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October 4, 2006

Do they really want to experimenting on the incapacitated?

Topics: Euthanasia

A recent article appearing in the Journal of Medical Ethics addresses the suggestion that medical experiments should be conducted on those who are considered in a permanent vegetative state. A chilling, if not frightening, account is reported by BioEdge:

What should be done with patients deemed to be in a "permanent vegetative state"? A discussion in the current Journal of Medical Ethics shows that there is a growing interest in using their bodies for medical experiments. They would be especially useful in studying the long-term effects of transplanting animal organs. The patients often survive for years, and if a virus affected their brains or other vital organs, very little harm would be done.

Some bioethicists have even contended that PVS patients are actually dead and can be treated as cadavers. But Dr Steven Curry, of the University of Melbourne, disagrees, partly because they aren't dead and partly because it would be too difficult to persuade the public that they are.

PVS patients are alive, he contends, but they have nothing to lose and they can contribute to the common good:

"Those who are in a PVS will not ever wake up, they feel no pain or discomfort and have no continuing interest in their own survival... these patients must also have a right to risk that life for the common good... The patients will not be able to have children and have no capacity for movement, so that their possible confinement does not violate the interest that underpins the right to free movement... Also, no risk of withdrawal of consent exists."
Ideally, of course, people should agree in advance to such experiments by enrolling in a register. But it is unlikely that many people will, as few people anticipate living in a comatose state for several years. Hence, says Dr Curry, it ought to be possible to get others to consent on their behalf "with reference to the person's values and stated preferences". ~ Journal of Medical Ethics, Oct
The utilitarian view of human dignity is apparent in the article and I see an implied proposition suggesting that the value of those who are considered PVS is linked to their contribution to the common good, which is enhanced by their use in experimentation. This seems consistent with the grisly reality of denying the intrinsic worth of humans. I wonder what would stop the same ethicists from asserting the legitimacy of organ harvesting from those who are PVS? For that matter, what about using those who, because of physical condition, can not longer contribute to society in what is considered a meaningful way? There is very little which cannot be justified when the standard for human dignity and value is linked to the perceptions of society.

Some bioethicists, including the euthanasia fanatics who sponsored Terri Schiavo's death via dehydration, believe that those in a PVS state are dead. This is, of course, a convenient redefinition for those who are anxious to experiment on others. Yet, it should be noted that Louis Viljoen awoke from a three year coma after he was administered a sleeping pill. Note that doctors had diagnosed Louis as being in a permanent vegetative state (PVS). They told his mother he would never recover.

Doctors gave Haleigh Poutre a death sentence by characterizing her as "virtually brain dead" and in a "permanent vegetative state". Less than three weeks later, the Massachusetts Department of Social Services pushed to remove Haleigh's feeding tube and respirator and won approval from the State Supreme Court to so. Despite her "hopeless" condition, and her status as "virtually brain dead", she began showing signs of improvement and was weaned off her ventilator. She is now in rehabilitation, able to eat scrambled eggs and cream of wheat, and has tapped out drum rhythms during physical therapy.

South African researchers, writing in the NeuroRehabilitation, showed effective treatment of three PVS patients through the administration of Zolpidem. (BBC Report here)

A study of 84 patients having a "firm diagnosis" of PVS which found that 41% regained consciousness by six months, 52% by three years:

  • Out of 40 patients diagnosed as being in a persistent vegetative state, 17 (43%) were later found to be alert, aware, and often able to express a simple wish. The study is one of the largest, most sustained analyses of severely disabled people presumed to be incapable of conscious thinking, communication, or awareness of their surroundings. The author, London neurologist Dr. Keith Andrews, said, "It is disturbing to think that some patients who were aware had for several years been treated as being vegetative.

  • Studies show PVS patients feel pain -- indeed, a Univ. of Mich. neurologist, in one of the most complete studies, concluded that, when food and fluids are withdrawn [to impose death], the patient should be sedated.

  • A study of 84 patients with a "firm diagnosis" of PVS found that 41% regained consciousness by six months, 52% by three years. These statistics certainly discredit the terms "persistent" and "permanent".
In practice, the terms of PVS have become so elastic as to categorize Christine Busalacchi, a young Missouri woman, as PVS -- even though she said "Hi" to a doctor, made sounds to indicate which soap opera she wanted to watch, pushed buttons on a cassette recorder to play tapes and recognized her father on TV.

You might also check out the testimonials published at BlogsforTerri. Here are a few:

See also Legalized Killing: The PVS Diagnosis

HT: Partnership for Medical Ethics Reform

Posted by tim at October 4, 2006 6:15 PM

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