Sunday, May 15, 2005

Schiavo Redux: The Culture of Life and A Taxonomy of Death

A single death is a tragedy, a million deaths is a statistic. – Joseph Stalin

I’ve been a bad blogger. While it’s no excuse, certain personal matters had called me away for an extended time. And now I return to finish off a piece that was less than current at the time I started it. I had, even then, determined to not write about the Terri Schiavo matter. It has been so extensively blogged on, what could I add to the discussion? I’m not sure that I can add anything. However, it touches on so many of the issues I’ve written on so far. When is a death a horrible tragedy and when is it collateral damage? When do Americans turn their compassionate gaze to the suffering of others and when do we close our eyes, minds and hearts?

In a previous post on America’s response to the tsunami in the Indian Ocean, I opened with:

The overall response of the American public to the aftermath of the Indian Ocean tsunami has challenged one of my long standing rules of thumb: the compassion of the American populace, on the whole, in matters of disaster or tragedy, is inversely proportional to the number of people involved, the distance from American shores and the darkness of the skin of those affected. I do not mean to deny or diminish the real and significant work of many caring people in the US. But, on the whole, a single white child trapped in a well somewhere in middle America seems to create a larger outpouring of compassion than ongoing distant suffering.

The Schiavo matter, on the other hand, tends to confirm my more cynical view. In the tsunami post I had posited that our concern for the victims of the tsunami was motivated in part by guilt over the victims of the invasion of Iraq. Those who sought to exploit Terri Schiavo’s condition saw an opportunity to make themselves feel morally correct without actually costing them anything. One of the reasons why we tend to be more moved by the case of one person rather than the larger problem of human suffering is precisely because it enables us to ignore the larger problem and its complexities and its demands for sacrifice, while not feeling heartless. Look at how we feel. Look at how we grieve. How could you say we lack compassion?

To my mind, the reaction to the decision to remove the feeding tubes from Terri Schiavo needs to placed in a matrix of attitudes towards life and death along with matters such as abortion, infant mortality, US deaths in war, “enemy” deaths in war, “collateral damage,” the death penalty, public health policy, poverty, deaths due to natural disasters and the daily death toll around the world of children and adults due to starvation or easily preventable disease.

I won’t take much time outlining the controversies surrounding Ms Schiavo. Wikipedia provides an excellent source of information regarding her condition and the issues raised. Most briefly, it is believed that a potassium deficiency brought on most likely by bulimia produced a heart attack. While waiting for the paramedics to arrive she experienced a loss of oxygen to the brain. She was in a coma for two and a half months. Subsequently, it was determined that Schiavo's cerebral cortex had been completely destroyed and replaced by cerebrospinal fluid. The upper brain was about 80 percent destroyed, and there was also damage to the lower brain. The only part of the brain that remained intact was the brain stem, which controls involuntary functions such as breathing and heartbeat—allowing Schiavo to survive (with a feeding tube) even though she no longer had any cognitive function.

Most of us, I think, if our brains literally turned to goo would not wish to be kept in a persistent vegetative state (PVS). It is certainly understandable that people close to someone in PVS might not want to accept reality. They may look for times when the random movements and sounds made by such a person coincide with external stimuli as use that as evidence of sentience. The decision to withdraw life support from the body can be gut wrenching. The very difficulty of caring for someone in PVS is likely to stir feelings of guilt in the caregiver. By ending life support, am I only being selfish? Others may consider that keeping the person in PVS physically alive just so that they can avoid the pain of letting go to be selfish as well. It is an intensely personal matter.

The matter is complicated, even at the individual level, by a culture that has become saturated socially and politically with status of life issues. What is human life? What is the right to life? Can we by our actions forfeit that right? Is there a right to death? Must that decision be positively affirmed during life by a Living Will? Even the framing of the questions matter. Where you stood on the Schiavo matter likely determined whether you thought the issue was the right to life or the right to death.

What interests me is the question of why we have become so obsessed with these questions. And what are the cultural and psychological dynamics of the positions being staked out? It’s rather a tall order. But I will try to tease out as best I can the threads of the political, cultural and personal dynamics.

Putting, somewhat, the cart before the horse, there is unquestionably the issue of identity politics. Schiavo’s case would most certainly gained no national attention had her parents not been devout Christians. There is a certain group of fundamentalist Christians that have come to define themselves by the “Culture of Life”, being “pro-life”, and fight for the “right to life.” The fact that one set of the protagonists in the Schiavo drama were part of that cultural subgroup was entirely determinative of the level attention paid to the matter and the level urgency with which it was felt.

Yet this factor alone, while necessary was not sufficient. There appears to be a variety of ways in which the Right-to-Lifers deem that the right to life may be forfeited. I’d like to whittle away at these as see what we have left.

  1. There are those who need to die. These include murderers and certain other violent criminals and traitors. Most obviously, they seem to feel that we may sacrifice our right to life through an overt act of extreme violence. Your life may be terminated, even against your will, if you are guilty in some fundamental way. We also seem to be becoming increasingly suspect of claims of diminished capacity. Rule Number One, then, is that there is a minimal level of moral worthiness required to retain one’s claim on life.

  2. Certain deaths necessary but regrettable. It’s important to us, in wartime, to first never accept that we caused the war. We must convince ourselves that we are responding to an attack or threat. We must locate the wrong elsewhere. We must see ourselves at the righter of wrongs. It is also important to us that we feel that we are using all measures at our disposal to limit war deaths to those who are in fact responsible. We don’t want there to be any more deaths than strictly necessary on wartime. Yet we accept that this is necessary. What’s interesting here is that whether a war death falls into this category or the first seems to be determined by the degree to which we may know the dead. If we can name the enemy dead individually, we will probably assign specific culpability to them for necessitating the war and those their own death. If we can at least assign the dead to some known category of persons, some named rebel group, again we’re more likely to think that they had it coming. Persons in this category are the undifferentiated mass of others who may simply have been born into the wrong place at the wrong time but nevertheless hold a degree of culpability by the fact of being an enemy soldier.

  3. Related are deaths that are an unavoidable necessity, but highly regrettable. We accept that in the process of getting the “bad guys” there will be “collateral damage.” The fact that we do not count the civilian dead in wartime, refuse to look upon images of them and even refuse to call them civilian dead, preferring a euphemism instead, all points to a deep dis-ease with this category of death. It is hard not to notice that the supporters of the invasion of Iraq and the people most concerned about Terri Schiavo’s “right to life” are largely the same – albeit not completely. We seem to be willing to accept that there are some people who “have to die” for the greater good. We just don’t seem to like it. It’s important than that it is seen as unavoidable. No small amount of the conservative rhetoric coming out of the Schiavo matter centered around how this “death” was not necessary. So Rule Number Two is that life may be forfeited when necessary.

  4. Next we turn to deaths that are not necessary, and yet not tragic since the death results from some personal failing. This category of personal failing, unlike the first, is of those who have failed themselves. This includes drug users, people with certain diseases, particularly sexually transmitted diseases, and people seen as too lazy or stupid to secure the food and shelter necessary to maintain their own lives. What’s at issue is having the capacity to choose a productive life. Children, to an extent, and Terri get let off the hook by their inability to be held culpable for their own situation. Actually making a positive assessment of being culpable is not necessary to attenuate the claim on life, but there must exist the possibility of culpability. So Rule Number Three is that adults must be minimally productive, sufficient to maintain their own life, and to refrain from behaviors which may result in loss of life or forfeit their right to it.

    A great deal of the callousness toward those in poverty or deaths due to inadequate medical care in the US stems from the idea that intelligent and industrious people will find a better result and therefore share a degree of culpability for a bad result. Whether you agree that poverty is a consequent of chance or choice is largely determinative of your concern for the well being of adults in mortal peril stemming from economic conditions. Thus cutbacks in Medicaid, which will certainly result in more than one death, are proposed by the same people in congress who rallied at the last minute to pass a law designed to give a chance at life to one person.

  5. Most deaths, here and abroad, are seen, at least in the abstract as tragic but essentially a personal matter. These deaths are seen as a part of the life cycle. These deaths are morally neutral.

  6. Perhaps there is no bigger contrast between the emergent crisis surrounding the status of one person’s life than the general attitude toward genocide. One of the most extraordinary facts about genocide is that no one seems to care much about it while its happening. That fact made genocide difficult to place in this scheme. On the one hand, we recognize it as the worst of crimes. And on the other hand, while it’s ongoing, we give it scant attention. The holocaust was no secret at the time. It just wasn’t front page news.

    From 1939-1945 The New York Times, arguably the country's most influential paper, barely covered the extermination of millions of Jews. There was plenty of coverage of World War II, but news of the Holocaust did not get the press attention that could have steered public discourse and ultimately saved lives.
    Laurel Leff, author of Buried By The Times: The Holocaust and America's Most Important Newspaper, says The Times minimized and misunderstood the Holocaust. The Times is not alone.
    There have been other genocides aside from the Holocaust in contemporary history — in Armenia, Bosnia and Rwanda to name a few. None received full press coverage in mainstream media outlets. And the problem continues. Today, while the crisis in the Sudan has escalated to a full-throttle genocide, mainstream media still minimize and misunderstand genocide.
    It's not a matter of lack of information. Leff says that at one point during the Holocaust, the World Jewish Congress handed The Times a detailed report and first-hand accounts of horror from Jews who'd escaped. It ran on page 36.

    I’m tempted to say that genocide is too big. Every good liberal knows what its like to wrestle with finding an appropriate response to a world that seems to offer a bottomless pit of need. Unchecked compassion creates the danger of consuming the individual. Demonstrating compassion involves taking onto ourselves some small portion of the suffering of the other. We devote time or donate money. We diminish the amount of resources available to fulfill our own needs in order to diminish the needs of others. Most of us devise strategies for when to respond and how much. Thus the tendency to localism and particularism: we are more likely to respond to suffering when we feel a degree of connection and thus responsibility. Localism limits the range of demand of others on our resources and thus buffers us from draining effects of the bottomless pit of need.

    I’m tempted to say that genocide is too distant. Genocide, at least in our historical memories, is other people we do not know or know much about taking the lives of still other people we do not know or know much about for reasons that are not easily comprehensible for us. Before we can come to care, we must first come to know. There are, for many, barriers to knowing. The insularity of American culture means that many people are simply unfamiliar with places like Sudan or Congo. To understand the unfolding tragedies they would first need to learn a bit about geography and non-American history. For many, this is a sufficiently high hurdle to demotivate people disused to worrying about events outside their borders. Resistance to knowing and resistance to caring are mutually reinforcing. I do not mean to imply that there is some sort of conscious calculation going on here. I’m saying that presented with evidence of distant genocide, many people simply withdraw, change the channel, or cluck their tongue while making the appropriate remarks and express the wish that someone else do something about it.

    Finally, I’m tempted to say that genocide us not distant enough. From the comfortable distance of time, we can come to know and care about genocide, once all that is required of us is compassionate feeling and the charge of remembering.

  7. Certain deaths due to natural disasters or environmental factors get elevated to the status of tragic yet deserving of some outside sympathy. These deaths result from no fault of their own and are unnecessary. Yet parsing out which of these rise to the level of compassion is less than straightforward.

    One year to the day before the tsunami, a 6.6 magnitude earthquake hit southeastern Iran, causing approximately 31,000 deaths. This last September saw a hurricane killing more than 3000 Haitians. The summer of 2003, a heatwave descended on Europe, killing approximately 35,000 people. None of these events penetrated the American consciousness in the manner of the Indian Ocean tsunami. The relative lack of response to the earthquake in Iran one year prior in contrast to the response to the tsunami has a few determinants. Firstly there is the relative magnitudes of the events. There is also the role Iran plays as part of the “axis of evil” and the too close connection between Iran and Iraq in the American psyche, creating a degree of ambivalence towards Iran. But I’m not sure that it would have made much of a difference had the quake happened in China or Africa. We were too self-involved, still nursing the wounds of 9-11, made anew by the implicit debate the election precipitated. Post-election, when the war’s supporters could feel a degree of vindication by the results, it became more possible to care about the suffering of others, just still not possible to direct that towards concern over Iraqi civilian death. Similarly, when hurricane Jeanne slammed Haiti, we had our own hurricane destruction to worry about. The European heatwave of 2003 brought to the fore resentments over the refusal of much of Europe to support us in the war. It was further complicated by the claim that global warming was responsible for the heatwave, and that these claims had political implications.

    Whether deaths due to natural disasters fall into this category or the fifth one seems to be tied the psychological and political costs. If the victims are tainted (Iranian earthquake) or the disaster is tainted (European heatwave) or we have our own to take care of first (Haitian hurricane), deaths due to natural disasters are likely to be thought of, if they are thought at all, as more a part of life not especially deserving of compassionate response.

  8. Certain deaths are not only not necessary, but they require specific prevention efforts. These include deaths due to certain diseases domestically and, to an extent, all deaths of children here and abroad from preventable causes. These are the deaths for which specific resources are marshalled to actively prevent them. These are the causes that private charities take up.

    Age is a factor. Famine relief organizations generally concentrate their fund raising efforts on appeals to saving children. Worldwide 30,000 children die each day from hunger or easily preventable disease. In the US 11.7 million children live in poverty. These appeals are more compelling than the statistics for adults. This is partly due to the sense that adults are more responsible for their own condition.

    Yet whether these causes rise to the level of motivating us to action depends upon our assessment of victims’ responsibility, whether we can identify others who are culpable or we feel should have a greater responsibility, the degree to which the deaths seem preventable and, most saliently, the degree to which we feel ourselves potentially subject to the same dangers. Most deaths that might fall into this category are actually treated as category five deaths – just part of life. It takes a specific and significant crisis or a nameable cause to turn routine deaths into a charity case.

  9. We devote public resources on a routine basis to attempting to prevent certain deaths. How expansively one feels this category should be is the topic for most of the political debates touching on life or death issues. For many of the most conservative people, including a good share of those who protested the removal of Schiavo’s feeding tubes, this category must be construed quite narrowly. The only universally agreed upon death for this category is murder. We all understand the importance of seeking to prevent murders where possible and using public resources to punish those responsible for them. What is less universally accepted is whether public resources are properly used to treat the potentially life threatening illnesses of the poor.

  10. As opposed to most deaths due to natural disasters, some rise to the level of meriting emergency assistance to survivors. Here we found most domestic disasters and the few foreign disasters where the innocence of the victims is unquestionable. Here we also find the known innocents in danger such as the proverbial “child in a well” and nameable individuals in peril such as hostages. To be included here, we’ve got to be able to name and see them. And they’ve got to hold no responsibility for their peril. What unites this category is that the deaths or potential deaths get a great deal of attention paid to and resources devoted to them for a short time. The emerge as crises and then fade from memory once the danger is no longer present.

  11. When conservatives talk about The Culture of Life of being “pro-life” it is the deaths in this particular category that mostly concerns them. These are the deaths that rise to the level of a crisis. They provoke large-scale distress among people who do not personally know the dead or person in jeopardy. In response, people will call for specific laws and/or government intervention. They are separated from category nine by their urgency and from category ten by their persistance.

    These are the deaths of choice. These include abortion, euthanasia, assisted suicide and suicide. Perhaps the Cardinal Rule of the Culture of Life is that death must not be chosen. What also unites the response to these deaths is the desire to control and regulate our bodies. This group of deaths are those in which some choice by some individual causes some individual body to transgress the boundaries of acceptable use resulting in death. They may not be individually known. But there is a notion of individual causation.

    Of these, abortion is the most related to the control over bodies. For abortion alone involves controlling a body other than the one whose “life” is at stake. And abortion alone revolves around the very question of the status of “life” in question. It is not even possible to speak of “life”, “death” or “body” in this context without controversy. What cannot be disputed is that the Culture of Lifers hold abortion to be of paramount concern. That this should be demonstrates the degree to the Culture of Life is motivated by the desire to control and regulate our bodies.

    The debate over abortion is significantly about control over our reproductive organs. If the Right was solely concerned about the fetus as a mini-person they would want to both work for reduction and elimination of abortion. Is it not unimportant to note that abortion rates in liberal Western Europe, with all their sex education, are 30% lower than in the US, where we have been at best ambivalent, if not downright hostile, to sex education for minors. In the United States, the teen abortion rate is nearly eight times higher than the rate in Germany, nearly seven times higher than that in the Netherlands, and nearly three times higher than the rate in France. Yet the Right is not willing to set aside their sex hang-ups long enough to focus on what really works to reduce the number abortion – education and empowering women to make their own reproductive decisions. If it were just about the fetus, and not also control and regulation of our sex bits, these results would matter to the Right.

  12. That Terri Schiavo gets her own unique category says much about the whole affair. At no other point in recent history has the US government declared that “saving” one individual life is a matter of great and singular importance. Not even for the Indian Ocean Tsunami did Bush interrupt his vacation to return to Washington to take action. So what made Terri Schiavo unique among all persons who have fallen into PVS? How did specific congressional action become necessary for this one person when there is not the same sense of urgent need for congressional action that could potentially save many other lives? As alluded to before, identity politics played a role. In Schiavo we find a collection of all the vectors of The Culture of Life. We find innocence, vulnerability, identifiability and individuation. Schiavo’s peril was seen as a result of the combination of injury and choice.

    But what put her over the top was the ability of those gripped with panic over her state to identify with her parents. I’ve argued before that people will privilege the survival of the identities over their lives. Both Schiavo herself and the fight for the survival of her body became repositories for the identities of many people. Keeping her “alive” was a demonstration of the efficacy of their worldview. It also became, at some level, a matter of the survival of the self. At that exact moment, Christian Fundamentalism was hooked up to those feeding tubes.

    That most Americans ultimately concluded that Congress overstepped its bounds shows the relative size of The Culture of Life. It also shows the inherent contradiction in the matter of choice in death. We don’t want someone to choose their death or the death of another. We don’t want someone else to choose for us. The contradiction lies in the fact that a real choice might go either way. For the apparatus of the state to impose a choice, even if it is to forestall another choice, runs aground the resentment of the agency of the Other that motivates the fear of choice in matter of life and death in the first place. Ultimately the fear of choice in life and death matters stems from our own sense of vulnerability. We want to exclude the possibility that someone else, or we ourselves in an emotionally vulnerable moment, might choose death.

  13. At the far end of the spectrum we have the deaths of 9-11. Not since Pearl Harbor, have deaths so redefined and reshaped American culture. The death of the victims of 9-11 was to nearly all Americans what the death of Terri Schiavo became to a very few. Here was an attack on America and Americans, the idea of America and our sense of national identity. In response, the US mobilized massive amounts of resources in effort to both punish those seen as responsible and to prevent a future recurrence. Here are a set of deaths that justified the taking of other lives and the sacrificing of still others to both punish those seen as responsible and to prevent a future recurrence.

    Americans of nearly all political stripes responded with grief and fear, but also with an instinctive assertion of the dimension of identity attacked – our nationality. The immediate proliferation of American flags and symbols of America was motivated by an unconscious understanding that our core identity as a nation was in jeopardy.

What we can take away from this survey of death is that the value of life in American culture is conditional. If liberals are frustrated by the conservative willingness to support the death penalty while claiming to be “pro-life” its because they’re missing this point, and perhaps overlooking the conditionality in their own schema of life and death. In the specific worldview of The Culture of Life, the value of life and the meaning of death depend upon moral worthiness, the degree of personal agency in causation, and the identifiability of the individual.

But we still need to ask why it is that our culture and politics have become so obsessed with status of life issues. To say that the religious right has forced the issue, while true, only shifts the question, it doesn’t answer it. We need to ask what urgent needs are being met by reclaiming control of the physical body generally that it blossomed into control over one body specifically. We need to ask how it matters that moral worthiness, mode of causation and identity are what determines the rules for the status of life.

Central to this question is the issue of control, and specifically control of one’s own physicality and control of others’ physicality. There are several significant dislocations happening in the US at this time. Consolidation in agriculture and other markets have changed owners into workers and producers into consumers. Globalization is restructuring who produces what and how it’s distributed. If you grew up in a “mill town”, even if you never planned on working in the mill, it was always there. If you did work there, that’s what you were – a Mill Worker. And chances are that many in your family and your past were too.

These dislocations have caused a break with history and tradition. Old understandings are no longer relevant. Old paradigms no longer apply. Certainties about where we fit in the order of things have eroded as the order of things has so drastically changed. If it seems that the US is harder hit by the social and psychological impacts of this global phenomenon, remember the US’s declining role as a world economic superpower. Americans are used to be primary. We define ourselves as doers and makers and producers.

So it should surprise us to see a longing for tradition and strength. So much of the more hysterical rantings of the social conservatives centers around the need for “standards” and that without them, they fear the total collapse of society itself. The fear is palpable. They are trying to express that there is some fundamental and critically essential part of human society at peril. And what’s at stake is who they are.

There’s a real fear of loss of control here, both specifically and generally. The ultimate fear is rather specific. The fear is of a world in which they will be isolated, alone, in which future generations will no longer think as they do and their last remaining source of cultural authority will be gone. Having invested their identity in right-wing Christian fundamentalism, the threat of its disappearance is the threat of the loss of self.

Now let’s see if we cannot pull these elements together to answer the question: What is the militancy involved with some forms of social conservatism and/or right-wing religion a substitute for?

It is a replacement for the certainty and security of identity that once came from our work lives. It is a replacement for the lost sense of tradition. It is replacement for our lost sense of efficacy – our ability to count for something. It tells what we are and what we mean. It’s a defense against impotence. It’s a source of identity and validation of identity in world that seems determined to render us invisible.

It is not a huge stretch to move from the disappearance of the self as identity to anxieties over the status of one’s own physicality. For most people the idea of self as identity and as a body are one and the same. To reassert certain and known moral rules for control of and status of our physical selves is to reclaim a degree of security.

Those deaths in the first two categories, those who need to die, are the ones who are seen to specifically threaten our physical security in some fundamental way. Introducing further moral filters further establish the solidity to the claim on personal security for those who hold the requisite moral turpitude and dismiss the possibly attenuating claims of those who do not. To further assign a stronger claim on life to those most like ourselves, whom we can identify and, more specifically, identify with, makes it more likely that when we need to press our own claim for life that it will have force.

As a package, The Culture of Life asserts for the claimants the strength and power of their claim to personal security, limitations on the ability of others to threaten that security and the cultural authority of the moral structure that houses their identity.

Terri Schiavo became every fundamentalist Christian. She embodied, literally, their sense of personal vulnerability and sense of personal innocence. Her cause became a test of their cultural authority.

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At 8:12 PM, Anonymous Ari said...

It is difficult to empathize with the death/tragedy of one person. People do not emotionally respond to statistics, but if you were to show them a picture of a single member of those statistics in pain, they would show an emotional outburst.

At 10:12 PM, Blogger The Mediterranean said...

Most of us don't empathize much (or at least not AS much) with the victims of the tsunami because they are not like us. In cultural, linguistic, national, religious terms, they are different. Liberals often have a hard time fathoming this fact because they seem fixated on big, abstract notions (like Humankind), with a concomitant failure to really understand how particular, more local bonds work--an American's bond to another American who died in the WTC (even if s/he was a stranger), the bond of family, of religious creed, etc. What do we share with Indians? Physical structure, little else. Culture is where the action is. Liberals, in my experience, don't get it, and they thus miss quite a lot.


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