Hey all, for the most part a very thoughtful discussion. As someone in the US healthcare field, let me give some definitions and facts of the case. I can tell you that legally and ethically this is a slam dunk case in favor of removing Terry’s feeding tube. We all agree that politically this has turned into a fiasco. Your moral stance (which is different than the ethics involved) is your own opinion and the cause of most of this thread’s debate.
Euthanasia: an intervention used by the physician with the goal of terminating the patient’s life. This is neither legal nor ethical in the US (although physician-assisted suicide (slightly different definition) is legal in Oregon). Note that the specific cause of death with euthanasia is the physician’s intervention, not the underlying illness. Using this accepted definition Terry’s case is not an issue of euthanasia:
Withdrawal of life-sustaining treatments: The removal of burdensome interventions. This is legal and ethical in the US. Note that the specific cause of death is the underlying illness, not the intervention. Interventions include ventilators, feeding tubes, etc. Terry’s case falls under this category.
Persistent Vegetative State: Numerous physicians have declared Terry to be in this state. Her husband, for 4 years, took her around the country getting 2nd opinions before finally accepting this diagnosis. Also, Terry’s parents have testified in the past that they accept the diagnosis of Terry being in this state. Various neurological exams and imaging and functional studies have definitively shown Terry to be in this state. She has no cortical function left, only brainstem activity.
I strongly disagree with previous statements on this thread that have stated that Terry is suffering or that we don’t know if she’s in pain or not. The appreciation/recognition of pain is a cortical function. Even the most primitive aspects of pain are above the brainstem level. Although I have never personally examined Terry, from what I’ve read there is no medical doubt that Terry does not have the brain functions necessary to process pain. This renders the issue of the humanity of starvation moot, although I can tell you that it is a relatively benign way to die.
The question, then, is what would Terry’s wishes be? Without living wills or advance directives, we can only go by hearsay. The term hearsay has a negative connotation, but is still valuable. The courts have determined, over a dozen times, that there is credible evidence that Terry had expressed in the past her desire not to be a vegetable. This isn’t hard and fast evidence, but Scott Peterson was convicted on less evidence than this, and not many of us would argue with his conviction. In testimony, Terry’s parents have stated that even if Terry had told them she wouldn’t want a feeding tube, they would still use one. In the US, courts have overwhelmingly sided with the patient in these types of cases. It varies by state, but most states, including Florida, have the spouse as the surrogate decision maker for patients who cannot make their own decisions. Parents are usually next in line. Whoever it is, however, must use substituted judgment, meaning they must act in what is believed to be the patient’s wishes, even if they are contrary to the surrogate decision maker’s opinions. Terry’s husband (her surrogate decision maker) is honoring her wishes, her parents, who are not her surrogates, are not. This is why higher courts are refusing to hear the case: it’s a slam-dunk case that has been legally settled. The only good thing to come out of this is the public’s awareness of advance directives and legal wills. I encourage all of you to write down your medical wishes and to discuss them with your significant others.
