PVS in the NHNE?

There is much to be learned from the case of Terri Schiavo, not just in the fields of medical ethics, the physiology of the brain, and our moral duties to the disabled, but also eschatology.

When I tell friends that I believe we're already in "the New Heavens and the New Earth," they're startled. "Why is there still death and war?" they ask. I reply that Isaiah the prophet foretold that there would be death in "the New Heavens and the New Earth":

(Isaiah 65:20) No more shall there be in it an infant that lives but a few days, or an old person who does not live out a lifetime; for one who dies at a hundred years will be considered a youth, and one who falls short of a hundred will be considered accursed.

This surprises many people, who have been raised to believe that at the Second Coming a perfect world without death, without pain, without challenges or obstacles, will be handed to us on a silver platter.

Does the Bible teach that those who are passive in this life will be rewarded with a static, predictable life in which there will a no race to run, no duties to perform, and no hurdles to overcome?

This question is related to decisions that were made in the case of Terry Schiavo, and the precedent set in that case may result in many millions of similar decisions being made in the future.

The New England Journal of Medicine rushed their current issue to the newsstands ahead of schedule, because it has several articles on the Schiavo case. Timothy Quill, M.D. is a nationally-recognized expert in palliative care and end-of-life issues who is a professor of medicine, psychiatry, and medical humanities at the University of Rochester, School of Medicine and Dentistry, and makes the following observation:

In considering this profound decision, the central issue is not what family members would want for themselves or what they want for their incapacitated loved one, but rather what the patient would want for himself or herself. The New Jersey Supreme Court that decided the case of Karen Ann Quinlan got the question of substituted judgment right:
If the patient could wake up for 15 minutes and understand his or her condition fully, and then had to return to it, what would he or she tell you to do?
Let me interrupt Dr. Quill and ask a question. If Terri Schiavo could have awakened for 15 minutes, and seen her parents, her sister and brother, hundreds of people outside her hospice, and millions of Americans who did not want her to die, what would have been her wishes? Here are the options:
  • "I have been in no pain or discomfort all this time; if you feel my condition can be improved, and if you don't feel that I would be too much of a burden on you, and if you would rather I be alive than dead, please continue feeding me."
  •  "Screw all of you! I want to go to heaven RIGHT NOW!"

If Terri had voiced the second option, would you want to pull the plug on her, and have her die with that thought in her heart? Or would you want to keep her alive just long enough to explain why she ought to consider the feelings of others? Is "Screw you!" the attitude that gets one into heaven? The law often makes assumptions about what "the reasonable man" would think or do. Why would we assume that with an entire nation praying for her life, Terri Schiavo, in no pain whatsoever, would choose to have the police forcibly prevent her parents from giving her food and water, and would choose to set a legal precedent that a person who did not make a "living will" instructing her food and water to be denied her should be presumed to have done so and to be forced to die of dehydration/starvation, despite the desires of  her parents and millions of people?

And yet there are apparently millions of people who have written "living wills" that give the government the power to put police outside their hospice door and deny parents or loved ones the opportunity to feed them.

Dr. Quill continues:

If the data about the patient’s wishes are not clear, then in the absence of public policy or family consensus, we should err on the side of continued treatment even in cases of a persistent vegetative state in which there is no hope of recovery. But if the evidence is clear, as the courts have found in the case of Terri Schiavo, then enforcing life-prolonging treatment against what is agreed to be the patient’s will is both unethical and illegal.

"Courts have found." This was the rallying cry of those who defend "the Rule of Law." The legislative branch, representing The People, must not be allowed to question the decision of a judge, a doctor, and an estranged husband who have a love of death. So we have been told.

Morphine is a good thing, and it's too bad the "war on [some] drugs" has made it more difficult for people at death's door to benefit from many drugs. Computer guru/author Peter McWilliams was being treated for cancer and was subject to intense nausea. He found relief from the vomiting by using marijuana, but a federal judge overruled California's Proposition 215 which would have allowed McWilliams legally to use marijuana for medical purposes, and McWilliams died choking on his own vomit. ("But at least he didn't become addicted to marijuana," some might say.) Ironic that something which which makes death less attractive is opposed by  "right-to-life" forces.

Among the right-to-die advocates, there was universal agreement that Terri Schiavo was a vegetable. She may have looked like she could interact with others around her, but those were reflex actions, we were told. She had no mental cognition. We were told her death would be pain free (though she was given morphine). So what would you say to a person whom doctors agreed was in no pain, who put your hand around a gun pointed at his head and wanted you to pull the trigger? Would you kill the person simply because "it was their wish?" Up until now, a person who killed another person could not escape conviction by saying "The deceased asked me to kill him."

There was a reason for laws against suicide. They teach that life has value, and even the life in darkness can be redeemed. And they teach that those who are not contemplating suicide should explain why to those who are.

Many people have said that all of this could have been avoided if only Terri had made out a living will. Trouble is, until the last few weeks, nobody knew you needed a living will if you wanted to, you know, live.

But Dr. Quill says (rather dogmatically) that the feelings of those who wish to give food and water to the dying are to be ignored and the "court-determined" feelings of a person who the same court determined has no feelings at all are to be "honored."

Suppose Terri had in fact drawn up a "living will," specifically stating that even if she were in no pain, and even if her parents wanted to bear the expenses of taking care of her, the government should use force to prevent them from giving her food and water. Isn't it the case the some wills are declared "void as against public policy?" Suppose Terri had left a will stating that all her assets should be used to hire a contract killer to murder her parents. Would any court enforce that will? The link above is to a case where the decedent's will ordered his horses destroyed. The court denied the request as "inhumane" and gave the horses to a horse club, which wanted the horses. Judge Greer implied a will never written, that a human being could be destroyed, and the parents of that human being could not care for her, though they wanted desperately to do so.

Christian ethics teaches that the way we treat "the least of these" is an index of our relation to Christ Himself.

(Matthew 25:31-46) When the Son of man shall come in His glory, and all the holy angels with Him, then shall He sit upon the throne of His glory: {32} And before Him shall be gathered all nations: and He shall separate them one from another, as a shepherd divideth His sheep from the goats: {33} And He shall set the sheep on His right hand, but the goats on the left. {34} Then shall the King say unto them on His right hand, Come, ye blessed of My Father, inherit the kingdom prepared for you from the foundation of the world: {35} For I was an hungered, and ye gave Me meat: I was thirsty, and ye gave Me drink: I was a stranger, and ye took Me in: {36} Naked, and ye clothed Me: I was sick, and ye visited Me: I was in prison, and ye came unto Me. {37} Then shall the righteous answer Him, saying, Lord, when saw we Thee an hungered, and fed Thee? or thirsty, and gave Thee drink? {38} When saw we Thee a stranger, and took Thee in? or naked, and clothed Thee? {39} Or when saw we Thee sick, or in prison, and came unto Thee? {40} And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these My brethren, ye have done it unto Me. {41} Then shall He say also unto them on the left hand, Depart from Me, ye cursed, into everlasting fire, prepared for the devil and his angels: {42} For I was an hungered, and ye gave Me no meat: I was thirsty, and ye gave Me no drink: {43} I was a stranger, and ye took Me not in: naked, and ye clothed Me not: sick, and in prison, and ye visited Me not. {44} Then shall they also answer Him, saying, Lord, when saw we Thee an hungered, or athirst, or a stranger, or naked, or sick, or in prison, and did not minister unto Thee? {45} Then shall He answer them, saying, Verily I say unto you, Inasmuch as ye did it not to one of the least of these, ye did it not to Me. {46} And these shall go away into everlasting punishment: but the righteous into life eternal.

Our acts of feeding the hungry and caring for the dying make us more Christian.

Our society is more Christian when we allow those who wish to give water to the thirsty to do so, rather than using government force to prevent them from doing so.

The Prophet Isaiah might have had some sympathy for people who lived in the "primitive" conditions of his day, centuries before Christ, who said they could not bear the rigors of life, and wanted to commit suicide. But today, 20 centuries after Christ, we live in luxury Isaiah could not have imagined. It is a different world altogether.

The only thing that hasn't changed is Christ and His Commandments.

Isaiah said that in "the New Heavens and the New Earth" people would die. Is it possible that these people might be in a "persistent vegetative state" (PVS) for some time before they died? Of course it's possible. Is it possible that Jesus wants people to obey His commandments and become more like Him even in "the New Heavens and the New Earth?" Why not? What is the alternative to obeying Christ and becoming increasingly more like Him?

Do we deceive ourselves if we think we will become "qualified" to live in "the New Heavens and the New Earth" by refusing to work and live in a way that is calculated to bring those conditions about?

Many people today are not clear about why they are here, why they were created (or evolved), and what it is they're supposed to do with their time on earth. These fundamental questions of human existence do not change in "the New Heavens and the New Earth," if we are to believe Isaiah. Isaiah said people will still die, people will still build houses (why would they need to build a(nother) house?), and people still plant crops ("I thought there would be no scarcity in 'the New Heavens and the New Earth,' and no work!").

The Bible says that some people are "willingly ignorant" of the truth. Where does the Bible say that all of the sudden these people, who "suppress the truth in unrighteousness," will passively become just like Christ -- without anyone having to preach to them, bear with them, encourage them, rebuke them, or go through all those time-consuming obstacles? Why won't "easy street" be handed to us on a silver platter?

This is Part Four of a series of reflections on the Terri Schiavo case.

The two stories below come from Linda Marshall, M.Div. RelationshipCoachingInstitute.com - The titles are mine.

Feeding Terri Schiavo in the New Heavens / New Earth

One night, this guy has a dream, and in the dream an angel comes and takes him on a tour of heaven and hell.

They visit hell first. It turns out that hell, surprisingly enough, is this huge banquet room, with tables full of all the food and drink you could possibly want. The people at the tables, however, are all thin and emaciated and wasting away. It seems that the silverware in hell is about four feet long and can only be picked up by the very end. So all these people are unable to feed themselves.

They leave hell and then go to visit heaven. It turns out that heaven, surprisingly enough, is also a huge banquet room, with tables full of all the food and drink you could possibly want. The silverware is exactly the same as in hell, four feet long and can only be picked up by the very end. The people in heaven, however, are all full, content and happy. The simple, yet profound difference is that in heaven, the people are reaching across the table and feeding each other.

Who Was Terri Schiavo?

Some time ago I received this e-mail that touched me deeply and spoke to me of the way I want to be with my friend. I sent it to her husband, as I will be one of his major supports in the coming years. I hope it is helpful to you.

It was a busy morning, approximately 8:30 am, when an elderly gentleman, in his 80's, presented to have sutures (stitches) removed from his thumb. He stated that he was in a hurry as he had an appointment at 9:00 am. I took his vital signs and had him take a seat, knowing it would be over an hour before someone would to able to see him.

I saw him looking at his watch and decided, since I was not busy with another patient, I would evaluate his wound. On exam it was well healed, so I talked to one of the doctors, got the needed supplies to remove his sutures and redress his wound.

While taking care of his wound, we began to engage in conversation. I asked him if he had a doctor's appointment this morning, as he was in such a hurry. The gentleman told me no, that he needed to go to the nursing home to eat breakfast with his wife. I then inquired as to her health. He told me that she had been there for a while and that she was a victim of Alzheimer Disease.

As we talked, and I finished dressing his wound, I asked if she would be worried if he was a bit late. He replied that she no longer knew who he was, that she had not recognized him in five years now. I was surprised, and asked him. "And you still go every morning, even though she doesn't know who you are?" He smiled as he patted my hand and said. "She doesn't know me, but I still know who she is."

I had to hold back tears as he left, I had goose bumps on my arm, and thought, "That is the kind of love I want in my life."

Terri Schiavo's parents will no longer have to worry about keeping Terri waiting for breakfast.

"Don't Feed Me"

We have argued that feeding the hungry makes us more like Christ.

But what about those who don't want to be fed?

There are many such people. This thinking is behind many "living wills" which express the wishes of those who "do not want to be a burden on anyone."

Do we become more like Christ if we allow ourselves to "become a burden?"

Nobody approves of lazy people who sponge off others. But if, through no fault of your own, you become needy, does God want you to let others meet your need, or is it better to be a "rugged individualist" and spurn their help?

What about the fact that Medicare and Social Security are fiscally bankrupt, and caring for people who are inevitably going to die puts a great strain on government resources?

Then took Mary a pound of ointment of spikenard, very costly, and anointed the feet of Jesus, and wiped His feet with her hair: and the house was filled with the fragrance of the perfume. {4} Then saith one of His disciples, Judas Iscariot, Simon's son, which should betray him, {5} "Why was this perfume not sold for three hundred denarii and the money given to the poor?" {6} (He said this not because he cared about the poor, but because he was a thief; he kept the common purse and used to steal what was put into it.) {7} Then said Jesus, Let her alone: against the day of My burying hath she kept this. {8} For the poor always ye have with you; but Me ye have not always.
John 12:3-8