With the news today of Terri Schiavo’s autopsy it’s tempting to consider the whole nasty affair concluded, and to a limited extent, it is: Michael Schiavo is vindicated by the confirmation that the brain of his wife was all but gone, that Terri was not abused, and that she would never, ever have recovered. The problem is that we essentially knew all that back in March, when Bill Frist was making his negligent videotape diagnosis that Terri “seems to respond to visual stimuli.”

Schiavo’s autopsy doesn’t necessarily help us resolve end-of-life issues because those issues go beyond medical facts. If we could have perfect certainty about diagnosis and prognosis, we might not have to answer tough questions about how long we would like to live on life support or the conditions under which we wish not to be resuscitated; we would know that in a given situation we would recover, or not. The problem is that we can’t know that definitively until we’re already gone. Our decisions or those of our caregivers can be informed by the best science in the world, but not dictated by it. It’s because we don’t have such certainty that we designate—or the law designates for us—people to act on our behalf and draft complicated advance directives that try to anticipate the potential set of unthinkable circumstances we might someday face. In the end we must be proactive and self-conscious, and we have to trust the people who may be empowered to make the decisions for us.

What was so troubling to me about the Schiavo case is the lack of respect to either the medicine at hand or the established procedures for making these decisions. Calling Terri Schiavo to testify or referring to her as “non-ambulatory” was simply obscene from either perspective. As The Walloper recently suggested, stubborn adherence to something so unreasonable is about far more than the truth; it’s about the demarcation of political and social territory. Frist, et al., didn’t care about the medicine then and I doubt they’ll be swayed now, holding onto some twisted notion about the sanctity of life so fiercely that they convinced themselves that someday she would get up and walk around again (and note, not that it would have helped Schiavo, these are some of the same people who decry stem cell research as fantasy).