Pulling the Plug- Do we have the Right?

[Guest Lottie]

Debate suggestion by Yona.

With the world watching the Terry Schiavo case do you think its right that we should be allowed to 'pull the plug' and allow a person to die who is in a vegatative state?

This will be a formal, 1 vs 1 debate. Awaiting 2 debaters. Each member will post one introduction, five body posts and one conclusion. Remember to quote your sources and keep the arguments civil and no flaming please. This is another sensitive topic.

Any questions, feel free to send Dis or myself a PM.

Edited April 11, 2005 by Lottie

[sane-scotty]

If the patient has made their wishes know and they are on record regarding euthanasia then there is no argument,

SO, in that light, I would wish to argue AGAINST pulling the plug (in cases where the patients wishes are not known), I hope this is aceptable....

However, I have just ended a debate and do not want to HOG them, so if someone else really wants to argue AGAINST, I would be willing to step aside, otherwise I am up for it.

Scotty

[stillcrazy]

I'm up for it, and I am willing to argue either side.

[Guest Lottie]

Fabulous! Thanks for getting involved guys.

Stillcrazy is debating for .

Sane-Scotty is debating against , (in cases where the patients wishes are not known)

The debate will consist of an introduction, 5 bodily posts showing countering of the opponent, good style, persuasive arguments and information relevant to the topic, and a conclusion. Remember to quote your sources, no flaming or offensive langauage.

Also please try and post within the time limts of the rules which are 7 days. If for any reason this is not possible during the course of the debate please let myself or disinterested know.

Any questions, we are just a PM away.

Edited April 3, 2005 by Lottie

[stillcrazy]

Opening statement:

Pulling the plug, while sounding cruel and and callous, can be more humane than allowing a persons body to continue being sustained by mechanical means. There are several areas that need to be addressed when making the decision to, in effect, commit murder of a human life.

In cases of injury were there is no written wishes or a living will, also known as a advanced medical directive, there should be a clear understanding of what is considered a viable human life. By viable, it should be understood that there is a reasonable belief that the person will regain some ability to demonstrate that a personality is still within a damaged body. In other words, a clear medical-legal definition of viable human life. This definition should be universal, and agreed upon by specialist in the medical and legal fields.

The second issue of who should be allowed to make that choice. Direct family members such as parents, siblings or children. Or members by marriage such as husbands or wives. Or a combination of both.

The third question, is how far do we allow others to involve themselves into a private, and emotional, family matter. How many court cases can we say are allowed before no more arguments will be heard or addressed.

The fourth question, and while it may seem petty to some, does play a very important role into the choice to end a life. The monetary cost to the family, insurance company or government. This is putting a price tag on a human life. But it is a question that needs to be addressed in that; is it fair to place an undue burden on families, insurance companies or government agencies to maintain life support on a body, and not a person?

The fifth question is the persons faith or beliefs. While many in todays world down play the relationship one has with their god or belief system, it is a question that needs to be addressed. If the person was known to have strong religious convictions, faith or beliefs, than that should come into the equation to end the life.

In summation, the five items above all play a role in the difficult choice to end a human life. But the most important factor should be remembering that a beating heart or lungs that fill with air do not make a person. It is the body's personality, soul, spirit, and being that defines life. The body may still be functioning, but the spirit of the person has left. And even if there is a small spark of that spirit left, is it humane and just to keep it imprisoned within a dying shell?

[sane-scotty]

INTRODUCTION.

First of all I would like to say hello to my counterpart in this debate, stillcrazy. I hope I have as much fun in this debate as I did during my first ever debate against Walken.

Also, I would like to add that I am aware that this subject is a delicate one and may cause concern/discomfort to some people who may have had some experience of this happening to a member of their family/friends. However, I will try my upmost to be tactful although I make no apologies for any statements I put forward in this post.

What is Euthanasia?

Well, the literal translation is `mercy killing`.

Now, the Cambridge dictionary defines this:

MERCY- kindness and forgiveness shown towards someone whom you have authority over:

KILLING- when a person is murdered

So therefore Euthanasia is the act of killing someone because you have the power and authority to do so under the assumption that you are showing the `victim` mercy.

Now, doing some research at the bbc.co.uk religion and ethics page we can see there are different types of Euthanasia,

1. Active (when death is brought about by an act - for example when a person is killed by being given an overdose of pain-killers.

2. Passive (is when death is brought about by an omission - i.e. when someone lets the person die by, say, withdrawing a feeding tube and essentially letting the patient `starve to death`.

3. Voluntary (at the request of the sick person who is of sound mind)

4. Non-Voluntary (occurs when the patient is unconscious or other unable to make a meaningful choice between living and dying. Someone else, their next of kin normally, makes the decision on their behalf)

Now, I am here to debate AGAINST Active or Passive Non-Voluntary Euthanasia. To put it in simple terms, `killing, either directly or in-directly another human being WITHOUT their consent under the auspice of showing them `mercy` because they are very ill.`

I am NOT here to debate `Voluntary Euthanasia` as it is an entirely different subject, due to the fact that the `patient` is choosing to end their own life. I hope you all can see the distinction between the two.

I will put to you over my next five posts reasons why the willful and deliberate killing of another human being is murder, regardless of their health and will also point out to you the `slippery slope` which non-voluntary euthanasia can lead to. I will also show you the religious and ethical difficulties involved in the deliberate murder of a very sick human being

I pass you over to stillcrazy

regards

sane-scotty

[stillcrazy]

As my esteemed opponent has stated, and very clearly, this debate is about mercy killings. The taking of ones life for the sake to end suffering. And in this debate, the sole matter is the act of euthanasia without a person's consent.

I have to agree with sane-scotty, that this can become a slippery-slope of when and how do we decide to end the life of another. Under what conditions do we determine that a person is no longer a viable human being, and is just a body maintained by mechanical or artificial means.

The first case of justifiable euthanasia without a person's consent, would be legal brain death, the standard that is accepted in the medical community, has the time the brain ceases to function, and it's ability to maintain, on it's own, the vital functions of the rest of the body and organs.

While we have the ability to maintain a person's body through the use of ventilators and cardiac stimulation, the use of these methods is pointless as the brain is dead. And brain cells will not regenerate themselves. Because the person, the being, is no longer there, the choice to discontinue support is justified.

Persistent Vegetive state: This is the top of the slippery-slope. According to the British Medical Journal, July 6 1998. 43% of patients were misdiagnosed as being in a vegetive state, and another 33% recovered from this vegetive state after diagnosis, but with treatment. This is why it is a slippery slope.

However, in my home state of Oregon, a right to die state that allows medical assistance in death of terminally ill patients, numbers speak volumes of why people would choose death over being maintained by artificial means. Of 91 persons prescribed lethal doses of medications, there end of life concerns were

'Loss of autonomy" 85%

"Inability to participate in activities" 77%

"Losing control of bodily functions" 63%

Being a burden to others and expense made up only 36% of the total concerns 34% and 2% respectively.

Patients were asked to list the top three reasons why they would rather die, than to wait until death came naturally.

If this is applied to those who cannot consent to the choice, then it would seem that most people would rather die a peaceful death on their terms, rather than lose the quality of life they knew.

Best solution

Without an advance directive, a phsycological evaluation should be required and reviewed by a panel of medical professionals prior to any recommendation of removing a person from any type of life support, in any case other than brain death. We perform phsycological autopsys on suicide patients who don't leave a final note to help and understand the reason for the death. And to determine that it was indeed a probable suicide. We owe at least that much to anyone who may never recover. We should also exhaust all possible treatments in cases like Terry Schiavo. For the record, this was not done, and I disagree strongly with the Judges in this case.

The choice to let a loved one go is never easy, and the motives of the family should always be examined. And in cases like Terri's, where family members disagree on treatment, a medically qualified panel should be placed as guardians to the patient, to ensure that all possible resources are exhausted prior to allowing a person to die.

We cannot allow euthanasia to become an assembly line form of medical treatment. But we should allow families the right to have a voice in what is best for loved ones who will never recover from severe brain damage or other severe illnesses or injuries.

[sane-scotty]

Main Body Post 1

Well, I must commend stillcrazy on his well thought out, intelligent first post. He is making this very difficult for me due to the fact that we seem to agree on quite a lot regarding non-voluntary euthanasia.

Yes, I agree that if a person was brain dead then, the person we knew, the mind, the spirit, the `essence` of what made that person `that particular person` is also dead. It would be a very hard decision to make, to see your loved ones body maintained by mechanical means but to know that their brain, the thing that makes them `them`, is no longer there. I just pray that I never have to do that. Maybe, in the future, as medical science progresses, this may change, we may develope the technology to revive the brain with little, or no damage, but until then I will entirely concede the point to stillcrazy.

Yes, I agree and will accept the statistics given by stillcrazy regarding the 91 people who were described lethal doses. However, remember, this was a PERSONAL, well-informed choice made by a sound minded individual whos body, not their mind, had let them down.

stillcrazy then says "If this is applied to those who cannot consent to the choice, then it would seem that most people would rather die a peaceful death on their terms, rather than lose the quality of life they knew"

No, I DO NOT agree with this statement. How can I?

Whats your favorite colour, mine is Red,

whats your favorite food, mine is Steak,

whats yours favorite drink, mine is Grolsch.

What do you prefer, blonde, brunette.

Do you think George Bush is a good President?

We ALL have different answers to these questions. Why, because we are ALL individuals and therefor we CANNOT assume the decision on wether a person wants to die or not, for them. We just DO NOT know what their wishes are. You must also consider the fact that these 91 people were slowly dying, they knew the inevitable outcome of their illness and had had lots of time to consider their situation. Now move this onwards to a person like Terry Schiavo whos illness was sudden. She didn't have the luxury of time to consider, rationally her predicament. Her heart attack was sudden and then it was too late for her to communicate her feelings.

I also accept the statistics shown by stillcrazy on the fact that

"According to the British Medical Journal, July 6 1998. 43% of patients were misdiagnosed as being in a vegetive state, and another 33% recovered from this vegetive state after diagnosis, but with treatment."

So therefore, if we took the view that, yes, non-voluntary euthanasia is ok,and we should let people die by, say removing their feeding tube, then these 33% would have been MURDERED. Simple as that. MURDERED.

By removing a feeding tube you are doing nothing less than starving them to death. A prisoner cannot feed himself unless his jailers bring him food. Stop taking him food and he will starve to death, THERE IS NO DIFFERENCE.

Finally, my opponent says he supports non-voluntary euthanasia, however, he has also stated that

"We should also exhaust all possible treatments in cases like Terry Schiavo. For the record, this was not done, and I disagree strongly with the Judges in this case. "

So stillcrazy agrees with me that poor Terry Schiavo was MURDERED. She was STARVED TO DEATH!

So was Tony Bland. A 17 year old football fan who was seriously injured at the Hillsborough Stadium disaster in 1989. He was resuscitated at the football ground and rushed to hospital and later diagnosed with PVS (Permanent Vegetative State). In 1992 his doctors went to court to seek permission to stop giving him food and fluids through a tube. The High Court, the Appeal Court and then the Law Lords all granted that it would NOT be unlawful to do this and Tony died of dehydration in March 1993, nine days after the tube was removed.

"They starved to death a 17 year old boy."

How can we support non-voluntary euthanasia when this happens? Medical science may have found a treatment for Terri or Tony in a few years time, and they both may have recovered and lived a near-normal life.

In my opinion there is no justification for non-voluntary euthanasia, and the only point I REALLY need to make is the Terry Schiavo case, or the case of Tony Bland.

My opponent will no doubt put forwards that he supports a `well policed non-voluntary euthanasia policy` but you can have no such thing.

Thankyou for reading.

Scotty

[stillcrazy]

Good opening argument. And I am pleased to see that you agree there is one case of allowing euthanasia. However, Terri Shiavo is a case that will remain a mystery until the results of her autopsy are final. But even with that, there will remain a side that will forever believe she was a person capable of thought and feelings. I will be amongst those numbers, for the simple fact that she was not afforded all possible treatments and therapy prior to the court's final order.

This is why I believe in legal, humane and ethical euthanasia. After all possible treatments are exhausted.

So far we have only mentioned two particular cases. Terri and Tony. Terri is only one of the 30,000 people in the United states that have been diagnosed with Permanent Vegetative State. What caused her case to become news, and the pro life-pro choice fallout, is the 15 year court battle that has ensued after her illness.

Your response to the 91 dyeing persons is very well intended, but the main point of bringing those people into the debate, was the fact that these 91 knew they were dying, with no hope of recovery or a miracle cure. They would rather choose death on their terms, than lose the quality of life they have.

In our legal system, we determine justifiable homicide as opposed to involuntary manslaughter by the definition of 'what a reasonable person, under simular circumstances would do in a given situation.' If a person is diagnosed with irreparable brain damage, and will live in a persistent vegetive state for years, being fed by only a tube, or maintained by artificial means is it not more humane to let that person go, than to try and maintain a hope that they may recover. Most people, like the 91, would rather move on to whatever their faith holds for them after death, than to remain trapped in a shell they have no control over, in a world that they cannot communicate with. So if we base a medically proven diagnosis, along with what a reasonable person would do, or want done, given a choice prior to an illness or accident, then medical homicide is justifiable

My next comment some may find disturbing.

With the exception of clinical brain death, I believe that the 'essence' as you call it, remains with the body until brain death. This is why it makes it all that much harder to chose to withhold treatment of a loved one after severe brain damage.

Motor skills, memories, sight, hearing, touch and everything else that makes a human function is controlled by different parts of the brain. It is very possible for most of the brain to be damaged, and yet the person, spirit, soul or essence to still function normally. The person now becomes entombed in a non-functioning brain. which is more inhumane, letting them go quietly, or condemning them to years of never being able to live a life that was remotely simular to what they once had. They may not react to pain, but they very well may feel pain. Is it fair to keep them in this state, just so we can feel better about ourselves.

So stillcrazy agrees with me that poor Terry Schiavo was MURDERED. She was STARVED TO DEATH!

Yes, in her case I feel that not all possible options had been exhausted prior to her murder. However, if all treatments had been tried, and the results were that she was not showing any signs of independent function, I would have to say let her go. But not by starvation, for the reason I stated above.

I don't agree with starving a person to death. It is cruel and inhumane. In Terri's case, she had suffered for about 5475 days, and many may argue what's another 7, or 9, or 14 more days of suffering when they have been kept alive for so long. Starvation is cruel in any animal. And in particular to a animal that cannot fend for itself. It is also cruel and inhumane to the loved ones waiting for the final breath.

Set a time and place for death to occur, allow loved ones to say their final words, and administer a sedative to end the life.

At the rate of advancement of science into the human brain, and in light of cut backs into stem cell research, hope of curing severe brain damaged people is years, if not decades away. We may never have a way to return a persons essence back into a remotely viable human.

When do you feel enough is enough? When is it time to let them go?

[sane-scotty]

Main Body Post 2

Ok, this is getting tough now so please bear with me as I attempt to show you the wrongs of non-voluntary euthanasia.

We need to try and understand just WHAT is happening to a person in PVS.

Do they sense anything at all?

Are they AWARE of anything around them in anyway?

Or is it more like being in a coma? Maybe they dream. Remember their lives, the good times and maybe the bad.

Are their soul, their spirit still there?

Are they still capable of `feelings`, ie, happiness, sadness, anger.

Yes, their lives are diminished but at least they ARE alive.

Is a little life better than no life?

The brain is an amazing thing, something that we VASTLY do not understand.

stillcrazy says

"It is very possible for most of the brain to be damaged, and yet the person, spirit, soul or essence to still function normally. The person now becomes entombed in a non-functioning brain. which is more inhumane, letting them go quietly, or condemning them to years of never being able to live a life that was remotely similar to what they once had. "

And it is a good question. Although the REAL question should be.

JUST HOW ALIVE ARE THEY?

I believe it is the ONLY question relevant to this debate. Answer this question and you have your answer to the entire debate.

As a poscript to the Tony Bland case. Another Hillsborough survivor has emerged from PVS. Andrew Devine can give yes and no responses with a touch sensitive pad. His doctor, Keith Andrews says

"There is still progression taking place. I don`t know what the end point will be."

source, bioethics.ac.uk.

My argument is this.

Under stillcrazys` method of well policed non-voluntary euthansasia, Andrew would already have been killed.

regards

Scotty

[stillcrazy]

Post three of five.

Under my well policed policy, Andrew Devine would not have been allowed to die. Neither would have Terri or Tony. Mainly because Doctors would not be allowed to petition the courts to withhold treatment. In fact, my policy would prevent more borderline cases from being murdered than it would allow. Mainly because it requires complete and full review of all medical facts, suppositions and prognosis. It also requires that all possible therapeutic treatments and medications be exhausted prior to the decision to end a life. Plus you add in a phsycological evaluation of a person to determine what they would want if they could respond.

The chances of ending a life of even a remotely viable person are decreased a great deal. And all of this is based on the family's wishes for their loved one. Where once again, motive would be scutinized to validate the request.

Now let's address some other aspects of the issue.

I know it sounds callous, but there is the on-going cost of maintaining a human life that is not a viable or recoverable human being. Hospital care, for just basic room and board is at around $1000 per day, Hospice care is far less, around $100 per day in some cases. So going with a lower number for the sake or argument, and to demonstrate the lowest possible cost. If Terri Shiavo had been in Hospice care from day one until her death, at $100 a day for fifteen years, that is over $547.000. That does not even include medical bills for direct treatment, medications or other treatments she may have required. Multiply that by the current 30,000 people who are in a vegetive, or severe non-recoverable state.

That's over 1 billion per year to maintain life in non-viable bodies. And that is a low, low number. Some one has to pay these bills. Be it the family, insurance, or the taxpayers. And even if Hospice or a hospital donates their services to a particular family, the cost will increase to someone else.

Faith. I know the mention of any type of religion in some circles is taboo. However, it is in many cases a very integral part of making a choice of maintaining a persons body, or allowing them to move on to the next level of their existence. What are the beliefs of the person, what do they feel will happen upon their death. Do we have the right to hold them here bound in this world if they believe that at their death they pass onto another world or life? Again, this would play into the final choice to end a life, after all other options are exhausted.

In my last post I touched on a "what if" question. I would like to expand on it again for a moment, and again caution our faithful readers that some may find it disturbing in it may be a possibility. This is speculation on my part based on my knowledge of medicine.

Medical science claims that a person in a vegetive state cannot feel pain, that the receptors of pain are either damaged or blocked by the damage done to the brain.

However, because medical science still does not fully comprehend the abilities of the brain there is a very real possibility that a brain damaged person would feel pain. But because they cannot demonstrate that they are suffering in their own world, unable to give us a clue that they are suffering, we don't medicate for this possibility. Terri Shiavo for the most part has been a poor example for my argument in the choice to pull the plug on a human life. Mainly because in my mind, she was not afforded every possible treatment. However, in this case she is a very good and prime example of what I'm talking about. The pro right-to-die people keep saying that all her movements are involuntary reflexes. This may be true. But the fact that she has these reflexes at all, means she is getting neuro-impulses from the brain to other parts of the body. Because the nervous system is a two way street, it stands to reason that the brain also received messages of pain, pleasure, hot, cold and so on. But due to damage, the brain cannot react to these messages in a appropriate manner. Because the brain is a very complex organ, we may never fully understand it abilities. We have a term called "phantom pain" or "phantom itching" for amputees. The brain says the limb is still there, and thus the pain or itch. Why is this not possible with brain damaged persons? Is it more moral and humane to deny these people relief from suffering, than to end it in a humane and reasonable manner. If there is no possible chance of even a miniscule recovery, after all options have been exhausted, is it not a better and wiser choice to let the person go.

Final note before turning back my very capable opponent. I have not quoted any bio-ethicist. Mainly because I do not agree with he term, "Human, non-person" to describe a PVS patient. Many B/Es believe that to be classified as a 'person', one must have self awareness. to know that they are. Problem is babies don't know they are a person. So the ideas of some Bio-ethicist, (and those numbers are increasing) would classify many as a human, non-person. In my mind, and again just my opinion, all humans are a person. But there is a time and a place to say that we need to end this persons time in this world, because this person is no longer with us, will never be with us again, and is locked away in a damaged brain where they may be screaming to be let go.

Back to you scotty

[sane-scotty]

Main Body Post 3

Thankyou stillcrazy.

stillcrazy would have you all believe that under his well policed policy

each individual case would undergo a complete review of all medical facts, suppositions and prognosis before a decision is made to `pull the plug`.

This is a great idea, however, if under this policy, even ONE person who

wasn`t brain dead and who`s body was capable of substaining them was non-voluntarily euthanised, then the policy is flawed. I`m not here to debate on the merits of a policy which prevents to others what happened to Teri or Tony but to debate on wether non voluntary euthanasia is right or wrong.

My opponent also mentions the cost of maintaining a human life.

What price do you put on a young 17 year old lad.

An old(ish) 45 year old woman,

Or a small little infant?

This is irrelevant.

I don't know how the health care system works in Oregon, but here in the

cold UK we all pay `national insurance` out of our wages each week which

entitles us to free healthcare, regardless of how good/bad it is.

I have paid this all my working life, so has my wife,and my dad etc...... so the cost is irrelevant to me. We are supposed to be a civilised country, and civilised countries don't kill people because feeding them or giving them medical treatment is too expensive.

Let me ask my worth opponent a question if I may.

A young kid, say, early teens, seriously injured in a car crash is in a PVS, their body is working fine but they need fluids to be fed to them through a tube. ALL treatments have been exhausted, there is nothing more that can be done to this person except let them lay there, in the hospital bed and feed them. In my opponents policy, what would he do?

The young kid has never expressed an opinion on euthanasia so we haven`t got a clue as to what they would wish. So, what do we do?

Now, ten years have passed and the young kid hasn't made any improvements, their brain is still alive, their heart is still beating by itself, their lungs still breathing for themselves. We still need to feed them though.

What do we do?

Faith comes into this, as does open mindedness. I think that most people on this forum have open minds due to the very nature of this web-site. Some of us believe in aliens, ghosts, the afterlife etc.... others don't. So, when we look at someone in a PVS our beliefs have a great impact on our decision. If we believe that when we die, we go to a better place, then we would be more inclined to let someone in a PVS die. If, however, you hold to the view that when we die, we die, thats it, game over, we just cease to exist then me may choose different.

Also, Christian religion tells us that it is wrong to kill or take our own lives. Catholics believe they go to hell so their beliefs will effect their decision. Other people believe God has a plan, so is it his plan for a person to lie in a PVS state? Would killing that person go against Gods wishes?

I have to admit that I struggle in believing in a God sometimes. I`ve seen too many bad things with my eyes. Other times however, especially when I`m with my kids and I see the great intelligence and wonder so clearly on their faces then it makes me think, are we something more than just animals?

With these feelings there is no way i can justify killing someone just because they cannot communicate with us and may or may not be aware of our presence. A person in a PVS may be experiencing a supreme calmness as, devoid from pain their minds are free of the everyday worries and pressures we usually have to cope with. They may dream constantly or not be even aware of their own existence at all.

We just don`t know, and I believe it is wrong to kill someone in ignorance.

Over to stillcrazy

regards

Scotty

[stillcrazy]

Main body post 4 of 5

Thanks Scotty,

Sane-Scotty would like you to believe that I am trying to place a price tag on a human life. I am not. But I am asking; when do we finally say enough is enough? Do we allow a body to be maintained regardless of cost just so we can say we are not placing a monetary value on a person’s life? Do we allow a person’s family to loose everything, just so we can say it was worth it to keep Teddy alive another twenty years, but he never knew what was sacrificed for him?

The health care system in the U.S. is those who can afford it have it. Those who can’t afford it don’t. And those who don’t have heath insurance often can’t even afford basic medical treatment. The system sucks considering we are one of the richest nations in the world.

Do we allow families to continue to build false hope that maybe years from now they may, in a one in a million chance, recover their loved one? What happens when the days turn into months, and months into years? Do you continue to tell them that there is still hope that maybe a cure or a procedure is around the corner? Not all PVS patients have parents like Terri.

Also, Christian religion tells us that it is wrong to kill or take our own lives. Catholics believe they go to hell so their beliefs will effect their decision. Other people believe God has a plan, so is it his plan for a person to lie in a PVS state? Would killing that person go against Gods wishes?

That’s an interesting notion. Because if you say God is the cause of the person being in a vegetated state, did not the doctors interfere with God’s plan of taking this person? Did not the doctors, by maintaining the life through artificial means, place themselves as the ones who hold the power over life and death?

Wait, some here say there is no God.

Okay, I can deal with that has well.

Nature has natural selection, the strong survive and the weak and injured die off. We humans, because we are superior to animals and insects have created a balance between weak and strong. However, nature still has a say in it. Regardless of what we invent to cure injuries and illness, nature will over time adapt to continue natural balance and selection. Case in point: New types of infections that have themselves become immune to our antibiotics. Natural selection will continue regardless of what we do to alter it.

God/nature, gave man the ability to create and invent and dream and be above all other species on the planet. It’s too bad we cannot, or will not use the compassion and wisdom we were granted to allow God/nature to do its job.

A young kid, say, early teens, seriously injured in a car crash is in a PVS, their body is working fine but they need fluids to be fed to them through a tube. ALL treatments have been exhausted, there is nothing more that can be done to this person except let them lay there, in the hospital bed and feed them. In my opponents policy, what would he do?

We pull the plug. Has cold and heartless as it sounds, is it more moral and compassionate to maintain a body that appears to have no hope of ever recovering to even a remote resemblance of a normal life. What, in your opinion, is the reason for keeping him alive?

Is it because you feel it would be wrong to allow god/nature to take their natural course? Why is it that you value the quantity of life over the quality of life. Without the quality, the ability to laugh, cry, love and all the other emotions and experiences that make us what we are, unique from each other, what is the reason to keep a body alive?

And your right we just cannot be certain what, if anything, is going on in the brain of a PVS patient. It could be as you say, an extreme calmness, or as I say extreme pain. Or it could be there is nothing at all. Not even a spark of the spirit.

So again it begs the question, is it more moral and humane to allow a shell of a human to be continued on life support, regardless of type or complexity, when all medical options have been exhausted. It is more moral and humane to allow families to falsely believe there may be hope down the road for a cure.

Or is it more humane and compassionate to allow those who have no, or miniscule hope of recovering, to slip into death? Is it indeed murder, if we allow God’s will or natural selection to continue on the journey already started.

Thanks for reading.

Back to you Scotty.

[sane-scotty]

Main Body Post 4

Compliments to you, stillcrazy on another intelligent post.

stillcrazy asks these two questions,

When do we say enough is enough?

Do we allow a body to be maintained regardless of cost?

The answers are simple. Enough is when a body is dead, the heart stops beating, the lungs stop breathing or the brain dies.

And YES, YES we do keep a otherwise healthy body alive REGARDLESS of the cost. Governments spend billions on weapons to fight wars in different lands, so it`s totally justifiable to have them spend millions more in treating people, not killing them.

stillcrazy goes on to say:

`Do we allow families to continue to build false hope that maybe years from now they may, in a one in a million chance, recover their loved one?'

I take exception to this statement because it is NOT false hope. I have given you just ONE example of how a seemingly lost case, Andrew Devine has started to make a small, yet significant recovery. I could do more research and give you lots more names, but it`s too early in the morning so I beg to you take my point at face value.

As long as that person is still alive, there is hope. Without hope there is nothing.

My opponent then mentions natural selection and natures way of balance by say, new types of infections etc.... Getting hit by a car or getting trampled in a football stadium are nor examples of natural selection carried out by nature, but instead are examples of horrific and preventable accidents caused by man.

So, to the end of my post and I want to put one more thing forwards.

What is life? How do we determine wether someone is alive or not?

In an online dictionary at work it says

"The state of being which begins with generation, birth, or germination, and ends with death; also, the time during which this state continues; that state of an animal or plant in which all or `any of its organs are capable of performing` all or any of their functions"

also life is defined as `metabolism`, This means that all living organisms must breathe, drink, eat, and expel waste.

If you go to the comarecovery.org web-page you will see a very indepth study was done on coma and PVS. Read through the lengthy report if you wish but I have here excerps from the CONCLUSION.

The Vegetative State is an uncommon disorder which, especially for the long-term care, has not been widely studied. This has created problems in carrying out research and, therefore, there is a lack of good quality information to help in policy decision making

it goes on to say

There has been a negative attitude to the potential for recovery and it seems possible that the full potential of many vegetative patients has not been reached

and then

There is still much to learn and there is a need for further good quality research before definitive statements can be made about the management potential (or lack of) of vegetative patients

So, what does this all mean?

I believe it means that we do not understand nearly enough about PVS to be making life-ending decisions. If stillcrazy could prove to me, beyond a doubt that NOTHING of a person remains when they are in a PVS then I would stand right beside him in calling for their `lives` to be ended humanely.

But he cant, because something DOES remain and people CAN and DO recover from PVS. In the same publication it tells us

Rosenberg et al describe the case of a 43 year old man who was in a Vegetative State for 17 months following anoxic brain damage before showing the first signs of awareness. He progressed to being able to tell stories and jokes though was unable to recognize complex collections of objects in pictures and was unable to read.

-----------------------------------------

In another case a 44 year old man in a Vegetative State showed signs of recovery only one year following a subarachnoid haemorrhage to regain nearly normal physical and mental capabilities.

-------------------------------------------

Other reports of recovery after a considerable length of time include that of an 18 year old lady in a Vegetative State for two and a half years following a road traffic accident. She progressed to a state within the following three years of being able to comprehend and communicate, take a considerable interest in her environment and able to establish interpersonal relationships

-------------------------------------------

An even longer period of six years in a Vegetative State is described concerning a 25 year old woman who was involved in a road traffic accident. After 14 months of rehabilitation she was able to feed and groom herself and could dress and transfer with some assistance whilst her speech and cognitive function improved considerably.

It then concludes the cases with this statement

It is recognized that there is a lack of long-term follow up studies of those patients still vegetative beyond 2-3 years. This is understandable since the number of patients is small and the patients are usually widely dispersed in hospitals, nursing homes or at home away from academic centres. The information on patients who have survived, say 20 years, has to be considered in terms of the health and social care available at the time of onset and may therefore not be applicable to those entering the Vegetative State at the present time.

This shows to all reading this, beyond doubt that YES, the person in the PVS IS alive and CAN recover.

The question is.

Do we allow them to live long enough to recover and then help rehabilitate them to recover as best as they can?

The only answer is Yes.

over to my dashing opponent stillcrazy

Scotty

[stillcrazy]

Main body 5 of 5

This will be a shorter version than my usual post. Has I only intend to rebut Sane-scotty's remarks.

1. I ain't all that dashing.

2. I don't advocate wholesale euthanasia of anyone. I only state that in cases that there is no possible chance of any recovery, that it be an option for families, without all the legal b.s. associated with every case.

3. A clear and universal policy of when is an appropriate time to end the life of someone in a persistent vegetative state.

4. That all medical options, such as therapy, surgery and medications be exhausted first.

It seems that Sane-scotty would keep all people alive regardless of the situation, other than clinical brain death. Even though the quality of life may very well be worse, and not just for the patient, but also the family.

The cases you outlined, and yes I did visit the web site, are very good examples of why we should aggressively treat PVS patients. Because if their is a glimmer of life that is struggling to make it's presence know, it will do so. But if that spark is not there or has decided it's time to go, why should we maintain a body that is not fighting for life.

The four cases you quote are very good examples of what I am saying about aggressive treatment. However, and if I read the comments right, these patients were all in "vegetive states" and not technically PVS patients. Meaning that they showed some response at some point in time to warrant further treatment. They had that spark of life I keep mentioning. But what happens after five years, ten years or even twenty years of aggressive treatment and you still have no response. What then? Another twenty years of treatment? I would say that after ten years of treatment, without any signs of any type of response, that is a fair definition of hopelessness. And if Doctors tell families about cases that have recovered, even though the circumstances are different, that is creating a false hope. Each human is different. We all respond to medical treatment is different ways. So each case must be evaluated on it's merits. Not on the fact that someone else recovered from simular circumstances.

In an online dictionary at work it says

"The state of being which begins with generation, birth, or germination, and ends with death; also, the time during which this state continues; that state of an animal or plant in which all or `any of its organs are capable of performing` all or any of their functions"

also life is defined as `metabolism`, This means that all living organisms must breathe, drink, eat, and expel waste.

According to your dictionary, the definition is correct. However, if the function of one organ must be maintain through artificial means, isn't that interfering with the natural order of life?

Sane-Scotty did not answer my question about man playing god by keeping a person alive that god has called home.

And to answer his question to me; no being hit by a car is not natural.

If stillcrazy could prove to me, beyond a doubt that NOTHING of a person remains when they are in a PVS then I would stand right beside him in calling for their `lives` to be ended humanely.

I, nor anyone else, can prove or disprove that there is anything going on in the brain of a PVS person.

That is a quandary faced by those who have loved ones that have spent years in a PVS.

EEGs may show some brain activity, but is it voluntary or transiant patterns firing at random. Even medical specialist cannot be 100% certain of all the possible reactions and readings.

But I do know, that after years of treatment and therapy and drugs, if there is no response to any of it, then the spirit, the soul, or whatever you want to call our being, is no longer willing, or able to fight for survival.

The human spirit is an amazing thing. It can cause medical doctors to proclaim miracles when they cannot explain the survival of a patient. But the spirit can also want to be set free from it's earthly bonds.

And YES, YES we do keep a otherwise healthy body alive REGARDLESS of the cost. Governments spend billions on weapons to fight wars in different lands, so it`s totally justifiable to have them spend millions more in treating people, not killing them.

The notion that our governments spend billions on wars and new fangled ways to kill people is nothing new. An I was not going to go down that path until my beloved opponent brought it up. But all over the world people die every day of starvation for a variety of reasons. Some are man made, others due to natural circumstances. As a species, we do very little to prevent or correct it. Many of the victims are very viable life forms. We also spend more on our collective militaries than we do on medical research. And most of that cost is borne by the consumer through the cost of our drugs. It could be argued that the money spent on keeping non-viable bodies alive, could be better spent of feeding very viable humans.

There are no easy answers to the debate. And I will state one more time, that I will always error on the side of life if there is a reasonable expectation that a person will recover even a minimal amount. However, if there is no chance of any type of recovery, it is better to let the person go onto whatever awaits on the other side.

Scotty, I look forward to your final post before our closing arguments.

And to our dedicated readers, thanks for being here.

[sane-scotty]

Main body post 5

It is obvious that stillcrazy and I agree on nearly everything about PVS EXCEPT, non voluntary euthanasia.

stillcrazy believes that there should be a `cutt-off` period where we say, thats it, that`s enough, we don`t believe he/she will recover so lets humanely kill them and put them out of their misery.

In my last post I hope that I proved to you that despite the outwards appearance, the personality of the person in a PVS still remains intact. And I strongly believe that as long as there is a chance, even a small one, of the `patient` recovering then we shouldn`t deliberately kill them.

There is a BIG difference in switching off the life support machine of a brain dead person and deliberately starving to death, or humanely killing a PVS patient whos `personality` may still be intact.

We can go over and over the same territory again and again but eventually it all comes down to

DO YOU BELIEVE THAT AN INTELLIGENT PERSON IS STILL ALIVE INSIDE THE BODY?

Your belief will effect your decision on non-voluntary euthanasia. And I don`t think it IS playing God. I believe we have a moral duty to help those in need as much as we can. Regardless of what you may believe, we only live once as the person we are now. We only know our family once, regardless of re-incarnation etc...

It`s right here, right now which matters and when your loved one is lying on a hospital bed, in a PVS could you say to yourself,

they aren`t human anymore.

they aren`t alive anymore.

I never could as I strongly believe the brain is our essence, what makes us `US`, its the only part of our body `unique` to us. You can replace my arm, my liver, my heart with someone elses, it won`t mater in the slightest, I will still be the same person I once was. But you can`t swap my brain. In the whole of me, my brain is the only TRUE part of me. It is what makes me Scotty, nothing else. If there is a soul then surely it resides in the brain, an amazing, complex, mysterious thing which we don`t even begin to understand.

I put it to you then, that if a patients brain in still active, still making it`s body breathe and digest food and still able to keep the heart beating then that person IS ALIVE. They may exist on a different level to the one we now know. Be free of all pain and emotion or just lie in a dream state. Without senses like sight, sound and feeling they may not even EXPERIENCE anything. Or maybe, like stillcrazy will have you believe, they are aware of the situation and that it`s like being shut up in a small dark room, sensory depravation they call it, you cannot see anything, hear anything or touch anything, but you are AWARE.

Maybe this a way the brain tries to heal itself, to shut itself off from its body. Who knows?

I don`t know, I honestly don`t but I have to believe that we are more than just the sum of our body parts and that we MUST look after these unfortunate people as best as we can.

Thats my argument over. It wasn`t a strong one towards the end due to the fact that essentially, myself and stillcrazy are of different opinions on a single, but vitally important point.

regards

Scotty

[stillcrazy]

Closing Statement.

I feel that Sane-scotty has made some very valid arguments. We differ on only one main point. And that is when do you say it's over. When is there no longer a viable person inside a body.

My main position is quality of life as opposed to quantity. If everything we consider our lives suddenly ended and we were left in a vegetive state, how many truly would want to live that way? It is a hard question to answer when your on the outside looking in. According to statistics on advance directives, most people would opt for a quiet death as opposed to prolonged medical intervention.

I advocate a strong set of policies for dealing with PVS patients. Give these people every chance we can medically for survival and recovery. Exhaust all options first. But when there is no quality, or even a spark or glimmer of hope, end the suffering for the patient and the family.

Regardless if you believe in a god or not, we are created or evolved above all other creatures, and our life has some sort of meaning in this world. If this were not true, than the value of our lives and all we hold dear in our families is nothing more than an illusion. But we have a moral responsibility to those who suffer, in that we should stop or ease the suffering. And if we cannot, we should end it in a humane way.

It has been a great pleasure to debate such a person as Sane-scotty. He has proven to very passionate of his views. And he has my highest respect for that.

This debate is not about who is right or wrong. It's about a real issue faced by families around the world everyday. If nothing else I hope our words here will make people stop and think about what they would want done in the event they suffered a catastrophic injury or illness. And then act on their convictions by having a living will or advance directive.

Thank you for your time.

Stillcrazy.

[sane-scotty]

Conclusionary Post

I too want to thank my opponent stillcrazy for his well thought out, intelligent and very convincing arguments.

It`s made my job very hard and he even NEARLY had me convinced a couple of times however, the fundamental difference in our belief of PVS is that my honorable opponent suggests that the `patient` is `suffering`,

I believe they are NOT.

As stilllcrazy says,

"This debate is not about who is right or wrong. It's about a real issue faced by families around the world everyday."

And I feverently hope I never have to face that decision. However, if I was to be so unfortunate to have an accident of some sort and lie in a PVS, my body totally healthy and self dependant and all that was needed to keep me alive was nourishment through a feeding tube then I WOULD wish to be kept alive, given EVERY chance at life.

Why?

Because I believe that our life is a wonderful, inexplainable privilege. I don`t know WHY we are alive, but we are. Is it for a reason? Or is it just some random, meaningless act of the universe.

Some believe we are part of this earth and this earth `experiences` things through us. Others believe a God put us here. And some believe we are the result of the enviroment of our planet and that out there, in the depths of the vast universe other races exist, sentient, like us.

Which is true, I don`t know but I DO KNOW that we should give EVERYONE the best chance of life as possible.

Finally I would like to echo stillcrazys sentiments

"If nothing else I hope our words here will make people stop and think .."

Thanks for reading and I hope stillcrazy and myself haven`t offended anyone and have helped in some small way to get people to understand alittle more about PVS.

Regards

Scotty

[Guest Lottie]

Wow! Yet again another interesting, well written and thought out intelligent debate. Thankyou to both of you for a really great read!

And now its time to pass this over to our fab judges...another tough one guys.

[Falco Rex]

Gentlemen, I can honestly say this is the toughest debate I've ever scored. Great job; both of you..

Debator 1: Stillcrazy

Relevancy:10

Countering:9

Style:7

Persuasiveness:8

Total:34

Debator 2: Sane-Scotty

Relevancy:10

Countering:10

Style:7

Persuasiveness:8

Total:35

[AztecInca]

Debator 1: Stillcrazy

Relevancy:9

Countering:9

Style:8

Persuasiveness:8

Total:34

Debator 2: Sane-Scotty

Relevancy:9

Countering:10

Style:8

Persuasiveness:9

Total: 36

Trully an awesome debate!

[Subtemperate]

Debator 1: Stillcrazy

Relevancy:9

Countering:8

Style:8

Persuasivness:8

Total:33

Debator 2: Sane-Scotty

Relevancy:9

Countering:9

Style:8

Persuasiveness:9

Total:35

Very good indeed

[Guest Lottie]

The scores are in!

StillCrazy finishes with a score of 33.6;

Sane-Scotty wins the debate with a score of 35.3

Thank you both for participating, this was an amazing debate!