If That Ever Happens to Me: Making Life and Death Decisions after Terri Schiavo

By Lois Shepherd | Go to book overview

7
QUALITIES
OF LIFE

At the end of the last chapter, I argued that someone who is in a permanent vegetative state should be treated differently from someone who is terminally ill or someone who is minimally conscious. In doing so, I have opened myself to the charge that I endorse “quality-of-life” distinctions—a perspective that disability rights groups decry and a number of courts have cautioned us against.

Why are quality-of-life assessments disturbing? Because when a life or death decision is made based on quality of life, it seems that the decision-maker is saying that the life has no value or too little value. And therefore others should not undergo the cost, the pain, and the trouble associated with keeping the individual alive.

Quality-of-life assessments are not as much of a problem when patients are competent to make decisions for themselves, because if they choose to refuse treatment based on quality of life, it is their own assessment of that quality that is controlling. Of course, the issue is not entirely absent with competent patients, either, because if they are refusing treatment when their prognosis for a healthy life is good, then doctors and others will question their competency— or perhaps merely insist upon a delay in order for them to be talked around to a different point of view. If the prognosis for a healthy life is poor, however, then doctors and others may confirm the wisdom of a patient's decision.

But when patients are incompetent and others are making the decision about life-sustaining treatment, then families, doctors, and courts (in individual cases) and legislators (in setting general legal parameters) are, to some extent, unavoidably, judging the quality of people's lives to determine whether that quality is high enough to be worth the burdens of continued treatment.

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If That Ever Happens to Me: Making Life and Death Decisions after Terri Schiavo
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Acknowledgments ix
  • Introduction 1
  • 1: Disorders of Consciousness and the Permanent Vegetative State 15
  • 2: Legal and Political Wrangling Over Terri's Life 35
  • 3: In Context— Law and Ethics 57
  • 4: Terri's Wishes 77
  • 5: The Limits of Evidence 96
  • 6: The Implications of Surrogacy 112
  • 7: Qualities of Life 128
  • 8: Feeding 143
  • 9: The Preservation of Life 162
  • 10: Respect and Care an Alternative Framework 173
  • Appendix - The National Right to Life Committee's Model Starvation and Dehydration of Persons with Disabilities Prevention Act 189
  • Notes 193
  • Bibliography 201
  • Index 215
  • Studies in Social Medicine 223
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