Category Assisted Suicide and Euthanasia

More on “Vegetative State”

Ed 3 Comments

In February I wrote about an article reporting that patients in a vegetative state may not be as unaware of their surroundings as doctors had previously thought (see News the Public Needs to Know). Now, I know that I’ve said I’ll try to be better in reading my books and magazines, but I just recently read the December 2009 issue of Scientific American. In it, there’s a short article about how some people can still learn while in a vegetative state.

A team of doctors at the Integrative Neuroscience Laboratory at the University of Buenos Aires has started developing tests to determine if patients have the ability to learn. The director of the lab, Mariano Sigman, said, “We want to have an objective way of knowing whether the other person [the patient] has consciousness or not.” The desire to find this objective method… (click here to read the entire article)

…stems in part from surprising neuroimaging work that showed that some vegetative patients, when asked to imagine performing physical tasks such as playing tennis, still had activity in premotor areas of their brains. In others, verbal cues sparked language sectors. …

To explore possible tests of consciousness in patients, Sigman and his colleagues turned to classical conditioning: they sounded a tone and then sent a light puff of air to the patient’s eye. The air puff would cause a patient to blink or flinch the eye, but after repeated trials over half an hour, many patients would begin to anticipate the puff, blinking an eye after only hearing the tone.

If two stimuli are delivered at exactly the same time, even snails will equate the stimuli. But the team actually delayed the puff after the tone by 500 milliseconds. To associate two stimuli separated by that time gap, “you need conscious processing,” says lead study author Tristan Bekinschtein of the Impaired Consciousness Research Group at the University of Cambridge. In fact, delaying the second stim­ulus by more than 200 milliseconds is enough to demonstrate some learning, he adds. By comparison, people under general anesthesia, considered to be entirely lacking awareness, showed no sign of such learning when given the tone and air-puff test.

…The detection of learning…also opens up questions about when patients should be classified as being in a persistent vegetative state, in which emergence isn’t predicted to be likely.

Why is this an important advance in diagnosing a patient’s condition? The article also states that: “A recent study found that about 40 percent of vegetative state diagnoses are incorrect” [emphasis mine].

In March, another news item on this topic showed up on the Scientific American website. It seems that certain patients in a “minimally conscious state” or a “vegetative state” due to brain injuries may be revived by injecting the patient with apomorphine, a drug used for patients with Parkinson’s disease.

Esteban Fridman of the FLENI hospital in Buenos Aires is one of the leading proponents in of this treatment. This excerpt tells a little bit about the theory and the research to this point (click here to read the entire news item):

Fridman hypothesizes that apomorphine might work by acting in place of dopamine. Flooding the injured brain with the chemical might stimulate it enough to repair the connections, enabling the patients to reach full consciousness. He notes the drug wouldn’t work in cases where the brain has been deprived of oxygen or blood, because the damage is more widespread. Terri Schiavo, a Florida woman whose care sparked a nationwide controversy that peaked in 2005, was in a vegetative state caused by that kind of injury.

…Fridman first tried apomorphine on a patient in 2004. The man had been in a minimally conscious state for 104 days. After he was given the drug the patient’s mother called Fridman to tell him her son had awakened after only 24 hours.

Over the next few years, Fridman and a colleague, Ben Zion Krimchansky at the Loewenstein Hospital Rehabilitation Center in Israel tried the drug on a total of eight patients. Seven recovered consciousness. (One subsequently died of an unrelated problem.) One welcome effect, Fridman says, was that patients did not regress even after the treatment was discontinued. Five improved to where they could walk, and one can now drive by himself.

…But because these clinical observations were not double-blind studies—in which neither the physicians nor the patients know if subjects get a placebo or the drug—Fridman currently is starting a formal clinical study with a total of 76 patients. The apomorphine will be given between one and four months after a traumatic brain injury, and the dosages will be spread over several weeks, given over 12-hour periods. Some patients will get the drug and some will be controls.

Maybe now that science has raised doubts about the realities of “vegetative state,” doctors and health-care professionals will be a little less quick to judge whose life is worth saving and whose is not. Maybe we’ll start honoring all people as human beings deserving of love and care, whether we think they can see us or hear us, or react the way we expect them. And when talking about Terri Schiavo and others in her condition, maybe we shouldn’t be so quick say, “I wouldn’t want to live like that.”

Because maybe, just maybe, that patient in a “vegetative state” can hear every word you’re speaking and is scared to death of what’s going on and that no one will hear her silent cries.

News the Public Needs to Know

Ed

The Washington Post published two articles this week that bolsters the pro-life side of the argument in two areas: abstinence and end-of-life issues.

The first article appeared on Tuesday, February 2, 2010 regarding a recently published study on abstinence-only education programs. Researchers conducted a study between 2001-2004 that had four groups of children involved. Here’s an excerpt from the Washington Post article (click here to read the entire article):

Students were randomly assigned to go through one of the following: an eight-hour curriculum that encouraged them to delay having sex; an eight-hour program focused on teaching safe sex; an eight- or 12-hour program that did both; or an eight-hour program focused on teaching them other ways to be healthy, such as eating well and exercising. The abstinence-only portion involved a series of sessions in which instructors talked to students in small groups about their views about abstinence and their knowledge of HIV and other sexually transmitted diseases. They also conducted role-playing exercises and brainstorming sessions designed to correct misconceptions about sex and sexually transmitted diseases, encourage abstinence and offer ways to resist pressure to have sex.

Over the next two years, about 33 percent of the students who went through the abstinence program started having sex, compared with about 52 percent who were taught only safe sex. About 42 percent of the students who went through the comprehensive program started having sex, and about 47 percent of those who learned about other ways to be healthy did.

The abstinence program had no negative effects on condom use, which has been a major criticism of the abstinence approach.

The lead researcher made a statement that can be seen as almost reconciliatory towards pro-lifers who have fought for abstinence-only education programs.

“I think we’ve written off abstinence-only education without looking closely at the nature of the evidence,” said John B. Jemmott III, a professor at the University of Pennsylvania who led the federally funded study. “Our study shows this could be one approach that could be used.”

The second article was published on Thursday, February 2, 2010. A study was conducted on 54 patients in a “vegetative state” to see if their minds were working or not. The study found that some of the patients could indeed hear, react, and respond to outside stimulation. Here is an excerpt (click here to read the entire article):

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

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

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

“This should change the way we think about these patients,” said Nicholas D. Schiff, an associate professor of neurology and neuroscience at Weill Cornell Medical College in New York City. “I think it’s going to have very broad implications.” …

As many as 20,000 Americans are in a vegetative state, meaning they are alive and awake but without any apparent sense of awareness, and 100,000 to 300,000 are in a related condition known as a minimally conscious state, in which they exhibit impaired or intermittent awareness. It is unclear what proportion of these patients would be affected by the study’s findings.

The message of pro-life Americans remains the same: all life is precious and valuable regardless of its state of being. For decades Americans have witnessed our values hijacked by a culture that tells us over and over through the popular media that the value of human life, both born and pre-born, is based on what that life contributes or “brings to the table.” “They” set the measuring stick by which “they” determine that value, and “they” use science to bolster their argument for promoting death as a “kind” and “worthy” alternative to life. What will they say as science refutes one of the very yardsticks they use to determine whether it’s time to pull the plug on someone’s beloved family member? Who do you want advocating for your loved one if they end up in a state where they are calling out for your help and compassion but their voices are locked inside them and you cannot hear their cries?

Quality Indicators for People with Dementia

Ed

Here’s something new for pro-life Americans to be concerned with that showed up in the manager’s amendment to H.R. 3962 Affordable Health Care for America Act; click here to download a copy.

A new section was added that should cause everyone to question where this so-called “health care reform bill” is heading. The new section is called “Quality Indicators for Care of People with Alzheimer’s Disease” [Sec. 1446].

The Secretary of Health and Human Services shall develop quality indicators for the provision of medical services to people with Alzheimer’s disease and other dementias and plan for implementing the indicators to measure the quality of care provided for people with these conditions [Sec. 1446(a)].

Although the wording is ambiguous since this will be a plan that the secretary of Health and Human Services will be creating, it would appear that the services to be provided to patients with mental illnesses will be determined on the quality indicators that are developed. Will this mean that people with a “lesser” so-called “quality of life” be denied medical services? This is but one sign of the intended health care rationing to come if H.R. 3962 were to be enacted.

Meanwhile, an amendment was introduced by Representative John Boehner (OH) (click here to read it) in order to substitute H.R. 3962. It would strike everything after the enacting clause of H.R. 3962 and insert an entirely new bill. This amendment would codify a permanent ban on tax-payer funds from being used to fund abortions and it will codify a conscience protection clause.

The Boehner amendment would explicitly prohibit tax-payer funding of elective abortions, including any monies held in a trust fund to which tax-payer funds were deposited [Sec. 602 of Boehner amendment, amending Title 1 of the United States Code]. Additionally, the amendment would provide for conscience protection by stipulating a penalty for anyone or any entity which discriminates against an individual or any health care entity (e.g. a hospital) for their refusal to “provide, pay for, provide coverage of, or refer for abortions” [Sec. 602 of Boehner amendment, amending Title 1 of the United States Code].

During the summer, Representative Bart Stupak (MI) and Representative Joseph Pitts (PA) submitted an amendment to H.R. 3200 that would explicitly ban usage of tax-payer funds for abortions (click here to read it). They would like to introduce the same amendment to H.R. 3962, but speaker of the house Nancy Pelosi (CA) is trying to push a “rule” so that there can be no vote on additional amendments to H.R. 3962.

Contact your representative today to tell them to support pro-life amendments and to vote NO on Speaker Pelosi’s rule that would ban a vote on pro-life amendments to H.R. 3962. You can find information on how to call your representative on the National Right to Life webpage by clicking here. This is imperative. The vote on Pelosi’s rule is expected to happen on Friday night (November 6) and the vote on the whole bill is expected to happen on Saturday night (November 7).

Health Plans Forced to Provide Assisted Suicide Counseling

Ed

Another little gem found in H.R. 3962 Affordable Health Care for America Act involves the requirement for your health insurance plan to provide and pay for assisted suicide counseling.

Section 240 requires that all companies offering a qualified health benefits plan to “provide for the dissemination of information related to end-of-life planning to individuals seeking enrollment in Exchange-participating health benefits plans offered through the Exchange” [Sec. 240(a)(1)]. This section also explicitly states that the insurance company cannot promote suicide, assisted suicide, euthanasia, or mercy killing [Sec. 240(a)(3) and Sec. 240(d)(1)].

The problem is that this section does not “preempt or otherwise have any effect on State laws regarding advance care planning, palliative care, or end-of-life decision-making” [Sec. 240(d)(3)]. Oregon, the first state to legalize physician-assisted suicide, does not consider their legislation to have allowed “suicide, assisted suicide, euthanasia, or mercy killing.” Instead, they consider their legislation to have allowed patients to make a choice to face “death with dignity.” In fact, it is called the Oregon Death with Dignity Act, as is the Washington version passed into law last year.

Thus, your health insurance plan will now be required to promote and pay for “death with dignity” consultations in those states that have passed such legislation. Why is it that this bill is interested in promoting life-ending programs rather than life-saving or life-extending programs?

For more information on Oregon’s Death with Dignity Act, go to the Oregon Department of Human Services . For more information on Washington’s Death with Dignity Act, go to the Washington Department of Health.

H.R. 3962 is just plain wrong for America; it does not protect human life and our well-being at any age or any stage as it purports to do; instead it does exactly the opposite: it promotes death and the devaluation of human life.

It is imperative that you contact your senator or representative today via mail, phone calls, and emails. Go to the National Right to life for assistance with how to do this by clicking here.

[Corrected March 21, 2010]

The VA’s “Your Life, Your Choices” Document

Ed

In all the hullabaloo regarding H.R. 3200 over the summer, one document that was regarded as an example of how the government would treat end-of-life decisions was the Veterans Affairs’ document Your Life, Your Choices: Planning for Future Medical Decisions.

I had previously written on the LCMS World Relief and Human Care website that this document uses derogatory terms such as “vegetable” when describing a patient. Another problem that I saw was that the document asks the patient to evaluate his life based on what he can or cannot do rather than the inherent value of human life as bestowed upon him by our Creator and through the sacrifice of our Savior, Jesus Christ.

In H.R. 3200, the advance care planning consultations were mandatory. Enough people made their voices heard and in the current bill in front of the House of Representatives, H.R. 3962, this section has been made voluntary and optional.

But the concerns still remain and the VA’s document is still a good example of what a government document on advance directives and end-of-life decisions would look like. The VA has removed the document from their website and you can no longer obtain it on-line from them. But you can still download it from my blog by clicking here.