The economics of Terri Schiavo?

Steve Landsburg weighs in on Terri Schiavo:

I have less understanding of why Schiavo’s parents want to keep feeding her. And insofar as they want others to keep feeding her–through Medicare, etc.–I think we can safely ignore their preferences. But provided they and their supporters are willing to bear those costs, I infer that this is something they want very much and there’s not much reason to stop them.

I doubt that a "willingness to pay" standard accurately values human life in such instances (in fairness to Landsburg there is more to his position, read his entire post).  Often it picks up a mere ability to spend money, rather than any relevant notion of human welfare.  Whether the husband can outbid the parents may simply depend on whether he has gone bankrupt from his previous involvement in her care.   

Nor do I think that family decisions — whatever your view in the Schiavo case — should be decided by a real or hypothetical societal auction.  If there is any "protected sphere" for human decision-making, surely it is here.  The problem is that we don’t agree on how to define the guardian of the sphere — is it "Terry" or "husband as guardian of a no-longer-living Terry"?

This case will only grow in symbolic importance.  Keep in mind, the care of Terriy Schiavo has been financed by the state of Florida and Medicaid for the last several years.  According to one AP story, it costs $80,000 a year to keep her alive.  Note that "a judge approves all expenditures, from attorneys’ fees to the woman’s haircuts."

Therein we see the problem for the future.  Say you take a "pro-life" stance on this case.  What will happen when we can maintain, say, 30 percent of the "dying" population in this kind of state for decades?  Such technologies are probably only a matter of time.

Say you take a "pro-husband" stance.  Presumably you cite evidence for Terri’s severely impaired mental facilities.  What will happen when we can keep, say, 30 percent of the "dying" population in a somewhat less impaired state for decades?  Such technologies are probably only a matter of time.  Was her vegetative state really the issue, or was it just cost?  Our views will be tested, sooner or later.

I don’t see much guidance here from economics, political philosophy, or virtue ethics.  My instincts are to "look toward the future," but I don’t have a good argument that avoids all possible repugnant conclusions.  (I will never forget Julie Margolis, asking me in my job interview at UC Irvine, why we do not value human life at replacement cost.  That would be no more than a few thousand dollars, given that some women stand right on the verge of wanting another baby.  I didn’t have a good answer, although they hired me anyway.)

As Medicare grows as a percentage of the federal budget, this issue will become increasingly important.  And as technology advances, no one will be left with a comfortable intellectual position.


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