future selves
A few months back, I wrote about how I didn’t think I would ever have gone down the path of assisted reproduction. Many people responded that I shouldn’t be so confident that I know how I would deal with the situation; several said that they wouldn’t have imagined in advance that they would make the choices that they eventually did.
I’ve been thinking about that conversation this weekend, and its implications for advance directives. Rivka at Respectful of Otters has a long and thoughtful post up about Terri Schiavo. One particular comment she made about one of the 17 affidavits jumped out at me:
Dr. Eytan would seemingly reject any pre-injury statement about the conditions in which a person would prefer to refuse medical treatment, "because we are all in the process of changing." In the greatest unintentional irony of the entire stack of affidavits, she remarks that "Ms. Schiavo is not the same person as she was when she made her alleged remarks about not wanting to live in a certain condition." By this logic, she would apparently argue to invalidate any Living Will or advance directive.
I have a living will, in which I spell out how I’d like to be treated in the event that I was no longer able to make these decisions. I’ve given copies to my parents and my husband, as well as registered with the US living will registry. Even though I tried to be specific, I know that the most important part is who I designated to make decisions for me (my husband), because it’s just not possible to lay out every contingency in a document.
We allow people to bind their future selves in all sorts of ways — by marrying, by having children, by signing contracts to deliver goods and services. But there are limits — at least in the US, you can’t sell yourself into slavery.
March 21st, 2005 at 7:44 am
I wonder where are all the “conservatives” who wail about the “nanny state” when we’re talking about programs that actually help large numbers of people, now that the state has inserted itself into the private affairs of one individual family?
This is a very frightening prospect. The government forcing people to remain alive through artificial means regardless of the stated wishes of the person, and regardless of the decisions of the legally responsible family member.
I find Dr. Eytan’s statement very disingenuous.
March 22nd, 2005 at 7:32 am
That’s interesting. I think what Dr. Eyton is saying has some truth to it, though I don’t know that it should outweigh Living Wills and all the law associated with them.
I get a lot of comments similar to the ones the women undergoing ART get–as a type 1 diabetic, people tell me all the time, “Oh my god, how do you do it? I hate needles! I could never give myself a needle. If I ever got diabetes, I would die.” And I find this extremely frustrating because, in fact, no one has ever died from type 1 diabetes because they were pathologically afraid of insulin injections. In that situation, you do it. YOu don’t think much about how scary it is. But I think people aren’t really capable of thinking of how preferable it is to take injections when the alternative is death–they’re not considering death as a serious option.
I remember in Canada a number of years ago there was a case where a family had a severely disabled daughter. They lived in Alberta, I believe. I can’t remember the extent of her disabilities, except that they were profound; I seem to remember she was confined to a wheelchair and was not able to do much, if anything, for herself, including washing, eating and changing (she was 12 years old, if I remember correctly). Care for this daughter’s disability was emotionally and financially exhausting, as I’m sure you can imagine. And one day the girl’s father killed her–shut her in the garage with a car running.
He was, by all accounts, a loving and devoted father who had never been anything but affectionate and caring for his little girl, and the case shocked the country. The vast majority seemed to believe that this was compassionate, very little different from assisted suicide, because who could want to live a life like that? What worth was there in that kind of life?
But I read a letter to the editor in a newspaper one day that completely changed my mind on the subject, and I’ll never forget it. It was written by a disabled woman, who said that an able-bodied person can never know the worth of that kind of life. That what looks like a terrible life to an outsider is the only life this person has, and it is good and sweet and worthwhile.
I think there is, for many people, a real inability to consider death as the alternative. No, type 1 diabetes and these kinds of disabilities are not the same as Ms. Schiavo’s injuries, I agree. And I believe there is a line beyond which a certain kind of life is not really different in any appreciable way from death. But I think it is worth considering or debating how well a currently able-bodied person can know in advance what kind of life is worth living.
I don’t think this should outweight a living will in cases where there is one, but I do think that most physically and mentally healthy people are not very good at thinking about death.
April 7th, 2005 at 10:03 pm
Just wanted to share the link to the best essay I’ve read on the Schiavo case:
http://www.michaelberube.com/index.php/weblog/liberals_in_their_own_words/