I have been writing quite a bit about Narcissism and its vicissitudes; I believe we are seeing, in real time, an example of an unintended consequence of our cultural turn to narcissism over the last 30-40 years.
One of the characteristics of the narcissistic is a lack of empathy. This makes sense, since the narcissist is typically concerned with the other only in so far as they can do something for him (offer emotional supplies of one kind or another). The unconscious equation is, "I need you because of what you can do for me" and "what you can do for me" primarily involves enhancing my self esteem. Being raised in a culture which celebrates narcissism (some have proposed a new diagnosis of "acquired narcissistic character disorder" to describe people whose celebrity has allowed them to essentially get away with doing whatever they want, and in fact, rewards them for it) has lead to devaluing empathy as a trait. For one example, think of the athlete who "disses" his foe when he is winning; the win is not complete without the added frisson of humiliation for the loser. Athletes with the proper "attitude" are routinely rewarded. In similar fashion, no one tells celebrities that they should hide their ignorance or indulgences; they are often rewarded with increased exposure for their foolishness. Nowadays, there is no act so shameful or heinous that someone can not use it to make money and attain celebrity stature.
Which brings me to yesterday's decision to remove the feeding tube from a woman who has been in a "near persistent vegetative state" for ~15 years, Terri Schiavo. Many people have written lots of words about this case. I will not recap the entire story, but would summarize that she has severe, though unspecified, brain damage, may or may not be responsive to her environment (her family and her husband, who is now living with another woman with whom he has two children, disagree on this). The aspect of this case I am concerned with is the thorough lack of empathy for the woman displayed by the court's decision to remove the feeding tuber.
Empathy involves the ability to put oneself into anther's shoes; ie, imagine yourself in their position and imagine how you would feel and what you would want. Our empathy allows us to imagine how other people feel and allows us to see them as real, three dimensional human beings, rather than objects. Some people have minimal capacity for empathy and show themselves to be cold and unfeeling; sociopaths generally have minimal empathy (empathy makes it difficult to be cruel to other people.) Even people who do have a capacity for empathy can easily lose the ability in certain times and places. Certain defenses, such as intellectualization (she is not a person but a body in a persistent vegetative state) or rationalization (she won't feel anything) allow us to distance ourselves from the painful awareness of another's suffering and humanity. While I am pro-choice I am also aware that it is much easier to abort a fetus than a real human infant (which is why my pro-choice would end when the fetus has reached the point of viability); it is easier to starve a comatose, PVS, than a real person of uncertain sensitivity. If the question was only whether or not to stop heroic life saving measures, (for example, taking a patient who has a hopeless prognosis off a respirator), then the question, though difficult, is clearer. Furthermore, when we know for certain that a person would want to be starved to death (actually, we are talking about death by dehydration, since she will die of thirst before starving to death) if they fall into a persistent or near persistent, vegetative state, then the question is also easily solved. However, in this case, where this woman never told anyone else of her wishes to die if faced with her present circumstances, with nothing in writing, we are taking a terrible risk as a society deciding that we can starve this woman to death with less safeguards than Scott Peterson will receive on his way to a probably indefinitely postponed date with a needle for a painless transition to his death. While the claim is made that she will not suffer, there is no way anyone can know that. People in comas who recover often have snippets of memory of events during their unconscious state. Patients who have been paralyzed in surgery but inadequately anesthetized, have told of feeling the pain during the procedure (luckily a very rare occurrence). There are people who have had brain stem strokes which leave them in a "locked in" state where they are apparently awake but unable to communicate. There are rare cases of recovery and some of these patients do remember having awareness of their situations and their environments; these cases fuel the Schiavo family's hope for a miracle. Ultimately, we have no way of really knowing what is going on in their minds.
Without knowing what is going on in Terri Schiavo's mind, we are left with the next best thing, our empathy. Imagine yourself being compelled to starve to death. If you were guaranteed you would feel no suffering, would you agree to this? If you were told there was a 10% chance you would experience all the pain and suffering of starvation and dehydration and then die, likely after first having seizures, would you accept that risk? 25%? 75%? We have no idea what she is experiencing and no way to find out. If we are not willing to give her the needle, we should never agree to withhold food and water.