Skip to comments.Bioethicist argues PVS diagnosed patients should not be kept alive
Posted on 04/12/2012 4:17:29 PM PDT by wagglebee
April 11, 2012 (LifeSiteNews.com) - If an American bioethicist gets her way, all patients evaluated as being in a permanent vegetative state (PVS) would by default have artificial nutrition and hydration (ANH) withdrawn unless they have made a prior wish to be kept alive.
In the March 2012 issue of Bioethics, Dr. Catherine Constable argues that in the absence of clear evidence that the patient would opt for this existence over death, keeping him alive by any means of assistance is ethically more problematic than allowing him to die.
Terri Schiavo was declared to be in a PVS state
and despite intense opposition from her parents
and thousands of supporters, her food and water
were withdrawn causing her to experience a slow,
Constables article however, does not appear to adequately confront recent research indicating that many patients have been misdiagnosed as PVS and have in fact had functioning, fully conscious brains. They have been unable to communicate their situation to caregivers and to those who in many cases made misguided decisions to end their lives. The highly respected Discover Magazine published a dramatic report on such research last year.
The term PVS itself is also being increasingly being challenged as inappropriate for human beings who it is argued can never be considered to be vegetative.
In her article titled Withdrawal of Artificial Nutrition and Hydration for Patients in a Permanent Vegetative State: Changing Tack, Constable suggests that the current medical presumption that favors providing nutrition and hydration to PVS patients is a violation of autonomy and that it goes against the best interests of the patient.
Constable, who teaches at New York University School of Medicine but who studied bioethics at the Ethox Centre at Oxford University, justifies her position using the philosophical premise of Peter Singer that [whether or not] a being is human, and alive, does not in itself tell us whether it is wrong to take that beings life. She drew heavily on Singers method for valuing persons in terms of consciousness that allows him to argue that the most significant ethically relevant characteristic of human beings whose brains have ceased to function is not that they are members of our species, but that they have no prospect of regaining consciousness.
Without consciousness, continued life cannot benefit them [PVS patients], Singer argued.
Constable runs with Singers line of reasoning, concluding that a decision to preserve the life of a patient in a state of permanent unconsciousness based on respect for life itself is morally no more sound than a decision to take that life.
For Constable, an individuals autonomy is the highest human good, overriding any other good, including what she calls the sanctity of life. Since a PVS patient presumably no longer has consciousness and therefore lacks autonomy, her argument runs, then there is no moral reason that such a patient should be kept alive.
In view of this conclusion, other considerations, such as the cost to the healthcare system (public, or any other kind) would seem poised to be deciding factors, she argues.
Constable goes as far as making the case that those who provide a PVS patient who may not have wanted to be kept alive with ANH have arguably committed a worse violation of autonomy by treating the patient than if we had not treated him against his wishes.
Bringing in surveys that indicate that a majority of people would not want to continue living in a permanent vegetative state, Constable argues that in continuing to provide ANH to PVS patients we are employing a treatment that most do not consider beneficial without consent. For Constable, ANH is simply a form of treatment that is concomitant with all the ethical ramifications that would normally accompany any other kind of treatment.
Constable even argues against keeping PVS patients alive through ANH under the pretext of a chance of recovery for the reason that the new life gained would be far less likely to resemble [the life that was] lost and would likely resemble some state of middle consciousness. She suggests that the life of a recovered PVS patient would be quite possibly, worse than non-existence.
Renowned bioethics critic Wesley J. Smith called Constables position paper a radical proposal that would set the stage for what he called a default for death policy [that] would establish the foundation for a veritable duty to die.
Smith warned that Constables arguments for killing PVS patients are not limited to the PVS.
Some bioethicists already claim that those with minimal consciousness have an interest in being made to die. And dont forget Futile Care Theory and health care rationing bearing down on us.
The Vaticans Congregation for the Doctrine of the Faith (CDF) stated in 2007 that the withdrawal of artificial nutrition and hydration from PVS patients is immoral. Their statements were approved by Pope Benedict XVI.
The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented.
The CDF clarified that even if a competent physician judges with moral certainty that a PVS patient will never recover consciousness, nonetheless, a PVS patient is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means.
The late John Paul II had also taught that the administration of water and food [to a sick person], even when provided by artificial means, always represents a natural means of preserving life, not a medical act.
We had better push back on this agenda, warned Smith on his blog.
The lives of tens of thousands of people may be at stake.
This attitude is beyond repulsive.
How can one tell the difference between PVS and any garden-variety Democrat?
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Gosh...that’s easy... a pvs accepts it without commene... a democrate demands it.
Wonder why that is.
Darn good question....LOL
Almost a decade ago, in South Africa, a doctor discovered by accident that a common sleep aid, sold in the US as ‘Ambien’, is in many cases waking people up from “permanent vegetative states”.
The theory of why this happens is based on why persistent comas happen. When part of the brain is damaged, the body released a chemical called GABA that “turns off” that part of the brain so it can be repaired. However, in some people, a big release of GABA *sensitizes* their entire brain to GABA, so that even the tiny, normal amount of GABA found in the blood normally, after production of GABA returns to normal, is enough to put the entire brain into a coma.
Ambien is a GABA blocker.
And remember that this has been known for a *decade* now, so if this “American bioethicist” is talking about killing people in persistent comas, she is either ignorant of this discovery, or, importantly, *indifferent* to it.
That is, in this latter case, that she *knows* that many of these people in “permanent vegetative states” could be *revived*, but she *wants* them to be killed, anyway.
I know this sounds truly horrifying, but such people are often so focused on how *they* define “quality of life”, that they are more than willing to sacrifice the lives of other people that they *feel* have an “unacceptable quality of life.”
I wonder what they will think when its their turn to go and someone else is making the decision......
If the patient recovers, then obviously he or she wasn't really in a permanent vegetative state. If the patient is killed by the medical profession, then obviously he or she will never recover so the diagnosis of permanent vegetative state was accurate.
It's really very simple.
The next group to be targeted will be the mentally and physically handicapped. After all, they will be happier dead, dontcha know?
We sink ever lower into the moral sewer.
Satan has deeply inspired this bunch.
Lorod have mercy on us.
This sounds like it would happen even if the patient did not want it to happen and had that in writing.
An excellent observation. Bioethics is predicated on a set of principles that insists upon the moral and intellectual superiority of the bioethicist to the patient. It is impossible to practice the craft if the practitioner (bioethicist) grants the absolute primacy of the patient.
Once a position has been carved out that permits life and death decision-making independent of the patient all manner of rationale becomes possible.
Consciousness is not an easily defined concept. In fact consciousness cannot be evaluated as to its existence. One conscious being using their consciousness to assess the relative consciousness of another being is not grounds for scientific methodology.
Bioethics, then, precludes and supercedes scientific endeavor. It amounts to little more than playing God.