Tuesday, March 22, 2005

Intolerable Life

Killing Terri is the blunt title of an article by another member of The President's Council on Bioethics, James Q. Wilson, The James A. Collins Professor of Management and Public Policy Emeritus at the University of California Los Angeles, and recipient of the Presidential Medal of Freedom.

Professor George of Princeton discusses Lives Unworthy of Life while Professor Wilson explores the Intolerable Life theme.

The intolerable life argument has support from many doctors and bioethicists. They claim that a person can be "socially dead" even when their brains can engage in some functions. By "socially dead" they mean that the patient is no longer a person in some sense. At this point their argument gets a bit fuzzy because they must somehow define what is a "person" and a "non-person." That is no easy matter.

Professor Wilson also discusses living wills, and answers a fundamental question I've been wrestling as I prepare a living trust and will.

But scholars have shown that we have greatly exaggerated the benefits of living wills. Studies by University of Michigan Professor Carl Schneider and others have shown that living wills rarely make any difference. People with them are likely to get exactly the same treatment as people without them, possibly because doctors and family members ignore the wills. And ignoring them is often the right thing to do because it is virtually impossible to write a living will that anticipates and makes decisions about all of the many, complicated, and hard to foresee illnesses you may face.

For example, suppose you say that you want the plug pulled if you have advanced Alzheimer's disease. But then it turns out that when you are in this hopeless condition your son or daughter is about to graduate from college. You want to see that event. Or suppose that you anticipate being in Terri Schiavo's condition at a time when all doctors agree that you have no chance of recovering your personhood and so you order the doctors to remove the feeding tubes. But several years later when you enter into a persistent vegetative state, some doctors have come to believe on the basis of new evidence that there is a chance you may recover at least some functions. If you knew that you might well have changed your mind, but after entering into a PVS you can make no decisions. It is not clear we would be doing you a favor by starving you to death. On the contrary, we might well be doing what you might regard as murder.

There is a document that is probably better than a living will, and that is a durable power of attorney that authorizes a person that you know and trust to make end-of-life decisions for you.

Thank you Professor.

Again, read the whole thing and Hat Tip to Kathryn Lopez.