By Shannon Montgomery
Terri Schiavo’s death made for high public drama. Politicians were pitted against the courts as they debated who should be allowed to choose life and death. People came as if on pilgrimage: they prayed, wept, and were arrested by the dozen as they tried to smuggle food and water into the dying woman’s hospice.
Yet as Schiavo’s life slowly slipped away — the result of a feeding tube removed by doctors after the woman spent 15 years in a comatose state — many faced a much more private turbulence. People began to wonder what would happen to them if they were faced with the same situation. As Peter Singer, head of the University of Toronto’s Joint Centre for Bioethics puts it, it was “an instructive spectacle.”
The popular solution offered up is called a living will, or an advance directive. This document works much like a will that deals with property and assets, but instead dictates someone’s wishes should they become unable to communicate them.
Sound easy? Unfortunately, a living will isn’t as simple as it seems.
These wills are under the control of individual provinces, so what is legal in one isn’t necessarily legal in another. Also, unless you make up a card to carry with you at all times, a living will may not be accessible when you need it, like if you’re in a car crash.
And the basic fact is that only 15 per cent of Canadians have a living will, showing that this really isn’t a popular solution to a problem that can happen to 100 per cent of people.
There should be an easier way for Canadians to make their wishes concerning their medical treatment known should they no longer be able to communicate themselves. The idea of allowing people to choose their preferred level of artificial life support already exists in the medical community. Upon admission into a hospital, patients are given the option of a note on their file telling doctors they do not want to be resuscitated should their body give out. Some faiths, as well, will request not to be given some procedures like blood transfusions.
It’s therefore possible for someone to have a clear wish put on their chart for use in the hospital.
A good model to bring together the idea of living wills and medical chart requests is seen in they way organ donations are managed.
In Ontario, the government keeps a registry of all people willing to donate their organs. This registry gives several options about what people feel comfortable donating; it’s not just a blanket yes or no question.
For example, the form gives options of which individual organs the person would like to make available for transplant and whether they would be willing to donate their entire body to medical research.
This type of public registry seems like a better idea — a sort of electronic “do not resuscitate” order. It’s a good idea to ask the question of patients when they are admitted to the hospital, but it doesn’t coverthose who may not be able to volunteer the information.
Obviously a living will gives more detail about these wishes, and is still a good idea.
But for the many Canadians who don’t have one — whether because they don’t want to think about the possibility, or think it would never happen to them — this type of registry could assuage the fears that watching Terri Schiavo die has raised in so many people.