Exit Strategies: Living Wills and Dying

Illustration by Liz Priddy

On March 31, 2005, when Terry Schiavo died after a seven-year legal battle, her case schooled the nation in the complexities of dying in a technological age. An agony for her parents, she provided text and example for the media and for the endless call-in programs dedicated to finding an answer: yes, she should be unhooked from life-support machines, or no, she should be kept alive, however minimally, for however long. It was surprising how many people found an answer in the formidable tangle of legal, medical, emotional and religious strands that made up the Terry Schiavo case. Generally speaking, it seemed that those who argued that Terry Schiavo should be kept alive might be identifiable with those who oppose abortion, those who put their faith in something we call "nature," who argue the position of "the right to life," assert themselves as "pro-life" and argue that "natural" solutions can be found because nature is good and synonymous with God and the religious will. During the seven years of her battle, the cause was peculiarly divided between the pro-life faction and the right-to-die faction.

Expressions like "the right to life" suggest a deep disturbance which Terry Schiavo's death pointed to: the disquieting feeling that human life now has to make its claim to life—legally, religiously, medically, socially, ethically—in a utilitarian complex. The cat is out of the bag: human beings have to prove, argue, justify that they have a right to life. The metaphysical understanding of the right to life, though perhaps sometimes intermittent and chimerical in the past, was an inborn assumption. No longer true! The desperate slogan "the right to life" is evidence of its serious diminishment of meaning. Terry Schiavo's death, embedded in technological, medical, legal and family claims, brought to the surface what we have suspected for a generation. We have to argue the case for what is human, and, paradoxically, the argument for the right to die may become a defense of what is human.

Suddenly the dying and the unborn claim our attention in a new way. Desperately, the fetus is declared to be "a person." Though cells are assuredly life, equating cells in a petrie dish with personhood cavalierly distorts the meaning of "person." At the other extreme, the justification for keeping Terry Schiavo alive seemed to depend upon whether personhood could be claimed for her, whether she was recognizably the same person her family and friends had known, as the definition of "person" retreats further and further behind wires, digits and computers. Buried beneath this discussion is the question of soul. One suspects that the terms "person" and "personhood" are contemporary terms for what many would like to call "soul." If so, arguments about the fetus and the rights of the dying would be better served if we discussed the place of the soul in matters of life and dying. Fearing that the word "soul" is archaic, however, we have substituted other terms and have lost the historical lineage of the discussion concerning the definition of what is human. Soul has lost the argument, and with that loss comes also the loss of a millennial history and continuity of the definition of "human." The metaphysical assumption of the right of human life was based on the belief that human beings had souls: they were not wired machines. What was meant by soul was not personhood, something left over after the wires had been dismantled. Once we see the human being as a machine, its rights become technical, not metaphysical.

The idea of the human as machine has gained steadily in philosophical respectability since Descartes's declaration in the seventeenth century that animals were machines. This assertion immediately invited speculation about human beings because it was difficult then, as it is difficult now, to erect a firm boundary between animal and human. In the four hundred years since Descartes's philosophy initiated this discussion, technology has advanced closer to confirming the human being...