The Measure of a Life Worth Living
Euthanasia has a tendency to slide from the voluntary to the compulsory, as people increasingly make judgments on behalf of others as to what is a human life worth living. The opinion is widespread that the persistent vegetative state — the condition in which a person with some kind of brain injury remains alive but unresponsive to stimuli — is one such life not worth living.
The problem is a complex one. A recent paper in The Lancet, from researchers in Cambridge, England, and Liege, Belgium, describes a method by which they proved that, of 16 patients in a persistent vegetative state, 3 demonstrated, by means of electro-encepahalograph (brainwave) recordings, that they were able to follow instructions, in this case to imagine either their hand or big toe making a movement.
Perhaps even more alarming, the EEG recordings of three of the sixteen normal control subjects, who were given the same task to perform and who were undoubtedly fully conscious (though students of psychology), did not reliably show that they had been able to follow instructions
In other words, while a positive test shows that there is a fair degree of consciousness, a negative test does not show an absence of such a degree of consciousness. The possibility remains that an unknown but large proportion of people in a persistent vegetative state retain a higher level of consciousness than hitherto believed, certainly by those inclined to call them “vegetables” as a prelude to withdrawing all treatment. As I used to tell my medical students, we must always remember that just because a patient cannot speak it does not mean that he cannot hear (and understand). There is a tendency to talk in the presence of the unresponsive as though they were there.
Of course, it is also true that being able reliably to imagine moving a hand or toe in response to a command to do so does not constitute a worthwhile life. It might very well be that consciousness makes the persistent vegetative state far worse than it would have been if accompanied by complete unconsciousness. Surely, no one would wish the condition of consciousness while in a persistent vegetative state upon himself if he had an alternative.
However, this is not quite the same thing as saying that such a life is not worth living. Whether a life is worth living can be judged only by the person living it. Most young people, if asked, say that life would not be worth living for them in a state of tetraplegia (paralysis from the neck down); most tetraplegics, though, do not agree, and do not want to die, much less ask for voluntary euthanasia by fatal injection or withdrawal of treatment.
Where does this leave medical ethics? Health economists would have no doubts: the money spent to keep a person in a persistent vegetative state alive could be better spent in some other way; that is to say, it would result in more health benefit per dollar expended. This, of course, depends upon there being a comparative measure of health benefit that is reliable and uniform across all situations and circumstances, like the utilitarians’ supposed unit of pleasure, which is very doubtful.
We are always, then, acting to some extent in the dark, not only because we are imperfectly informed and there are things that we do not know (such as the thoughts and feelings, if any, of patients in a persistent vegetative state), but because not all things are commensurable even if known. As Hippocrates put it quite a long time ago, judgment is difficult.
A very difficult topic.
I can say for certainty I would not wish to deteriorate the way my Mother did…Progressive Supranuclear Palsy…bed ridden, on a feeding tube, unable to speak for the last 5 years of her life.
I personally would much rather say goodbye while I still could, and end it all with a revolver.
But I cannot at the same time, say Moms life needed to end sooner, with a little extra “help”, for her own good.
Some issues have no easy answers….
We as a society must keep an honest conversation going, and on a private basis, make your wishes KNOWN to your family.
I’m scared to decide now what I would want if. Now it seems to me that being conscious in a vegetative state is hell on earth literally and that I’d prefer anything to having to tolerate that. But I can’t know for certain how I might actaully feel if I’d have the terrible misfortune to be there. Maybe I’d still not want to die. Maybe I’ll find some way to engage myself even in that state. Maybe I’d spend my days creating stories, songs and pictures in my head and thinking interesting thoughts, and would feel this is still better than stop existing. So I don’t want to decide now that in such a state they should let me go. On the other hand, what if this state would really be as intolerable as it seems to me now and I wouldn’t be able to stop it? If I can’t even decide for myself, I surely can’t decide for another person.
Stephen Hawking probably doesn’t have the greatest quality of life but he seems glad to be alive.
Life is precious and most of us truly have a survival instinct even if it means living with a face that is falling apart like Roger Ebert or burn victims who no longer even resemble their former selves.
To save someone’s life and give them a chance to live in a non-vegetative state is a worthy risk in my humble opinion.
I was thinking the same thing. While I wouldn’t want to live Steven Hawking’s life, I would never deem his life isn’t worth living. My wife and I recently completed filling out our living wills and directions. I watched one of my brothers lose his battle with cancer last June and don’t want extraordinary measures to keep me alive when there is no hope. That’s a personal decision that I would never try to impose on anyone else.
Actually, the control result suggests that it is perfectly normal for the test to fail ~3/16 times. However, the obvious correlation between normal people passing and vegetative people failing is promising; they need to expand their sample size to ensure (1) that the test works and (2) the number of vegetative people passing is statistically significant compared to the failure rate of the control group. Imagine the implications, though, if we could communicate with people in a vegetative state.
The statistics industry standard is a failure rate of 1/20. 3/16 is unacceptably high for any diagnostic.
Did not know that, thanks. I didn’t want to come right out and say that the control result suggests that the test was not accurate, because there is still the obvious correlation between the dependent and independent variables, but it certainly needs another few passes through the revision process.
The 3/16 failing probably suggests that college life turns some people into zombies, particularly in the humanities.
Haw Haw Haw
What nobody acknowledges is this is not an issue of “morality” in the Judeo-Christian sense but of corporate greed. In the United States, those who are not super-rich are left to suffer and die without any succor at all once greedy insurance companies,hospitals, doctors, and drug companies have bled them dry of every cent they own.
I wonder if Mr.Dalrymple, who is British, would support raising taxes on UK millionaires to a high enough level to restore the NHS to the peak of its compassionate glory before it was gutted by the greedy Milk Snatcher in to provide more money for a mini-version of Ronnie Raygun’s war machine.
Greed is the only reason this issue exists.In a compassionate society, there would be unlimited care avaliable to all.
@Throbbin: You are an idiot, an more than willing to engage in party-specific ideology. Drop off the edge of the world, please, and don’t come back.
At the end of the fourth paragraph, add the word “not.”
There is a tendency to talk in the presence of the unresponsive as though they were NOT there.
I often consider how I would take care of one of my relatives should he/she slip into a persistent vegetative state. Assuming they hear and understand, I would play music and favorite programs on an automated schedule, when the person is not “sleeping” at night, when I couldn’t be there. I would make visits to report family news and read excerpts of books I know they like.
Now, I suppose I should set about to detail to my family members my favorite music and books. It comes down to the Golden Rule, and that is why I always hated the “Survivor” TV shows. Voting someone off the island is a symbol of destroying the civilization that holds us all together.
Mel Blanc came out of a coma when someone finally asked him, “Hey bugs, you in there?” He answered in his Bugs Bunny voice and came to! How cool is THAT?
The human brain is incredibly complex…we have a long way to go!
I spent my teens very, very ill, dealing with chronic pain and fatigue that were later resolved after the underlying medical issue was diagnosed and treated. I can not count the number of times people said things to the effect of, “If I was in pain all the time, it wouldn’t even be worth living!”
Here’s the thing–I probably would have thought the same thing, before I got ill. The human capacity for imagination is very limited, and it’s hard to imagine that a life of exhaustion, pain and a merry go round of doctor’s visits is still worthwhile. As a healthy adult, I look back on the years I was sick and realize they were some of the happiest of my life. I met and married my husband in those years. I got my college degree. Illness seriously limited me, but those years were still very much full and happy.
The experience changed me in a lot of ways, but it really brought home to me how incapable we are of imagining the experience of someone sick. It made me conclude that euthanasia was absolutely immoral.
Is Barney Frank’s Life Worth Living?
Barney Frank, R.I.P.
No, Barney Frank isn’t dead. He isn’t among the deceased but he is being virtually canonized by Long Island’s resident nitwit congressman Steve Israel as “a champion of American families.”
Rep. Israel has one peculiar concept of “family.”
Called “the most powerful homosexual in Congress,” Barney is merely retiring so he can rest up in peace, away from the slings and arrows of political infighting, his scandal-plagued career, and those meanie Republicans who keep dredging up his complicity in the 2008 banking debacle that led to Obama’s continuing Great Recession.
Barney is surrendering his position as ranking member of the House Financial Services Committee, the same committee he headed during the banking meltdown when he and then-Senator Chris Dodd forced financial institutions and their buddies at Frannie Mae and Freddie Mac to loan vast sums of money to people who barely had a pot to pee in.
However, Frank and Dodd felt they should have a shot at the American Dream, and then vote for Frank and Dodd.
Barney’s dream and one of America’s nightmares will be over next year since he has unexpectedly announced he won’t run for re-election after 32 years representing the good, people of the most liberal state in the union, Massachusetts. Democrats will probably turn over his committee job to another class act, Rep. Maxine Waters.
Barney’s reasons for packing it in, so to speak, are debatable.
Although his advancing years and the re-districting of his ultra-safe 4th c.d., home to the leftist bastions of Dartmouth and Wellesley, may have played a part, Barney was somewhat vague in his announcement saying only that he didn’t want to introduce himself to new voters and that he had “other things I’d like to do.”
Good thinking, Barn!
Convincing a whole new electorate that he is still “the liberal lion of the House” and thereby worthy of their vote would be challenging enough for 71 year old Barney. Persuading them that a former owner of a homosexual bordello should represent them could pose an even greater obstacle, even in Massachusetts. . .
(Read more at http://www.genelalor.com/blog1/?p=7818.)
Interesting topic. There are several points to take into consideration:
Life is only precious to those it affects.Millions of people are born,die and are killed every year.If every life was so valuable there would be no murder,self destruction,mass reproduction,suicide,war,or 4 yr prison sentences for murder.
Self determination.People facing incurable,hopeless,deteriorating,pain ridden futures have no legal rights to determine their fate while conscious.Personal directives are a must for vegetative states and need to be respected by ALL.It’s your life be responsible and determine your fate.Death is part of life,fearing it won’t stop it.
Lack of knowledge.Dr’s are limited to whatever is currently known,what they currently know and what tests reveal. Also,Physicians have personal beliefs ,economic and emploment concerns that are part of their decisions and opinions.
Is moving a toe a sign of a cognizant life of quality ? It depends on the individual.
If euthanasia is ok for people in a vegetive state who might want or not want to live. then why is it torture for to starve a suicide bomber. Please explain