April 1, 2005

How the Schiavo case will change the law.

Sheryl Gay Stolberg, in the NYT, analyzes how the Schiavo case may affect American law:
Nearly 30 years after the parents of another brain-damaged woman, Karen Ann Quinlan, injected the phrase "right to die" into the lexicon as they fought to unplug her respirator, Ms. Schiavo's case swung the pendulum in the other direction, pushing the debate toward what Wesley J. Smith, an author of books on bioethics, calls " the right to live."

"This is the counterrevolution," said Mr. Smith, who has been challenging what he calls the liberal assumptions of most bioethicists. "I have been frustrated at how difficult it is to bring the starkness of these issues into a bright public discussion. Schiavo did it."

Experts say that unlike the Quinlan case, which established the concept that families can prevail over the state in end-of-life decisions, the Schiavo case created no major legal precedents. But it could well lead to new laws. Already, some states are considering more restrictive end-of-life measures like preventing the withdrawal of a feeding tube without explicit written directions.
It will be hard to craft legislation that satisfies everyone, since the interests are so profoundly and fundamentally opposed.
Around the country, state lawmakers are contemplating changes, as well. The Alabama Starvation and Dehydration Prevention Act would bar the withdrawal of a feeding tube without explicit written instructions. A lawmaker in Michigan is proposing a measure that would prevent an adulterer from making medical decisions for an incapacitated spouse.

Some medical ethicists say they are horrified. R. Alta Charo, a professor of law and bioethics at the University of Wisconsin, foresees a chilling effect on hospitals and doctors, who may become uncomfortable carrying out a patient's wishes against the backdrop of a family feud. Professor Charo said there was no way for lawmakers to predict all the permutations that play into decisions on death and dying.

"If you go back to Cruzan, the presumption was in favor of extending biological life," she said. "Over the last 30 years, the presumption has slowly shifted toward allowing people to die. What we are seeing is the counterinsurgency."
Just as the fight over abortion must go on forever, this controversy will never be resolved, and it will never be disentangled from the political struggles that exploit the deep beliefs and genuine emotions people feel about life, death, killing, autonomy, and the terrible disputes that take place within families.

(Note: Alta Charo, quoted above, is my colleague here at the law school.)

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