Perhaps the most extraordinary thing about the tragic death Thursday of Theresa Marie Schindler Schiavo was that the entire United States and much of the world knew about it within minutes.
The removal of a feeding tube from a patient in a persistent vegetative state is not new. The action received court sanction in 1983, when the family of Nancy Cruzan, a young woman injured in a car crash, asked to have her tube removed after eight years. It was reaffirmed in 1986, when the wife of Paul Brophy, a man left comatose by a burst aneurysm, asked a court to allow the discontinuation of nutrition.
Since then, it is safe to say that thousands of end-life patients have died after having nutrition stopped. Thousands more may have died because forced feeding was never begun. And then there are the legions of patients who were quietly removed from respirators or other life-extending medical devices over the last 30 years -- since the Karen Ann Quinlan case made headlines.
The truth is that no one in America knows how many people die when heroic efforts of one kind or another are eschewed or stopped. No one knows how many lives are extended or for how long by feeding tubes or respirators, or how many patients are resuscitated only so that they can spend days or months in limbo. No one knows how much of the nation's limited resources are expended on the extension of lives of people who have no reasonable expectation of recovering from a comatose or vegetative state -- and who, if they could speak, would prefer to die in peace.
And we would not know about Terri Schiavo either, if it weren't for the fact that somewhere along a 15-year timeline her husband, Michael, and her parents, Bob and Mary Schindler, came to disagree about Terri's quality of life, her prospects of recovery and whether she would have wanted to continue to live in the body she was left with after her heart stopped for several minutes in 1990, when she was 26 years old.
Positions hardened on both sides. Schiavo and the Schindlers each came to be surrounded by partisans for their own positions. The death-with-dignity crowd gravitated toward the husband; right-to-lifers surrounded the Schindlers. They were caught up in a judicial, legislative and political maelstrom over which they came to have little more control than Terri had of her own body.
Victims and villains
There are villains in this sad story, but their names aren't Schiavo or Schindler. Not that they have been particularly kind to each other -- but their motives were pure. They were convinced that they were working in the best interest of Mrs. Schiavo. The same cannot be said for the opportunists -- some of them hypocrites of the first rank -- who attached themselves to members of this tormented extended family.
By day's end, Thursday, both sides agreed on one thing, that Terri Schiavo had found peace in the arms of the Lord. They will probably never agree on the timing of that peace.
That could be legacy enough for Terri Schiavo. But it would be better if her legacy were that no family will have to go through the torment that hers experienced. That is possible if the attention her suffering and death received inspires husbands and wives, parents and children, to discuss who they would want to be treated in a medical emergency or at the end of a long illness. And that they formalize those wishes with a living will, power of attorney or similar document.
Almost no one who saw the videos of Terri Schiavo said they would want to live her life. And, it is worth noting, those images were years old. No one but her family, friends and caregivers have seen her in recent years. And yet, even people who said "I wouldn't want to live that way," couldn't accept a husband's assurance that his wife had told him that she wouldn't want to live that way either. This was a story so driven by emotion that the humanity of the woman at its center was all but lost -- until she was dead.