Recently a friend commented that he thought I had joined the religious right in reference to Terri Schiavo, and it has occurred to me that I must have done a poor job of delineating my position as I have tried to explore the expression of the life and death instincts in our culture. I see many difficult issues in this case, legal, moral, ethical. Legal issues have been addressed by many other more knowledgeable people than myself and I am comfortable with the idea that the legal system has worked as it is supposed to in this instance (working correctly, not necessarily justly.) Pulling Terri's feeding tube is, apparently, legally correct. That leaves the question of whether or not it was just and morally proper. Here I think we begin to see the collision between the personal and the political (by which I am referring to the effect on and the role of the "body politic", the culture at large.)
For an excellent summary of the history of Terri Schiavo's death, John Hawkins of Right Wing News has put together a FAQ on the case. While there are many questions about it, I suspect most Americans are comfortable with stopping all heroic life saving measures in hopeless cases (although a feeding tube hardly qualifies as "extraordinary means" as far as I can tell.) Anyone who is in such a state would hope that no state authority would or could intervene between them and their family. One positive outcome of the entire sad situation is that so many people will now take the time to think about the unthinkable and make living wills, assign health care proxies, and make arrangements for their wishes to be known and respected.
In Part I of this series, I discussed some of the history of the concept of Thanatos, or the Death Instinct, introduced by Freud in an effort to understand the seemingly inexplicable tendency of some people to harm themselves, up to and including suicide; this went against everything he had believed in establishing his theories around libido, the life instinct. In Part II and Part III I tried to draw a parallel between the vagaries of the instinctual conflicts within an individual and its expression within a culture. The idea of a culture reacting to unconscious drives is, of course, speculative, but the metaphor has some usefulness and may even have some grounding in the reality of our zeitgeist.
To continue the metaphor, it seems to me there is a common thread running through much of our political discourse today, and that reflects the balance between Libido and Thanatos, the drive for life versus the drive toward death. In the case of Terri Schiavo, the passion with which both sides of the argument are fighting suggests its origins lie in, and are fueled by, unconscious drives. After all, one could conclude it would be best for her to be allowed to die while recognizing the sadness of her situation and acknowledging that there remain unanswerable questions and there are no winners here; yet too much commentary shows an angry, dismissive tone to those who wish her to continue living and gleeful satisfaction when court judgments go against her family's wishes. At the same time, her more extreme supporters show the evidence of their drive processes when they threaten dire consequences to politicians for not breaking the law to save her life. Both sides proclaim they are fighting for her rights, yet where is the greater loading of Thanatos? Terri Schiavo's death is an endorsement of death as the default position in cases where the wishes of the patient are not and can not be known. This is dangerous. If we could always be sure that we were only acting out of rational motives, perhaps this could be done safely. Unfortunately we can never be certain of all of our motives. Unconscious mental processes take place out of our awareness, with a growing body of recent research suggesting that much of our behavior consists of actions, followed ex post facto, by conscious explanations. Obviously, we cannot allow ourselves to be paralyzed by indecision; we cannot wait until all our motivations are known before acting, but we would be wise to assume that not all of our motivations are pure. If death is the default position for those whose quality of life is inadequate, we are already sliding down the slippery slope. The next step is simply to codify what makes a life worth living. The Europeans are ahead of us here; we all know they are much more sophisticated than the rubes of the new world (and they do have much more experience determining who deserves to live). Hugh Hewitt wrote about the Groningen Protocols in Death by Committee last December:
WHEN NEWS of the Groningen Protocol surfaced in October, it was reported in the Grand Forks Herald,though I didn't read of it, nor apparently did many others. The Groningen Protocol could have been the stuff of a fine presidential debate question, or a series of questions, but I doubt if any of the debate moderators or either of the presidential candidates had heard of it either. It is an intriguing title, but it should enter the history books as shorthand for an appalling brutality, so appalling in fact, that "The Groningen Protocol" could have been an entry on the agenda at the Wannsee Conference.
The Groningen Protocol is the proposal of doctors in the Netherlands for the establishment of an "independent committee" charged with selecting babies and other severely handicapped or disabled people for euthanasia.
Understandably some disabled people have been frightened by the outcome of the Terri Schiavo case. James Taranto at Best of the Web described their reactions:
Some of the most passionate commentary on the Schiavo case has come from people with severe disabilities. One is Harriet McBryde Johnson, who wrote in Slate last week:
I watch nourishment flowing into a slim tube that runs through a neat, round, surgically created orifice in Ms. Schiavo's abdomen, and I'm almost envious. What effortless intake! Due to a congenital neuromuscular disease, I am having trouble swallowing, and it's a constant struggle to get by mouth the calories my skinny body needs. For whatever reason, I'm still trying, but I know a tube is in my future. So, possibly, is speechlessness. That's a scary thought. . . .
I hope against hope that I will never be one of those people in the shadows, that I will always, one way or another, be able to make my wishes known. I hope that I will not outlive my usefulness or my capacity (at least occasionally) to amuse the people around me. But if it happens otherwise, I hope whoever is appointed to speak for me will be subject to legal constraints. Even if my guardian thinks I'd be better off dead--even if I think so myself--I hope to live and die in a world that recognizes that killing, even of people with the most severe disabilities, is a matter of more than private concern.
And here is Mary Johnson, editor of Ragged Edge, a disability-rights magazine:
No; it's not about Terri Schiavo. And it hasn't been for quite awhile.
It's about us.
It's about each of us who thinks "I wouldn't want to live if I were a vegetable." It's about each one of us who thinks, as one blogger wrote, that Michael Schiavo has been "chained to a drooling sh--bag for 15 years."
But it's also about those of us who are those vegetables, those drooling sh--bags. Those of us who want to live but know we're a burden to our families. Those of us who fear "do not resuscitate" orders. Those of us who use ventilators, and who use feeding tubes. And those of us who can communicate with clarity only through artificial means. . . .
There isn't a single disability rights activist I've heard from who is happy that things ended up at such a sorry pass, and who isn't afraid that this will make liberals hate them even more than they now do.
Still, their perspective is worth considering. An able-bodied person may look at Terri Schiavo and think: I wouldn't want to live like that. Someone with a severe disability is probably more apt to hear the talk of Mrs. Schiavo's "poor quality of life" and think: I don't want to be killed like that.
This should alarm you; it alarms me. If Doctors, with the understanding of the patient and their family, decide to assist a patient to hasten their end, or allow a hopelessly brain damaged person to slip away, they will have to come to terms with their own conscience and morality. If a society decides that starving a brain damaged person to death, or euthanizing hopeless cases, will become the law of the land, we are in a terrible fix. If the right to die is legislated, the right to kill, only for the best of reasons, will inevitably follow. Consider that the right to kill those whose quality of life falls below our thresholds will be much easier to exercise than the right of society to exact capital punishment from those who have murdered innocents; this would be a triumph for Thanatos.
Libido always falls before Thanatos; the strength of the Libido wanes throughout the life cycle, and while the passion that arises from Thanatos may weaken (rage is an emotion for the young and begins to diminsh by middle age), its expression is certain in the end. We would be wise to do everything we can to delay its expression in our society, lest we prematurely fall victim to it ourselves. Death has a habit of increasing its sway. It is further speculation, but tempting speculation, to wonder if the left, which has done so much to interfere with our ability to protect ourselves (in war, we express Thanatos in the service of Libido), which is at the forefront of the right to die movement, and which has glamorized revolutionary violence for so long (Che, Castro, Michael Moore's "Minutemen", et al) is now unconsciously pushing an agenda contaminated by Thanatos.