Sunday, February 07, 2010

The Week

It's difficult for me to pick my 'favourite' news item this week to blog about. Two stand out, a study published in the New England Journal of Medicine, and the latest news from spokespeople of the cult of misery as my good friend Russell Blackford likes to call the Roman Catholic Church. The study in the NEJM was mistaken by large media organisations to further substantiate the claim that folks diagnosed to be in persistent vegetative state (PVS) or minimally conscious state (MCS) actually are not in such states, but rather that they're fully conscious persons trapped in a completely unresponsive body. Researchers in Belgium and France measured brain reactions in 54 such people in both countries and discovered to their surprise that some of them had the same brain regions light up that did light up in the healthy control group. This does indeed suggest that there's a possibility that in those folks a functional brain capable of understanding and responding to questions is kind of stuck in an unresponsive body. That is scientifically truly interesting and deserves further research. However, it's worth noting that despite the media hype (and hype by 'pro-life' activists) of the 54 PVS participants only a 5 responded in the manner I have just described, and 'in three of these patients, additional bedside testing revealed some sign of awareness, but in the other two patients, no voluntary behavior could be detected by means of clinical assessment.' The researchers sadly failed to ask how these 'responsive' people felt about being stuck in an unresponsive body, whether they wanted to continue living, questions that have been for a long time central in ethical and policy debates about the proper treatment of people in such states.

Stan Terman, MD, PhD of Caring Advocates commented (sensibly): "The finding that while bedside behavioral testing detected NO awareness (the hallmark needed for the diagnosis of Permanent Vegetative State), a high tech scan (fMRI) allowed one patient (out of 23) [not 4] to answer five simple Yes-or-No questions such as, “Is your brother’s name Alex?” Sensational news reports claimed that technology allowed this patient “to communicate for the first time since [the accident].” This may be an overstatement in terms of what we mean by “communication.” While the authors intend to ask patients about pain in the future, they did not suggest posing the ultimate existential Yes-or-No question, “Do you want to live in this state?” Surveys indicate that most people answer “No,” but there are still some who may this limited finding as a reason to never give up hope. Family members of patients with severe disorders of consciousness, especially if they are people of faith may use this finding to bolster their argument to continue to provide aggressive medical care and tube feeding when physicians consider such medical treatment to be futile. In addition, powerful faith-based health organizations, that determine their institutions’ policies regarding refusal of medically administrated food and water, may cite this result from one patient to continue tube feeding, indefinitely. Yet there is something I do not hear: So far, no professional has proposed, based on the finding that fMRI could help NONE of the patients whose PVS resulted from loss of oxygen (as opposed to physical trauma), it is therefore now both morally and ethically correct to withdraw feeding tubes from those PVS patients. I suppose the news media would prefer to report findings as providing hope—that’s what people want to hear. Unfortunately, bolstering false hope could lead to an inappropriate allocation of scarce medical resources." Stay tuned for more to come on this issue. I suspect the debate is far from over!

Well, then there are my friends from the Roman Catholic Church. Reeling from - by now - substantial numbers of (sexual) abuse cases involving children in their care across the globe, the organisation is being hit with the same scandal in Germany, where the number of abuse cases has reached more than one hundred (and counting). Of course, this ain't really newsworthy, we're used by now to the fact that some of its celibate staff are anything but celibate, particularly so when kids are about. Since 1995 about 100 of them were investigated in the context of child abuse allegations in Germany alone. Quite a number! As usual senior management tried as long as possible to protect its staff from prosecution - while busy preaching to the rest of society what proper sex and morals are all about. It is this bit that annoys me ever more. I do not understand why anyone in this day and age would even bother listening to representatives of this organisation the moment they say 'ethics' or 'morality'. Routinely historical truth is being mutilated in the name of the ideological cause, when bishops declared at one point or other that the holocaust is abused as a propaganda instrument by Jewish people, and, of course, that abortion is akin to genocide (tell that to the folks who were slaughtered in Rwanda, for instance). Incidentally, Christians fanatics from a southern state of the USA have been on the road again, in good colonial style, to grab kids in third world countries. It looks like in Haiti a whole bunch of them will be prosecuted for kidnapping kids (whose parents and/or relatives are alive and kicking). The official version is that they planned to hand them over to adoptive parents in the USA. It goes without saying that it all was a misunderstanding now. I pray to the non-existing Gods that they will be sentenced and put in Haitian jails and won't be simply extradited to the USA. There got to be some justice in this world every now and then.


2 comments:

  1. Sex, sex, sex...thats all those Catholics ever think about, whether it is over who is having it or what is happening after it. Never mind that Jesus spoke more about helping the poor than abortion or men banging men. Reminds me of a scene in Monty Pythons' The life of Brian when Brian's mum is going on about his oppessions with the subject.

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  2. Filipe Calvario (from Brazil)February 10, 2010

    Wow, this must be horrible! Imagine being conscious in a unresponsive body! Perhaps the euthanasia is even more applicable in such case.

    P.S.: You might want to change the font size of some parts of the post.

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