From the Guardian:
The Italian government has been plunged into a constitutional crisis over the fate of a 38-year-old woman who has been in a coma for the past 17 years. Eluana Englaro was left in a vegetative state after a car crash in 1992. After a decade-long court battle, doctors reduced her nutrition on Friday in preparation for removing her feeding tubes, which her father claims would be in accordance with her wishes.But in an extraordinary turn of events, the country's prime minister, Silvio Berlusconi, after consultation with the Vatican, has issued an emergency decree stating that food and water cannot be suspended for any patient depending upon them, reversing the earlier court ruling. On issuing the emergency decree, Berlusconi declared: "This is murder. I would be failing to rescue her. I'm not a Pontius Pilate."
Justifying his campaign to save Englaro's life, the prime minister added that, physically at least, she was "in the condition to have babies", a remark described by La Stampa newspaper as "shocking". Giorgio Napolitano, Italy's president, has refused to sign the decree, but if it is ratified by the Italian parliament doctors may be obliged to resume the feeding of Eluana early this week.
Thanks to all the readers who sent this in to us, and check out the conversation about this on the community blog on Nettle Syrup's post.
The issue of the "right to die" has been bubbling up over the last few years, particularly in light of the Terry Schiavo case. Euthansia, medically assisted suicide, all of these issues are things that our governments are going to have to deal with in the coming decades. But this Italian case would seem to be more straightforward, when someone has been in a coma for the better part of two decades.
Apparently not. The fact that the Italian Prime Minister (after consulting the Vatican, which was obviously a terrible idea) is using her reproductive capacity as a reason to deny her the right to die is absolutely absurd. This kind of logic really makes me wonder if more people than I'd previously thought really do see women as fetal containers.
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Okay, though I disagree with it, I kinda get the general idea behind wanting to keep her alive. (Kinda.) However, the comment about her still being able to bear children and this somehow justifying the argument makes me ill. Does this mean that if she stays alive until after she's gone through menopause, it'll suddenly be okay with them to remove her feeding tubes because she can't have children?
But all they'd need to do is get her pregnant and then she can be a comatose mother!!/1/1
I sympathize with people who wouldn't want to see her die, especially close family, but I think it's so stupid that people wouldn't respect someone's wish to die if that is truly what they wanted.
In this case I think its her family that wants to remove the feeding tube.
Its always a tough call if the person didn't leave specific instructions, but I think if the doctors say there's no chance of brain activity ever coming back, you're dead.
I have been following this case, which has been going on for years, and this is the first I have heard of the PM's inclusion of reproductive capacity as a reason for keeping her alive. Which is bizarre, sick, and beside the point.
The reason it has been such a big deal is that it was judged against Italian law, then legal, but no nursing home caring for her would do it. Everyone thought it was a disgusting act and immoral. The dad has been trying to find a place to move her to where they would do it. (I am not sure why he didn't take her home himself and just have a nurse come and remove it, but, maybe that was just too much for him.)
I am not sure what "consulting with the Vatican" entails (notice this was not detailed), or why Miriam calls it such a horrible idea. Linking it in the article by following it with a statement about her ability to have babies seems to suggest a connection between the two. But I find it very hard to believe.
Ah, rereading the article it seems as if the Vatican called the PM -- not the other way around-- in order to lobby him to help keep her dehydration death from commencing.
Which makes it even more confusing as to why the comment from Miriam about the Vatican?
The Vatican has no business interfering in this matter.
First of all, isn't the Vatican technically considered to be it's own country? So why are they even involved in this?
Second of all, is this person that was consulted at the Vatican a doctor? My guess is no. If not then they have no need to be consulted as this is a medical issue.
That's why Miriam is saying this is not a good idea. The Italian PM is making this a religious issue instead of a medical one, which is what it actually is.
I do not think that issues of medicine are ONLY medical issues; many are ethical issues as well.
Think about it: How many people brought up all kinds of moral statements wrt the octuplet lady and her conception/implantation of that many embryos? Why isn't it ok to experiment on the criminally insane as long as there is good pain medication given? Why can't we promote buying eggs from poverty-stricken women and using them in the developed world for fertility clinics or medical research?
The Vatican is one internationally prominent organization that is religiously affiliated, and which has in the modern world they repeatedly spoken out in favor of peace, the rights of people not to be exploited, and the inviolable dignity of people who are not to be reduced to numbers or material for the state or corporate machine to use and discard. It's also entirely possible that the bishop or cardinal who spoke with the PM was a doctor. They usually are, on the medical ethics commissions.
Look, I know some people here would call the Vatican patently evil and opppresssive, and wouldn't care if they DID get some opinion about human rights correct because all the others are wrong. I am not trying to convince those people of anyhting. I just find it appalling how often I hear immediate dismissal of anything that comes from the Catholic Church or other major religions. If you are determined to say that all religion is bad and can never have anything useful to contribute to larger society, then fine. Nothing much I can do about your prejudice.
But not everybody thinks that religious groups should never speak in public about anything not specifically about themselves. It's a ludicrous idea.
But if the family has already made this decision (I mean they are the ones that knew this woman best) then don't you think they're already wrestled with all the moral dilemas? The Vatican has no business here. And the reason it's a medical issue is because the Vatican is claiming the reason she should be kept alive is to basically house babies. What kind of ethical garbage is the Vatican spewing there?! They are citing a medical reason for keeping her alive. So this should then just be left up to her doctors and family.
See my other posts (if you want) for my argument about the problems with having the family decide, especially without a direct statment related to food and water specifically, that an otherwise functioning person should die.
As far as the Vatican goes, unless someone shows me that the statement to the PM was "She should not be killed! We can use her as a baby factory!" I do not believe for a second that was their message.
The CAtholic Church opposes withdrawing food and water from anyone who is otherwise healthy, no matter what their gender or baby-making possibilities. They have absolutely no reason to invoke that as a justification. Nor would they.
The PM, sexist assh**e that he is, was using her reproductive capabilities as an example of how her body is completely functioning all on its own, separate from a nutrition tube.
Maybe you should read the thing, in stead of relying on stereotypes to inform your opinions.
That statement is so wrong, I'm not even going to bother with it because I'm sure other commenters will express a similar disgust.
But everyone should take this as a reminder to WRITE A LIVING WILL! and talk to your family about what you want to happen should you be permanently incapacitated. There's no guarantee everything will be followed the letter, but it gives voice to your wishes when you are no longer able to do so. A document with an explicit statement of what you want to happen is much more powerful than a family member remembering a conversation you once had a few years back where maybe you might have said you wouldn't want to be kept alive as a vegetable. A casual conversation holds little weight and doesn't address the various issues that can arise (For example: maybe you don't want to have a machine breathe for you, but if you can still breathe on your own you'd like to be kept alive via feeding tube). It's not a pleasant task but it's not fair to leave your family and the courts trying to decide what you would want when you are no longer able to speak for yourself.
I understood from the BBC article that, while a person may refuse treatment, living wills are illegal in Britain.
I understood from the BBC article that, while a person may refuse treatment, living wills are illegal in Britain.
Ugh. I meant Italy. Stupid brain.
Noted. Put a little asterisk at the end of my post and include
*if living wills are legal in your country.
OK- just one more, sorry I really have been involved in this case a lot (in my own head, at least) but the term "right to die" is so bizarre to use here. This woman did not ask to be withdrawn from food and water. Her father is doing it for her, conjecturing that she would "never want to live this way." She never gave any indication that she knew what this measure (of removing hydration) would mean, and it is a far cry from saying, "Do not resucitate me if my heart stops and I am already dying from something else."
This is an important topic becuase I find the whole idea of someone else making claims about what someone would want to do with her body, without direct evidence of that opinion, to be very very disturbing. Particularly when it involves life and death. It also smacks of the idea that people would "rather be dead than disabled," which is a prejudice against the disabled that I find offensive all on its own, but especially when you project it onto somebody else who is not in a position to tell you.
She's not disabled, she's a vegetable. It's not like she's blind or can't walk. She can do nothing. There is quite a difference, and quite frankly, I would never, ever want to put the financial burden of keeping me artificially alive for seventeen years on my family.
I am not trying to be rude, but I find it interesting that your criteria for value is the ability to "do" something.
And that you seem willing to impose your own personal beliefs about what constitutes a burden, and the proper treatment of the person herself, on another.
I was bringing up the "better dead than disabled" mindset for this very reason. Most people, when they are healthy and strong, have the immediate reaction against any kind of weakness or disability in themselves. But how is a person who is healthy to know, really, what they would want when disabled? This prejudice allows us to impose our own beliefs about worth and quality of life on others, and has already led to some cultural shifts that suggest people who are disabled OUGHT to remove themselves from being a burden. For G-d's sake, the director of Aging in the UK said she wants voluntary suicide for older people, and admitted that she hopes not to have to care for her aged parents!
It's the "better dead than disabled" mentality that leads to... many things, but I will just highlight this one: The speculation that one cannot imagine life as (insert: quadraplegic, cripple, depressed person, mother of eight, etc...) can lead to the extrapolation, years later and by people who may or may not have YOUR interests in mind (an ex-husband who has already started a new family, or an insurance beneficiary, or an exhausted caregiver, or a hospital looking at its bottom line) that you would never want to live "THIS" way. And, despite the fact that your body is otherwise functioning, you are starved to death. I personally know more than one disabled person who depends on the paid labor of others for some daily care, or who have ability relating to others and communicating their thoughts to the outside world, and they live every day cognisant of how much they depend on others' assessment of their own so-called quality of life or ability to "do" things in order to continue living.
This poor girl may or may not have ever woken up again, and she may or may not have been conscious of anything (PVS is a catchall term, like schizophrenia, and is not well understood or even agreed upon as a diagnosis.) My point is that the mindset that allows someone else to decide how you would want to live in a given situation, without your express and specific wishes known (which is sketchy even then, because how many people change their minds and DO want to live?)... this is a *dangerous* area.
Am I alone in feeling this way? Doesn't anyone else think about this stuff? (Did anyone read my rant? Thank you for plowing through.)
You are not alone in your feelings.
However, there IS a difference between having a disability and being completely braindead.
And by "do" something, kissmypineapple did not mean save the world, have a child, cure cancer, she meant NOTHING. The woman cannot open her eyes, she most likely cannot have a conscious thought. She IS different from a disabled person who can see and/or think and/or feel and or/walk or talk or what have you.
It isn't that her life does not have value. Its that her father says that she never would have wanted to be kept alive by machines in this manner, and he wants to honor her wishes. Do her wishes not have value?
I totally agree that there is a basic difference between PVS and other disabilities.
However, leaving aside the fact that a persistent vegetative state is a kind of "catchall" diagnosis, about which there is very little known and on which doctors often disagree wrt a single patient, here is my problem with this kind of decision-making, in her situation:
1) The desire to "not be kept alive by machines" is quite different from "not given food and water." Some people incorporate the understanding of both into their stated wishes, others are only picturing the machines that pump your heart, or breath for you. If a person did not state explicitly what they meant, how would we know they were talking about basic sustenance?
2) Furthermore, these machines often have a level of uncertainty built in: If you take the breathing aparatus away, docs might think that you will likely die, but there is always the possibility that you will breathe on your own. However, if you take away someone's food and water, you WILL die. (I am also thinking about Terry Schiavo here, in which she was able to be fed via a spoon but the court inexplicably ordered that she not be spoon fed! This is outright killing! NOT keeping someone alive "with machines")
3)Her family might be the most loving and reasonable family on the planet. They might not be, too, and also as I pointed out above there is no guarantee that they will be working completely in your best interests. An exhausted caregiver , who needs support or relief, could be the sad reason for your death by dehydration. Or, a selfish ex-husband who has already spent your insurance windfall and wants to move on to his new life. Or a hospital that wants to get you out of its space.
ISTM that, in the absence of a direct statement about food and water, this is one thing that should NOT be removed from an otherwise functioning person. We ought to err on the side of protecting the person's autonomy by NOT ASSUMING that they would want death if they cannot contradict you.
Further, this is especially important for a PVS, because a person in a persistent vegetative state is most likely not suffering the consciousness of his or her own condition. So in essence, we say, "we will not kill people off on speculation!"
(If you take issue with "otherwise functioning", and claim that it's different because she is not, then you must argue that she doesn't deserve to err on the side of living because she is not doing anything, and this has implications for what you say is a person, or a person worthy of being sustained. If you say that the cost of keeping that person alive when they have nothing to contribute to the world is too expensive, then you are also putting a dollar limit on how much a person is worth versus their productivity. These are DIRECTLY applicable to the disabled community, some of whom are unable to feed themselves or move. And many disabled people with health problems have encountered pressure to sign DNR's, and to refuse medical help in the event of emergencies!
Not to mention that utilitarian understandings of human life completely degrade the notion of human rights.
Think about it: the death of Terry Schiavo in this country was NOT just protested by conservatives, "right-to-lifers, "wingnuts" etc. It was protested nationally by disabled-rights organisations, liberal atheists like Nat HEntoff, and other liberals like Ralph Nader. It is because of the underlying attitudes that go into deciding what they decided, beginning with the lack of credible evidence that the person stated she would want to be starved to death rather than live as a disabled or non-conscious person.
People who have completely unexamined thoughts
on the subject tend to equate food and water with artificial respirators and claim that other people can extrapolate what you would have wanted in this state without your direct statement. But this can't go on! Think, people! It is too easy to abuse people from here!
"Without direct evidence"? This is her family we're talking about!
Just quickly: Your family may or may not know what you would want in a given situation. Mine would, others' might not. We also can never be sure that it is OUR wishes and not their own that are being carried out. I have seen both cases. (Read my reply above, if you like.)
FYI, the BBC News website reports that Ms. Englaro has just died.
http://news.bbc.co.uk/2/hi/europe/7880070.stm
FTA: "Italy does not allow euthanasia. Patients have a right to refuse treatment, but they are not allowed to give advance directions on the treatment they wish to receive if they become unconscious."
FTA: "Italy does not allow euthanasia. Patients have a right to refuse treatment, but they are not allowed to give advance directions on the treatment they wish to receive if they become unconscious."
Seriously?
Her brain doesn't work, but her uterus might; thus, it's worthwhile to keep her alive after 17 YEARS in a coma. :shudder:
Haven't they heard the Terri Schiavo story?
Given how little information we have in this short blurb, I hesitate to comment on the "right to die" issue. Whether Ms Englaro is likely to wake from her coma, and what her quality of life would be in that instance are topics for her family and doctors to discuss.
Having said that, I have to express my disgust at the prime minister's reasoning behind prolonging her life as it now stands. If her only value as a human being lies in her potential as an incubator, and she is in no condition to give consent, then the only way she could become pregnant is through non-consensual means. I'm pretty sure that's rape, even if done through artificial means, and I can't imagine the Vatican endorsing such a horrible crime. Either they're clinging to incredibly faint hope that Ms Englaro will come out of her 17-year coma with her mental faculties intact, make a full physical recovery, and want to bear children in the time before she reaches menopause. It doesn't sound to me as though they've really thought their own argument through.
Considering what a misogynist asshole the PM of Italy is, I'm not surprised.
Does anyone here know the physiology of a vegetative state? For instance, does one have the capacity to feel pain or does a persistent vegetative state negate such a possibility?
If she can't feel pain, and wont wake up, then taking her off her feeding tube is humane. If she CAN feel pain, then euthanasia would seem to be a better route rather than a slow death due to starvation...
In any case, it's sad that her life has little meaning more than "baby factory" to the vatican/PM.
A freaking court determined that she expressed the desire to die rather than be kept alive artificially prior to the accident, but this gasbag Berlusconi and a gang of Vatican thugs are saying it's a crime against humanity to let people decide what to do with their own lives. But I suppose it's progress considering their history of burning people at the stake left and right and using Malleus Maleficarum as a manual on how to deal with women.
The body snatching from the Italian Government is sickening, indeed.
I'm glad she found her peace as she passed away last night.