"Culture of Life"

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There are finite resources in the world. We can't treat everyone. Using resources to treat one person could well kill another.

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You've already said that, and it's already been answered. http://forumserver.twoplustwo.com/sh...Number=4204071

[coffeecrazy1]

Okay...fair enough point about the "culture of life" thing...whatever that phrase means(I'm suspicious of most sound-biteish catchphrases).

And again, not to sound callous, but isn't there a reasonable degree of grayness to this particular case? Let's say I buy the notion that no one with a life-threatening condition should be denied based on money...wouldn't it be more, I don't know, in the spirit of the law to specify the condition as being emergent, rather than a longstanding condition such as this? Isn't there a quality of life argument somewhere here, i.e., she would die in a place without the machines, but, since she's on the machines, does she now have a right to those machines?

Believe me, I'm not saying I agree with pulling the plug, despite this woman's pleas...that seems to be overly harsh, even for a libertarian such as me(hey, I'm a human being, too). I'm merely debating the principle at hand.

[DVaut1]

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I don't really understand your whole killing/murder difference. If you kill a human being it's murder, if you kill a pig it's a killing.

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I'm sure you can recognize the idea that not all killings are murder.

If you kill in self-defense, it's not murder, for instance -- and that's instantly recognizable; I don't know anyone who would argue that killing in self-defense is tantamount to murder. Perhaps more debatable are such things like killing someone in a war, capital punishment, etc. Regardless, there are many ways in which humans cause the deaths of other humans that we'd uniformly call a 'killing' but not call a murder - hence the distinction.

To put it as simply as possible (and putting our strict dictionary definitions aside): murder is the unjustified premature ending of a life. Even that may not be simple enough -- I don't doubt adding 'premature' might open up my definition for debate. And I think my definition is terribly crude; but what I'm trying to get across is that we internally rationalize all murders as being unjustified -- which is not the case for all killings (keeping in mind that we readily accept the notion that self-defense is widely accepted and justified form of killing).

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I mean when you kill a pregnant women you aren't charged with 1.3 homicides.

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We're not talking about the legal ramifications, or how states recognize personhood (although I think it's a terribly interesting conversation to have). We're just having a philosophical discourse here. So merely because the state doesn't charge someone with 1.3 homicides doesn't mean that I necessarily agree that fetuses are equal to other post-natal humans -- surely in the same way that many pro-lifers don't feel that merely because the state approves of abortions means they have to accept them, either morally, ethically, or philosophically.

Regardless, while I might not be charged with 1.3 homicides, I think the much more interesting inquiry is to how I would be punished for killing a pregnant woman (and I would venture a guess that it varies across the justice system) - in other words, if I were to kill a pregnant woman: is the justice system normatively applying relatively consistent penalities? Would I get the same jail time as typically handed to those who have committed 1 homicide? Would I get the same jail time as typically handed to those who have committed 2 homicides? Would it fall somewhere in between? Such a study (I doubt one exists but I'd be fascinated to see one) might shed some light on how the justice system truly views the status of the fetus.

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I don't really agree with the concept of something being partially human. We don't really have any laws or concept surrounding a being that is partially human.

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I think we do -- even if we don't readily admit it. But fetuses, or the 'brain dead', the comatose, etc. -- I think we all have internal conceptions of such people which may be something less than human. The Terri Schiavo case is a rather clear one (in my mind) of how the law will recognize some entity as being 'partially' human - and I think abortion laws may apply here as well.

I'll bow out of this discussion here and let this thread return the subject of the OP -- anyone (leighguy, for instance) who would like to slap me around on this is free to PM me or start a new thread, etc.

Media reports have the facts wrong, I think. I dont think this law applies if the patient is conscious. If the patient is unconscious, and the patient has not filed an advance healthcare directive, and the medical facility makes a determination of futility, THEN they can pull the plug. They cannot do so over the wishes of a conscious patient.
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Believe me, I'm not saying I agree with pulling the plug, despite this woman's pleas...that seems to be overly harsh, even for a libertarian such as me(hey, I'm a human being, too). I'm merely debating the principle at hand.

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I agree, I think we could debate the merits of the Texas law. We do have to deal with living in a world of finite resources, and spending tens of thousands a day on someone on life support who's not going to recover is one of the least efficient ways to spend health care money.

I'm just saying that if you think that Terri Schiavo should still be on life support, you should be horrified by this law. I think it's revealing that so many conservative politicians jumped to grandstand on the "Save Terri" bandwagon and then did nothing about this case. I bet if Bill Frist and the rest of them had given the same kind of attention and publicity to this case, they could have collected enough donations to keep the woman alive to see her mother.

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Media reports have the facts wrong, I think. I dont think this law applies if the patient is conscious. If the patient is unconscious, and the patient has not filed an advance healthcare directive, and the medical facility makes a determination of futility, THEN they can pull the plug. They cannot do so over the wishes of a conscious patient.
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Your link doesn't actually say that. This account says specifically that she was conscious and responsive when the doctors shut down the respirator.

[coffeecrazy1]

For the record, I've had a DNR since I was 17(which, ironically, is an adult in Texas), so you can probably guess where I stand on Terri Schiavo.

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Media reports have the facts wrong, I think. I dont think this law applies if the patient is conscious. If the patient is unconscious, and the patient has not filed an advance healthcare directive, and the medical facility makes a determination of futility, THEN they can pull the plug. They cannot do so over the wishes of a conscious patient.
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Your link doesn't actually say that. This account says specifically that she was conscious and responsive when the doctors shut down the respirator.

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Sorry, follow the internal link to the statute.

I skimmed it, but didn't see anything that said that. Can you give a direct quote?

Basically, this chapter deals with medical directives, which are instructions for what care you want in the event you can't presently communicate those wishes (e.g., in a coma).

The controversial section that the hospital used in opting to terminate treatment, was § 166.039(a). That section states, in relevant part:

"If an adult qualified patient has not executed or issued a directive and is incompetent or otherwise mentally or physically incapable of communication, the attending physician and the patient's legal guardian or an agent under a medical power of attorney may make a treatment decision that may include a decision to withhold or withdraw life-sustaining treatment from the patient."

This requires that: (a) there be no directive; and (b) the patient must be incompetent or incapable of communications.

Thus, the patient cannot have been conscious when the hosptial made this decision. The media reports got it wrong.

What about in instances where the patient has made an advance directive to request life sustaining care, but the hospital disagrees? Goto § 166.046.

"If an attending physician refuses to honor a patient's advance directive or a health care or treatment decision made by or on behalf of a patient, the physician's refusal
shall be reviewed by an ethics or medical committee. The attending physician may not be a member of that committee. The patient shall be given life-sustaining treatment during the review."

If the review process still says no treatment, there is a transfer process: "If the attending physician, the patient, or the person responsible for the health care decisions of the individual does not agree with the decision reached during the review process under Subsection (b), the physician shall make a reasonable effort to transfer the patient to a physician who is willing to comply with
the directive."

If no transfer is possible, "The physician and the health care facility are not obligated to provide life-sustaining treatment after the 10th day after the written decision required under Subsection (b) is provided to the patient
or the person responsible for the health care decisions of the patient unless ordered to do so under Subsection (g)."

This all applies where the hospital is trying to go against the patient's advanced directive for life sustaining care. The advance directive isn't even effective, however, unless the patient is unconscious.