[The following letter concerns the death of Terri Schiavo in 2005. Because of an editorial oversight, this letter was not published last year, and it seemed appropriate to include it here.]
[Dr. Weijer responds:]
The purpose of my commentary1 was to disagree with those who suggest that living wills are a moral panacea. Although living wills are an important means by which people express their wishes for future treatment, they seem an unlikely solution for cases like that of Terri Schiavo. People in their teens and 20s are unlikely to complete living wills. Even if a living will is in place, a deeply divided family will disagree as to its meaning. As a result, physicians need to employ techniques of communication, negotiation and mediation to keep families united in making decisions for loved ones whenever possible.
Erban is critical of how Terri Schiavo's plight was unduly publicized by political conservatives and the media, pointing out that the resulting frenzy was an affront to her dignity. I agree.
Sullivan concurs that living wills are not a panacea, but points out that they are generally useful. He is right that “it is worth writing [a living will] to provide guidance to surrogate decision-makers” and, I would add, health care providers.
Ney disagrees with my position, labelling it “opinion not based in fact.” The removal of artificial nutrition and hydration from patients evokes strong reactions because people have differing values. Some believe that one has an obligation to preserve life. Others, perhaps the majority of Canadians, believe that an individual's right of privacy is more important. I have written elsewhere that the values of those with religious or cultural reasons to preserve life in a persistent vegetative state ought to be respected.2 But tolerance is a 2-way street. Terri Schiavo did not share the conservative Catholic views of her parents and told her husband “I don't want to be kept alive on a machine.” Terri Schiavo's values and choices are just as worthy of respect as those who would choose differently for themselves.