FutureWire - futurism and emerging technology

Saturday, March 19, 2005

What Terri Schiavo is Teaching Us

Yesterday, as you no doubt heard, the feeding tube of Terri Schiavo, a severely brain-damaged woman, was removed at the request of her husband, and against the wishes of her parents. The removal was a culmination of years of legal battling and protests that literally involved an act of Congress, and is not over yet.

The Schiavo case is important to futurists because it gives us a glimpse into issues that will rock society in the years to come. The most obvious issues are the advances in medicine that allow profoundly disabled individuals such as Schiavo to remain alive... as well as provide hope of recovery through stem cell research and other means.

The other issue is demographic. As our population ages, we will have many more people who will have long life without health. They will become critically ill and disabled, to the point where they, like Schiavo, will be unable to communicate their wishes and needs, leading to second-guessing and conflicts. This, combined with medical technology that can prolong if not enhance life, will create a legion of Terri Schiavos -- and a morass of legal, ethical, religious and even economic controversies for the rest of us to navigate.

Indeed, what makes the Schiavo case so difficult is its central set of contradictions. Terri is not "brain dead" or on a resiprator; she is not elderly, suffering from a terminal disease or otherwise facing end of life. If I were her parents, I would want to keep her alive. If I were her husband, I wouldn't fight to disconnect her feeding tube. On the other hand, I wouldn't want to live like that, and I don't know who would.

Most futurists believe that advances in medicine will one day find ways to reverse brain damage... but the key phrase there is "one day." In the meantime, those of us who could find ourselves in Terri Schiavo's unfortunate position (which is to say, any of us) owe it to ourselves and our loved ones to consider living wills that will give our families and doctors guidance for our care. Living wills (a.k.a. healthcare or physician directives) can specify many medical decisions, including tube feeding and resuscitation, so that individuals -- not courts, special interest groups, Congress, or anyone else -- can control their healthcare to the very end.

Perhaps Terri Schiavo is not so much teaching us as warning us, that healthcare can be a double-edged sword, and one that will become ever more problematic in the coming years.

UPDATE 1: MSNBC reports that advocacy groups such as Aging with Dignity are being flooded with requests for help in preparing living wills in light of the Terri Schiavo controversy. Aging with Dignity offers a "Five Wishes" document that helps individuals create their own living wills without the need of a lawyer, and that are legally binding in most states. Nonetheless, MSNBC notes that 85% of Americans do not have written living wills.

UPDATE 2: Technology Liberation Front cites an excellent commentary that views the Schiavo case in light of advancing biotechnology and nanotechnology.