Quality of Life Is the Real Issue

HOW does society determine the value of human life? Can it be measured - in monetary terms or by biological experience? Or is it a matter of personhood? Are there classes of persons - persons of higher or lower worth? These are philosophical and theological questions, but now they are finding their way into the courts. Judges will have to set legal guidelines; yet the larger issues remain.

This term, the United States Supreme Court will grapple with what is called a right-to-die case. It's the first one the justices have faced. The High Court is not likely to come down with a definitive ruling. It seldom does the first time around. There will be other cases like this in future years. A consensus will eventually be reached.

The case at hand - Cruzan v. Director, Missouri Department of Health - involves a heart-wrenching situation. The parents of a young woman, who for the past six years has been in what is described as a ``vegetative state,'' want the apparatus designed to keep her alive to be removed. They say their daughter, Nancy Beth Cruzan, would not want to live in an entirely dependent condition. Her wish, they contend, would be to reject artificial feeding and other mechanical support.

But Missouri officials say they have a responsibility to keep her functioning and refuse to withdraw the apparatus.

At stake is the broader issue of privacy. This concept is not spelled out in the Constitution but is implied in the Bill of Rights. It has been threaded through court rulings in recent years. Privacy has been the basis for allowing a degree of individual choice in abortion. It underlies the right to use contraception.

Some have defined privacy as the right to be left alone. The Cruzans say that includes the right for their daughter to be free from unwanted medical treatment. Missouri officials stress that previous courts have extended this choice only to the individuals involved. There is no proof that Miss Cruzan would have rejected life-support systems, they say, and there is little precedent for parents or others to make that choice.

A trial court sided with the Cruzans, but the Missouri Supreme Court reversed the decision, ruling that the right to refuse medical treatment is not absolute and is outweighed by the state's interest in preserving life.

This case has broad implications. Women's advocacy groups say it could affect the ability of a woman to make decisions about her own body. Lawyers for NOW's Legal Defense and Education Fund say that if the state prevails over the Cruzans on the issue of privacy, the decision could permit ``greater hardships'' on women than have been imposed by recent rulings limiting abortion.

Other groups - especially those who choose alternatives to medicine in their treatment of disease - will be watching this case closely. For example, the Cruzan decision could affect the right of parents to decline medical care and rely radically on prayer to heal their children.

Those with differing views might find common ground over the issue of quality of life. Our society places great emphasis on meaningful existence. This isn't a question of survival of the fittest but of providing opportunity for developing the intellectual and spiritual values of the individual.

A fetus or a heartbeat may represent biological vitality, but this isn't the whole of humanity. The debates over abortion and the right to use mechanical means to prolong human life - as important as they are - address limited questions. More broadly, should not the preservation of individual being be considered?

Some may pass this off as a metaphysical concept that has little to do with the legal questions at hand. But the underlying issue of quality of life cannot be ignored.

Courts of law can only go so far in adjudicating that which is basic to a moral being. We are then on our own to resolve these matters through enlightened thought.