minutia press.

No matter what your opinion might be concerning what actions or inactions should be taken on behalf of Terri Schiavo, this whole situation brings to light the need for a default plan of action for those who cannot speak their wishes.

The STL newspaper this morning offered several perspectives, and I found the nurse's the most interesting. At what point should action be taken to preserve "life"? It's not just feeding tubes that must be considered, but also, for example, what to do in the case of kidney failure. Is dialysis an extreme measure? There is no clear call on any of this, and it may vary from person to person.

This is going to sound heartless but I believe there is rationality in the following argument. I propose that each medical plan should have a default plan of action for people enrolled in that plan. When a person enrolls, they then have the opportunity to specify what they want in terms of extreme, or even nonextreme existence-preserving (I'll avoid the term "life-preserving" because we don't yet know what a "life" really is).

Each plan can also specify what is covered at the regular fee one pays, and one can add on for extreme measures. Do you want a feeding tube inserted indefinitely? Or do you want it removed after a month if there is no reasonable hope of recovery? What level of loss of brain function would you tolerate before you would want to be allowed to die? And if you are going to die, would you want to avoid starvation in favor of a faster and more merciful means?

If a person elected not to consider the preservation parameters, then the plan for that person spells out what will be done absent such specification. For those not on any medical plan, there should be a national set of guidelines that prevails if a certain form isn't filled out and filed with the government.

Presumably, the premium medical plans that offer long-term existence-sustaining services will cost more. I can already hear a mob yelling "DISCRIMINATION AGAINST THE POOR!!!"

But otherwise, good idea!

BTW, this is my first comment on your blog. I recently found it through a StudLife article that pointed to -273 which pointed here.

Glad you dropped by. I guess it depends on which side you think suffers when denied existence-sustaining services (in the face of severe brain damage). But it's a good point you raise.