Over Holy Week and now into the first week of Easter we as a nation have followed the events and controversy surrounding the end of Terry Schiavo’s earthly life. As I write this note the TV news is reporting that yet another appeal by members of the family to have the feeding tube replaced has been denied. I’ve lost count of the number of appeals that have been filed in the last days, but the number and intensity all stem from a fundamental disagreement within Schiavo’s family about what her wishes are regarding basic medical life support.
I can empathize to a large degree with the pain that the family is going through. In the years that I have served the Church as a priest I have journeyed down this same path many times with parishioners and their families. I have been down this path three times in the last 5 years in my own family.
Speaking from personal experience, the conflict within Schiavo’s family is not all that unusual though the forum in which the conflict is playing out certainly is. Many families will find themselves in disagreement over how to handle the question of continuing life support and the even harder questions of whether or not to remove it.
In my family there was disagreement between the siblings about what the best course of action would be for our mother as she came to the end of very long illness. The clergy in the family (my middle brother and myself) believed that there comes a point where medicine ends up frustrating the natural order of things. My brother the doctor disagreed and saw death (not surprisingly) as the enemy – and believed that death must be avoided by all means possible.
Unlike the Schiavo situation however, our family had a family meeting with my mother as soon as it became clear that such decisions would have to be made. As uncomfortable as it was for all of us, we sat down together and talked with my mother about what her wishes were in matter. (That’s an important point to remember – the patient’s wishes are the deciding factor in these issues.) She sided with my brother the doctor. She was clear that she still had things she wanted to do in her life and she wanted very much to do them. As a family we decided then that my youngest brother should serve as her medical decision maker (I continued to have power of attorney in other matters) because he and my mother were most closely in agreement about end of life issues.
When the time came a year later to have to make the decision, my brother decided to attempt an aggressive treatment plan for my mother and to have all the possible support options provided. Sadly none of these were successful and as you probably remember, my mother died three years ago in January.
But the upshot for us is that because we had talked openly about what we thought might happen and had met together as a family and had the difficult discussion, when the time came there was no conflict within the family. I may not have agreed with the choice that was made at the time, but I knew it was in keeping with my mother’s wishes and that my youngest brother was doing the right thing. At the end we grew closer together as a family rather than apart. The evening conversation we had together was one of the best and last gifts my mother gave to all of us.
It has been my experience though that many families do not have the conversation in time. This leads to conflict between family members and has in at least a few cases opened rifts within the family that have still not been healed. As a priest it is my responsibility to my parish to remind them regularly to talk with each other about these issues (as well as to do the other preparatory work like making up a will). I am sad to report that many people tell me they will not have the conversation about end of life issues because it makes them too uncomfortable.
Please take the horrible conflict that exists within the Schiavo family as an object lesson. Speak to each other clearly about what you want and don’t want to happen should you require others to make medical decisions for you. Remember that there are many different possible scenarios so when you talk, be clear about not just what you want but how you came to that decision as well. If you can choose a person to have the responsibility to make medical decisions for you, make sure that you inform the rest of the family who that person is (and maybe why you chose them.)
Like my own mother, you may be giving your family the gift that allows them to focus on God’s love and care during your illness and perhaps ultimately hold together as a family when you are no longer part of their earthly lives.
-Nick+
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