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Tube-feeding case law should not be a function of which families have the gall and money to litigate longest. We need simple rules that will return the justice system to more important matters, such as Hillary Clinton’s and Dubya Bush’s insider trading.
Whether patient x lives or dies is of life-threatening importance only to patient x. Custom no longer requires that the surviving spouse join the funeral pyre. And if patient x can’t break zero on the SAT (or some other measure of mentation), then by definition life or death matters not even to patient x.
If the patient can’t communicate, the considerations are who pays for medical care, and who has a feel for the patient’s preferences in extreme medicine when last able to communicate. Until the US has national health care or Karl Rove is omniscient, Congress and president must therefore butt out. The decision belongs to whoever knew the patient or pays the insurance premia.
And let’s not give all power to the spouse. Spouses can remarry, with no legal limit even as to what constitutes a decent interval. In other words, what kind of deal goes down for tube feeding depends on the marriage. If you like feeding tubes, say so in writing while you can still break zippo on the SAT, or get a divorce.
Meanwhile, democratize the tube-removal process. Take a vote. Weight the votes by relationship. Using a formula may seem cold, but coldness is exactly what we want from government. Compassion in the hands of government is insider trading and changing the constitution for Arnold. Die intestate, and a similar formula applies to the disposition of your worldly goods. The formula might be:
Aunt, uncle, first cousin, grandchild 5%
Now multiply each vote by the voter’s SAT score. Yes, the SAT directly measures only the ability to apply square-root-of-three over two without a bathroom break. Yes, square-root-of-three over two is patriarchal and Eurocentric. No, the SAT won’t predict even the ability to do college work until the SAT happens five years later and becomes the GRE, MCAT, and LSAT. Yes, what the SAT measures is inapplicable to the case at hand–or is it? The SAT does measure self-discipline and rigor in thinking, and you can’t network your way to a better score. Similarly, passing Latin qualified Eric Blair to be a policeman in Burma. What in society meets even these standards? What would be a better test of your relatives’ judgment? How about:
Did Dubya Bush as Texas governor sign a bill to allow hospitals to pull the tubes of indigents? T/F
Did Dubya Bush steal the 2000 election? T/F
Was Al Gore’s attempt to steal the 2000 election incompetent? T/F
Suddenly your relatives think the SAT is not so bad after all. So we’re back to: If you can’t break zero on the SAT, verbal or math, within a year of the onset of tube feeding, your relatives vote on whether to shut you down.
OK, I’m kidding. None of the foregoing matters. As with Christopher Reeve, the lead story in tube feeding is the patient’s medical plan. The decision to pull the plug is in the hands of your HMO and its lifetime cap. Especially in Texas. And the most humane administration of an HMO cap is lethal injection, not starvation
HUNTER GREER can be reached at: firstname.lastname@example.org