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While there is life, there is hope

the difference between God and a doctor is that God doesn't think he's a doctor

Back in 2005 the pro-life movement took a hit when judge after judge decided that an incapacitated woman could be killed by dehydration. At the time, we on the pro-life side were lambasted as some kind of mindless Neoliths who were incapable of understanding even the simplest biological concepts while those in favor of this abomination patted themselves on their all too often white- and black-clothed backs and congratulated themselves on successfully squaring the circle of a previously unsolved ethical conundrum. In short, it was a replay of the arguments over abortion except this involved a helpless woman who was inconvenient to her husband, not a baby who was inconvenient to its mother.

We were right then to fight for the right of the defenseless to not be killed and today the science vindicated our position and especially the position of Terri Schiavo’s parents who claimed they detected lucidity beneath the paralysis.

Today’s Washington Post reports “In ‘vegetative state’ patients, brain scanners show some alert minds”

Many of the patients were labeled with the same grim diagnosis: “vegetative state.” Their head injuries, teams of specialists had concluded, condemned them to a netherworld — alive yet utterly devoid of any awareness of the world around them.

But an international team of scientists decided to try a bold experiment using the latest technology to peek inside the minds of 54 patients to see whether, in fact, they were conscious.

One by one, the men and women were placed inside advanced brain scanners as technicians gave them careful instructions: Imagine you are playing tennis. Imagine you are exploring your home, room by room. For most, the scanner showed nothing.

But, shockingly, for one, then another, and another, and yet two more, the scans flashed exactly like any healthy conscious person’s would. These patients, the images clearly indicated, were living silently in their bodies, their minds apparently active. One man could even flawlessly answer detailed yes-or-no questions about his life before his trauma by activating different parts of his brain.

“It was incredible,” said Adrian M. Owen, a neuroscientist at the Medical Research Council who led the groundbreaking research described in a paper published online Wednesday by the New England Journal of Medicine. “These are patients who are totally unable to perform functions with their bodies — even blink an eye or move an eyebrow — but yet are entirely conscious. It’s quite distressing, really, to realize this.”

Although Owen and other experts stressed that much more research is needed to confirm findings and refine the technology, they said the results could provide profound insight into human consciousness — one of the most daunting scientific mysteries — and lead to ways to better diagnose brain injuries and treat tens of thousands of patients. The technology also offers the tantalizing possibility of being able to finally communicate with some patients and ask, at the very least, whether they are in pain and need relief.

Imagine, indeed.

While I can understand the selfishness of the husband and the addlepated behavior of judges in this case I’ve always been at a loss to understand the callous, if not gleefully anticipatory, behavior of the a substantial number of the medical profession when given the chance to off the helpless. When the Hippocratic Oath’s first rule is “do no harm,” great swaths of the medical profession lined up to sentence Terri Schiavo to a slow death. Yet another parallel this case has with the fight against abortion.

On issue after issue we, as a people, are being inveigled with the idea that we should submit the very important decisions in our lives to the experts. We are supposed to trust Michael Mann and his ilk to reorder our economy to prevent global warming. And we are supposed to rely upon the medical profession as authorities in just about every thing else.

What this study demonstrates is that science is not fixed but rather changes with time. We don’t know if Terri Schiavo was vegetative or conscious and we never will but what we know today is that no one at the time she was killed knew either. Instead selected members of the medical profession decided to support the idea of euthanasia when they had a moral and ethical obligation to oppose the idea. They were abetted in this killing by judges who decided that 5,000 or so years of Judeo-Christian tradition and Western jurisprudence was subordinated to convenience and quackery.

While science may inform our decisions, it is a pathetic society that allows science to order it. That is a society devoid of humanity. For the same reason we should oppose an expert commission to make tax and spending decisions we must demand that life decisions are properly within the purview of the people, not a clique of philosopher kings. In these discussions we must be guided by morality to choose the difficult right of preserving inconvenient life rather than the easy wrong of killing the weak, the defenseless, and eventually the unfortunate and unpopular.

Back to the story.

Finding a way to communicate with brain-damaged patients has long been a goal of neuroscientists. It has also been the subject of literature and films, including the 2007 film “The Diving Bell and the Butterfly,” which told the story of French editor Jean-Dominique Bauby. Bauby, paralyzed in a “locked-in syndrome” by a stroke, could communicate only by blinking his left eye.

But some urged caution, saying that the new technique raised a host of thorny questions.

“If a patient wanted to die, if they were asked, ‘Do you want to die?,’ could they explain themselves adequately?” said Joseph J. Fins, chief of the division of medical ethics at Weill Cornell Medical College. “If they say yes, what does that mean? If this person said yes but meant maybe, or it was ‘sort of yes,’ we may not be able to understand that sort of nuance. You have to be very careful.”

Sure you have to be careful when you ask an ambiguous question. But why doesn’t Dr. Fins recommend the simple solution. Ask “do you want to die of thirst?” or “do you want me to kill you?”, which is what he’s really asking with his nebulous “do you want to die?” question? The reason is obvious. He knows that in most cases a person who is alive clings to life. And while some number of terminally ill people decide to end their lives the overwhelming majority fight tenaciously for every moment of life. Because so long as you are alive there is hope.

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