Res Publica 2005

Today is a day that we should reflect.

It comes as we see a family feud strewn nation-wide, but brought on by disagreements as to the ethics of dealing with severely brain-damaged people.

Did Terri lose her personhood rights when she lost most of her personality due to brain damage?

Currently, the popular consensus seems to be something like: Cognito, ergo sum. And therefore, Non cognito, ergo, non sum. If I think, I exist. But if, because of brain damage I cannot think in higher ways, or communicate that thinking to others, the "I" I was, is no longer, and therefore, I am not a legal person any more.

Some of this is no doubt driven by fear of being in a similar condition.

But some of it deals with conception of the whole person. Are we really just our brains, using the rest of our body just as a carrier for that brain? Is our soul, if we have one (not all believe in it, I know), released with the massive brain damage, or does it wait until the end of our body's life?

What is the ethical way to deal with those trapped between cognitive life and physical death the way that Terri was?

My personal guideline comes from the Catechism of the Catholic Church:

2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.

Let us use this time to decide how do we balance the rights of the individuals to make their decisions with the ethical concerns for those who cannot speak for themselves and are vunerable to the choices of others.

Wesley Smith at NRO noted the following in a debate he had about the Schiavo case:

My debate about Terri Schiavo’s case with Florida bioethicist Bill Allen on Court TV Online eventually got down to the nitty-gritty:

Wesley Smith: "Bill, do you think Terri is a person?"

Bill Allen: "No, I do not. I think having awareness is an essential criterion for personhood. Even minimal awareness would support some criterion of personhood, but I don't think complete absence of awareness does."

If you want to know how it became acceptable to remove tube-supplied food and water from people with profound cognitive disabilities, this exchange brings you to the nub of the Schiavo case — the “first principle,” if you will. Bluntly stated, most bioethicists do not believe that membership in the human species accords any of us intrinsic moral worth. Rather, what matters is whether “a being” or “an organism,” or even a machine, is a “person,” a status achieved by having sufficient cognitive capacities. Those who don’t measure up are denigrated as “non-persons.”

This is the situation we are in now. If you don't meet some societal definition of personhood, then you don't have rights. Thus killing the unborn is all right, because they aren't persons yet (although, if damage is done to the unborn by anybody except the mother, there is a growing amount of case law giving at least some status as a person0. Killing the severely handicapped is all right because their reasoning ability is so low that they have lost their personhood, and therefore are trash ready to be taken out.

Part of my problem with this form of ethics is that it allows a shifting definition of who should be a person. Does the late stage alzheimer's patient lose their personhood? How about the person who has cerebal palsey and has deep trouble communicating? A person who is in a "locked in" but thinking form of disease - ALS, late stage Parkinson's, and a few other diseases cause this, along with trauma - do they lose their personhood too?

This is an important place to think about what we are doing, and define it carefully. If we make personhood the determining factor, who is going to define it?

Concerns are growing internationally as the outbreak of the Ebola-like Marburg virus is spreading in Angola. With 126 confirmed deaths, this is already the largest Marburg outbreak ever recorded. Infections are now also reported outside Angola's Uige province and among health workers.

While the Marburg outbreak is still mainly concentrated in the northern province of Uige, 4 deaths have already been reported in Angola's capital, Luanda, and several more are infected. Also in Angola's northern exclave Cabinda, one death has been confirmed and 14 contacts have been placed under hospital quarantine.

There are also concerns that the epidemic may spread outside the country. A recent passenger from Angola to Portugal died on Saturday. His death, which is still under investigation, may have been caused by the Marburg virus and Portuguese authorities are on high alert. Finally, authorities in Congo Kinshasa (DRC) are on alert, as that country neighbours both Uige and Cabinda in an area where borders are porous.

The Angolan Ministry of Health has formally declared an epidemic in the province of Uige and is now closely monitoring the few cases reported outside Uige. National authorities further are receiving technical support from the World Health Organisation (WHO) and other UN agencies to control the spread of the deadly virus.

The work to control the outbreak is however not without risks. At least two policemen, two physicians and six nurses have died due to their work with Marburg patients. The two physicians - from Italy and Vietnam - died in Luanda last week after treating patients in Uige. Another Angolan physician is also infected.

The Marburg virus disease has no vaccine or curative treatment and is mostly rapidly fatal. In the present outbreak, most deaths have occurred between 3 to 7 days following the onset of symptoms. The Ebola-like disease is a viral haemorrhagic fever causing an acute febrile illness. A severe watery diarrhoea, abdominal pain, nausea and vomiting are early symptoms, as are severe chest and lung pains, sore throat, and cough.


Source: Afrol News

From the Sydney Morning Herald

A three-metre-high tsunami struck Simeuleu Island near Aceh minutes after the huge earthquake that struck off Indonesia's western coast, Kyoto and Agence France-Presse news agencies reported.

And the fate of around 5000 people living on the isolated Banyak islands close to the epicentre of the massive earthquake remains unknown, as aftershocks continued to rattle Sumatra today.

``We are extremely concerned about the fate of 5000 people living in the Banyaks island group. We've had absolutely no news from these islands," Jude Barrand, communications officer for international aid agency SurfAid, told smh.com.au.

"There has been no contact and they were very close to the epicentre of the earthquake.''

A military commander in Indonesia's Aceh Province said the three-metre tsunami had caused extensive damage on Simeuleu Island.

According to an Aceh-based journalist who made contact with the island, the main hospital in Sinabang had been destroyed and could not be used. He said there were unconfirmed reports of 25 dead on the island.

Earlier today there were reports only of tsunamis running to 25cms high, leading experts to express their bafflement as to why last night's quake had not generated a larger tidal wave as in the Boxing Day disaster.

But there were later reports that an entire town which survived the Boxing Day quake - Aceh Singkil, on the south-western coast of Aceh province -had been levelled by the latest quake.

More than 10,000 people fled their homes there, Antara news agency reported. But there were no details of any casualties.

Endang Suwaraya, the military commander in the western Indonesian province of Aceh, close to the epicentre of the magnitude 8.7 quake, said he had received reports that Sinabang's port and airport were damaged.

The earthquake is believed to have killed between 1000 and 2000 people on the popular surfing island Nias, the country's Vice President Jusuf Kalla said today.

Already reeling from fatalities caused by the Boxing Day disaster, the 600,000-strong island found itself near the epicentre of the quake, which struck at 11.15pm local time (2.15am today AEST)