Schiavo on Thursday: Loss of Patient Autonomy on Friday?
The Schiavo case is to be affected by some action taken tomorrow, Friday March 18, 2005. The feeding tube of this lady in a persistent vegetative state may be pulled or some laws either in Florida or the U.S. Congress will be signed. The pulling of the tube is legal and ethical and represents the substituted judgment provided by the Mrs. Schiavo’s husband as the court confirmed legal surrogate. The laws which may be signed tomorrow will all be suspect and surely will undergo court scrutiny. The reason for the legal concern about these laws is that they will upset the whole ethical and legal concept of the court appointed or the patient’s advance directive appointed legal surrogate and remove the powers such an appointment currently provides. In effect, it will no longer be the legal surrogate to speak for the incompetent patient regarding what is known as the patient’s wishes but it will be the Florida legislature or the U.S. Congress who will make the decisions or allow other individuals or committees or judges to do so. And that will be a tragedy since these laws if passed will not only affect the decision making of this one tragic medical case but will affect all decisions by legal surrogates both in Florida and perhaps throughout the country.
The Schiavo issue is not one of termination of this patient’s tube feedings but has turned into an issue of termination of all the rights for autonomous personal medical decision-making for all patients. Mrs. Schiavo will never recover, with or without the tube feedings and that is sad but the greater sadness is that if these laws are signed, an important part of the ethical and legal ideal of autonomy and free choice in America will be lost. A big day, Friday. ..Maurice.