Beyond the Gate

Christian Carnival
This week's Christian Carnival is up at Proverbs Daily. Thanks, Jeff Smith, for the hard work of putting this week's Carnival together!

Next week's Carnival will be hosted by Another Think. You can find participation instructions here.   

New Christian Blogs
Author JD Wetterling has started a new blog. This should be a good one. Visit The Ultimate Reality Check . Get a look at the gorgeous view from his backyard (I grew up in a little town nestled in those mountains, only a few hundred miles north.), and read his introduction to the blogosphere.

Author Barbara Curtis has been blogging at Mommy Life since January. Read this ex-feminist turned mother of twelve (including four with Down's Syndrome--three adopted), as she evaluates the Terri Schiavo case from her unique perspective in The Slipperiest Slope of All.

Nick Queen has posted his latest addition of the Out of the Wilderness, new blog showcase.   This week's featured blogs are Thoughts of a Stranger and Stand Up and Walk. You can read the interviews at Nick's site and then visit the showcased blogs.

King George
GM's Corner is defending his crown as King of the Blogs. Stop by the King of the Blogs site and cast a vote for him and visit his fine site here. It's not often one gets to vote for a king, so vote soon and vote often.

Building Cathedrals
Mark Olson of Pseudo-Polymath hosted his own round-up on the topic of what "Cathedral-building" ought to look like in the modern era of the Church. Head on over there for links to some very thoughtful posts.

Thoughts on Personhood
My friend Akiko let me know about this article by Ken Meyers of Mars Hill Audio. Be sure to follow the last link in the article, which leads to an piece in First Things arguing that "letting Terri die," was morally acceptable, followed by a response to the contrary. Great discussion.

Comments

[Mark Olson]

Thanks for the plug. :)

[shokenjii]

THROUGH A FEEDING TUBE DARKLY

Arigato gozaimashita, Dory and Akiko, for presenting the essay, “Ethics & Life’s Ending,” by Messrs. Orr and Meilaender to the Wittenberg Gate readership. Many ethical issues on tube feeding are covered in this scholarly and respectful treatise -- much to agree, and disagree with – among both conclusions and bases for discussion. And you may question if the choice of sightlines -- from the stomach, through a polyurethane tube of few centimeters diameter, and 12 - 18 inches long – offers a sufficiently broad vantage point to examine ethical issues on dying. [Dr. Orr cites dialysis machine, feeding tube, and respirator as elective, artificial, life-sustaining organ functions. While the kidney and lungs are examples substituted, the feeding tube is not a stomach – esophageal (tube) function can be replaced by a small hole in the stomach wall, scar tissue, and adhesive tape, to enable food and water without artificial aid, if that is preferred. However, life expectancy has increased 50% in our generation – much of it due to artificial means.]

Both writers passed quickly over Cruzan v. Director, Missouri Department of Health (to discontinue life support for Nancy Cruzan in a persistent vegetative state), where initial pleadings were successful as a right-to-choose issue, with the trial court deciding that an advance directive was reasonably inferred, and the patient had refused life support and medical options (the feeding tube). In appeals, however, the State of Missouri prevailed on due process issues and its “unqualified interest in (Nancy’s right-to-life),” upheld by the Supreme Court in 1990. In the recent example of similarly impaired, but conscious Terri Schiavo, the trial judge a) honored her right to choose, and b) found that she too refused life support (the feeding tube), “not (wanting) life artificially extended” (based on Schiavo family testimony, absent explicit directives). This decision was not reversed.

Under provisions recognized in most states, an able person may 1a) stipulate “advance directives,” prior to disability or death -- instructions for a living will, durable power of attorney, organ donation, and preferences for resuscitation and life support; and 1b) or, through an appointed guardian, accept or decline initiation and continuance of optional medical procedures after review (“informed consent”). 2) Additionally in Oregon, a person may terminate life via assisted suicide.

With medical advances, we have come to expect increasing costs and diminishing risks for many procedures. Inasmuch as risks remain, feeding tube placement will stay an elective – thereby requiring go-ahead approval, or informed consent, after patient review. The occasional refusal of life sustaining electives with 90% success rates seems more akin to medically approved suicide than an example of patient’s right-to-choose -- when possessing otherwise normal life expectancy.

My concern continues that informed consent is neither knowledgable nor mature consent. Oregon assisted suicide laws, and equally dreadful provisions now pending in other states, are surprisingly thoughtful in safeguards, and sensitive to stresses that burden moribund patients. In Terri Schiavo’s wake, a simplistic rush to complete advance directives will neither wipe away uncertainties, nor sufficiently educate us; but there is wisdom in placing advance directives, informed consent, and sanctioned suicide on one page -- to make sense of the interrelationships – if only for those choosing to die ahead of schedule.

Medical electives for the morbid are rarely a matter of choosing between tempting flavors of ice cream. Most often, there is really but one choice -- you take it and hopefully extend life. If (tube) feeding is discontinued, Terri Schiavo dies. The judge told us that Terri made the choice herself – death – no signs of hope, no miraculous healing by a merciful God; because those options were never discussed with her.

Many of us remain deeply troubled over the courts and appeals system which paved the way for Terri’s execution, an event celebrated by 2/3 of Americans as a right-to-choose victory. As the Terri Schiavo story continues on television and in the news, I still mull over factors that determined her death.

PVS Diagnosis: PVS is now the codeword for a medical diagnosis – a virtual death sentence for our most vulnerable citizens, including the disabled, and morbid with physical pain and emotional despair. It is apparently a desensitized, socially acceptable form of dumping underperforming human beings. The court and doctors found Terri to be useless. This was the reason for execution.

Trial Court Ruling: Armed with a PVS diagnosis, it was possible for Terri’s feeding tube to be disconnected by guardian approved, informed consent provisions -- it was installed under the same conditions. However, with legal action by the Schindlers, judicial review was required to confirm removing artificial life support. It is curious that direct entry of food and water to the stomach was not permitted, to enable Terri to live without artificial life support, yet satisfy feeding tube removal. The trial court ruling is further puzzling because a) only testimony by two Schiavo family members was accepted, b) to determine intent of an often unsure Terri Schiavo with ongoing health problems; and c) all evidentiary findings were cursory and offhand, emotional comments by Terri at dying relatives bedside or funereal settings – no calm, deliberate discussions on death or advance directives in more than five years of marriage, from age 20 through 26. This was the instrument of execution.

Guardians I (Trusted Custodians): Were it not for diverging decisions on custody cases overflowing football fields, this is the area of law where the battle over a living Terri Schiavo should have occurred. With the husband Michael Schiavo’s now unquestionably divided loyalties, coupled with the family request to assume Terri’s personal care, Judge George W. Greer, should have reassigned custody, in favor of life. These were the executioners.

Guardians II (Public Trustees): Some newspapers and politicians made Terri Schiavo a referendum on right-to-choose – a real life, blood sacrifice. Yet, considering her youth prior to cardiovascular accident, it is unlikely that she made an informed and focused choice about dying. Maybe it was really a strained, unhappy inter-family matter, where her parents blamed the son-in-law for their daughter’s impairment; and in turn, the husband grew to dislike his in-laws sufficiently to destroy the contentious symbol they treasured most. However it evolved, it ended with a public majority misled and polarized – these were the witnesses, applauding a disabled woman’s execution.

Until there is widespread wisdom to respect the value and brevity of each life, we who have committed our lives to God’s timing, need to persevere on watch -- to provide shelter for the disabled and the innocent – and to always side with life and the faint sounds of trumpets over a distant hill. We must not forget either the desperation or faith of those in the Gospels who preceded us -- placing ailing friends and loved ones at the feet of a humble carpenter for miraculous healing – and for triumph over death.