“Americans overall are very conflicted about death,” said Jose Maldonado, assistant professor of psychiatry and behavioral sciences at Stanford’s School of Medicine and the Stanford Center for Biomedical Ethics. He was one of three panelists at last night’s discussion entitled, “Health Care and Life Extension: Ethics and Policy.”

The event, organized by Stanford in Government, hosted Maldonado as well as Jon B. Eisenberg, a civil appeals attorney with the American Civil Liberties Union, and Rabbi Patricia Karlin-Neumann, senior associate dean for religious life at Stanford.

Much of the night’s focus was spent on the Terri Schiavo case, as Eisenberg was part of a team of lawyers representing Michael Schiavo, Terri’s husband, in court.

Stanford in Government member Eric Friedman, a junior, said the event’s topic was chosen because of the Schiavo case but also to “demonstrate the more general implications of the issue,” if the ethics behind life and death. The panelists’ represented a variety of perspectives on the issue, he said.

Eisenberg provided the legal framework for life extension decisions by giving an overview of the current law. In California, Eisenberg said, residents are constitutionally guaranteed autonomy in health care and the right to privacy. When applied to end of life issues, these rights allow residents to refuse health care or treatment at any time. Although the law is clear in this regard, it gets more complicated, according to Eisenberg, when the patient’s mental competence is in question.

In a legally perfect world, everyone would have an Advanced Health Care Directive, a legal document that explicitly states an individual’s health care preferences, should they be declared incompetent. But Eisenberg said only 10 percent of Americans have such a document. Then, directions to family members take precedence over health care decisions, as they did in the Schiavo case.

Karlin-Neumann provided a religious take on the ethics of life extension. In the past, “religious traditions were inherently conservative about life,” she said, but more recently, liberal interpretations of the Talmud, a collection of Jewish rabbinical writings, and other texts have lent support to those who choose to end their loved ones’ lives by removing feeding tubes.

Though a doctor himself, Maldonado freely admitted that the medical profession often falls short when it comes to patient preferences. Doctors tend to aggressively push treatment at patients, even when it is against the patient’s wishes.

The three panelists agreed that the ethics of life extension and health care are complex, especially when family members of unconscious loved ones attempt to reconcile legal, religious and bioethical perspectives. According to Maldonado, the issue is compounded by human irrationality.

“I’ve never seen a reasonable person,” he said.

The panelists’ discussion was extended to a question-and-answer session with the 20 or so audience members. In response to one question about what people should do, Eisenberg urged the audience to create their own Advanced Health Care Directives in order to avoid possible confusion in the event of an emergency.