Terri Schiavo and the O'Reilly Solution

During the height of the Schiavo controversy, on his TV show and in his column, Bill O'Reilly offered his solution. I think his approach is very problematic for the reasons outlined in this essay.

Click here for complete essay.During the height of the Schiavo controversy, on his TV show and in his column, Bill O'Reilly offered his solution. Briefly, it was this:

Her husband, Michael believed that Terri was in a persistent vegetative state (PVS). His position then, was that she was completely unaware of her environment, incapable of thinking and incapable of experiencing pain. In short, he believed that his wife was no longer a sentient being.

If this is truly how he felt at the core of his heart, then as O'Reilly opines, he should have simply put an end to the incredible acrimony surrounding this case and have had guardianship transferred to her parents. By this argument, it wouldn't have mattered to Terri and it would helped give her parents peace and enable them to care for her in her final days. Perhaps this would helped them to achieve some degree of closure. In addition, it would have had the added benefit of giving Michael a chance to end this bioethical disaster and go on with his life. Perhaps, in the eyes of some, he would even have come off as a hero. O’Reilly saw no “down-side” to this solution.

On the surface, this seems like a reasonable, almost Solomon-like way out of this quagmire. However, are things really that simple?

I have very strong ethical feelings about such a plan. Before I discuss them, I need to clarify where the uncertainties of this case lie.

I don't know the motivations behind the principals of this case. I don't have any idea of what Terri wanted. I don't have any idea of whether Michael was acting out of a deep love of his wife and a desire to fulfill her wishes or whether he had more base motives. I don't have a clue as to whether Terri's parents in fact believe that Terri wouldn't have wished her life to be ended in these circumstances. Conversely, I don't know whether they were grieving parents emotionally unable to "let go" of their daughter and were willing to say or do anything to prevent it.

These true innermost motivations are unknown and unknowable to the public. They are known only to the family members themselves. There are some things, however that I do know to a strong degree of certainty.

• Terri Schiavo was in a PVS and was not going to recover. I believe this because of many things I've read regarding her medical care (particularly here) and from what I know as a physician about the biology of PVS. People debate this publicly but a reading of the court record would suggest this conclusion to the vast majority of practicing physicians without an ideology to promote. The medical data is one of the few aspects of this case that is relatively certain.
  
  
• Although as I've said, we won’t ever know the true motivations of Terri's family members, we do know what the courts have adjudicated multiple times. The lower court ruled that Terri Schiavo would have wanted her life to be ended under her final circumstances. In fact the entire mandate of the lower court's guardianship was to make such a determination. A thorough discussion of the serpentine meanderings of this process are described in Matt Conigliaro's excellent blog Abstract Appeal. He's a Florida attorney who follows the U.S. eleventh Circuit Court of Appeals.
  
  You or I may or may not have come to the same conclusion but the lower court has and countless reviews by higher courts have affirmed it. This is not open to debate.

O'Reilly's solution then was to ignore what the courts have determined to be Terri's legal wish to withdraw medical support (which under Florida statutes can include tube feedings and IV hydration) and instead, succumb to mere expediency. In other words, 'if she's unconscious, what difference would it have made’ if Michael simply ceded guardianship to Terri's parents?

O'Reilly's solution ignored the central issue of this bioethical disaster which is what did Terri want? The courts have repeatedly found as a matter of fact that Terri had told her husband (and several in-laws) that she would not wish to be kept alive were she to end up in her state prior to her death.

The fact that she was unconscious should in no way alter the legitimacy of that wish. All people have the right to live with the certainty that, when legal, their wishes on these most core of all human issues will be followed. To ignore them in the interest of expediency and a perceived, though misguided, "kindness" to Terri's parents misses the whole point.

This entire controversy was about Terri, not her family. Her husband fulfilled what the courts have judged to be her wishes. At least Terri will have slipped into her terrible state knowing that her desires and her rights were protected.

Let all of us who have expressed such wishes in advance live with the certainty that those charged with executing them will have the determination and the support of our community and our legal system to carry them out.

Terri is gone. After extensive review, our legal system determined that that was what she wanted. This is the essence of justice.