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Little PP3 - 4.8.08 LifeSupport 's...

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Unformatted text preview: HarrisonLittlePositionPaper3 4.8.08 LifeSupport. Startingin1998whenMichaelSchiavofiledfortheremovalofTerriSchiavo's feedingtube,muchcontroversysurroundedtheTerriSchiavocase.Thedebatethat ensuedoverthepermanentvegetativestate(PVS)shehadfallenintowasa controversythatinvolvedbiology,ethics,andlegality.Thebiologicalaspectwasa debateoverthedefinitionofapermanentvegetativestateandthedetailsofa vegetativestate.Theethicalsidewasacontroversyovertheprinciplesofremoving thefeedingtube,andwhetherornotitwasjudicialmurder.Thelegalperspectiveof thedebatewasanargumentoverthestate'sinvolvementintheprocess. TerriSchiavofellintoapermanentvegetativestateafterasevereheartattackthat deprivedherbrainofoxygen.Thelackofoxygenforcedhertofallintoacomaand ultimatelysufferfromseverebraindamage.Severalweeksafterfallingintothe coma,sheawokeinapermanentvegetativestate.Thisisastateofbeingshe appearedtobeawake,butshewasnotawareofhersurroundings. Astandardpatientinapermanentvegetativestatewillrespondtotheir surroundingsreflexivelyratherthanacontrolledmotion.Forexample,Schiavo's eyeswouldfollowaballoontravelingacrosstheroombutshecouldnotrespondto aquestion.ThegeneralmedicalcommunitywasataconsensusthatSchiavowould notcomeoutofthevegetativestate. Morerecently,thelinebetweenawarenesshasbeengrayedforpatientsinaPVS. Neuralstudiesperformedonpeoplelegallydeemedasinapermanentvegetative statehaveshownthatpatientshavesimilarneuralresponsestoacontrolgroup1. Themostprominentevidenceofthisisacasewhereapatientwastoldtoimagine playingagameoftennis.TheresultsoftheMRIwerethencomparedtoacontrol groupandneuralactivitytookplaceinthesameareasofthecorneathatcontrol motorskills. TheethicsandlegalityoftheSchiavocasewereveryinterestingandcontroversial. TheimportantthingsofnotetoconsiderformypositionisthatMichaelSchiavowas legallywedtoTerriSchiavowhereasTerri'sparentshadnolegalbindingstoher. Michaelwantedtoremovethefeedingtubewhileherparentsclaimedshewasstill conscienceandremovingthetubewouldbeinhumane. Inmyopinion,whenapersonsinksintoalegallydefinedpermanentvegetative state,thefateofthepatientshouldbedecidedtowhoeverislegallyboundtothe person.Ifthepatienthaslegallyprescribedapersontomakeadecisioninthecase thattheysinkintoanonresponsivestate,thenitisthatindividual'sdecisionoftheir fate.Ibelievethatonceapatientisinanonresponsivestateforseveralyears,like 1Thecontrolgroupofthestudyincludedpeopleinastandard,healthystate HarrisonLittlePositionPaper3 4.8.08 Schiavohadbeen,theyforfeittheirindividualrightsaboutchoosingwhetherornot tostayonlifesupport. Studieshaveshownthatifsomeoneisinavegetativestateforseveralmonths,their chanceofrecoverydecreasestoalmostnothing.Becausetheirchanceofrecoveryis soinfinitesimal,Ifeelstronglythattheirindividualrightsareforfeited.Schiavomay havebeenabletoliveanother15yearsonafeedingtube,butherunconsciousstate wasarguablyindefinite.Thus,thechoicetokeeporremovethefeedingtubewas correctlygiventoMichaelSchiavo. Ibelievethatapersonshouldbejudgedasbeinginapermanentvegetativestate basedontheirneuralandphysicalresponsestotheirsurroundings.Despitethefact thattheirneuralresponsesaresimilartoahealthyindividual,thiscouldbea reflexiveresponse,muchliketheirphysicalactionstotheirsurroundings.The neuralresponsesthatarestudiedarebasedonwhatthepatienthears.Theneural responsemaybeareflexiveresponsetotheparticularvibrationsoftheeardrum. Themedicalcommunityshouldestablishadefinitionofavegetativestate,sothat onceapersonfallsintothisstate,theyforfeittheirlegalrights. Inthecasethatsomeonefallsintoavegetativestateandtheyhavenotlegally prescribedtheirrightstosomeoneandtheyarenotlegallyboundtoanyone,they forfeittheirrightstothestate.Itisthenthechoiceofthestatewhetherornotto maintainthepatientonlifesupportortoletthepatientpass. Asafinalargument,atthebeginningoftheyearweestablishedtheconceptoflife. Livingorganismshadseveralkeycharacteristicsincluding:beingcomposedofcells, maintaininghomeostasis,beingabletorespondtostimuli,havingametabolism, beingabletoevolve,andbeingabletoreplicate.Apatientinapermanentvegetative state,likeTerriSchiavo,hadallofthesecharacteristicswiththeexceptionofbeing abletomaintainhomeostasis.Ibelievethepurposeoflifesupportistobeableto supportapatientuntiltheyareabletomaintainhomeostasisontheirown.If someonefallsintoaPVS,thenhisorherchanceofbeingabletoeventuallymaintain homeostasisisessentiallyzero.Lifesupportshouldserveasatemporaryanswer, notalifetimeanswer,toapatient'smedicalstate. Resources Owen,Adrian."DetectingAwarenessintheVegetativeState".17July2006. http://www.sciencemag.org/cgi/content/full/313/5792/1402. Wallis,Claudia."TheTwilightZoneOfConsciousness".23October2003. http://www.time.com/time/magazine/article/0,9171,524498,00.html. Pearson,Helen."Righttodiecasehighlightsbrainmysteries".22March2005. http://www.nature.com/news/2005/050321/full/news0503215.html. ...
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  • Spring '08
  • DRAPER
  • Astandardpatientinapermanentvegetativestatewillrespondtotheir surroundingsreflexivelyratherthanacontrolledmotion.Forexample,Schiavo, shehadfallenintowasa controversythatinvolvedbiology,ethics,andlegality.Thebiologicalaspectwasa debateoverthedefinitionofapermanentvegetativestateandthedetailsofa, TerriSchiavofellintoapermanentvegetativestateafterasevereheartattackthat deprivedherbrainofoxygen.Thelackofoxygenforcedhertofallintoacomaand ultimatelysufferfromseverebraindamage.Severalweeksafterfallingintothe, Inmyopinion,whenapersonsinksintoalegallydefinedpermanentvegetative state,thefateofthepatientshouldbedecidedtowhoeverislegallyboundtothe person.Ifthepatienthaslegallyprescribedapersontomakeadecisioninthecase, thattheysinkintoanonresponsivestate,thenitisthatindividual'sdecisionoftheir fate.Ibelievethatonceapatientisinanonresponsivestateforseveralyears,like 1Thecontrolgroupofthestudyincludedpeopleinastandard,healthystate, Ibelievethatapersonshouldbejudgedasbeinginapermanentvegetativestate basedontheirneuralandphysicalresponsestotheirsurroundings.Despitethefact thattheirneuralresponsesaresimilartoahealthyindividual,thiscouldbea

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