Friday, March 25, 2005

Why so much attention to a family tragedy?

The New York Times > National > Behind Life-and-Death Fight, a Rift That Began Years Ago

Yet another story about the Shiavo family tragedy. Why did this story get so much attention? Other than the length of the debate and the legal ferocity, this was otherwise medically (somewhat) routine. In the early 90s, assuming there was a reasonable family consensus in a patient with this type of condition, it would have been quite routine to discontinue tube feeding. I seem to recall that even in catholic hospitals this not unheard of -- until the Vatican reveresed course in the mid-90s and decided tube feeding was a minimal requirement. (But one could simply wait for pneumonia to set in, and treat that without antibiotics.)

So what made this a big story? Here are my guesses. Maybe it was all of these.

1. Of course the congressional cynicism and political ploys made this a big story. It's not every day our government goes nuts. This amplified the story, but the story was already out there.

2. The drunken sailor effect. There are a bunch of angry white men who won big in a viscious hard fought election. They've pummeled and broken their feeble opponents. We lie whimpering and defeated. Sadly, that gives the victor no pleasure. They wanted a fight. So like a drunken sailor, they're weaving around looking for another battle, another way.

3. The 'use it or lose it' problem. The culture wars built up a largely right wing cultural media machine, which in turn needs more culture wars to keep it fed and energized. In a hyper-developed sophisticated economy these feedback loops are very powerful -- but they were well understood by Randolphy Hearst generations ago. The 'military industrial complex' is a good analogy. This right wing media machine is a fine honed weapon, with nothing left to shoot at. This story gave it something to do.

4. Blood and purity. This is the most intriguing part of the story. I think it may be more cultural and geographic than political. In a chunk of the nation it seems the real issue was that the wishes of a spouse dominated those of a blood kin. This may seem quite obvious to many of us, but it's not all obvious to a large chunk of America. For this group, blood is what matters. They were surprised to discover that the law says differently. This made them angry.

5. Boredom. Iraq is fading from public attention. Afghanistan is long forgotten. The tsunami is all but forgotten. The elections are over. Social security is boring.

6. Demographics. The boomers are starting to run into these situations. We're intensely interested in them.

7. All of the above.

[Update 3/27: On reflection I'll toss in the millenialist aspects of this story. I'm getting the sense that about 10% of the population is looking for evidence of direct divine intervention. For example; Ms. Shiavo speaking -- that would qualify as divine intervention in my book. For this group they see a 'test case' from God. Given that perspective their passion will be, by necessity, enormous.]

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