The Conservatorship of A Body

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The Conservatorship of A Body

It was September 1993 when Robert Wendland flipped his pickup truck off a freeway in Lodi, California. By the time I was writing about him in 2001, he had been living with a feeding tube down his throat for eight years. I was working as a researcher and writer in the Program in Medical Ethics at UC San Francisco and we were closely following the final stages of a trial that had raged on for six of those eight years and that had divided the Wendland family, who now sat on both sides of the courtroom.

The trial hinged on the question of his feeding tube, on whether it should be re-inserted each time anew, after Wendland continuously tore it from his esophagus, or whether the man should be allowed to die of starvation, not as an act of cruelty, but as one of release. The crux of the problem was this: after emerging from his initial coma, Wendland had regained some iota of consciousness, but only to the minutest degree, as if he had been abandoned in a kind of purgatory, a liminal zone between awareness and a persistent vegetative state. His wife and children claimed that this life was no life at all. Although Wendland could react to stimuli and even grasp convulsively at objects, which his physical therapists tirelessly held in front of him, he displayed no connection to his former self. He could not speak. He could not walk. And he could not eat without the assistance of a feeding tube. But more than this, they claimed that he was unable to recognize them, his family, his closest relations. To them, he seemed little more than a machine, and a barely functioning machine at that, one that would certainly never be returned to the fullness of life again. Supposedly before his accident Wendland had expressed his own aversion to this kind of depleted existence, but, of course, after the fact, these words could hardly be verified. On the opposing side was Wendland’s mother, who argued that her son was in no pain, his body continued to function, which she took as evidence of an underlying will to live, and that somewhere within his glassy stare, she had, in fact, seen the faintest glimmer of recognition. It was the indeterminacy of Wendland’s state of consciousness that made the whole thing a very speculative affair. Of course, when it came right down to it, no one could say for sure what Wendland experienced, whether he choose life or whether he longed for death, or whether anything at all went on in the deeper realms of his being.

Our department in medical ethics was interested in the case, not only because it would set certain precedents that had bearings on the medical/legal world, but because the issue of advanced directives—or, more often, the absence of any advanced directives—always presents a potential issue for any hospital dealing with end-of-life care. Had Wendland created a living will, in which he explicitly stated his wishes for any given critical situation, or had he filled out a durable power of attorney for health care, in which he appointed someone to be his proxy, the conservatorship of his body would have raised no legal issue at all. But, of course, Wendland—like most people—never left any explicit directions, should a situation like this one arise.

Often, when the topic of advanced directives comes up among health care workers, you hear the same kinds of explanations as to why so few people fill them out. It seems to be generally accepted that the reason people don’t address end-of-life issues while they’re still healthy is because people are afraid of their own finitude. Death may be a perfectly benign discussion topic, so long as it remains abstract, but it’s an entirely different story to imagine the intricate details of one’s own demise. Now this makes a certain kind of sense, and I’m sure that it contributes, in some minor way, to the general scarcity of these end-of-life documents. But it occurred to me the other day, as the Wendland case came back to me in full force after all these years, that if there is any deeper philosophical resistance to filling out an advanced directive—that is, if there is any resistance at all, and not just a general forgetfulness about planning one’s own hypothetical death while trying to juggle the immediate demands of life—it has something to do with the relinquishment of one’s own voice. In the case of a durable power of attorney, one places in the hands of another the decisions regarding one’s own health care, and potentially one’s own life. Even in the case of a living will, where you may have clearly articulated your wishes for a variety of potential scenarios, there is no way to totally and perfectly account for every unforeseen event. Inherent to the advanced directive, then, is the possibility that someone else will have to make a final decision for you. And I don’t think it matters how well you know, love, or trust this person, the idea that you will not be there to speak on your own behalf, but that someone else will speak in your stead, this carries with it its own discomfort.

The Wendland case has been haunting me for the past few weeks, and for a while, I just rolled with it, not bothering to interrogate the meaning of its return. It has been over ten years since the trial ended. Why it’s resurgence right now? Then it dawned on me: on Tuesday, the country will go to the polls to vote for the next president. On Tuesday, we decide who will speak on our behalf for the next four years. Collectively, we turn our voices over to the individual who will, hopefully, make decisions in accordance with our values, our interests, and our beliefs. The nation is a body politic, and nothing less than its conservatorship is at stake in this national election. As divisive as the Wendland family fighting over the life or death of its loved one, we wage such a vehement battle against each other because it is nothing short of an entire way of life—a mode of existence, a value structure—that hangs in the balance of this election.

Robert Wendland died of pneumonia two weeks before the trial ended in favor of his mother, who fought for six years to prevent that death. Maybe things have a way of correcting themselves in spite of human intervention, but if you had the power to choose your own conservator, you would surely think long and hard about who would best represent your most pressing concerns.

-Jacqueline Abrams

2 Comments On This Topic
  1. stacey widger posted
    November 20, 2012 at 8:36 pm

    good lord, you are a fine writer!

    • Allegra posted
      January 17, 2013 at 9:34 pm

      who would you choose? Do you have an advanced directive and/or living will?

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