It is an interesting, and perhaps vastly unsatisfying element of the Terri Schiavo case that the manner of letting her die is starvation. If the decision is to let her body die, why take what is arguably one of the most morbid paths to that end? Why not do it quickly by another method?
As I see it, it is the result of what I consider a flawed philosophical viewpoint: that being passive, that by withholding action, we absolve ourselves of responsibility.
There is the belief that if we actively do something, then we are responsible for that action and for the outcome. However, if we are able to act but decide not to, then somehow we have no responsibility for what happens as a result. This belief may seem reasonable at a glance, but a deeper consideration reveals that it is hollow at best, and an excuse for unethical stances at worst.
It is my opinion that we cannot, in most situations, choose what we are and are not responsible for; that determination is made by what we are able to do, not by what we choose to participate in. If you are able to act but decide not to, then you are just as accountable for the result as if you took direct action instead. In short, responsibility does not stem from action, it stems from choice. Both action and inaction are choices, and both result in personal responsibility.
But we fool ourselves by saying that since we did nothing, that we are not involved, and so nothing can be our fault. That’s wrong, and it can easily be proven so. You walk down a street and see a person immobile and bleeding to death. No one else is in sight. You have two options: call for help and save the person’s life, or walk away and let them die. Sure, you weren’t the one to hurt them in the first place, and no, you did not choose to find them. But could you truly walk away with a clear conscience? The answer is, of course, no. Inaction would have consequences just as clearly as action would; your choice determines your responsibility. If you walk away when you could save that person, then you are just as responsible for their death as the person who hurt them in the first place, because your choice caused them to die.
This choice is often mitigated, in the eyes of many, by personal sacrifice. What if saving the person’s life would cost you something? What if you knew that it was a gang killing and there would be retribution against you? In that case, you would have to balance the risk to you and the responsibility of causing that person to die. There is a point at which it might be understandable, if the risk to you were excessive. Few would fault you for not jumping onto the railroad tracks to save someone about to be hit by a train if there were a fifty-fifty chance that you both would get struck and killed.
Less exonerating is the “why me?” factor. I didn’t choose to be put in this situation, so I should be free to leave it. Well, it may suck to have to make a choice like that, but life isn’t fair. If you find yourself with the choice to act or not act, then the responsibility is yours, like it or not. “It’s not my problem” is an excuse, not a reason.
Then there’s the question of how far this idea can be taken. For example, I always have the choice of keeping all my money for myself and buying cool and comfortable stuff to make my life more enjoyable. Or I could get a minimally livable apartment, eat as cheaply as possible, not get myself any goodies and stash away just enough to survive in retirement–and give every other cent I earn to people who need it more than I do, so they can avoid disease, starvation and have enough to survive. The choice is mine. If I am selfish, I keep the money, but by doing so, I let others suffer who could have used that iPod money for food and medicine.
Few people would accept that mantle of responsibility. Partly that is because of the “not my problem” philosophy of passive avoidance, but also partly it is because in order to achieve true parity, we would have to impoverish ourselves to the same extent as the poorest people on Earth so as not to be indirectly responsible for their suffering. Again, we meet up with the question of how much taking action will cost us. Then there are the less satisfactory excuses we hide behind: I can’t save the world by myself, I earned everything I make and those people didn’t, others are in a better position to help, I didn’t do anything to make them poor or sick–or even the compromise of giving a small amount, perhaps even tithing, to salve our conscience and make us feel like we’ve done our part.
In the end, however, I think that we cannot absolve ourselves here. The fact is, we are selfish. We do admire people who are willing to give up everything for others, but let’s face it: most of us are not like that. It doesn’t mean we are not responsible–we are–but we should realize and accept that this is what we are. Let’s not bandy excuses or try to justify ourselves. We’re selfish, plain and simple. It’s a bad trait, but it is what we choose. Accept it.
Now, this is about responsibility, not about social acceptance. Those are two different things. Social mores delineate what we accept as a society and what we do not. We accept that rich people can selfishly keep most of their money, for example, but we also expect some form of contribution from them back to society. Call it a social compromise between what we allow out of our selfish nature, and what we demand from our recognition of responsibility.
This brings me back to the Terri Schiavo case. (Thought I’d forgotten all about that, didn’t you?) The social mores for allowing a person in her situation to choose death are fairly well set, as most people believe that the choice was hers, and she made it. But then there is the question of the method of death. Why starvation, after all? If we are decided that death will be allowed, why do it that way?
The reason lies in our misguided belief that inaction absolves us of responsibility. By removing the feeding tube, we are simply letting nature take its course. That, of course, is wrong. We decided to cause the death. Sure, Terri decided that herself before all this started, but at this moment in time, she’s out of the game, and instead, we have the choice to follow her wishes and allow her body to die, or to not follow her wishes and keep her body alive anyway. Since we have the ability to act, we’re involved, and therefore responsible. And if our choice is to let her die, then shouldn’t that choice be “humane,” which is to say quick and clean?
Two factors could mitigate this: first, the possible wishes of the patient. Terri wanted not to be kept alive by a feeding tube, this the courts have resolved; however, would she have objected to an injection to put her body down instead of simply withholding nutrition and hydration and “letting nature take its course”? We don’t know. Maybe she would have chosen the latter. The second mitigating possibility is the fact that in her present condition, Terri cannot feel any pain. So even though dehydration and/or starvation appears cruel and unusual to us, it makes no difference to Terri–aside from the possibility that it offends her memory.
It could be, in fact, that doing it “quick and clean” would not be for Terri’s sake at all, but rather for ourselves, to make us feel better about it–just the same as people who would let her starve because that would also make us feel better, like we somehow avoided true responsibility for the result.
So perhaps, within the living wills that so many of us are writing these days, we should add the condition that if death is to come, have it come by the manner of our preference. Of course, then we start encroaching on the shores of “mercy killing” and “euthanasia,” which are other sticky issues–but false in this case, as allowing someone to die is allowing them to die. Whether we let it happen by starvation or we make it happen by lethal injection is a pure technicality; the end result is exactly the same, as is the measure of our responsibility for our action or inaction. For our choice.