keep usable bodies on life support…”

That is a good prediction, Askel5.

It does appear that to many in the parts harvesting industry, we’ve become nothing but bio-commodities:

Morally acceptable Organ
Donation and Transplantation:
And Catholic Church teaching

By Richard Mahoney, Founder
NATIONAL AMERICAN HOLOCAUST MEMORIAL

With sacred biblical teaching, I will explain why the donation of vital organs is prohibited and immoral. Our Lord tells us in sacred scripture that "the life is in the blood" (Genesis 9 and Leviticus 17). Physiologically the fundamental building blocks of the human person are at the cellular level. Each cell within the body receives the oxygen and biochemical nutrients it needs for cellular metabolism through the blood. When perfusion (blood flow) ceases at the cellular level, whether through cardiopulmonary arrest, cardiopulmonary insufficiency, shock, exsanguination, etc. and the cells are no longer supplied with blood, metabolic acidosis ensues. For a certain time period this respiratory and/or metabolic acidosis is reversible by reestablishing ventilation and sufficient blood flow (perfusion) to the cells and vital organs. This is the basis of CPR (Cardiopulmonary Resuscitation) and ACLS (Advanced Cardiac Life Support). A person, who arrives at a medical center in cardiac arrest and asystole and is resuscitated, was not dead and then brought back to life. The CPR and ACLS merely reestablished adequate perfusion to the cells and vital organs before such an extensive ischemia and necrosis takes place as to make it irreversible (persistent irreversible catabolic state). Physiologically, death is an irreversible catabolic state leading to total cellular necrosis of the entire human body. Spiritually, death is the separation of body and soul. When the soul, which inhabits and animates the human person, no longer has a living organism to embody, it leaves the body and goes to its Creator.

Having thus laid the most basic premises of human physiology, life and death, we will now expose the falsehood and immorality of epivalothanasia (the Greek word for "imposed death") and euthanasia. In organ transplantation the donor's organs are taken while their heart is still beating and their vital organs adequately perfused. The donor is not only alive while his organs are being excised for transplantation, physiologically his organs are very healthy and in good shape. Historically over the past 40 years, in order to justify abortion and epivalothanasia, the American Medical Association has redefined the beginning of life, from the moment of conception to the moment of nidation (implantation) and has redefined death as a cerebral phenomena which they have coined "brain dead". In so doing, the vast majority of the medical establishment has chosen the "quality of life" ethic over the "sanctity of life" ethic. Initially they used cerebral electroencephalographic activity as a measure of classification. Currently, medical institutions have been using a Glascow Coma Scale as a screening criterion for organ donation. A human being's worth or quality of life even after a severe cerebral trauma (subdural hematoma, subarachnoid hemorrhage or ventricular bleed, etc.), pathology or anomaly cannot justify any "death dealing excision" of his vital organs. In the worst case scenario, although a medullary or pontine infarct would precipitate nearly immediate fatal demise, to excise organs while a person is alive is murder. To use a utilitarian philosophy to promote or actuate the death of a human person is heinous and immoral. The Church teaches that the donation of non-vital organs that would not cause death or debilitation of the donor is allowable as well as certain tissues such as corneas, bone and skin, which can still be useful for donation even after death.

In conclusion Pope John Paul II reminds us "Neither human life nor the human person can ever be treated as an object to be manipulated or as a disposable commodity; rather each human being at every stage of existence, from conception to natural death, is endowed by God with a sublime dignity that demands the greatest respect in vigilance on the part of individuals, communities, nations and international bodies". Father John Powell states in his book Abortion: The Silent Holocaust, "The problem of birth control and birth selection are extended inevitably to death selection and death control whether by the individual or by society". Quoting Malcolm Muggeridge, "We will not recognize the true value of our own lives until we affirm the value in the lives of others; however low it flickers or fiercely burns, it is still a Divine Flame which no man dare to presume to put out, be his motives ever so humane and enlightened".

Richard Mahoney, RRT CPT

http://cpforlife.org/id87.htm

=== I doubt it, although that might end up being the unintended consequence of such a move.

Unintended, perhaps by those carried away with dignity of life equaling life support somehow. I just have the feeling that these folks want the "vegetables" kept alive -- rather than having a natural death -- so that in the absence of directives, those determined to have authority will do the right thing and use what organs may be harvested.

Having worked for healthcare attorneys for years and observed the Futile Protocol movement and other strictly Economic triage of patients, I cannot fathom that legislators acutely aware of the Big Bucks to be had in organ transplants (particularly as the Hep-C epidemic looms on the horizon) that this is an unintended consquence of those pushing the artificial life support measure.

But ... like I said, just a prediction. I have no illusions about how useful are the utterly predictable inclinations of pro-lifers to the Leadership who are always one step ahead of the Game.

Good to see you, btw!! Trust all is well with you and yours.

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