Wednesday, July 02, 2008

Good: Delaware Didn't "Learn the Lesson" of Schiavo

The Delaware House of Representatives has passed a resolution in support of protecting the life of Loren Richardson, who like Terri Schiavo before her, is the subject of a bitter court fight over removing her feeding tube. The resolution states:

This Resolution establishes protections for mentally disabled individuals in the State of Delaware. The impetus for this Resolution comes from the case of Lauren Richardson, a 24-year-old Delaware woman who, after suffering brain injuries and impaired consciousness, now faces the possible removal of her nutrition and hydration, despite the absence of her clearly specified and legal consent to any such a course of action. The State of Delaware has, through recent legislation prompted by the abuses at the Delaware Psychiatric Center, endeavored to protect the rights of mentally disabled patients in the First State. Lauren, as a mentally disabled person, is enumerated those same protection and rights.
Too many of us dismiss people like Lauren--and I am not referring here to her mother who wants treatment stopped--as "vegetables" (a word that should not be used as it is as demeaning and dehumanizing as the odious N-word), "brain dead" (as the Orlando Sentinel unrepentantly did for so long regarding Terri), or other such denigration. Meanwhile, some bioethicists look longingly at these people as "living cadavers" who can be harvested for their organs or used in medical experimentation.

Good for the Delaware Assembly for not shrinking from such demagoguery.

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31 Comments:

At July 02, 2008 , Blogger Rich said...

I know you dislike the term brain death, but do you have a problem with the concept itself, as defined by the Uniform Determination of Death Act of 1980?

In other words, suppose it could be proven to your satisfaction that - for a given individual - there was no current brain activity and no chance for reactivation. Would you be opposed to the parents or legal guardian of that individual terminating life support and donating their organs?

(I presume you know the difference between a vegetative state and brain death)

 
At July 02, 2008 , Blogger Wesley J. Smith said...

I have a problem with calling something brain death that isn't.

If you read this blog, you will see I accept neurological criteria--assuming proper diagnosis--as dead. It is not wrong to stop medical applications to a dead body or to procure organs. It is wrong to do so from a living patient diagnosed with PVS.


However, doubts are beginning to creep in.

 
At July 03, 2008 , Blogger Rich said...

Strictly speaking, the body of a brain dead individual is still alive.

 
At July 03, 2008 , Blogger viking mom said...

Good for Delaware. The full materialistic view IN PRACTICE is that we are all just biological "machines".

So some want to discard the less than perfect biological "machines" just as we might get rid of a defective car.

But we are so much more ...

and if our culture "progresses backwards" to the pre Judaeo Christian LOW view of humanity...
expect human life to be Super Cheap...

 
At July 03, 2008 , Blogger Lydia McGrew said...

Okay, the $64,000 question: Does this resolution have the potential actually to protect Lauren and to prevent her from being dehydrated to death? Does this actually alter the legal situation?

Rich, I have no idea why you are bringing up the brain death issue in this thread. There is no question of Lauren's being brain dead, and you yourself are emphasizing the difference between PVS and brain death. Lauren breathes on her own, as did Terri. So there's no point in even discussing the validity of brain death as a criterion for death in this context.

 
At July 03, 2008 , Blogger Rich said...

I bring it up because 1) a brain dead individual is a "living cadaver," and 2) most people do not understand the distinction between brain death and PSV. So, I wanted to be clear (for the reader's benefit) what WSJ was advocating, and if he thought legal protection should include brain death.

On a related tangent, Terri's brain had severely atrophied. Should there be a point where the condition of the brain factor into the decision of PSV individuals?

 
At July 03, 2008 , Blogger Rich said...

I bring it up because 1) a brain dead individual is a "living cadaver," and 2) most people do not understand the distinction between brain death and PSV. So, I wanted to be clear (for the reader's benefit) what WSJ was advocating, and if he thought legal protection should include brain death.

On a related tangent, Terri's brain had severely atrophied. Should there be a point where the condition of the brain factor into the decision of PSV individuals?

 
At July 03, 2008 , Blogger Rich said...

I bring it up because 1) a brain dead individual is a "living cadaver," and 2) most people do not understand the distinction between brain death and PSV. So, I wanted to be clear (for the reader's benefit) what WSJ was advocating, and if he thought legal protection should include brain death.

On a related tangent, Terri's brain had severely atrophied. Should there be a point where the condition of the brain factor into the decision of PSV individuals?

 
At July 03, 2008 , Blogger Stephen Drake said...

Lydia,

I spent some time today researching the questions you ask, because they also occurred to me as important ones.

The answer is the same to both questions: No. Nothing changes. It's a nonbinding resolution.

I'm getting ready to write about it now.

 
At July 03, 2008 , Blogger Jeremy said...

"On a related tangent, Terri's brain had severely atrophied. Should there be a point where the condition of the brain factor into the decision of PSV individuals?"

Rich - there is no singular point where someone goes from deserving life to deserving death. There is no bright line where someone becomes so impaired that they are better off dead.

 
At July 03, 2008 , Blogger Lydia McGrew said...

Thanks, Stephen. I was very much afraid of that.

Jeremy, agreed. The short answer to Rich's question is "no."

 
At July 03, 2008 , Blogger Jeremy said...

Lydia - I generally prefer to stay away from absolutes to hypothetical questions. But to real situations where facts can be known, then yes... obviously the answer in the two cases presented is no. There is no question of actual death, there is ample resources to sustain life. What's to debate??
One thing that bugs the heck out of me is that it is impossible to be absolutely SURE of correct action in these case (without faith). Since we can't be SURE beyond all doubt, it seems prudent to error on the side of life rather than death. This is so obvious to me that I am distressed that someone would argue that when you cannot be totally sure, that you should error on the side of killing?

Terri took 13 days to die. That is not a body longing for death. That is a disabled person clinging to life. It would have been more merciful to put bullet in her head. If you insist on killing, than kill, don't dress it up as 'letting them die.'

 
At July 04, 2008 , Blogger Lydia McGrew said...

I agree. What is really terrifying is that there are people pushing for declaring people like Lauren and Terri "dead" and simply taking their organs from their breathing bodies. What have we become?

 
At July 04, 2008 , Blogger Wesley J. Smith said...

I am glad Rich is commenting so candidly. With his disdain for the most vulnerable among us by denigrating them with the oxymoronic epithet "living cadavers," he proves that I am not paranoid as I try to warn about the evil that this way comes.

The biggest threat is not that some would destroy universal human rights by throwing some humans out of the moral community--ironically as they put some animals in--but that the people will not believe it can happen or will shrug their shoulders and let the so-called "experts" handle it. But I can tell you from the heartbroken people I hear from, whose agony at how their loved ones were treated and their seeming powerlessness in the face of institutional bullies to influence the course of events, that the danger isn't just prospective, it is here and now.

But I am confident that an alerted populace will thwart at least some of these agendas. Hence, SHS and my other work.

 
At July 04, 2008 , Blogger Laura(southernxyl) said...

May I point out that we don't know how atrophied the brain of a non-damaged person would be if he or she spent a decade immobilized and with no sensory input, and then was dehydrated over a period of two weeks.

 
At July 08, 2008 , Blogger Rich said...

My question about the state of Terri's brain was an honest one, but it seems to have made you defensive and confuse PSV with brain death.

I am glad Rich is commenting so candidly. With his disdain for the most vulnerable among us by denigrating them with the oxymoronic epithet "living cadavers," he proves that I am not paranoid as I try to warn about the evil that this way comes.

I said, "a brain dead individual is a 'living cadaver,'"

And this is what you said in response to my initial question about brain death:

If you read this blog, you will see I accept neurological criteria--assuming proper diagnosis--as dead. It is not wrong to stop medical applications to a dead body or to procure organs.

So which is it? Are the brain dead living cadavers or are they the "most vulnerable among us", because you can't have it both ways.

 
At July 09, 2008 , Blogger SBSorized Dale said...

On an idealogical and societal perspective, I find it troubling that convicted mass murderers on death row are kept alive appeal after appeal supported by public media appeal ..etc but yet the life of the helpless and needy citizen in good standing is not given such extension of preservation concern. To me this appears extremely duplicitous and morally vacant.

Since I've accepted these societal positioning extremes from the exact some people as fact, the question that I want answered is "Why?". How can any rational person be capable of such pendulum positions? Is something more at work than what is being presented as relative moralism?

 
At July 09, 2008 , Blogger rafaelmarie said...

"Brain Death" is Not Death!

http://initiative-kao.de/KAO-Braindeath_is_not_death.htm

Essay - At a meeting of the Pontifical Academy of Sciences in early February 2005

Von: Paul A. Byrne, Cicero G. Coimbra, Robert Spaemann und Mercedes Arzu Wilson

In medicine we protect, preserve, and prolong life and postpone death. Our goal is to keep body and soul united. When a vital organ ceases to function, death can result. On the other hand, medical intervention can sometimes restore the function of the damaged organ, or medical devices (such as pacemakers and heart-lung machines) can preserve life. The observation of a cessation of functioning of the brain or some other organ of the body does not in itself indicate destruction of even that organ, much less death of the person.

Dr Paul Byrne

By Paul A. Byrne, Cicero G. Coimbra, Robert Spaemann, and Mercedes Arzú Wilson.

On February 3-4, the Pontifical Academy of Sciences, in cooperation with World Organization for the Family, hosted a meeting at the Vatican entitled "The Signs of Death." This essay is based on the papers that were submitted to the Pontifical Academy as well as the discussions that took place during those two days.

The meeting was convened at the request of Pope John Paul II to reassess the signs of death and verify, at a purely scientific level, the validity of brain-related criteria for death, entering into the contemporary debate of the scientific community on this issue.

In a message to the Pontifical Academy of Sciences, made public at the February meeting, the Holy Father said that the Church has consistently supported "the prac-tice of transplanting organs from deceased persons." However, he cautioned that transplants are acceptable only when they are conducted in a manner "so as to guarantee respect for life and for the human person."

The Pope cited his predecessor, Pope Pius XII, who said that "it is for the doctor to give a clear and precise definition of death and of the moment of death." He encouraged the Pontifical Academy to pursue that task, promising that scientists could count on the support of Vatican officials, "especially the Congregation for the Doctrine of the Faith."

Background
In 1968 the "Harvard criteria" for determining brain death were published in the Journal of the American Medical Association, under the title of "A Definition of Irreversible Coma." This article was published without substantiating data, either from scientific research or from case studies of individual patients. For this reason, a majority of the presenters at the conference in Rome stated that the "Harvard criteria" were scientifically invalid.

In 2002 the results of a worldwide survey were published in Neurology, concluding that the use of the term "brain death" worldwide is "an accepted fact but there was no global consensus on the diagnostic criteria" and there are still "unresolved issues worldwide."

In fact between 1968 and 1978 at least 30 disparate sets of criteria were published, and there have been many more since then. Every new set of criteria tends to be less rigid than earlier sets and none of them is based on the scientific method of observation and hypothesis followed by verification).

Attempts to compare the newer criteria with the time proven, generally accepted criteria for death - the cessation of circulation, respiration, and reflexes - show that these criteria are distinctly different. This has resulted in an unhappy situation for the medical profession. Many physicians, who feel that the Hippocratic Oath is being violated by acceptance of such disparate sets of criteria, feel the need to expose the fallacy of "brain death," because the noble reputation of the medical profession is at stake.

Philosophical considerations
In his presentation to the Pontifical Academy, Robert Spaemann - a noted former professor of philosophy from the University of Munich - cited the words of Pope Pius XII, who declared that "human life continues when its vital functions manifest themselves, even with the help of artificial processes."

Professor Spaemann observed: "The cessation of breathing and heartbeat, the "dimming of the eyes," rigor mortis, etc. are the criteria by which since time immemorial humans have seen and felt that a fellow human being is dead." But the Harvard criteria "fundamentally changed this correlation between medical science and normal interpersonal perception."

As he put it: Scrutinizing the existence of the symptoms of death as perceived by common sense, science no longer presupposes the "normal" understanding of life and death. It in fact invalidates normal human perception by declaring human beings dead who are still perceived as living.

The new approach to defining death, the German scholar continued, reflected a different set of priorities:

It was no longer the interest of the dying to avoid being declared dead prematurely, but other people’s interest in declaring a dying person dead as soon as possible.

Two reasons are given for this third party interest:

guaranteeing legal immunity for discontinuing life-prolonging measures that would constitute a financial and personal burden for family members and society alike, and
collecting vital organs for the purpose of saving the lives of other human beings through transplantation. These two interests are not the patient’s interests, since they aim at eliminating him as a subject of his own interests as soon as possible.
The arguments against the use of "brain death" as a determination of death are being made, Spaemann noted, "not only by philosophers, and, especially in my country, by leading jurists, but also by medical scientists." He quoted the words of a German anesthesiologist who wrote, "Brain-dead people are not dead, but dying."

Medical evidence
Dr. Paul Byrne, a neonatologist from Toledo, Ohio, offered a medical perspective - he testified:

When organs are removed from a "brain dead" donor, all the vital signs of the "donors" are still present prior to the harvesting of organs, such as: normal body temperature and blood pressure; the heart is beating; vital organs, like the liver and kidneys, are functioning; and the donor is breathing with the help of a ventilator.

Furthermore, Bryne told the Academy, that approach is required for most transplant surgery, because vital organs deteriorate very quickly after a patient dies. "After true death," he said, "unpaired vital organs (specifically the heart and whole liver) cannot be transplanted."

Transplantation of unpaired vital organs is legal in most Western countries, including the United States, and in some developing nations like Brazil, but the important question for anyone is: "is it morally permissible to terminate a life to save another?" Pope John Paul II has repeatedly said as recently as February 4, 2003 message to the World Day of the Sick: "It is never licit to kill one human being in order to save another." The Catechism of the Catholic Church clearly states (2296): "It is morally inadmissible directly to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons."

"In medicine we protect, preserve, and prolong life and postpone death," Byrne said. "Our goal is to keep body and soul united." When a vital organ ceases to function, he argued, death can result. On the other hand, medical intervention can sometimes restore the function of the damaged organ, or medical devices (such as pacemakers and heart-lung machines) can preserve life. He said: "The observation of a cessation of functioning of the brain or some other organ of the body does not in itself indicate destruction of even that organ, much less death of the person."

Defending the criteria
Some participants in the February meeting defended the use of the "brain death" criteria. Dr. Stewart Youngner of Case Western University in Ohio admitted that "brain dead" donors are alive, but argued that this should not prove an impediment to the harvesting of their organs. His reasoning was that there is such poor "quality of life" in the "brain dead" patient that it would be more beneficial to harvest their organs to extend the life of another than to continue the life of the organ donor.

Dr. Conrado Estol, a neurologist from Buenos Aires, explained the steps that should be followed in determining the "brain death" of a prospective organ donor. Dr. Estol, who is strongly in favor of harvesting human organs to extend the life of other patients, presented a dramatic video of a person diagnosed as "brain dead" who attempted to sit up and cross his arms, although Dr. Estol assured the audience that the donor was a cadaver. This produced an unsettling response among many participants at the conference.

A French transplant surgeon, Dr. Didier Houssin, acknowledged the difficulties that arise because of the discrepancies between the different criteria for brain death. He observed that "death is a medical fact, a biological process, and a philosophical question, but it is also a social fact." It would be difficult for a society to admit that a man could be said alive in one place and dead in another place. However, as a proponent of transplants, he said that it is important for society to trust doctors.

Another French physician, Dr. Jean-Didier Vincent of the Institut Universitaire, emphasized that a "brain dead" person has suffered complete and irreversible destruction of the brain. Dr. Vincent was questioned closely about the case of a pregnant women, diagnosed as brain-dead, who continues her pregnancy while on life-support system, even producing breast milk for her unborn child. He admitted that the mother produces milk, but regards that production as an inhibited mechanical reflex rather than a sign of enduring human life. When reminded that the production of breast milk results from the signal sent from the anterior lobe of the pituitary that stimulates the secretion of milk, and possibly breast growth, thus requiring a functioning brain, he replied that there could be some minimal hormonal production in the brain.

The apnea test
In his presentation at the conference, Dr. Cicero Coimbra, a clinical neurologist from the Federal University of Sao Paolo, Brazil denounced the cruelty of the apnea test, in which mechanical respiratory support is withdrawn from the patient for up to 10 minutes, to determine whether he will begin breathing independently. This is part of the procedure before declaring a brain-injured patient "brain dead." Dr. Coimbra explained that this test significantly impairs the possible recovery of a brain-injured patient, and can even cause the death of the patients.

He argued:

A large number of brain-injured patients, even in deep coma, can recover to lead a normal daily life; their nervous tissue may be only silent, not irreversibly damaged, as a consequence of a partial reduction of the blood supply to the brain. (This phenomenon, called "ischemic penumbra," was not known when the first neurological criteria for brain death were established 37 years ago.) However, the apnea test (considered the most important step for the diagnosis of "brain death" or brain-stem death) may induce irreversible intra-cranial circulatory collapse or even cardiac arrest, thereby preventing neurological recovery.
During the apnea test, the patients are prevented from expelling carbon dioxide (CO2), which becomes a poison to the heart as the blood CO2 concentration rises.
As a consequence of this procedure, the blood pressure drops, and the blood supply to the brain irreversibly ceases, thereby causing rather than diagnosing irreversible brain damage; by reducing the blood pressure, the "test" further reduces the blood supply to the respiratory centers in the brain, thereby preventing the patient from breathing during this procedure. (By breathing, the patient would demonstrate that he is alive.)
Irreversible cardiac arrest (death), cardiac arrhythmias, myocardial infarction, and other life-threatening detrimental effects may also occur during the apnea test. Therefore, irreversible brain damage may occur during and before the end of the diagnostic procedures for “brain death.”
Dr. Coimbra concluded by saying that the apnea test should be considered unethical and declared illegal as an inhumane medical procedure. If family members were informed of the brutality and risk of the procedure, he stated, most of them would deny permission. He pointed out that when a heart attack patient is admitted to the emergency room he is never subjected to a stress test in order to verify that he is suffering from heart failure. Instead the patient is given special care and protection from further stress to the heart.

In contrast when a brain-injured patient is subjected to the apnea test, further stress is placed on the organ that has already been injured, and additional damage can endanger the patient’s life. Dr. Yoshio Watanabe a cardiologist from Nagoya, Japan, concurred, saying that if patients were not subjected to the apnea test, they could have a 60 percent chance of recovery to normal life if treated with timely therapeutic hypothermia.

The question of a brain-injured patient's possible recovery also concerned Dr. David Hill, a British anesthetist and lecturer at Cambridge. He observed: "It should be emphasized first that it was widely admitted, that some functions, or at least some activity, in the brain may still persist; and second that the only purpose served by declaring a patient to be dead rather than dying, is to obtain viable organs for transplantation." The use of these criteria, he concluded, "could in no way be interpreted as a benefit to the dying patient, but only (contrary to Hippocratic principles) a potential benefit to the recipient of that patient’s organs."

"The deception"
Dr. Hill recalled that the earliest attempts at transplanting vital organs often failed because the organs, taken from cadavers, did not recover from the period of ischemia following the donor's death. The adoption of brain-death criteria solved that problem, he reported, "by allowing the removal of vital organs before life support was turned off - without the legal consequences that might otherwise have attended the practice."

While it is remarkable that the public has accepted these new criteria, Dr. Hill remarked, he attributed that acceptance in large part to the favorable publicity for organ transplants, and in part to public ignorance about the procedures. "It is not generally realized," he said, "that life support is not withdrawn before organs are taken; nor that some form of anaesthesia is needed to control the donor whilst the operation is performed." As knowledge of the procedure increases, he observed, it is not surprising that - as reported in a 2004 British study - "the refusal rate by relatives for organ removal has risen from 30 percent in 1992 to 44 percent." Dr. Hill also suggested that when relatives see with their own eyes the evidence that a potential organ donor is still alive, they harbor enough doubts so that they are not ready to consent to the organ removal.

In the United Kingdom, Dr. Hill reported, there is mounting pressure for individuals to sign, and always carry with them, donor cards authorizing doctors to use their vital organs. Today only about 19 percent of the country's people have registered as organ donors, but vehicle-registration forms, driver's-license applications, and other public documents provide "tick boxes" allowing citizens to give this advance directive; even children are encouraged to sign. All such documents specify that organs may be harvested only "after my death," but there is no definition of what constitutes "death."

Again, Dr. Hill remarked, the acceptance of transplants hangs on the public's lack of understanding about the procedure. And yet, he pointed out, "For any other procedure, informed consent is required, but for this most final of operations no explanation nor counter-signature is required, nor is the opportunity given to discuss the question of anaesthesia."

Bishop Fabian Bruskewitz of Lincoln, Nebraska, addressed the issue of the donor's consent. "As far as I know," he told the Pontifical Academy, "no respectable, learned and accepted moral Catholic theologian has said that the words of Jesus regarding laying down one’s life for one’s friends (John 15:13) is a command or even a license for suicidal consent for the benefit of another’s continuation of earthly life."

The bishop went on to observe that current technology enables doctors only to monitor brain activity "in the outer 1 or 2 centimeters of the brain." He asks: "Do we have then, moral certitude in any way that can be called apodictic regarding even the existence, much less the cessation of brain activity?"

From the perspective of Catholic moral teaching the bishop said: The dignity and autonomy of a human being - whether zygote, blastocyst, embryo, fetus, newborn, infant, adolescent, adult, disabled or handicapped adult, aged adult, adult in a comatose or (so-called) persistent vegetative state, etc - are viewed, as they have been viewed throughout the history of the Catholic Church, as worthy of respect and entitled to protection from untoward human intervention effecting the termination of human life at any of those stages.

In light of the serious questions about the validity of the "brain death" criteria, Professor Josef Seifert from the International Academy of Philosophy in Liechtenstein argued that medical ethicists should invoke the true and evident ethical principle (emphasized by the whole Church tradition of moral teachings), that "even if a small reasonable doubt exists that our acts kill a living human person, we must abstain from them."

The Signs of Death
Conclusions reached after examination of Brain-Related Criteria for death, at the Pontifical Academy of Sciences meeting

On the one hand the Church recognizes, consistent with her tradition, that the sanctity of all human life from conception to natural end must absolutely be respected and upheld. On the other hand, a secular society tends to place greater emphasis on the quality of living.
The Catholic Church has always opposed the destruction of human life before being born through abortion and she equally condemns the premature ending of the life of an innocent donor in order to extend the life of another through unpaired vital organ transplantation. "It is morally inadmissible directly to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons." "It is never licit to kill one human being in order to save another."
"Nor can we remain silent in the face of other more furtive, but no less serious and real forms of euthanasia. These could occur for example when, in order to increase the availability of organs for transplants, organs are removed without respecting objective and adequate criteria which verify the death of the donor."
"The death of the person is a single event, consisting in the total disintegration of that unitary and integrated whole that is the personal self. It results from the separation of the life-principle (or soul) from the corporal reality of the person." Pope Pius XII declared this same truth when he stated that human life continues when its vital functions manifest themselves even with the help of artificial processes.
"Acknowledgement of the unique dignity of the human person has a further underlying consequence: vital organs which occur singly in the body can be removed only after death - that is, from the body of someone who is certainly dead. This requirement is self-evident, since to act otherwise would mean intentionally to cause the death of the donor in disposing of his organs." Natural moral law precludes removal for transplantation of unpaired vital organs from a person who is not certainly dead. The declaration of "brain death" is not sufficient to arrive at the conclusion that the patient is certainly dead. It is not even sufficient to arrive at moral certitude.
Many in the medical and scientific community maintain that brain-related criteria for death are sufficient to generate moral certitude of death itself. Ongoing medical and scientific evidence contradicts this assumption. Neurological criteria alone are not sufficient to generate moral certitude of death itself, and are absolutely incapable of generating physical certainty that death has occurred.
It is now patently evident that there is no single socalled neurological criterion commonly held by the international scientific community to determine certain death. Rather, many different sets of neurological criteria are used without global consensus.
Neurological criteria are not sufficient for declaration of death when an intact cardio-respiratory system is functioning. These neurological criteria test for the absence of some specific brain reflexes. Functions of the brain not considered are temperature control, blood pressure, cardiac rate and salt and water balance. When a patient on a ventilation machine is declared "brain dead," these functions not only are present but also are frequently active.
The apnea test - the removal of respiratory support - is mandated as a part of the neurological diagnosis and it is paradoxically applied to ensure irreversibility. This significantly impairs outcome, or even causes death, in patients with severe brain injury.
There is overwhelming medical and scientific evidence that the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem) is not proof of death. The complete cessation of brain activity cannot be adequately assessed. Irreversibility is a prognosis, not a medically observable fact. We now successfully treat many patients who in the recent past were considered hopeless.
A diagnosis of death by neurological criteria alone is theory, not scientific fact. It is not sufficient to overcome the presumption of life.
No law whatsoever ought to attempt to make licit an act that is intrinsically evil. "I repeat once more that a law which violates an innocent person's natural right to life isunjust and, as such, is not valid as a law. For this reason I urgently appeal once more to all political leaders not to pass laws which, by disregarding the dignity of the person, undermine the very fabric of society."
The termination of one innocent life in pursuit of saving another, as in the case of the transplantation of unpaired vital organs, does not mitigate the evil of taking an innocent human life. Evil may not be done that good might come of it.
Signatories:
J.A. Armour, physician, University of Montreal Hospital of the Sacred Heart, Montreal, Quebec.
Fabian Bruskewitz, Bishop of Lincoln, Nebraska
Paul A. Byrne, past president, Catholic Medical Association, US.
Pilar Mercado Calva, professor, School of Medicine, Anahuac University, Mexico.
Cicero G. Coimbra, professor of Clinical Neurology, Federal University of Sao Paolo, Brazil.
William F. Colliton, retired professor of Obstetrics and Gynecology George Washington University Medical School, Virginia.
Joseph C. Evers, clinical associate professor of Pediatrics, Georgetown University School of Medicine, Washington, DC.
David Hill, emeritus consultant anesthetist, at Addenbrooke’s Hospital, and associate lecturer, Cambridge University, England.
Ruth Oliver, psychiatrist, Kingston, Ontario.
Michael Potts, head of Religion and Philosophy Department, Methodist College, Fayetteville, North Carolina.
Josef Seifert, professor of Philosophy at the International Academy of of Philosophy, Vaduz, Liechtenstein; honorary member of the Medical Faculty of the Pontifical Catholic University of Chile in Santiago, Chile.
Robert Spaemann, professor emeritus of Philosophy, University of Munich, Germany.
Robert F. Vasa, Bishop of the Diocese of Baker, Oregon.
Yoshio Watanabe, consultant cardiologist, Nagoya Tokushukai General Hospital, Japan.
Mercedes Arzú. Wilson, president, Family of the Americas Foundation and World Organization for the Family.

Source: Essay - meeting of the Pontifical Academy of Sciences in early February - Dr Paul Byrne, to The Compassionate Healthcare Network, March 29, 2005 via e-mail

Annotation: The protocol of this meeting has not been officially published so far and is presently in the hands of the Congregation for the Doctrine of the Faith.

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At July 09, 2008 , Blogger Wesley J. Smith said...

Rich: Perhaps I misunderstood you. The use of "living cadaver" has been used in the Journal of Medical Ethics to denote people in PVS, as a means of justifying using them in xenotransplantation research, for example.

A patient declared dead by neurological criteria is not a living cadaver, unless the criteria for making the diagnosis are invalid. If that is the case, the body is alive and a patient and the only approach to organ procurement will have to be non heartbeating cadaver donors. But then, they have living cells at the time of procurement too, including in the brain, and so they too are living cadavers.

So, I guess the game that is really afoot is to destroy the dead donor rule. And my points stand.

 
At July 09, 2008 , Blogger Rich said...

Usually, at the time brain death is declared, the body is still being kept alive artificially on machines, so they still have a beating heart and breathing lungs - hence, living cadavers.

UNIFORM DETERMINATION OF DEATH ACT, 1980
§ 1. [Determination of Death]. 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.
-------------
...Under part (2), the entire brain must cease to function, irreversibly. The "entire brain" includes the brain stem, as well as the neocortex. The concept of "entire brain" distinguishes determination of death under this Act from "neocortical death" or "persistent vegetative state." These are not deemed valid medical or legal bases for determining death.

This Act also does not concern itself with living wills, death with dignity, euthanasia, rules on death certificates, maintaining life support beyond brain death in cases of pregnant women or of organ donors, and protection for the dead body. These subjects are left to other law.

This Act is silent on acceptable diagnostic tests and medical procedures. It sets the general legal standard for determining death, but not the medical criteria for doing so. The medical profession remains free to formulate acceptable medical practices and to utilize new biomedical knowledge, diagnostic tests, and equipment.
www.law.upenn.edu/bll/archives/ulc/fnact99/1980s/udda80.htm

 
At July 09, 2008 , Blogger Wesley J. Smith said...

I have often said here that the medical professional have to develop uniform methods in this regard.

Living cadavers is still an oxymoron and inaccurate as a matter of law.

 
At July 09, 2008 , Blogger Monica said...

I will pray today for Lauren and her family. May God sustain them. It is a very heavy cross the one they have. It will be much easier for them to accept it if others were to help them. If they do accept it in patience, may God be moved to mercy and kindness towards them. Oh God be merciful; for your children are suffering, and want to terminate the life to terminate the suffering to terminate their trust in you. Where does a negotiation that starts with "I do not trust in You" ends.

 
At July 09, 2008 , Blogger Michael said...

"Terri took 13 days to die. That is not a body longing for death. That is a disabled person clinging to life. It would have been more merciful to put bullet in her head. If you insist on killing, than kill, don't dress it up as 'letting them die.'"

That is the most profound and clear way of saying it.

 
At July 14, 2008 , Blogger Judith Blakley said...

Thanks for sharing this information!

 
At August 01, 2008 , Blogger Okakura said...

This post has been removed by the author.

 
At August 01, 2008 , Blogger Okakura said...

This post has been removed by the author.

 
At August 01, 2008 , Blogger Okakura said...

Rich: Appreciate all of your posts. How anyone could construe either what you wrote or your evenhanded tone as "disdainful" is in my opinion remarkably....well, a little paranoid actually -- in this instance, extremely defensive of having a frank, objective discussion of the many issues concerning PVS, definitions of death, and sanctity vs quality of life arguments. These are valid discussions, and I didn't see youaccusing Mr. Smith or his like-minded supporters of being inhumane ideologically-driven 'torturers' (which is how some people rudely characterize proponents of vitalism). They should return the same courtesy instead of labelling all those who see things differently as part of "the Culture of Death." Since when did such name-calling ever help prove one's case or result in a more enlightened discourse...

 
At August 16, 2008 , Blogger jack009 said...

This Saturday our guest will once again be Princeton University Professor Robert P. George.

Because there was not nearly enough time on the July 19th program speaking with Professor George, he has kindly agreed to be our guest once again on this Saturday's America’s Lifeline.

Professor George is a member of the President's Council on Bioethics and formerly served as a presidential appointee to the United States Commission on Civil Rights.
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jack
Delaware Drug Treatment

 
At August 26, 2008 , Blogger albertjames said...

Floyd Landis has a hip ailment (advanced osteonecrosis) that keeps him in constant pain and makes it hard for him to walk. And he's had this condition for a couple of years. Yet he's a top contender in this year's Tour de France (and won this year's Tour of California, Tour of Georgia, & Paris-Nice.) WOW! The Tour is considered by most to be the single hardest physical sporting event in the world. About 2300 miles on a bike at an average speed of 25mph for three weeks. Like running back-to-back marathons for three weeks. World class cyclists ingest about 10,000 calories a day, and have their metabolisms so revved up, few other animals surpass them. Cyclists have been known to lose five to ten pounds in a single race.
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albertjames
Delaware Alcohol Addiction Treatment

 
At September 01, 2008 , Blogger Canadian Valerie said...

In perusing the comments someone said "Terri's brain was severly atrophied". Terri did not act that way, even near her death: e.g. she would close her eyes when Fr. Pavone would indicate that he was about to pray with/for her and she would re-open them as soon as he said, "Amen." THAT does not sound like atrophy to me. Too many people make comments without the all the facts.
Bravo to Deleware for giving hope to coma/PVS people who will not die a horrid death of starvation/dehydration and may miraculously recover because of it.

 
At October 23, 2008 , Blogger Ianthe said...

When someone is really brain dead, the body isn't far behind and follows suit, and it's not long before the body is dead too, whether or not the person is on "life support," and without the "help" of any cessation or removal of "futile care." Don't start me on "brain death," "pvs," "coma," etc. They tried all those gambits before, despite their having been unsuccessful, they murdered my mother, who was, to observers besides me, aware and afraid when they did. This stuff shouldn't even be a subject of discussion; a smarter society would quash the deathmongers.

 

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