History's Garbage Dump - TANSTAAFL

Just got home from a longish day on the cancer unit. I saw a lot of tears, heard a lot of prayers, said a few myself. Got through the day without kicking out any plugs or yanking out any tubes. When I last walked by the staff lounge TV, Fox News was on and Terri was still alive. Haven't yet checked again. On the way home, I celebrated my relative good health by taking advantage of Kroger's sale on treif meat. Before I made it into the house, I had to evaluate a neighbor kid's jammed finger and my son's self-inflicted finger abrasion. All in all not too atypical a day for me.

But the whole day was colored by the plight of Terri Schiavo, and its relation to the terminally ill I was caring for. Every nurse I spoke with had the same reaction to the Schiavo case. As a group, there was an understanding of the path we're now on. We can all see the horrible potential for the legalized murder of people no longer able to speak cogently for themselves.

Our culture until now has taught, 'when in doubt, err on the side of life'. This has guided Western medicine for some time. I wrote earlier, "In hospitals, we make hard decisions about life and death frequently. They are often agonizing decisions, for both the families involved and the professionals who implement them. They are made with as much input as can be gathered. Where they are known, the wishes of the patient involved are given the most weight." Though we have learned to cease our efforts when there is truly no hope, there is a world of difference between ending medical therapies that are no longer efficacious, and ending therapies that sustain life.

Today I cared for people no longer able to carry on a conversation. Their charts carried "Do Not Resuscitate" orders. But no one dared suggest that we end measures to keep them in as much comfort as possible, or to provide hydration and nourishment. A week from now, a year from now, that may not be the case. A court, aided by helpful physicians and lawyers, might find that one's 'quality of life' was insufficient, and order therapies terminated, or allow such termination, which may amount to the same idea. As this idea is carried to its extreme, a court might order euthanasia.

I also wrote, "There was in recent history a nation that institutionalized such murder. They began with the mentally ill, the nursing home vegetables, then the social undesirables. They ended with Europe in flames and rubble. We have now started down that same slope." I've been accused of hyperbole in the above statements. That such things can't happen here. That same statement was made in Germany in the 1930s. Well, guess what- we've a legal system that places strong reliance on precedent. My sailing master taught me that all 'accidents' at sea are the culmination of a series of mistakes and/or careless acts. That applies to bad law and judicial decisions as well. You embark on a slippery legal slope with one or two spectacularly bad decisions- and go downhill from there. We've had the idea of abortion as contraception. Now we have the idea of withholding basic care from those unable to ask for it.

If you can tell me, 10 years from now, that my fears were misplaced, I'll be a very happy camper. And a humble one.