When Catholics speak on the pro-life issue, I listen, even though I'm not Catholic. The Catholic Church has thought through every nuance of the pro-life issue, often ahead of Her time. Pope Paul VI's Humanae Vitae, for instance, written in 1968, was profound and prophetic. That's just one example.

If I say the Catholic Church is inspired on the pro-life issue, my Catholic friends will flog me and say it is inspired on every issue. But at risk of flogging (wasn't Luther also flogged?.. :) I will say it anyway, because I want to impress upon my Protestant friends the importance of Catholic teaching on the pro-life issue, and that they should embrace it.

So when the Vatican released a statement September 14 on the topic of providing artifical hydration and nutrition to persons in a persistent vegetative state, I was very interested....

This came as a result of the U.S. Bishops asking Rome two specific questions following the death by starvation of brain-damaged Terri Schindler Shiavo in 2005. Terri's Catholic parents said this was murder.

Some theologians had gotten tangled between Pope Pius XII's teaching in 1957 on resuscitating certain patients who were dying or even dead, which people in vegetative states are not, and Pope John Paul II's teachings on the latter in 2004. This is what the Vatican was asked to clarify. And it did in a very short statement, which first listed the questions:

First question: Is the administration of food and water (whether by natural or artificial means) to a patient in a "vegetative state" morally obligatory except when they cannot be assimilated by the patient's body or cannot be administered to the patient without causing significant physical discomfort?

Response: Yes. 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.

Second question: When nutrition and hydration are being supplied by artificial means to a patient in a "permanent vegetative state", may they be discontinued when competent physicians judge with moral certainty that the patient will never recover consciousness?

Response: No. A patient in a "permanent vegetative state" 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.

Real clear. Here is a link to a Catholic news agency article that provides additional information and context. And here is the statement released by the National Catholic Bioethics Center, also on September 14.

So it has been clarified that the Catholic position on artificial hydration and nutrition draws a clear line of distinction between patients who are truly dying of some disease or injury, and those who may be severely injured, disabled, and even unconscious but nonetheless are stable and not dying.

UPDATE, 8:10a: Those whose eyes may be glazing over at what they consider simply a religious post should take heed of this teaching. It will have serious ramifications in your world. It will likely pit Catholic hospitals, Catholic or like-minded doctors, Catholic or like-minded families and Catholic or like-minded patients against medical and legal professionals and nonlike-minded families and patients into the court system.

[Hat tip: Brother Francis]

Exactly.

And Jill, I noticed you even referred the Church with the term "her"...that means a lot to me. Thank you.

Eesh. I can't make the decision for anyone else, but if my family didn't let me die, I'd be pretty ticked. I have a question- if someone asks to be taken off of life-support, or says in their living will that they do not wish to be kept alive by artificial means, should their request be granted? Because this makes it sound like their shell should be kept alive whether or not that's what they want.

Erin,

As you are not a Catholic, and have no desire to spend eternity in heaven, you are free to do whatever you want. At this point in time, and with the choices you've made up til now, I hardly think that your eternal soul is going to suffer much more damage by a cowardly and easy death. Go for it.

Oh, but Erin,
just don't try to do it in a Catholic Hospital.

mk, I'm just asking. If a person specifies in their living will that they would like to be taken off life-support, will a Catholic person be in trouble with their church for aquiescing?

I believe so yes. A Catholic would. But by trouble, we mean something different than you. It's not like we'll have to sit in the corner for a time out.

I just reread your question. We would not be in trouble with the Church. We are never "in trouble with the Church"...we ARE the church. We would however have to explain to God why we refused to help Him carry His cross...why we said no.

Erin -

Excellent question. I'm not sure the answer though.

I can only say that there is a huge difference between artificial life support and artificial nutrition. If you will die because a machine is turned off, then I don't think the Catholic Church has a problem with that. But if you can survive on your own but only need assistance for basic human needs such as food and water, then it is a different story.

We are talking about human rights here. This is something PCer's talk about all the time. Food and water is a basic right. To remove that right just because a person cannot speak or properly communicate is still a violation of their basic needs.

Terri was able to survive on her own. She just needed assistance for her nutrition. When you remove that right of food and water, you are killing a breathing living person. Just because we call someone "in a vegatative state" doesn't mean they have any less rights or value than you or me?

What next if this taking away of rights becomes widly acceptable in society? Don't give food and water to a quadraplegic? Sure, they can speak and tell us their thoughts, but they cannot do anything for themselves and they are a burden to all around them, right?

This is what happens. Everything has to be taken one step further........

Erin,

If you read the above post carefully you will see that they differentiated between a person who is not functioning mentally but is healthy in every other way.

They were careful to state that if the person is able to use the nutrition and hydration without help, that is to digest the food, and filter the water naturally and only need help getting it into them, then you must not withhold it.

This is very different from someone who is say, dying of cancer, and their body is shutting down, no longer able to digest the food or take the water.

Allowing a person to die when it is their time is honoring their dignity just as much as keeping them alive when they are death is NOT imminent...

Of greater significance is that the commentary responds to the claim that John Paul II and Pius XII stand in opposition to each other over the question of whether food and water should be provided to patients in a persistent vegetative state. The commentary acknowledges that the address of Pius XII to a Congress on Anesthesiology, “The Prolongation of Life” (November 24, 1957), is often cited in defense of the view that nutrition and hydration may be taken away from these patients; however, it points out that this is clearly a misreading of the text. Pius was addressing the question of resuscitation in those who had suffered a serious illness and were in the process of dying or already dead. Patients in a vegetative state are not dying. They “breathe spontaneously, digest food naturally, carry on other metabolic functions, and are in a stable situation.” When food and water are removed from these patients, “the cause of their death will be neither an illness nor the ‘vegetative state’ itself, but solely starvation and dehydration.”

We're not monsters.

Erin,

I'm sorry if I was glib. I assumed you meant if you were in a state like Terri. I shouldn't have just blown you off like that. I'm sorry. It's so rare to have a legitimate, honest question about the faith here, that I guess I just assumed you were being facetious.

Erin,
I would need clarification by someone more knowledgable, but I believe the answer to your question is that a Catholic would be committing a mortal sin by participating in the killing of an innocent person who has requested to be taken off of life support or have nutrition and hydration removed in an advanced directive. (Removing nutrition and hydration is permitted if the body is dying and it is counter productive.)

Also a Catholic who wants to abide by Church teaching cannot ask to have life support or nutrition and hydration removed in an advance directive. i believe some reasons may be acceptable, like if something is overly burdensome. Again, I am not an authority on the matter.

Thank you Jill for the recognition of Catholic Church teaching on this matter.

MK- I'm not suggesting that you are. I'm really, honestly not trying to be offensive. I'm just curious about carrying out the wishes of a person specified in a living will. Personally, if I had no mental capacity, if I could not move, think, or feel...I would consider that death. It often seems to me that it is more of a support for a family than for a patient- it prevents a natural grieving process, keeps a false hope alive. If there is no preference specified, I feel that there is no obligation either way for the surviving family members. I'm solely interested in the cases where it is specified that a person would prefer to be allowed to die. Who would hold the blame, in the eyes of the church/god? The person who wrote the living will, or the person who allowed their wishes to be carried out? And how is a surviving family member supposed to balance that kind of guilt?

Erin,
One more thing. Please understand that the Church's purpose is to intactly (is that a word?)pass on the deposit of faith given to the Apostles by Jesus. The concern of the Church, as was Jesus', is that you spend eternity in Heaven with him. A Catholic doesn't get "in trouble" by the Church. The Church is there as a guide, drawing on two millenia of history to address modern variations of the same old sin.

I know you must look at the Church negatively. I hope someday you will ocme to appreciate her beauty.

By in trouble, I mean like...how pro-choice politicians are getting excommunicated, I consider that 'getting in trouble' with the church. Could you get excommunicated, or some form of discipline like that? Lol, my knowledge of the Catholic church is almost all historical and kind of drops off after the end of their reform in the late 1600s.

Lol, wait, no, my most recent knowledge of the Catholic church is that they un-excommunicated Martin Luther rather recently. That seems odd to me. How does that work? If you're excommunicated, I think, it's understood that your soul isn't going to be saved, right? But then...they undid it...I'm not going to lie, I don't understand how it works. When they un-excommunicated him, did God look down and say, "Martin? You can come up now!"

Actually, seriously, how does that work? Is it just a technicality?

Erin

I really want to take time and answer this, so I'm going to do it in the morning if that's okay. I'll be so much better then...I'm a morning person and I've just about run out of steam...waaaaay past my bedtime!

No problem, MK. I need to get to bed too- I just seem to have had a little pop of energy in the last hour or so, and it's driving me nuts. I feel giddy.

I think what I have heard was that indirect "euthanasia" (aka removal of life support, ventilators, etc) is morally acceptable in most situations, depending on the case. Most of the time the person is dying and/or has no hope of recovery.

Direct euthanasia (withholding nutrition, poisoning, etc) is ALWAYS morally wrong.

On a personal note, wondering where PAS stands here, in terms of national ethics, because obviously it is the patient themself that ultimately ends their life. But I'm sure the Church is against it, as suicide is a mortal sin.

Interesting story. A cardiologist in STL was charged for attempted murder after putting RAID in his mother's saline drip. She survived thanks to the quick actions of the nurse, and his defense was that he just wanted to help her die quickly and less painfully.

At first his sentence was to work at a different hospital (WHAT?!) and thanks to much public outcry about it, is now serving time in prison.

Erin,

I found this...

Q. What can a person do to ensure that their wishes and their religious beliefs are respected by their family, medical personnel and the courts?

A. The best way is by means of an Advance Directive which states the patients wishes with respect to aggressive medical treatment. There are two basic kinds, a Living Will by itself or an Advance Directive with a Durable Power of Attorney (or Proxy) for Health Care Decisions. The merits of each are as follows:

1. Living Will. By this document a person decides completely in advance whether they want to be kept alive by technology. It is a "yes" or "no" statement, which then places the matter in the hands of the medical community. Many Catholic bishops and moralists consider this an unsatisfactory approach, as it does not provide for unforeseen circumstances. Despite the enthusiasm of the media, many medical professionals, and sadly even some Catholic institutions, Living Wills are NOT the way to go!

2. Advance Directive with a Durable Power of Attorney or Health Care Proxy. These documents give to a friend or family member the authority to make health care decisions according to one's mind as expressed in an Advance Directive. By appointing an agent, or giving someone durable power of attorney, the patient allows for unforeseen circumstances. By stating in an Advance Directive that one wants Catholic teaching adhered to, one can ensure that neither the agent or the medical institution will disregard that teaching. Together they ensure that a trusted person, rather than strangers, will make circumstantially appropriate decisions, in keeping with the Faith.

I just want to jump in here and clarify.
"Excommunication" does not mean one is going straight to hell. Rather, it is a call to the sinner to consider the very grave sin being committed, as well as a statement to the Faithful in general. It is basically saying "You are not in communion with us" and therefore, cannot participate in public Catholic life until you turn from your sins (generally, some kind of public repentance was performed, but not so much in the modern day).
It's the last ditch tough-love effort of a loving Mother, who is always ready to welcome back a wayward child but can't let them be a bad influence on the other children.

Also, as others noted, artificial hydration/nutrition is NOT life support. It is not a breathing machine, etc. It is simply, food and water. The Church is saying that if a person can't feed themselves, others should feed him or her and that it is wrong to starve someone to death whether they can chew and swallow their own food or not.

Further, as I understand it, advance directives/living wills should have a durable power of attorney that kicks in when the person can no longer make their wishes known - naming one or more other people to make decisions for them. So you should discuss these matters CLEARLY with them. They are put into the living will as a guide - but they are not written in stone. They are merely a useful indicator of what the incapacitated persons' wishes were.

Here's a link to Catholic info on excommunication:
http://www.newadvent.org/cathen/05678a.htm

"Catholic doesn't get "in trouble" by the Church. The Church is there as a guide, drawing on two millenia of history to address modern variations of the same old sin."

Beautifully stated.

"I know you must look at the Church negatively. I hope someday you will ocme to appreciate her beauty."

I know I have.

Greetings,

I prompted Jill's post on this. Thank you Jill for the encouragement to pay attention to Catholic teaching!

Just a few things in response to the discussion here. . .

First, a link to the NCBC FAQ on the Persistent Vegetative State
This FAQ is a helpful clarification on PVS because there is confusion about what PVS actually is.

Erin, you wrote, "I'm solely interested in the cases where it is specified that a person would prefer to be allowed to die." This is a key issue here and when PVS is understood correctly, it becomes clear that your problem about a person being allowed to die does not apply to PVS and similar cases. That is because, as the Catholic response from the Vatican explains (and the FAQ on PVS from the NCBC), people in a "persistent vegetative state" are not dying; PVS is not a terminal condition in itself. They are severely disabled, but are stable. If simply given basic care, including food and water, they are not in danger of dying from a terminal condition. This being the case, the basic Catholic moral principle here, is, "thou shall not kill." Allowing a patient to die who is truly near death because of a terminal illness, is simply permitting nature (and God's providence) to take its course. However, causing a person's death by neglecting to feed them is not letting nature take its course--it is active killing by withholding that which is necessary for life.

My doctoral study is on advanced directives (primarily the Texas Advanced Directives Act of 1999, but I've studied living will policy in the US). They were designed by a euthanasia proponent named Louis Kutner that believed the following:

If we can get people to play God and make directives regarding their own death, then:

a. the stigma regarding passive euthanasia will begin to crumble.
b. removing care from patients will become commonplace
c. even patients that have no written directive will have care removed based on their perceived wishes
d. eventually, active euthanasia will ensue

I'd say that Kutner has succeeded. Terri had no advanced directive and was condemned to death anyway. In Texas, physicians may decide against the family to remove care.

MK is right- Living Wills are a scientificly-proven disaster. Even if you don't have a moral opposition to them, they fail to accomplish their intended purpose. Doctors don't have to follow them, they are misinterpretted or ignored 99% of the time, they can never predict the details of the situation they speak of, they can be used to condemn you when new, alternative treatments are available- and they tie the hands of your family that will have full knowledge of the situation and your options. Your family might want to consider a new therapy- only they are unable to because you wrote some ambiguous death wish. Furthermore, treatment costs money that states and insurance companies don't want to pay. They'd sooner enforce the Living Will than let your family attempt to help you.

I wrote about Living Wills here, years before my real research began. It's poorly written (I wrote it while fasting and staging prayer vigils for Terri), but it gets the point across.

Also noteworthy- in my study of euthanasia policy, I found that we would not have passive euthanasia if the Catholic Bishops in California would have stood firm against it. When they came on board supporting the first state advanced directives law, states all began to follow. Now we have ill, elderly, premature and disabled people murdered against their will in all 50 states. It reminds me to support the Church completely, because they exercise considerable influence in life and death policy-making.

Eesh. This topic gives me the heebie jeebies. In my mind, being a vegetable is worse than death, which is probably why this topic weirds me out. Heh, I remember when the Terri Shiavo case started getting hype. I made my living will as soon as my mom let me go talk to our lawyer. Plus, I guess it seems weird to me to simply designate someone to make all the decisions, and in my life, my personal control is a huge thing. I am a major control freak.

Hi Erin.

"how pro-choice politicians are getting excommunicated"

This is a common misconception, but there is nothing in the code of cannon law that supports this (I got into a bit of a tussle with Zeke about this a couple weeks ago). But according to cannon lawyer Ed Peters

"To those wanting the immediate excommunication of pro-abortion politicians, I have to say that canon law simply does not read that way. To make a long story short, an excommunication for abortion has to be linked to a specific abortion and, given the structure of American government and medical institutions, one simply can't link a given legislator's vote with a specific abortion within the limits of causality recognized by canon law. "

You can read his interview here
But yeah, the Church does not excommunicate politicians who support legal abortion. God love you.

In my mind, being a vegetable is worse than death

Well, isn't that bigotted. You aren't OWED your brain function and you're not better than someone who doesn't have the same cognitive abilities. You are no better than they are. When people spout this shallow drivel, I hear a child screaming, "If I can't have my pony, I'll just DIE."

Furthermore, no human being is ever a VEGETABLE. Human beings are always human beings. Disabled human beings are human beings. Brain injured human beings are human beings. Premature human beings are human beings. Elderly human beings are human beings. Cognitively disabled human beings are human beings. Ill human beings are human beings. Even dead (heart ceases to beat, turns cold) human beings remain human beings.

Calling anyone a vegetable is an offense to mankind. It offends me more than anything else. It makes me want to kick some ass.

But yeah, the Church does not excommunicate politicians who support legal abortion.

They should not be welcome at the Lord's table until they repent. What an offense against the Body and Blood of Christ to support/enable child sacrifice and then receive Him!

Hi Jacqueline. Remember when you taught me how to do this? Woo hoo! God love you.

Jacqueline,

Then don't get into it with Doug...you know human beings are not "persons" and all that...although there are times when I'd like to see someone kick his...never mind.

"Personally, if I had no mental capacity, if I could not move, think, or feel...I would consider that death"

Erin, I notice here that you are shifting the definition of what death is. Death has long been (and at least for now, still is) considered by the medical profession and by popular consensus to be equated with death of the body. If the body is alive, the person is alive, and vice-versa. However, if the definition of death were shifted to something like not being able to move, think, or feel, a Pandora's box with potential for great evil would be opened.

Modern medicine confronts many situations where patients recovering from serious illness or injury are in this condition. Intensive care units in hospitals all over the country have people in such a state. And, although some don't', many of them recover. In fact, sometimes, this condition is deliberately induced by a health care team to assist the body to heal from a traumatic treatment regimen, prolonging by medication the period of time before consciousness and wakefulness are permitted to return. (For example, in the summer of 06 I took part in a program at a Catholic hospital that provided training in giving spiritual care in a hospital setting. I knew a patient whose open heart surgery did not go well, and they had to leave his chest open as they stopped surgery and returned him to intensive care. He was kept deliberately unconscious by medication so that his body could be still and he would not have to suffer the awful condition of lying in bed with his chest open. He was like this for several days. Eventually he improved, further surgery was done to close the chest, and the last I knew he had recovered consciousness and was on the road to recovery).

According to a new definition of death, where people could not "move, think, or feel," this would produce the very odd situation where significant numbers of people in hospitals would be dead and then return to life. And this would be the course which certain serious conditions normally take. The man I described above would have been dead in your account. And so, that would mean nurses and doctors were skillfully caring for a "dead" man for about three days. What would have happened if someone had deliberately ended his bodily life during this time of medically deliberate suspension of consciousness? Could you prosecute someone for killing a dead man?

We do not want our culture to go in this direction. Consider the many abuses that would certainly take place. Many instances of coma and PVS in hospitals here in the U.S. are temporary conditions that are an expected phase of a larger process of recovery. Yet, for a period of time, such patients cannot move, think, or feel. Only for some of them does this eventually turn out to become a pathway to a worsening condition which becomes terminal and finally results in death. If we were to consider all of them "dead," in the interim, even the many who go on to recover, what consequences would this have for our society? As a matter of fact, every instance of putting a person "out" by general anesthesia would by your account be making the person temporarily dead. All surgeries done by general anesthesia would be operations on dead people, even though they had beating hearts.

If we start shifting death from being something other than bodily death, we would be putting ourselves into a huge moral mess that would be impossible to untangle.

To learn more about how a Catholic point of view treats the subject of death in today's medically advanced society, see this FAQ on the NCBC website.

"They should not be welcome at the Lord's table until they repent. What an offense against the Body and Blood of Christ to support/enable child sacrifice and then receive Him!"

Oh indeed! This IS in the code of cannon law, though, cannon 915. In fact, Archbishop Burke recently wrote an article about how cannon 915 says that Bishops should withhold the Eucharist from those public figures who support legalized abortion. He is THE MAN! God love you.

However, that is NOT the same as Excommunication.

And yes, any one who is conscious of having an unconfessed mortal sin should take it upon themselves to not receive Communion.

Sometimes, though, personal responsibility is shirked and the bishops have to step in. They do this for persistent, unrepented, public sin (which, a public endorsement/vote for abortion is.)

If I was in a persistent vegetated state I would not want to be kept alive by any means. Then my family and friends could use their time, money and energy for something that can appreciate it. Like maybe helping an underprivileged child.

But no one really wants to be a martyr anymore.

Hi Bobby Bambino ... September 19/07 10:00 AM,

I kinda was interested in your link's answer, because more than a few priests have left their ministry in the last few decades ... often WITHOUT Ecclesial approval.

I was taught that a priest does not marry a couple. He is an official witness to their union. Therefore, the couple is rightly married ... the witness is a fraud.

Ross Foti says no one should be offended by her pictures. Ok then can I show pictures of tissue cleansing and say, "This is what your inside turn into if you eat meat."

http://poetry.rotten.com/tissue-cleansing/index2.html

It's true that's all built up animal byproduct and it's festering in your colon making you sick right now.

I hope you get my point.

As far as I know, the medical community considers death to be irreversable lack of cardiac and lung function. But many consider death to also be irreversable coma (i.e. total brain death). In this case, there is absolutely no chance that a person will wake up, recover, or function properly AT ALL. In this case, it is up to the family, but generally people are either allowed to die naturally given these circumstances (wait for cardiac and lung function to fail), and often if requested organ donation can ethically be performed. Medical professionals say PVS is a gray area, but anything above that would be unethical to do any such thing. Many say in case of PVS it is ultimately up to patient's wishes or their proxy what to do. Often PVS people die quicker than a normal person would and is considered a stage of dying.

That's how I understood it, anyway. Someone here correct me if I'm wrong.

Hi John. Oh, so a few weeks ago Jacqueline showed me how to make my text actually be a link, and I wanted to show her that I was using it. The link I gave above to jimmyakin.org actually has nothing to with the topic at hand. But you are correct that it is indeed the man and women marry each other and not the priest, see catechism paragraph 1623. However, in order for two Catholics to be married, they must adhere to the proper form of marriage as found in the Code of Cannon law. If they do not follow the proper form, a sacramental marriage does not take place. But this is only for Catholics. Non Catholics are not bound by canonical form, and so this is why we assume that non Catholic marriages are indeed valid. The two non Catholic spouses marry each other according to whatever form their religion deems appropriate. Since the Catholics that Jimmy talks about in his blog do not follow the proper form of marriage (although they are not aware of it), their marriage is invalid. BTW, the part of "proper form" that I keep referring to in a Catholic marriage that the couple did not adhere to is that you need a validly ordained priest or deacon, not to MARRY you, but to be a valid representative of the Catholic Church. God love you.

Well, I have worked in LTC for most of my career. Esh, I may really catch it from PLfers here, but I don't want to be kept alive like this either. This is why I have a living will.

Br. Francis,

I think Erin was speaking of herself personally and not looking to mandate her wishes in these situations onto others. I know it would be the same for me.

Some people (especially particularly active people) would consider a life spent confined in a bed, unable to do anything for yourself a life they would not want to live. They might consider it worse than death, but certainly it is only their personal opinion. There are certainly others that wish to live as long as they possibly can, in whatever condition. These people would consider death the very worst possible thing, but certainly it is only their personal opinion.

I think what I have heard was that indirect "euthanasia" (aka removal of life support, ventilators, etc) is morally acceptable in most situations, depending on the case. Most of the time the person is dying and/or has no hope of recovery.

I would like to comment on this also. From a Catholic point of view, the status of a human act as being right (moral) or wrong (immoral) depends, along with other things, on what the person doing the act intends in his mind to be doing. What does the person performing the act want to bring about? What is the goal that he has in mind? What would be the answer to the question, "What result are you aiming for?" In the terms of moral theology, this is called the "end" of the act. (what is the intended end)

Euthanasia, properly speaking, is always morally wrong. This is because in the case of euthanasia, no matter what means are envisioned, the intended result is death itself; the goal that is being deliberately aimed at is the death of the patient. Having the intention of bringing about the patient's death makes any sort of action (or omission, such as neglecting to feed a person who can't feed himself) toward this end wrong. It colors the whole action with the immoral character of killing the innocent by act or omission.

For example, when a family asks that a ventilator be removed from a terminally ill patient, they do not intend the death of their loved one, even though that will probably be the result. They intend to let nature take its course, and to reduce the duration of suffering involved. If the patient then dies it would not be because he was killed, but because his illness overcame him and resulted in his death. Maintaining the ventilator was judged to have lost its benefit and become simply a prolongation by technology of the inevitable point of death with no more real benefit (though a benefit would be there when there was still hope of recovery).

By way of contrast, if a family wants to have a ventilator removed from a loved one because they want this action to cause their loved one to die, their intention means that they are attempting euthanasia which is a form of killing the innocent and always wrong.

We can remove technological interventions which have become no longer beneficial if our reason for doing so is to reduce the suffering that takes place on the way to a death that is now seen to be inevitable. And so when death comes, it would not be caused by us, but by the body succumbing to the terminal condition itself.

The bottom line is, it is never OK to intend to bring about someone's death through the acts or omissions that we choose. This is not the same as not excessively clinging to life to the point where we end up seemingly doing battle with God's plan to bring someone home from this life to the next. The Catholic perspective wants to ensure that in whatever we choose to do or not do, we are never in the position of trying to usurp God's dominion over human life. Are we putting ourselves in God's place, or, are we doing our best to leave Him as Lord over human life even as we do everything we can to heal the sick and injured, and also to love and comfort the dying in a respectful, dignified way?

I do understand both sides. I've also worked in Hospice where people were preparing for the end of life. Comfort care was provided. These were people who chose to stop chemotherapy, or they were people who were terminally ill. They were in the end stages of their illnesses.

Just out of curiosity, why is the Catholic Church referred to as her or she? I've never run across this before.

"Death has long been (and at least for now, still is) considered by the medical profession and by popular consensus to be equated with death of the body."

Incorrect. Death occurs when a person is brain dead. It is possible for the human body to still be alive (ie. organs are still functioning, ect) even if the person's brain has ceased to function. Despite this function, the person is considered dead.

I'm with Erin on this one. I believe that, for me personally, being in an irreversible vegetative state would be worse than death.

There is a difference between existence and life. It is possible to artificially sustain life or to keep an individual's body alive even when that individual's brain is no longer capable of any kind of higher thought. But this is not life. This is a pretended life that can only make a mockery out of what life is supposed to be. I believe that it is a mercy to allow a person's body to die if, by virtue of brain function, they are already dead.

But many consider death to also be irreversable coma (i.e. total brain death).

First of all, brain death is not death. That false definition of death was conveinently invented when doctors found ways to transplant organs and needed organs to transplant. You can not take an organ from a dead body, so the lesser, weaker, unworthy folks that couldn't defend themselves (i.e. the comatose, the PVS) were sacrificed for the "greater good" of saving better, communicative, ambulatory, worthy people. This is murder. This is bigotry. Essentially we're saying that people with lesser functioning are are lesser than those without and should sacrifice themselves for those "better" people to continue to live their "better" lives. Do you see the dangerous line we're walking? If someone is less than another because of ability, let's take kidneys from the mentally retarded that will never be self-sufficient and will stay housebound anyway and give them to people that need them to work and contribute to society. That's an idea! While we're at it, let's start taking kidneys from lesser people on welfare and giving them to better, richer folks that lose productivity by having dialysis. Where does it end? This is what happens when people lose equality. Babies are aborted for being inconvienent, people are euthanized for being too expensive and time-consuming to care for. When all human life is equal, people aren't exploited for their weakness-They are protected and cared for. This is expected of us as moral beings.

In this case, there is absolutely no chance that a person will wake up, recover, or function properly AT ALL.

PIP, I disagree. There is always a chance. Moreover, do you know how many people have recovered from PVS and comas? How many never got the chance because of euthanasia or being murdered for their organs?

Most importantly, even if these people never wake up- they are still people. They still have the right to live. You don't cease to be a person when you suffer a brain injury. All people will die eventually- the comatose will succumb somehow. "Helping" people die is murder- no matter what cognitive or physical state the person is in. Taking vital organs kills people- that is murder.

We have to draw the line.

Then don't get into it with Doug...you know human beings are not "persons" and all that...although there are times when I'd like to see someone kick his...never mind.

@@

It is the fact that personhood isn't attributed to the unborn that has you bummed in the first place, MK.

"The bottom line is, it is never OK to intend to bring about someone's death through the acts or omissions that we choose. This is not the same as not excessively clinging to life to the point where we end up seemingly doing battle with God's plan to bring someone home from this life to the next."
I'm pretty sure that this is what I meant.

My only question is this. Didn't Terri have a living will? I thought she'd specified that she didn't want to be kept alive this way. I was under the impression that her husband was trying to respect her wishes.

My point? Why have a living will if they aren't going to be respected?

Hey there Enigma.

"Just out of curiosity, why is the Catholic Church referred to as her or she? I've never run across this before."

We believe that the Church is the bride of Christ. One sees where we get this from passages like Ephesians 5:21-32. So the bride of Jesus is referred to in the feminine.

Just out of curiosity, why is the Catholic Church referred to as her or she? I've never run across this before.

Enigma, have you ever heard of "Mother Russia"? Same deal, to a large extent. It is personification.

Sometimes said as "Holy Mother Church," it is the idea that the Church is the mother, so to speak, of all Christian believers, or at least all Catholic believers. Additionally, there is often an implication of the "Bride of Christ."

I read a couple spy novels years ago, and believe it or not there was the description in them. No offense meant to anybody if I'm wrong in what I remember.

Doug

Jacqueline,

"First of all, brain death is not death."

Yes, it is. If death is only determined by whether or not the body itself is dead
(ie. no major organ function) then why is it possible to revive people from and have then still be alive?

"You can not take an organ from a dead body, so the lesser, weaker, unworthy folks that couldn't defend themselves (i.e. the comatose, the PVS) were sacrificed for the "greater good" of saving better, communicative, ambulatory, worthy people. This is murder. This is bigotry. Essentially we're saying that people with lesser functioning are are lesser than those without and should sacrifice themselves for those "better" people to continue to live their "better" lives."

Do you have any idea how diligent doctors are about, first, proving that the individual is dead, and then how careful they are about making sure that they can harvest organs? It's not an easy process. Doctors don't simply harvest organs from everyone indiscriminately. The person involved has to have given written consent (signing the back of their driver's license, ect.) and then, in most cases, their families have to agree. It's not nearly as simple as you're making it out to be.

"Do you see the dangerous line we're walking?"

Actually, no. If a person who is going to die by your definition anyway in the immediate future and they've already consented to letting others have their organs, what's the harm in taking from the dead what can benefit the living?

You're drawing a chain of events that doesn't logically follow.

"When all human life is equal, people aren't exploited for their weakness-They are protected and cared for. This is expected of us as moral beings."

I'm sorry, the dead aren't alive any longer. Their concerns (if one can argue that they still have concerns) do not have the same value as those of those living.

There is not always a chance of recovery. The brain may be an amazing organ but even it has limits.

"We have to draw the line."

And we have. You simply refuse to accept it.

Heather,

Terri Shiavo did not have a living will. According to her husband, she had previously expressed a verbal desire to him that she did not want to be kept alive in the manner in which she was. He was trying to honor her wishes.

PIP: "The bottom line is, it is never OK to intend to bring about someone's death through the acts or omissions that we choose. This is not the same as not excessively clinging to life to the point where we end up seemingly doing battle with God's plan to bring someone home from this life to the next." I'm pretty sure that this is what I meant.

PIP, then I'd say it's a matter of degree - and at what point do we say, in your case, that it'd be "against God's plan"?

I realize this is very arguable, but there is also the question of when is it still actually "someone" there, rather than just a human body kept going by medical technology.

My opinion - the person that Terri Shiavo had been before was long gone.

Doug

Enigma, thank you for clearing that up. I saw this on the news, but I wasn't clear on all the facts.

Bobby and Doug,

Thanks for explaining.

You can never recover the brain cells you lose. I believe that's why children are so enthusiastically discouraged from huffing household chemicals.

Hi JKeller.

"You can never recover the brain cells you lose."

Right, not naturally. However, this is one of the things they are trying to do with stem cells. By injecting them into a damaged organ that does not heal on its own, the hope is that the stem cells will differentiate into into cells to replace the damaged organ. I know this has been done on many body parts already using adult stem cells, but I don't know if they've done it on the brain yet. I don't know what bearing that info has on the conversation, just wanted to share. God love you.

Doug--

The paragraph about morality earlier was what I thought was the view of the Church rather than myself.

PVS means that the brain is dead except for the part responsible for organ function. Although total brain death and irreversable heart and lung malfunction are the accepted versions of death by the medical community, most people use the patient or proxy's wishes as the line to which the actions concerning PVS is okay.

What I'm trying to say is that if someone is in a PVS and they are concerned about Church law, then no. But I think that if they had specified that they don't want to live like this, then we should respect their wishes. I know I wouldn't want to live like that. If the proverbial lights are on but the person will never ever come home, who gets the say whether or when the lights are going to be turned off? Why, the resident of course.

But anyone above the level specified by PVS, it would be morally wrong to withhold food, hygiene care, etc. If granny is incontinent and her personality changed, I still don't think it is right to starve her to death or put raid in her IV. This stage is indicative that granny will probably soon lose organ function other places as well, and a DNR order can be requested. Until then, she needs to be taken care of properly. Noone says you can't help ease the pain, either, which is a humane action on both parts.

PAS is hard to say. In Oregan it is legal. If the patient ultimately kills themself, it is on their conscience. I have discussed this with a few people. If the doctor says, "Here is a prescription for 100 sleeping pills. I order you to not take more than two, because more than that might kill you," and the patient takes 30, the doctor is partially responsible but it was the patient's ultimate actions.

For the most part, I am inclined to not charge a doctor doing that for murder or similar charge. But I think I should think it through more.

Then don't get into it with Doug...you know human beings are not "persons" and all that...although there are times when I'd like to see someone kick his...never mind.

I realize this is very arguable, but there is also the question of when is it still actually "someone" there, rather than just a human body kept going by medical technology.
*
My opinion - the person that Terri Shiavo had been before was long gone.

I did warn you Jacqueline...

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Definition of Death

Death: 1. The end of life. The cessation of life. (These common definitions of death ultimately depend upon the definition of life, upon which there is no consensus.) 2. The permanent cessation of all vital bodily functions. (This definition depends upon the definition of "vital bodily functions.") See: Vital bodily functions. 3. The common law standard for determining death is the cessation of all vital functions, traditionally demonstrated by "an absence of spontaneous respiratory and cardiac functions." 4. The uniform determination of death. The National Conference of Commissioners on Uniform State Laws in 1980 formulated the Uniform Determination of Death Act. It states that: "An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem is dead. A determination of death must be made in accordance with accepted medical standards." This definition was approved by the American Medical Association in 1980 and by the American Bar Association in 1981.

http://www.medterms.com/script/main/art.asp?articlekey=33438

Nice to know that our REPUBLIC legislates death.
::snark::

Enigma,
Re: Terry Schiavo. I bet it was her wishes that he remain faithful to her in sickness and in health, but that didn't stop him from having a girlfriend even as he was so "compassionately" forcing the hospital to starve his wife to death via court order.

I'm sure he just thought maybe he'd be honoring that way too.

That's interesting, Bobby. I think its a good reason why stem cell research is so important to many people.

"I guess it seems weird to me to simply designate someone to make all the decisions, and in my life, my personal control is a huge thing. I am a major control freak"

Erin,

I sympathize with this. Being able to have a certain control over our own lives, as much as is reasonable, is a great good. However, if you were in a long term state of unconsciousness for whatever reason, the issue of whether you still had control would be a moot point. You would not. The only question would be: who do you want to speak on your behalf and make decisions in your name?

The point someone made above about living wills not really doing much to put control in the patient's hands is very true. The problem is the interpretation of the living will. And if the patient has not designated a particular person of his own choice (via a health care proxy/durable power of attorney), guess who gets to interpret what the living will means?--the doctors and the hospital administration. And they do not necessarily have to listen to anyone else, including family and friends of the patient.

No matter how comprehensive living wills try to be, no static document can adequately forsee all possible future negative health events. It will likely happen that a situation will come up that is similar to, but also different in a significant way from the example situations given in the living will. And in this case (and I'm sure this happens often), the document itself is not sufficient to guide treatment. A decision has to be made by someone responsible to speak in the patient's name, thereby interpreting the document to cover areas that it did not make clear.

If you do not designate a proxy to speak in your name, the result would be that instead of someone who knows you speaking for you, a complete stranger or team of stangers (physicians, administrators, hospital ethics board members, etc.) would end up speaking for you. Which would be preferable? I would rather have someone making important decisions on my behalf whom I knew and whose judgement I trusted, rather than a hospital staff doctor I don't know.

JKeller,

I hope you're not confusing embryonic stem cell with adult stem cell research.
Adult stem cells, unlike ESCs, have shown great promise in treating diabetes, heart disease, and genetic disorders. ECS have so far cured nothing.
It would certainly make sense that the time, effort, rhetoric, and money be applied toward what has been shown to hold some promise, which is adult stem cells. Hopefully, ASCs can be used someday alleviate the effects of brain damage.

I'm not going down this path- You people redefine life and death to suit yourselves. It's not life if you want to abort it. It's not life when you want to euthanize it. You have no moral compass- so how can I begin to appeal to your non-functioning consciences?

Death is the cessation of the heart. Nothing less. All other definitions suit another motive- To escape life as a disabled person, to harvest organs, to avoid caring for the sick, to save money, ad nauseum. Our brains don't make us human. A brain injured cat is still a cat. A brain injured person is still a person. Kill an innocent person- you're a murderer.

By the way, Terri never indicated she wished to starve and dehydrate to death. In fact, her friends and family testified to the contrary. Her husband suddenly "remembered" this deathwish 4 years later, after he was awarded a small fortune for her lifetime care (and after he took a mistress on the side). In fact, just months after he got the money, he placed a Do Not Resusitate order on Terri's chart. Her then sought to kill her.

It's also good to note that Michael was an abusive husband. Terri's bone scan showed multiple fractures in different stages of healing and she had her mysterious "collapse" the night she told her family and friends that she was going to leave him. It's suggested by pathologist Micheal Baden that she was choked. Although Michael Schiavo knew CPR, (he was certified in it, as a restaurant manager) he left her facedown, untreated, allowing the lack of oxygen to brain, causing the brain damage. He failed to call 911, but called Terri's parents instead.

Besides the money and the mistress, Michael had a significant vested interest in seeing Terri dead and immediately cremated.

Those that knew Terri explained that she loved music, the outdoors, pictures of her family, etc. Michael denied her all these things in an effort to keep her hidden. Watch videos of her laughing with her mother, laughing at her father's jokes. She could say small words like Mom and Stop.

She was handicapped- not dead. Dead people don't laugh.

I think I need to retire from this conversation. I love Terri and know her family. Listening to ignorant (and morally bankrupt) people defend her 13-day murder is too much for me.

In conclusion, you pro-aborts will attack anyone defenseless if it suits you- the unborn, the elderly, the ill, the disabled. Stop being such cowards! Pick on someone with a fighting chance. Like me, for example. I'd like to see you try that suction machine, currette, starvation crap with me.

Indeed, Mary. Another major problem with ESR is that injecting embryonic stem cells has resulted in tumors (in mice) because they are so unstable. This is why people want to push so much for human cloning because you would need your own ESC so your body won't reject them. God love you, Mary.

Jacqueline,

Your words reflect my mood today. There are just days when I get so sick of soullessness that I almost despair. I try, I really do, to see where these guys are coming from. But their consciences are either warped, weak or lacking all together and it's one depravity after another, piles and piles of behavior that is so cowardly, so morally bereft...

Anyway, You said what I couldn't and you said it beautifully.

Pro choicers: PICK ON SOMEONE YOUR OWN SIZE!!!

And Jacqueline, You are so blessed to know Terri's family. I keep staring at her face and thinking...that is what the face of an angel would look like if they had faces...she is sooooo incredibly beautiful! These guys wouldn't want to be like her? They couldn't be like her in a million years, because what you see on her face is Joy, Innocence and Purity of Spirit...things that pro-choicers have never experienced...

Jacqueline, 100 percent agree with you!!

And Jacqueline, You are so blessed to know Terri's family. I keep staring at her face and thinking...that is what the face of an angel would look like if they had faces...she is sooooo incredibly beautiful! These guys wouldn't want to be like her? They couldn't be like her in a million years, because what you see on her face is Joy, Innocence and Purity of Spirit...things that pro-choicers have never experienced...

Well said!

Jacqueline, I also agree with you.

Yeah the Schaivo case is just shady to me. I don't know much about it so that's why I haven't been commenting on that specific case. I think it is just sad how it's all turned out, especially when it became so public.

SLAM!
*standing ovation for Jacqueline*

Care to add an emoticon here, Bethany!

We weren't "picking on" anyone.

We were being quite respectful and naturally inquisitive.

But whatever.

Doug,

I see him like Norma McCorvery, from the Roe decision. I don't think she even ended up having the abortion....?
*
She's a sad, lonely woman trying to be in a "club" now, even if she's switched sides, and she's hoping to be supported by pro-lifers. That's not to say she didn't have plenty of problems before, either.

So we can't measure fetal brain waves but you can read Norma McCorvey's mind? Isn't that special?

Of course if you had said "Now, I think Norma McCorvey is a sad, lonely woman..." but you didn't. You presented that as an external truth...Weren't you saying somethin about always letting us know when it's your opinion?

"There are just days when I get so sick of soullessness that I almost despair. "

Little wonder why the Holy Hearts bleed!

Brother Francis,
To which order do you belong? And how did you get to know our beloved Jill?

Erin,
When is your surgery scheduled? I would like to offer you up in prayer when it's in progress. If it's kosher with you.

Peace.

JK,

I believe she was responding to this...

I realize this is very arguable, but there is also the question of when is it still actually "someone" there, rather than just a human body kept going by medical technology.
*
My opinion - the person that Terri Shiavo had been before was long gone.

As well as the general idea that abortion, euthanasia, embryonic stem cell research, killing the weak, compromised and mentally marginalized...are all morally acceptable to the pro choice side. All on the grounds that it is better for THEM. The selfishness of it all gets a bit overwhelming at times...

I found this on a website and thought I'd share:

"Dr. Cheshire had this to say about Terri's pain:

"And yet, in my review of Terri's medical records, pain issues keep surfacing. The nurses as Wooside Hospice told us she often has pain with menstrual cramps. Menstrual flow is associated with agitation, repeated or sustained moaning, facial grimmacing, limb posturing, and facial flustering all of which subsides once she given ibuprofen. Some of the records document moaning, crying, and other painful behavior in the setting of UTIs."

The Autopsy never said that Terri couldn't feel pain."

http://www.infowars.com/articles/life/schiavo_terris_exit_protocol.htm

OP means order of preachers, which is Dominican.

Correct me if I'm wrong Bro. Francis! :)

Question for all the pro lifers...PLEASE answer.

How many of you consider abortion murder, despite the fact that it legally permissable?

Don't all pro-lifers consider abortion murder?

Me.

MK, I consider abortion murder.

Me too.

Saying that she was not the person that she was before is disrespectful? Because regardless of how you feel about PVS individuals, it's true.

Me too, it's murder.

"Despite the fact that it['s] legally permissable"...has nothing to do with it.
Abortion is murder. Just because the law allows it doesn't suddenly make it okay.

Hitler passed laws okaying the murder of Jews, Catholics, the disabled, Gypsies...and that didn't suddenly make it *not murder*.

Doug,

September 15, 2007
Brain stem may be key to consciousness:

An article in this week's Science News discusses whether the brain stem may play a more central role in consciousness than it's usually given credit for.

It focuses on children with hydranencephaly, a where the cortex fails to develop in children and instead, the space is filled with cerebral spinal fluid.

Typically, affected children survive only a few months after birth, but those that do survive seem to remarkably more conscious than you would guess based on theories that suggest the cortex is where all the action happens to support consciousness.

Swedish neuroscientist Bjorn Merker wrote an article [pdf] in February's Behavioural and Brain Sciences journal arguing that these cases suggest we need to rethink our ideas about how the brain supports conscious thought, and perhaps, even consciousness itself.

Merker argues that the brain stem supports an elementary form of conscious thought in kids with hydranencephaly. It also contains auditory structures capable of preserving hearing in someone without a cortex. In contrast, optic nerve damage in hydranencephaly frequently impairs vision, regardless of what the brain stem does.

Self-awareness and other "higher" forms of thought may require cortical contributions. But Merker posits that "primary consciousness," which he regards as an ability to integrate sensations from the environment with one's immediate goals and feelings in order to guide behavior, springs from the brain stem.

If he's right, virtually all vertebrates—which share a similar brain stem design—belong to the "primary consciousness" club. Moreover, medical definitions of brain death as a lack of cortical activity would face a serious challenge. At the very least, physicians could no longer assume that individuals with hydranencephaly don't need pain medication or anesthesia during invasive medical procedures.

Link to Science News article 'Consciousness in the Raw'.
pdf of BBS article 'Consciousness without a cerebral cortex'.

—Vaughan.

http://www.mindhacks.com/blog/2007/09/brain_stem_may_be_ke.html

JK, yes, of course it's disrespectful. I realize that Terri had changed, because she was unable to do things she previously able to do. But Terri was still in there. Even if she didn't have the same personality, she was still terri. Even after she died, she was still Terri.
She didn't turn into another person. She was still Terri, except she was handicapped.

Answer me this. If a woman can awaken from a coma after being in it for 6 years, after everyone assumes "she" is gone, then talk, eat, laugh, and show her personality, memory, etc, just as she was before, then why do you assume you know better and that everyone who has changed is "not there" just because you assume it? Do you know everything there is to know about the brain?

Christa Lily

Obviously, there are many things about the brain that we simply do not understand.

Thanks so much all,

Well Doug,
There is your answer...

(Doug asserted that since abortion was a legal term, no pro-lifers really thought it was still murder. When I finished laughing and cleaned up the milk that flew out of my nose, I thought I'd get your opinion...

Question for all the pro lifers...PLEASE answer.

How many of you consider abortion murder, despite the fact that it legally permissable?
Posted by: mk at September 19, 2007 1:41 PM

Don't all pro-lifers consider abortion murder?
Posted by: prettyinpink at September 19, 2007 1:43 PM

Me.
Posted by: carder at September 19, 2007 1:43 PM

MK, I consider abortion murder.
Posted by: Carrie at September 19, 2007 1:46 PM

Me too.
Posted by: Bobby Bambino at September 19, 2007 1:50 PM

Saying that she was not the person that she was before is disrespectful? Because regardless of how you feel about PVS individuals, it's true.
Posted by: JKeller at September 19, 2007 1:55 PM

Me too, it's murder.
Posted by: Bethany at September 19, 2007 1:58 PM

"Despite the fact that it['s] legally permissable"...has nothing to do with it.
Abortion is murder. Just because the law allows it doesn't suddenly make it okay.

Hitler passed laws okaying the murder of Jews, Catholics, the disabled, Gypsies...and that didn't suddenly make it *not murder*.
Posted by: Milehimama at September 19, 2007 1:59 PM

Doug,

That's the problem with basing you morality on science and external truths. There is only one authority on external truths that doesn't change. And science ain't it. 50 years ago we drilled holes in peoples heads when they behaved strangely, 100 years before that we exorcised them, today you say only brain stem function doesn't signify personhood, tomorrow you will be old news...

While we, who believe abortion is murder, will front and center, as usual.

As Mary had pointed out, this board is interesting because we are not all marching in lock step. I am saying that personally, I do not want to be kept alive this way. I want my living will to be honored.

At the risk of duplication:

Paging Doug...Please repport to the forum..paging Doug...

. . . I think Erin was speaking of herself personally and not looking to mandate her wishes in these situations onto others. I know it would be the same for me.

Some people (especially particularly active people) would consider a life spent confined in a bed, unable to do anything for yourself a life they would not want to live. They might consider it worse than death, but certainly it is only their personal opinion. There are certainly others that wish to live as long as they possibly can, in whatever condition. These people would consider death the very worst possible thing, but certainly it is only their personal opinion.

JKeller,

You bring up one of the most fundamental issues underlying this discussion with this comment. It gives rise to the question: Is suicide OK, or not? Apart from whether or not we should ask others to participate, do we as a society still think killing ourselves is something we should not do?

From a historical point of view there is a major shift going on that we should take note of. Only a few decades ago, I think I'm on safe ground to say that American society, by an overwhelming majority, thoroughly rejected suicide as a viable option, even for the suffering and the down-and-out. Even when I was a kid (back in the 70's), when a suicide happened, it was always portrayed as an awful, horrible thing. The standard reaction to the idea of suicide used to be to completely reject it. Why is our society now beginning to think about it as a morally viable option? We should not overlook that this shift is recent and has huge implications for our entire culture.

Also, you speak of one's idea about whether suicide should be an option or not (you don't mention the word but I take it that the idea is implied) as only a matter of private opinion ("only their personal opinion"). And this brings up the whole issue of whether or not there is any such thing as common moral standards that apply equally to all, or not.

If there is any such thing as a set of basic moral standards that indeed apply to all people (e.g., rape, child abuse, and torture are bad--agreed?), does the traditional moral norm that one ought never kill the innocent (i.e. murder) include suicide in whatever form? . . . It used to.

If a person does not think that there are any moral standards at all that are obligatory for all people, then for such a person the whole discussion is irrelevant, because all that would matter is his own opinion.

I don't think any of us commenting on this blog, of whichever side, are truly complete moral relativists. Surely we agree, I hope, that there are some universal standards of right and wrong that we must all accept and live by. This, in part, is why we make the effort to comment on a blog like this, because we think that others should see things our way--that there is some common norm that should be true for all, and we want to persuade others to see it.

If this is the case, the point of view expressed in JKeller's comment then begs the following question as well: If we agree that all morality is not simply a matter of private, personal opinion, why then should suicide, which our society used to be in wide agreement about as a moral evil, shift from a matter of public morality, to one only of the private realm?

A person in a temporary coma who wakes up and continues living his or her life in the same way= the same person. A junkie who falls into a drug induced coma and wakes ups turns over a new leaf and now leads a sober-drug free life= a different person. A person who has suffered irreversible brain damage and is no longer able to do the things that they used to do or live the life that they had been living previously= a different person.

Notice I don't mention that I think any of these people should be killed for their differences.

OOps, this second paragraph at the top of my just posted comment also should have been italisized as a quote from JKeller:

Some people (especially particularly active people) would consider a life spent confined in a bed, unable to do anything for yourself a life they would not want to live. They might consider it worse than death, but certainly it is only their personal opinion. There are certainly others that wish to live as long as they possibly can, in whatever condition. These people would consider death the very worst possible thing, but certainly it is only their personal opinion.

"Joy, Innocence and Purity of Spirit...things that pro-choicers have never experienced..."

How do you know? You don't know what I do every day, you don't know how I feel. The fact that you assume I can't feel these basic emotions is very insulting to me. I don't think we can have discussions anymore if you don't see me as a human being, me who is sitting here breathing and moving and thinking.

"Doug asserted that since abortion was a legal term, no pro-lifers really thought it was still murder"

Now, MK, we are, after all, just ordinary web-surfin' pro-lifers.

Perhaps Doug was referring to the heavy-hitters in Prolife-ism. Let's see, maybe Bernie Nathanson, former abortionist Levatino, Ms. McCorvey, oh! How about the Scheidler crew? You know, the BIGGIES. We should ask THEM.

(Now watch, he's going to post that he was misread, misinterpreted, you were wrong, and now we'll all be coming 'round the mountain again.)

I believe we have to take into account the advances in modern medicine. We can bring people back from death and save people who are an inch away from death. If this advancing technology did not exist, many of the people we debate about we would not have to worry to because they would have succumbed to whatever had put them in their present condition. Is it suicide to concede that there is nothing we can do to help someone recover from their disease, infections, injuries, etc.?

Also I think my main point is, is it right to disregard a person's legal rights because they infringe upon someone else's morals?

Consciousness in the Raw
The brain stem may orchestrate the basics of awareness

Bruce Bower

In October 2004, Swedish neuroscientist Bjorn Merker packed up his video camera and joined five families for a 1-week get-together in Florida that featured several visits to the garden of childhood delights known as Disney World. For Merker, though, the trip wasn't a vacation. With the parents' permission, he came to observe and document the behavior of one child in each family who had been born missing roughly 80 percent of his or her brain.

INNER BRAIN. Animal studies and observations of children born missing most of the brain's outer layer, or cortex, suggest that the brain stem generates a fundamental form of conscious thought. Here, cutaway of a normal human brain shows the folded cortex atop the brain stem (in box).
W. Krutein / Photovault.com

These children, 1 to 5 years old at the time of their Disney adventure, had suffered strokes as fetuses or had experienced other medical problems shortly before or after birth that destroyed nearly all of the brain's outer layer, or cortex. In this rare condition, called hydranencephaly, cerebrospinal fluid fills the gaping hole within the child's head.

Such youngsters often die in the first year of life as a result of seizures, cerebral palsy, lung abnormalities, and a variety of other physical ailments. With proper medication and the installation of shunts to drain fluid from the braincase, however, some individuals live 20 years or more.

Neurologists typically regard hydranencephaly as an anatomical sentence to a lifelong "vegetative state." Such children supposedly validate a brutally simple equation: Little or no cortex equals no awareness of any kind.

In family activities observed in the Magic Kingdom and elsewhere, the kids quickly cast doubt on that standard assumption. Merker noted that these cortex-deprived, nonverbal children remained alert for much of the day. They reacted to what happened around them and expressed a palette of emotions. A 3-year-old girl's mouth opened wide and her face glowed with a mix of joy and excitement when her parents placed her baby brother in her arms.

The youngsters displayed good hearing but limited eyesight, a curious pattern given that they typically retained small parts of the visual cortex but none of the auditory cortex.

In observations at each child's home, Merker noted that these youngsters recognized familiar adults, liked familiar settings, and preferred specific toys, tunes, or video programs. Although saddled with limited mobility, some kids took behavioral initiatives, such as learning to activate a toy by throwing a switch.

In the February Behavioral and Brain Sciences, Merker, an independent neuroscientist in Segeltorp, Sweden, described how the accomplishments of these children relate to behaviors recorded in prior studies of human-brain function and of animals after surgical removal of the cortex. His analysis generates a provocative proposal: Basic awareness of one's internal and external world depends on the brain stem, the often-overlooked cylinder of tissue situated between the spinal cord and the cortex.

Merker argues that the brain stem supports an elementary form of conscious thought in kids with hydranencephaly. It also contains auditory structures capable of preserving hearing in someone without a cortex. In contrast, optic nerve damage in hydranencephaly frequently impairs vision, regardless of what the brain stem does.

Self-awareness and other "higher" forms of thought may require cortical contributions. But Merker posits that "primary consciousness," which he regards as an ability to integrate sensations from the environment with one's immediate goals and feelings in order to guide behavior, springs from the brain stem.

If he's right, virtually all vertebrates—which share a similar brain stem design—belong to the "primary consciousness" club. Moreover, medical definitions of brain death as a lack of cortical activity would face a serious challenge. At the very least, physicians could no longer assume that individuals with hydranencephaly don't need pain medication or anesthesia during invasive medical procedures.

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"To be conscious is not necessarily to be self-conscious," Merker says. "The tacit consensus concerning the cerebral cortex as the 'organ of consciousness' ... may in fact be seriously in error."
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Brain drain

The roots of Merker's thesis emerged more than 50 years ago in the operating room of Canadian neurosurgeons Wilder Penfield and Herbert Jasper. The surgeons pioneered the removal of large chunks of cortex as a treatment for severe, uncontrolled epilepsy. To identify and avoid damaging still-functional brain areas, Penfield and Jasper kept patients awake during the surgery and administered only local anesthesia.

Various mental abilities suffered during and after the operations, depending on the site and extent of the neural loss. Nevertheless, patients maintained a conscious stream of thought, Penfield and Jasper found.

In the course of electrically stimulating various brain areas during operations to identify key functional areas, they noted that current delivered to the right spots could produce every kind of seizure except one—so-called "absence epilepsy" characterized by a sudden loss of consciousness for a few seconds. On the basis of what they knew about the brain, the researchers theorized that structures within and just above the brain stem typically trigger absence epilepsy and collaborated with the cortex to regulate conscious thought and intentional acts.

Animal research, predominantly with rats, has since indicated that three adjacent parts of the brain stem comprise a "neural reality simulator" that gives rise to a fundamental form of consciousness, Merker asserts.

Along the top of the midbrain, which represents the roof of the brain stem, layers of cells interpret the spatial layout of an animal's surroundings relative to its body. Just below, a patch of gray tissue influences emotion-related behaviors, such as aggression, sex, defensive maneuvers, and pain reactions.

Farther down the brain stem lie interconnected regions that regulate the direction of eye gaze and organize decisions about what to do next, such as reaching for a piece of food or pursuing a potential mate.

Together, these structures surround brain stem tissue that connects to sensory areas throughout the cortex.

Merker proposes that, in creatures with a brain stem but little cortex, the neural reality simulator produces a two-dimensional, screenlike map of the world featuring moving shapes. A large cortical endowment beefs up the neural reality simulator, creating an ability to perceive a three-dimensional world composed of solid objects. Neural expansion also allows people to reflect about what they think and feel.

In support of his theory, Merker cites studies conducted over the past 40 years in which rats and cats showed relatively few behavioral problems after surgical removal of the cortex, either in infancy or adulthood. These cortex-deprived animals use vision and touch to orient to their surroundings, learn where to find food in mazes, and remain capable of standing, climbing, grooming, mating, and caring for offspring.

Merker also cites an unusual phenomenon known as the Sprague effect. Complete removal of the visual cortex on one side of the brain renders animals unable to see anything in the half of the visual field opposite the surgical site. Yet a tiny cut to the midbrain restores the animal's ability to detect and approach moving entities, even though it still can't distinguish one object from another.

The Sprague effect underscores the brain stem's visual influence, Merker argues. Visual-cortex removal derails brain stem activity via numerous neural links to the midbrain's spatial cells that suddenly lack meaningful input. A well-placed midbrain cut halts activity by some of those wayward connections, allowing a partial return of sight, in his view.

Any entity with the equivalent of a neural reality simulator, "whether cast in a neural medium or eventually in silicon," would experience consciousness, Merker theorizes.

Cortical divide

Of 27 comments by mind and brain researchers published with Merker's article, nearly half agreed that the inner workings of consciousness lie in the brain stem.

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"The roots of consciousness exist in ancient neural territories we share with all vertebrates," says neuroscientist Jaak Panksepp of Washington State University in Pullman. "By the weight of empirical evidence, all mammals are sentient beings."

In his own research, Panksepp studies the ability of animals to experience biologically based states of mind or feelings that range from hunger and thirst to emotional delight and distress. For instance, Panksepp and a coworker reported in a controversial 2003 paper that rats express "joy" while playing with other rats by making ultrasonic sounds that represent an ancestral form of laughter.

Psychologist Carroll Izard of the University of Delaware in Newark emphasizes that this form of primary consciousness, as Merker would put it, or "primary affect," as Panksepp terms the rats' consciousness, consists of sensory activity in the brain stem. This capacity generates emotions and an awareness of one's surroundings but not an ability to talk about what one has experienced, Izard continues. In the same way, people can become conscious of a feeling that they can't label or describe, a phenomenon that's especially common in healthy infants and in children lacking a cortex, Izard says.

The existence of primary consciousness challenges widespread assumptions among physicians that newborns and fetuses can't feel pain, adds pediatric neurologist K.J.S. Anand of the University of Arkansas for Medical Sciences in Little Rock. Evidence now suggests that adult and immature brains use different systems to process pain, Anand says.

The brain stem and the thalamus, a relay station for sensation just above the brain stem, foster pain responses in babies before and after birth, he asserts. The cortex takes over pain perception as it greatly expands during childhood and adolescence, Anand hypothesizes.

Other investigators criticize Merker for denying the cortex its traditional position as the brain's engine of consciousness. Even if a basic form of consciousness exists, they regard it as at least a partial product of the cortex, not just the brain stem as Merker argues.

Conscious thought probably relies on the workings of connected brain areas within and outside the cortex, contend Susanne Watkins and Geraint Rees, neuroscientists at University College London. "It seems unlikely that activity in any single area of the human brain will be sufficient for consciousness," they write.

Children with hydranencephaly studied by Merker possess remnants of cortical tissue that could have triggered states of awareness, the researchers suggest.

Other commenters, including philosopher Gualtiero Piccinini of the University of Missouri–St. Louis, cite prior evidence that the cortex by itself regulates visual awareness. Following visual-cortex damage, certain patients report no conscious ability to see on one side of their visual field but still unconsciously perceive the identity and location of items in that same visual field. Scientists call this phenomenon blindsight.

The most extensively studied blindsight patient has frequently reported being aware of "something" in his blind visual field, Merker notes. This man retains primary visual consciousness of his surroundings but can't describe what he sees in words, the Swedish researcher contends.

Reclaimed kids

In a 1999 report, D. Alan Shewmon, a pediatric neurologist at the University of California, Los Angeles Medical Center, and his colleagues described home observations of three children, ages 6 to 17, who had been born with hydranencephaly and raised by loving, attentive parents. Each child displayed comparable signs of conscious mental activity, the researchers reported.

For instance, shortly after birth, a newborn girl's brain scan revealed an almost total lack of cortical tissue. Physicians told the girl's mother that the child would live no more than 2 years as a "vegetable." A neurologist concluded that the girl's brain was "like that of a reptile" and that she would never interact with other people.

Shewmon first visited the girl at age 5, observing her behavior at home. Despite difficulty sitting up or walking without aid, she exhibited excellent health. She smiled in response to Shewmon's friendly overtures and immediately looked at objects brought close to her. In a videotaped play session with her mother, the girl uttered "ah-ah" when encouraged to say "mama."

She brightened upon hearing happy songs, but often cried during sad songs. She enjoyed the sensory stimulation of car rides, crying at stops and calming down as motion resumed. She disliked the loud noises of vacuum cleaners and hair dryers. She demonstrated understanding of a few words, including "bunny rabbit" for one of her stuffed toys.

"If these children had been kept in institutions or treated at home as 'vegetables,' there can be little doubt that they would have turned out exactly as predicted," Shewmon says.

After making his own observations of children with hydranencephaly and their families, Merker seconds that point. He notes that well-treated youngsters born with little or no cortex regularly display brief losses of consciousness due to absence epilepsy, a clear sign that at other times they're conscious.

Parents described these lapses of awareness in their children to Merker with phrases such as "she is off talking with the angels."

Perhaps most intriguingly, kids with hydranencephaly demonstrate that the brain stem is not simply a reptilian relic stashed in the brain's basement. "The human brain stem is specifically human," Merker says. "These children smile and laugh in the specifically human manner, which is different from that of our closest relatives among the apes."

For now, the neural puzzle of consciousness remains unsolved. But cortically endowed investigators may have much to learn from cortically deprived kids

You can go to the direct link for all sources and references:
http://sciencenews.org/articles/20070915/bob9.asp

Carder,

You HAVE been paying attention...I owe you big time.

"I don't think we can have discussions anymore if you don't see me as a human being, me who is sitting here breathing and moving and thinking."

Yet we can trash the unborn like trash, call it justifiable homocide (SoMG's reference), and keep a conversation with you?

What color is the kettle?

I don't think we can have discussions anymore if you don't see me as a human being, me who is sitting here breathing and moving and thinking.

What did the unborn baby say to it's mother?

I don't think we can have discussions anymore if you don't see me as a human being, me who is sitting here breathing and moving and thinking.

What did Terri Schindler say to Michael Schiavo?

I don't think we can have discussions anymore if you don't see me as a human being, me who is sitting here breathing and moving and thinking.

A person in a temporary coma who wakes up and continues living his or her life in the same way= the same person. A junkie who falls into a drug induced coma and wakes ups turns over a new leaf and now leads a sober-drug free life= a different person. A person who has suffered irreversible brain damage and is no longer able to do the things that they used to do or live the life that they had been living previously= a different person.
Notice I don't mention that I think any of these people should be killed for their differences.

I guess that you and I may be meaning something different when we say 'different person'. That's probably what is happening here.

JK,

Also I think my main point is, is it right to disregard a person's legal rights because they infringe upon someone else's morals?

It is someones morals that gave you those legal rights? Why do you think we have laws. Because somewhere, someone deemed them to be morally right.

A junkie who falls into a drug induced coma and wakes ups turns over a new leaf and now leads a sober-drug free life= a different person

See, my definition of this person would be that he is same person, who is now making better choices for himself. Not a different person, just the same person, making better choices. He would still have the same personality traits, have the same feelings and emotions, etc. He probably would still have the temptation. But he would still be the same person. (I use "he" so I don't have to say he/she).

It is someones morals that gave you those legal rights? Why do you think we have laws. Because somewhere, someone deemed them to be morally right.

Yes, exactly!

Terri Schiavo had a devoted family ready and willing to care for her. Why wouldn't Michael just let them have her? Why should he care? He could divorce her, go on with his life, and who would blame him for doing so, but let Terri's family have her if they want her. What did he have to lose?

We can never know with absolute certainty what cognitive function Terri had. She may have been aware of a loving family, their care, and of the people around her, as both her family and caretakers at the nursing home insist she did.
No one can say for certain she wasn't.

I'm talking about who you are, not your physical identity. Like if you took leave of your senses and went on a shooting spree you would still be Bethany physically, but you would be a drastically different person than you are today.

JK,

Also I think my main point is, is it right to disregard a person's legal rights because they infringe upon someone else's morals?

It is someones morals that gave you those legal rights? Why do you think we have laws. Because somewhere, someone deemed them to be morally right.

Mary, that I do agree with!

JK,

Like if you took leave of your senses and went on a shooting spree you would still be Bethany physically, but you would be a drastically different person than you are today.

I'm a drastically different person today than I was 2 years ago, 2 day ago and 2 hours ago...we change all the time. Are we going to measure our worth by how much we've changed?

I'm talking about who you are, not your physical identity. Like if you took leave of your senses and went on a shooting spree you would still be Bethany physically, but you would be a drastically different person than you are today.

I would still be myself, who decided to make a horrible, devastating choice. Or myself, who lost her mind. I would be *acting* like a different person, but really I would be the same person.
I'm not talking about a physical entity as much as the spiritual entity.

I never said we should measure our worth by it (but it does happen everyday), I was using it as an example of how it was not disrespectful for someone to call Terri a different person, because that's what she was.

Brother Francis,
To which order do you belong? And how did you get to know our beloved Jill?

Yes, I am a Dominican. The initials OP stand for Order of Preachers ("ordo praedicatorum" in latin). We were founded by St. Dominic in the early 13th century. I am a student at the Dominican House of Studies in Washington, DC, preparing for the priesthood in a few years. Here is a link to a student blog of sorts that we run. It's more of an ongoing news and events bulletin, really, and not a blog in the usual sense. Here is a link to our student web site that gives information about our life and who we are.

How do I know Jill? Before I entered the Dominican order (back in 2003), I worked for Priests for Life for two years as Director of Research. During this time, Jill had occassion to collaborate on some things with Priests for Life. This was how I first met her. We have been friends since. And may I say, that Jill is a wonderful person, and I am grateful to be counted among her friends! Thanks for asking.

Thank you, MK that is exactly the point. I have changed DRASTICALLY over the years, yet I am the same person, with the same emotions, the same reactions, the same personality, the same temptations, the same desires, etc. I am Bethany and always will be Bethany no matter what choices I make in the future, no matter what happens to my body, no matter what happens to my mind. When I die, I will still be Bethany.

Brother Francis,
You haven't weighed in...do you consider abortion murder?

Let's just say we have differing views about personal identity.

How many people have said, after they have changed something about their life or had their life changed by something, "I'm a different person today than I was then", or "I was a different person then". Do they not genuinely believe or mean it?

We can post pictures on here?

I guess I'll break the tension:

I would guess, not personally knowing Br. Francis, that he does consider abortion to be murder or Jill would never consider him in such a favorable light.

How many people have said, after they have changed something about their life or had their life changed by something, "I'm a different person today than I was then", or "I was a different person then". Do they not genuinely believe or mean it?

Yes, I've heard it....It's a figure of speech. An idiom. Like if I say, I was shaking in my boots! I wasn't literally shaking in my boots, it is a figure of speech. It means that they have changed their ways, turned over a new leaf.

I believe it's a state of mind.

Can you expound on that a little?
Are you saying that a drug addict that goes sober literally is a new person? He doesn't have to battle the same temptations anymore? He doesn't have to work hard to make the choice NOT to use drugs?

Bethany, you have the gift of endless debate, but I'm afraid I'm going to have to pull myself away, I've told my mom that I would come eat dinner with her and my sister. I'll check back in later.

:-)

Aww sorry Jk, I've just had a little extra time on my hands today. Sorry if I'm taking time away from your family! :) I'll talk to you more about it later. :)

Ok, one more.

He has the temptations of a former addict, yes. But he does not live a life of using and all the things that that entails. He doesn't have to be chasing to function and he doesn't have to deal with the pitfalls of coming down, or be the burden on his family and friends. His philosophy is different because he can understand that he doesn't need drugs. Most of all his daily life and activities without drugs is different.

If granny is incontinent and her personality changed, I still don't think it is right to starve her to death or put raid in her IV. This stage is indicative that granny will probably soon lose organ function other places as well, and a DNR order can be requested. Until then, she needs to be taken care of properly. Noone says you can't help ease the pain, either, which is a humane action on both parts.

I fully agree, PIP.
......

PAS is hard to say. In Oregan it is legal. If the patient ultimately kills themself, it is on their conscience. I have discussed this with a few people. If the doctor says, "Here is a prescription for 100 sleeping pills. I order you to not take more than two, because more than that might kill you," and the patient takes 30, the doctor is partially responsible