COMMENTARY: CASE POINTS UP URGENCY OF WILL TO LIVE.(Terri Schindler-Schiavo, health care)(Brief Article)

It is evident from e-mails and other communications coming in to NRLC's Department of Medical Ethics that many grassroots pro-lifers are shocked and appalled by the denial of food and fluids to Terri Schindler-Schiavo. Apparently, they cannot believe this is happening in America. (See story, page 6.)

It is appropriate to be appalled, but no one should be shocked.

Denial of food and fluids to people who cannot speak for themselves has been going on for 15 years in this country. It is routine practice in hospitals and nursing homes across the country. And for over a decade, the law on this, established by numerous court decisions and statutes, has been largely settled. If someone who is now incompetent to make health care decisions has not left clear instructions in a legal document (variously called an "advance directive," "durable power of attorney for health care," "living will," or the like), then a surrogate decision-maker can legally decide to cut off the person's food and fluids.

The surrogate decision-maker is normally whomever is classed by the particular state as the closest relative, but if no relatives are available it may be a guardian or even the person's doctor. Such surrogates are daily authorizing the cutoff of food and fluids to patients who are unable to speak for themselves and never gave any indication that they might want to be starved.

Only in the comparatively rare cases when there is some dispute among relatives, such as in the Wendland case in California, the earlier Hugh Finn case in Virginia, and the Schindler-Schiavo case now in Florida, do these cases reach public attention, normally in the context of lawsuits.

It should come as no surprise that, with important exceptions, the prevailing view in the judiciary, as in the medical profession, is receptive to the quality of life ethic. ...