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AmericaOxford Handbook of Psychiatric EthicsOxford Studies in Normative EthicsOxford Studies in Normative Ethics, Volume 7Oxford Textbook of Philosophy of PsychiatryPassionate DeliberationPatient Autonomy and the Ethics of ResponsibilityPC, M.D.Perfecting VirtuePersonal AutonomyPersonal Autonomy in SocietyPersonal Identity and EthicsPersonalities on the PlatePersonhood and Health CarePersons, Humanity, and the Definition of DeathPerspectives On Health And Human RightsPharmaceutical FreedomPharmacracyPharmageddonPhilosophy and This Actual WorldPhilosophy of BiologyPhilosophy of Technology: The Technological ConditionPhysician-Assisted DyingPicturing DisabilityPilgrim at Tinker CreekPlaying God?Playing God?Political EmotionsPornlandPowerful MedicinesPractical Autonomy and BioethicsPractical EthicsPractical Ethics for PsychologistsPractical RulesPragmatic BioethicsPragmatic BioethicsPragmatic NeuroethicsPraise and BlamePreferences and Well-BeingPrimates and PhilosophersPro-Life, 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This memoir chronicles ten days of crisis for the Galli family.
Seventeen-year-old Jeffrey broke his neck diving into the swimming
pool at a family friends' house on July 4, 1998. He was rushed
to hospital and his life was saved. But he was now completely
paralyzed from the neck down. He cannot even breath for himself.
Once the full horror of the extent of Jeffrey's injuries become
clear, his parents wonder whether they should now kill him.
Although Richard and Toby make their decisions together as husband
and wife, it is Richard's experience of events we learn of, since
it is his memoir, and he gives the impression that he is the main
decision-maker in the marriage. He is a lawyer, and it is clear
that he is used to arguing his case articulately and convincingly.
The story is powerful enough on its own to pack a punch, but Galli
really manages to bring the events alive, and he conveys at least
some of the agony that he felt for his son, for his family, and
Their friends rally round wonderfully, coming to the hospital,
writing notes, offering help and love. Richard and Toby spend
a great deal of time at the hospital, occasionally getting a little
sleep or food, but mostly just trying to work out what to do,
and communicating with Jeffrey as he starts to become conscious
and aware of what has happened to him.
In the first few days, it is clear from Richard's notes to himself
that he believes Jeffrey's new life will not be worth living,
and that they should let his life end. It seems that Toby is in
agreement on this. They find out what steps they would have to
go through in order to turn off Jeffrey's breathing support, and
they meet with experts and the hospital ethics committee.
The professionals convince them that they can wait a few days.
As parents, they have the legal right to make the decision to
discontinue life support until Jeffrey's eighteenth birthday,
which is not until the following November. But they want to find
out more about what Jeffrey's new life could realistically be
like. They read the memoirs of Christopher Reeve and
but they know Jeffrey's life will be nothing like these role models,
because he lacks their resources and their achievements. Jeffrey
hasn't even had a girlfriend, and he had been struggling in high
school. Only after getting treatment for depression had Jeffrey
started to find his feet and match the accomplishments of his
Richard and Toby visit some nursing homes for people who need
full-time care, but it soon becomes clear that their son's injury
is too severe for even these facilities, and that the only place
Jeffrey will be able to stay is at home. They know that Jeffrey's
life span is likely to be severely shortened by his injury, but
that there is still a high probability that they will eventually
reach an age when they do not have the physical strength to look
after Jeffrey at home. So there is a strong chance that, at some
point in his life if he lives into his thirties and forties, Jeffrey
will have to be taken into a facility a long way from their home
in Rhode Island, where he would be looked after by strangers.
From Richard's reconstruction of those ten days, it seems that
there were two factors that changed their mind about ending their
son's life. First was the acknowledgment that Jeffrey should have
some part in deciding whether he lives or dies. Second was being
given the assurance from a physician, whose name is never mentioned,
that he would be ready to help Jeffrey terminate his life support
if that was what Jeffrey and his family wanted.
This is an important book for anyone interested in the rights
of the disabled, the responsibilities of parents to their disabled
children, and the quality of life of people with severe spinal
injuries. I'd recommend it also for use in classes on medical
ethics. One of the most controversial aspects of the story is
the way that Richard is ready to make a decision to turn off the
life support machines without bringing in Jeffrey into the decision-making
process, even though Jeffrey was conscious and would within a
few months be a legal adult himself. While the parents were within
their legal rights, many would say that their approach was ethically
questionable. On the other hand, we should be aware of the dangers
of second guessing someone else's thinking unless we have had
experience of similar crises ourselves, and most are grateful
never to have to face such a terrible decision.
Jeffrey Galli Web Site
© 2001 Christian Perring. First Serial Rights.
Ph.D., is Chair of the Philosophy Department at Dowling College,
Long Island. He is editor of Metapsychology Online Review.
His main research is on philosophical issues in psychiatry.
He is especially interested in exploring how philosophers can
play a greater role in public life. He is available to give talks
on many philosophical or controversial issues in mental health.
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