Today I read a story about a woman at the center of a controversial legal battle in Italy.
Eluana Englaro had been in a vegetative state since she was in a car accident 17 years ago. The media was calling Englaro "the Terri Schiavo of Italy," because her case was similar to woman here in the United States. (Schiavo's husband as legal guardian, wanted his wife's feeding tube removed, but Schiavo's parents fought their son-in-law for years to keep the tube in place).
Englaro's father fought the Italian courts to remove his daughter's feeding tube, which kept his daughter alive, saying it was not his daughter's wish to be kept alive "artificially."
This case sparked heated debate between parts of the Italian government and the Catholic Church, who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.
This case sparked heated debate between parts of the Italian government and the Catholic Church who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.
Unfortunately, the woman died before any of these legal issues were resolved, and I'm sure this is a controversial debate that will rage on among contending parties for years to come.
But one of the most interesting aspects of this story has nothing to do with lawmakers and government officials at the center of the debate. Rather, it's the way the people in the region have taken matters into their own hands, and the ever-expanding role technology is beginning to play in the public's interpretation of the law.
Over the weekend, some Italian citizens began creating living wills on YouTube, documenting their personal wishes with regard to "do not resuscitate" (DNR) orders, designation of health care proxies and any other modifications they feel are important, in the event they are rendered incapacitated. But the irony lies in the fact that in Italy, there is no legislation on end-of-life issues and no recognition of living wills as legal documentation of a person's wishes.
Here in the U.S., it's quite the opposite. As physicians, a standard question that we must ask all patients upon admission to the hospital is whether or not they have a living will. If they do, we request to see a copy of it so that it can described in detail in the patient's chart.
But I have to tell you, in the last few years since this law was mandated, I can literally count on one hand, the number of patients that have answered yes to that question. For many of us, it's human nature to try not to think about what could go wrong, so we often don't take the time to plan for it.
So when I look at these people taking matters into their own hands, making a short video clip detailing what they would want done in a worst-case scenario, I'm curious about how these videos will be interpreted by the law in future ethical debates, and at the end of the day, if their wishes will be honored.