At the end of Million Dollar Baby, Maggie was completely paralyzed due to a spinal cord injury at higher position (C1 and C2). After some moral struggling, Frankie disconnected the artificial respiratory tube and injected a lethal dose of poison into Maggie’s body to make her rest forever. The scene was very touching indeed. However, legally speaking, Frankie committed a murder. If Maggie lived in Oregon, she might sign a living will explicitly stating that she wanted to die. Physician could help her achieve that ultimate goal.

Nowadays the case of Terri Schiavo is boiling down the whole countries on issues such as life, human rights, and legalization. Briefly, Terri’s brain was accidentally damaged during a cardiac arrhythmia arrest 15 years ago. After the settlement of malpractice lawsuit which awarded Terri and her husband about $1 million, Mr. Schiavo filled a petition to remove Terri’s feeding tube, thus ending Terri’s life. However, this proved to be controversial both morally and legally. Terri’s parents fought back ferociously, claiming that they (and Terri herself) wanted Terri alive. The feeding tube was ordered to be removed by court but under the intervention of Governor Bush, the tube was eventually restored. Last weekend, the tube was removed again which provoked another wave of heated discussion over the media and the legislators. George W. Bush also signed an urgent law requiring a Federal court to re-adjudicate the Terri’s case.

Unfortunately, the Federal court denied the petition of tube restoration by claiming that the plaintiffs (Terri’s parents) failed to show the “substantial likelihood of success” in the merits of their arguments. Terri was still on her way of dying. The lawsuit will surely go on and on until everything is exhausted—money, energy, and legal possibilities.

Let’s first put aside controversial legalization and human right issues. Think about the similarity and difference between Maggie and Terri for a second. Apparently, both of them are in the process of leaving this noisy world no matter what point of views you may hold.

Then what can you do with terminally ill patients? If they wish to die, or have stated so in a living will before becoming unconscious, “Physician assisted suicide (PAS)” and “euthanasia” are two ways to help patients accomplish their final missions. PAS is what physicians have the least moral and legal guilty because it is essentially patients who kill themselves. On the other hand, euthanasia requires physicians to inject a lethal dose of poison to “kill” patients. Physicians who performed this kind of duty were once called “murderers” by many pro-life conservatives. Now people are gradually accepting the fact that many people indeed don’t want to live in tries.

However, the law requires that patients should clearly state their decisions beforehand. This divides Maggie and Terri’s fates. Because Maggie can think and talk, she can make her own decision of killing herself, while Terri is in “persistent vegetative state”—a state that one can’t think, talk, or voluntarily move herself due to severely brain damage but still have breath and heat beating. Therefore, according the Oregon’s Death with Dignity law, Maggie can commit suicide with the help of doctors, while Terri can do nothing about herself.

Despite that many protesters plead for preserving Terri’s life, biologically, Terri is dead. It may be astonishing that human death is not a clear-cut definition. Before the invention of techniques such as cardiopulmonary Resuscitation (CPR) and artificial respiratory system, the stop of heart beating and breathing was considered as “dead”. Modern definition of death relies more on “brain death”. Because neo-cortex of brain controls brain activities such as thinking, talking and voluntary moving which are characteristics of living human beings, some have proposed the death as “death of neo-cortex”. However, the US chooses a conservative definition(Uniform Definition of Death Act ). Specifically, death refers to the status of “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.”The brain stem is the nerve center which controls heart beating and breath. Based on the US definition of death, Terri is not legally dead even though her neo-cortex has been shown severely and irreversibly damaged.

Therefore, one can’t eliminate Terri simply by claiming she is dead. The other way around to get ride of her is to let her commit suicide. However, Terri can’t think and talk; she didn’t have any living will either. Fortunately, from the very beginning, a guardian was assigned to her. It is her husband, Mr. Schiavo.

Legally, “a guardian is someone who is appointed by a court to make personal and/or financial decisions on behalf of another person”. The incapacitated person losehis/her most if not all civil rights: “the right to marry, the right to vote, the right to hold a driver’s license, the right to make a will, the right to enter into a contract, and other rights”.

According to the guardian definition, Mr. Schiavo is able to make health decision for Terri. His decision on eliminating all treatments except feeding tube is legally protected. However, is that legal for a guardian to decide one’s life? The law on guardian requires the guardian’s decision to be appropriate. It is up to the court whether removing tube is appropriate or not. After spending considerable efforts on medical examinations and legal hearings, Judge Greer determined that the removal of feeding tube was legal and appropriate. Petition was granted.

To Terri’s parents, this is outrageous. How could a Judge determine an innocent people’s life based on a rascal’s evil desire? Speculations are widely circulating about the greediness of Mr. Schiavo, his de facto remarriage, his abuse on Terri, and his lies on stating Terri’s willingness to die. Nevertheless, Mr. Schiavo seems to have survived these accuses.

Overall, the ethical issue in Terri’s case is centered on whether Terri is “alive” and has the “right to die”. HOWEVER, how do you know Terri wants to die? In fact, she even doesn’t know whether she exists or not. But one thing is for certain, this conundrum will give ethicists and legislators enough work to entertain themselves for years.

To be continued…