Edward I. Koch
Saturday, Nov. 1, 2003

Terry Schiavo’s husband has successfully petitioned Florida courts for the right to remove a feeding tube that keeps her alive. Her parents, who believe that she will one day recover, unsuccessfully opposed the husband’s efforts in court and later turned to Florida Gov. Jeb Bush and the Legislature for help.

According to The New York Times, the governor and legislature responded by passing a law “authorizing the governor to order the feeding of patients in a vegetative state who lacked living wills.” On the basis of this new law, Mrs. Schiavo’s feeding tube for both food and water has been reinserted.

If I were in a vegetative state, I would not want to continue to live or to be resuscitated. I have spelled this out in a living will. My older brother, Harold, who had a heart condition as well as kidney failure, was hospitalized when he went into a coma shortly before his death. His wife, as well as my sister and I, knew he would not want to continue life in a vegetative state.

When the doctors told us he would not recover his cognitive ability were he to come out of the coma, his wife – with our consent – authorized his plug to be pulled, which terminated dialysis and ended his life with the passage of a few days and the onset of uremia poisoning.

All of us believe we were carrying out his wishes. We loved him dearly, and we still mourn for him.

My initial response to Mrs. Schiavo’s case was to support her husband’s decision to end life support and condemn Gov. Bush and the Florida Legislature for interfering with that decision. I was not aware, although it was reported in the media, that the husband, who stated that his wife’s wishes were, like my brother’s, not to be kept alive through artificial means, has been living with another woman with whom he had a child and is expecting a second.

Furthermore, a $1 million malpractice judgment awarded to pay for his wife’s care will become his upon her death. He alleges the monies have been used for her care and the amount remaining is $50,000, which he will not take.

Faced with these facts, The New York Times editorial board favors putting Mrs. Schiavo to death as a means of upholding the right to die. I believe the situation is far more complex than The Times reports. The dilemma for me relates to what may be done to end Mrs. Schiavo’s life. It is not simply the pulling of the plug of a machine of massive intervention, e.g., a dialysis machine, but the ending of a basic need, in this case feeding.

Is that the same? Not long ago I would have said “Yes.” But I no longer feel that way. After talking with friends, including a doctor, I concluded we cannot say with certainty that depriving a person of food and water will lead to a painless death.

After removal of the feeding tube and before it was reinserted, Mrs. Schiavo lived for six days. If the feeding tube had not been reinserted, she still might have lingered for several weeks. How can we be sure she would have felt no pain during that time? Do we know that she would have consented to such pain? We do not.

I believe we should have the right to die in a dignified way and not to suffer pain or other indignities flowing from the inability to lead a life significantly free from infirmity and dependence. In my opinion, physician-assisted suicide as permitted in Holland and the state of Oregon ought to be available everywhere.

I also believe suicide is a decision to be made by the individual or someone clearly authorized by him or her to make it in the event of incapacity.

In this case, the desires of Mrs. Schiavo are sufficiently murky to cause me to conclude she should not be put to death. I think we can understand the husband’s concern for his wife and also his current relationship with another woman, the mother of his child. However, in view of these competing interests, he cannot be considered objective in this case on what his wife’s wishes were.

What he should do is divorce her. If Florida law does not allow for divorce under these circumstances, the Legislature should amend the law forthwith. Mrs. Schiavo’s parents should be given full custody and control over their daughter and her medical care.

On the issue of removing a feeding tube as a means of ending a person’s life, if we were putting a dog down, you would not be allowed to starve it to death. If you did, you would be charged criminally. Why should it be otherwise for a human being? Doctor-assisted suicide is far more humane.

Edward I. Koch is the former mayor of New York City. His commentary for Bloomberg radio is republished here. You can hear his weekly radio show by clicking here.

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