Personal Autonomy and Moral Agency Case 2: Elizabeth Bouvia11 Elizabeth Bouvia was born a quadriplegic resulting from cerebral palsy. For the first few years of her life, both of her parents cared for her. When she was five, however, her parents separated, and Elizabeth went to live with her mother. Then, when Eliz- abeth was ten, her mother remarried, and Elizabeth was put in a home for disabled children. One thing young Elizabeth did not lack was determination. Despite her troubled start in life, Elizabeth eventually worked her way through college, earned a bachelor’s degree (with support from the state), and married. Unfortunately, events took a turn for the worse about the time she started working on her master’s degree. First, Elizabeth suffered a miscarriage. Then, being unable to deal with her disability, her husband left her. Next, Elizabeth’s mother became ill with cancer. In the midst of these traumatic experiences, Elizabeth’s arthritis was putting her through nearly unbearable pain. Unable to cope any longer, she checked herself into a hospital, where she was put on a morphine drip to control the pain. Still unable to find relief, Elizabeth decided that she wanted to end her life. She refused to eat, so doctors inserted a feeding tube into her stomach. Elizabeth then petitioned the court of California to have the tube removed. When asked at a news conference whether she really wanted to die, Elizabeth explained that she felt that she no longer had any quality of life. The court initially denied Elizabeth’s request; upon appeal, however, the courts reversed the earlier decision and allowed the feeding tube to be removed. Once this was done, Elizabeth again stopped eating but soon gave up on the attempt to starve herself to death. When another doctor offered Elizabeth an aggres- sive program of pain management, she accepted. Elizabeth Bouvia is still alive today. Although it’s certainly very difficult to judge Ms. Bouvia’s attitudes and ac- tions, they do raise several important concerns. Most obviously, of course, Eliza- beth’s trying to die amounted to an attempted suicide. Furthermore, a number of disability groups have been highly critical of Elizabeth’s efforts to end her life. As they see it, Ms. Bouvia’s actions demean persons with disabilities because they imply that life with a disability is not worth living. These people feel that a meaningful life is possible even for a person in Elizabeth’s situation. If a dis- abled person were to desire to commit suicide, it would probably be because that person is not receiving proper care—a problem common within our society. Proper care certainly includes effective pain management but also much more. The state of California offers home support services, for instance, which allows a severely disabled person to live in her own home and receive all necessary care. In addition, there are work programs designed to help the disabled find suitable employment. Was Elizabeth Bouvia familiar with these opportunities and open to them? She claimed that she knew all about these options but refused to take advantage of them. She did not like the idea of someone else taking care of her. Elizabeth also steadfastly refused any counseling or help. Anxious over her behavior, her ex-husband requested that she receive a psychiatric evaluation (which the court refused). Elizabeth’s father was also upset by her actions. In response to her claim that she had received no love, her father maintained that she had refused his help. Was Elizabeth’s attempt to end her life simply an act of despair resulting from an episode of deep depression, self-pity, and withdrawal? Elizabeth insisted that it was not.