Too busy taking sides in the tragedy that has befallen Terri Schiavo, we have forgotten to question the choices open to us and to her. In fact, this debate is less about dying than about how to die.
Schiavo wanted and deserved to die with dignity, yet nothing of what she received came close to a dignified death. Together with food and water, society withheld from her the option of a quiet, peaceful and swift death by active euthanasia. We should think of Schiavo as not just the victim of an accident that occurred 15 years ago, but also of a society that has structured its public conversation about matters of life, death and dignity in ways that fail to do justice to those who need it most.
Instead of asking only whether a person would prefer to die should she find herself in a permanent vegetative state, we ought to factor in the ancillary question of what kind of death she would be willing to die. As we know, in Schiavo's case, the withholding of food and water over a period of two weeks triggered chemical imbalances in her organism, and ultimately her death. She died slowly, gradually. Although she apparently did not feel any of this, her family did, and so did we.
From close or from afar, the spectacle of a human being fading away had a symbolism to it that is a heavy burden to carry. It is not unreasonable to intimate that forcing her to die this kind of death violates her right to decide how she wanted to be remembered, as U.S. Supreme Court Justice William Brennan argued in his dissent in Cruzan vs. Director in 1990.
Schiavo was probably unfamiliar with the distinction between acts and omissions that is still a pillar of her country's legal system. She probably could not have fathomed that in her society it is legal to let someone starve to death, but illegal, unless when motivated by society's will to punish, to inject a lethal substance into that person. We find it more acceptable to see a human being dying away slowly without food and water than to imagine euthanasia.
It is hard to grasp why that should be so. The experience of other countries has proved flat wrong the familiar argument that euthanasia can be abused, which is regularly invoked in this context and has figured prominently whenever courts confronted this question. Another possible argument to the effect that actively killing someone would have a negative impact on the image of the medical profession in society wrongly assumes that removing the feeding tube followed by inaction is less damaging to how we look at our medical doctors. We are left with the conclusion that such a framework is steeped in a hypocritical belief that we society, we judges, we doctors, are not the ones ending Schiavo's life. That is a lie, and not a noble one.
We all want to die with dignity. We hope to exit this life uncrushed by the fear of our passing and of the unknown that awaits us. Death is as deeply personal as it incomprehensible, and a mature society should aim at respecting the decisions of its members about when and how to die. The laws of Terri Schiavo's country made it impossible for her to die with dignity, as she wanted, and virtually no voice echoed her all-too-human wish. She deserved better.