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| Here's something for all you people who think its OK to kill the comatose... | |
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| Tweet Topic Started: Nov 16 2012, 01:04 AM (2,664 Views) | |
| Moonbat | Nov 17 2012, 03:42 PM Post #51 |
Pisa-Carp
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The 'soul' in the Descartian inner eye sense, is an attempt to explain mental phenomena. This explanation whilst initially intuitive, on examination, can be shown not to work. However, just as accepting an explanation of a phenomena does not make the phenomena cease to exist, so too rejecting an explanation of a phenomena (the 'soul') does not make the phenomena (mental experiences) go away. 'Mind' is the word we use to refer to the kind of fluctuating collection of mental experiences we identify ourselves as and that we implicitly perceive behind the actions of others.
First of all Ivory those aren't my terms, they are your terms, they have always been your terms. Over the years I've written quite a lot on this forum yet the phrase 'radically independent autonomous biomachine' is not something I've ever laid claim to, in fact the only time I've written such nonsense is in direct response to you stating it. Secondly it's an empirical fact that humans can predict what other humans will choose in various situations (i.e. what they would want) with accuracy vastly better than chance, thus the claim that we cannot know anything about what people want without 'direct' communication is empirically false. |
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| ivorythumper | Nov 17 2012, 03:43 PM Post #52 |
I am so adjective that I verb nouns!
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It's not exploitation to point out that you are exploiting human beings for your utilitarian purposes just like they did for their's -- the parallel is both exact and appropriate. After all, that's what this is all about: when can we consider a human being to just be a thing to be either used for spare parts or taken off the budget for medical care. I've already said it in the past -- when the body can no longer process food or oxygen or hydration. Inanimate things (like dead bodies) don't do this. Animate things, like living bodies, do this. |
| The dogma lives loudly within me. | |
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| Moonbat | Nov 17 2012, 03:51 PM Post #53 |
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Pisa-Carp
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So if someone is on a respirator (cannot process oxygen) then they are already dead? Or if someone has a cholera infection (cannot process 'hydration') then they are already dead? Or if someone has had their stomach removed (cannot process 'food') then even if they are speaking to you, they are already dead? |
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| John D'Oh | Nov 17 2012, 03:56 PM Post #54 |
MAMIL
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The problem is that frequently the only thing keeping them alive by providing food, oxygen and hydration, is a machine. There is definitely a point at which it's time to turn off the machine. In the example I gave about someone I knew, the people who loved the person had made that decision, based on medical advice and their own understanding of what they believed the person would have wanted, and what was the right thing to do. Somebody else felt very strongly that they were killing him. If he'd had his way, he'd have been kept 'alive' by a machine indefinitely. |
| What do you mean "we", have you got a mouse in your pocket? | |
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| Dewey | Nov 17 2012, 05:45 PM Post #55 |
HOLY CARP!!!
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In the cases that I've been around, the first criterion was pretty much what bach first described - testing for corneal, gag, and pain reflexes - se Glasgow Coma Scale. We'd notify the tissue/organ/eye donation folks with a heads-up any time we had a patient with a GCS of 5 or less; GCS of 3 is the point of deep coma/death, at which point decisions about life support were to be exercised. But there were very often additional brain death testing, to determine if there were any cerebral blood flow, just for final confirmation. FWIW, it's these patients who are brain-dead, yet still being kept "alive" on a ventilator - who are the only candidates for organ donation. Before my chaplaincy experience, I wasn't aware of this. After a "normal" cardiac death, organs are not suitable for donation (tissue and cornea/eyes may still be harvested). But the only people who will be eligible to give the gift of life to up to eight other people waiting for organ transplants, will be precisely the ones who have a Living Will stipulating that they be allowed to die if in a persistent unconscious state, or who has had a HCPOA who has made the brave and compassionate decision to allow for organ donation. There are some exceptions, and "Donation after Cardiac Death" (DCD) but that is by far the exception to the rule. So for anyone you may know who is alive today because of organ donation - say, maybe this guy:  Give thanks for someone who made the painful but compassionate decision to recognize death as death, and life as life. |
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"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685. "Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous "Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011 I'll answer your other comments later, but my primary priority for the rest of the evening is to get drunk." - Klaus, 12/31/14 | |
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| Renauda | Nov 17 2012, 06:12 PM Post #56 |
HOLY CARP!!!
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http://www.youtube.com/watch?v=IWINtUCshxY |
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| Amanda | Nov 17 2012, 08:23 PM Post #57 |
Senior Carp
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All this is giving me a good bit to think about, especially in blithely signing the organ donor card on my driver's license. I wonder whether or not physicians tend to behave differently as a group, in how they handle this decision - for themselves and/or members of their families. OTOH, one would assume, they are the most informed about risks to themselves and kin. OTOH, they are also, one would (also) assume, the most pro-donation... I believe I've read it two ways, in regards to another question: can one be declared "dead" without having ones brain function checked? Otherwise, asked, could one be in a "locked in" state without it's being noted prior to transplant surgery being undertaken? Sounds like that old nightmare being revisited - "buried alive". It's something that used to be a more realistic fear before it was possible to check "corpses" in today's sophisticated ways (e.g. brain waves, flat-lining). I've read spooky stories from the past (or about areas without fancy medical services) - where they found coffin with scratch marks from inside, suggesting the "corpse" woke up and tried to escape.  That one anecdote about proceeding on the transplant, despite the anesthesiologist's trying to halt it, is horrifying. George? George? What say you? And what does bachophile think? I already read his comment that acting on different standards, would halt most transplants. But regardless, what standards of death would you want applied to you and family members? Anyone familiar with this (below) recent case? To do with a young woman who successfully sued (against her parents) to be allowed to die - then reversed it. Having to do with definitions of suicide and variations of Christian belief. Unusual communication methods used. http://www.nytimes.com/2012/10/07/nyregion/sungeun-grace-lee-changes-her-mind-and-decides-to-stay-on-life-support.html Edited by Amanda, Nov 17 2012, 08:24 PM.
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[size=5] We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.[/size] "Daily Telegraph", London July 27 2005 | |
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| Dewey | Nov 17 2012, 08:47 PM Post #58 |
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HOLY CARP!!!
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Again, I can only speak from my own experience, but in those occasions, the doctor is almost NEVER a part of the conversation with the patient's family about organ donation. Those conversations were always the domain of the chaplain and the donor bank staff, and very rarely did the doctor participate in them. These meetings typically included the doc, and me. Of course, the doctor would explain the physical situation to the family, but would then excuse himself/herself from the conversation and let us take the conversation further. Typically, I would simply provide pastoral/spiritual care to them, discussing things in a far broader context than the actual question of organ donation. Once that took place, I'd have some understanding of where they were in their thoughts regarding donation. Then, I'd explain to them that it was state law that all deaths had to be referred to the donation bank, and not to be surprised by their follow-up telephone call when it came - it was required by law. In a brain-death case such as we've been talking about, I would then add at this point in the conversation that unlike other patients who died and were ineligible to be organ donors (versus tissue and eyes), they were actually in a very unusual position - one that only about 1% of people are ever in, the position of being a potential organ donor. If our earlier conversation indicated that their personal beliefs would be consistent with the idea of donation, I'd talk a little bit more about the benefit and process, and let them know that if they were interested, the donor bank would need to be involved right away (and before life support was removed). If they seemed at all agreeable to the idea, I passed this additional information on to the donor bank. On the other hand, if they were opposed to it, for any reason - even "he's already been through so much, and so have we; we know it might help others but we just want to have some closure for him and for us; we'd rather we just let him go now, in peace" - then that was a perfectly acceptable and respected decision, and I passed that information on to the donor bank as well. They also respected those decisions immediately, with respect, and never tried to push or force anyone into any decision whatsoever. The idea that a patient might get different treatment, in order to produce organ donors, or that doctors or others "pushed" families into being donors, just simply did not occur, ever, from me, or any doctor or other person involved in the process, on my watch. |
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"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685. "Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous "Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011 I'll answer your other comments later, but my primary priority for the rest of the evening is to get drunk." - Klaus, 12/31/14 | |
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| Amanda | Nov 17 2012, 10:13 PM Post #59 |
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Senior Carp
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Thanks very much, Dewey. I read your comments with interest. It's a fascinating picture of a twilight world I'm afraid I could never handle. Good there are people like you! Unfortunately, though, I'm afraid there was a misunderstanding about my first paragraph questions. I was wondering how doctors handle organ donor cards (for their driver licenses or otherwise)? As I understood bach's comments and other ones on this thread, the usual qualifying definition, doesn't seem to rule out a minimally conscious state like the one described in the first link. I want to know how doctors handle their own organ donor instructions including drivers licenses. Are there certain tests they want performed ? Do THEY feel there's a risk of missing a conscious patient? One like the one in the first link? Likewise, when it's their families. Edited by Amanda, Nov 17 2012, 10:14 PM.
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[size=5] We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.[/size] "Daily Telegraph", London July 27 2005 | |
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| Amanda | Nov 17 2012, 10:19 PM Post #60 |
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Senior Carp
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You missed an interesting, key point, kenny. These people are all in the UK being treated at a special neuro-rehabilitative center. Doubtless if they were Americans, they would have been allowed to die. They ALL have "insurance". Of course, even in England, I wonder how elders are treated! A good point for the GOPers responding. I doubt many folks would be insurable or otherwise able to obtain treatment in the US for such a condition! Can't get massive neuro-degenerative conditions treated in the ER, folks! |
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[size=5] We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.[/size] "Daily Telegraph", London July 27 2005 | |
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| ivorythumper | Nov 17 2012, 10:29 PM Post #61 |
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I am so adjective that I verb nouns!
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The soul in the classical sense is the same model of thought, and mind in your model of thought is the same thing. You are describing a phenomena and using recourse to metaphysical constructs to do so. The difference between us is that my system actually allows for metaphysics but you deny it. So you are the one being inconsistent. Your "terms" as far as I can tell are pure physicalism. You have stated that all ideas about 'being' are only more or less useful taxonomical classifications of energy and matter and physical stuff imposed by "mind". You insisted that value loaded language is not meaningful for making ethical decisions. You've denied human nature, and humanity. So all we have left is some sort of biomachine or bioprocess. Are you now changing those terms? Are you saying that we are not radically isolated? Tell me what necessary import is there of the action of one thing we call human on another thing called human. You appeal lamely to "empathy" which we know is nothing but a response to stimuli of some set of chemicals and electromagnetic activity. That is compeltely changeable -- we just have to change the chemistry -- we can use magnets to change the way people thinks -- and voila! the problem of empathy is eradicated. Are you claiming that we are not autonomous composites of electrochemical activity? That there is something actually that binds us morally and ethically, and that admits of an objective order to how we "ought" to act, regardless of what the chemistry determines as inexorable reaction to the laws of physics? If so, go ahead and make the case, but as far as I can tell "radically autonomous biomachine" is a far more apt description of what you are talking about rather than the metaphysics of "person" and "mind" and "humanity" that you keep confusing your own idea with. You can't even follow the argument, friend. You can only know at best generally what some bandwidth, or statistical norm, of other biomachines might want, not "anything in the specific case", not " what another specific biomachine 'wants'". And what you can know about some supposedly general case (which is so obviously fraught with problems that it is laughable that you even presume it) is completely meaningless as ethical grounds for making life and death decisions for others. You have no inherent right to make a decision that another human being dies for any reason -- all you are doing in that case is exerting power and violent force. Such is exactly what a government does when they execute a person found guilty of a capital crime -- they exert power and violent force. But at least the government makes a metaphysical claim to "justice" -- whereas you have already a priori rejected metaphysics and justice. So all you have is the power of one biomachine or a group of biomachines over another biomachine. That's your world, Moonbat -- I am just helping you understand the implications of your own terms. |
| The dogma lives loudly within me. | |
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| Amanda | Nov 17 2012, 10:36 PM Post #62 |
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Senior Carp
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@Dewey, here's the link which most gave me pause for thought regarding organ donors' drivers' license OK: http://online.wsj.com/article/SB10001424052970204603004577269910906351598.html Hence, I want to know how doctors handle the issue - for drivers' licenses and otherwise. Who else would know and how to assess their opinions, except for what they do? |
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[size=5] We should tolerate eccentricity in others, almost to the point of lunacy, provided no one else is harmed.[/size] "Daily Telegraph", London July 27 2005 | |
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| ivorythumper | Nov 17 2012, 10:49 PM Post #63 |
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I am so adjective that I verb nouns!
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I actually predicted this sort of line of inquiry -- although I hoped against it. Oh well. A respirator (mechanical ventilator) does not mean they cannot process oxygen, it simply is a device to move air in and out of the lungs so that their lungs can process the oxygen. Take a dead body (by my definition) and hook it up to a respirator, and there will be no blood gas exchange. That's how you know they are dead. A cholera infection still allows the body to hydrate, the problem is that the body dehydrates too fast and gets electrolyte imbalances. The obviously flawed part of your view is that rehydration is actually part of the treatment for cholera -- if the body was not able to process hydration, then rehydration couldn't possibly be a treatment for cholera. And you can pump all the water you want into a dead (by my definition) body and it will just fill up over time and start leaking out -- there is no processing. Food is the general sense of nutrition -- as I have stated many times in the past. When the body cannot process nutrients, it is or soon will be dead. But as long as it can process nutrients we *know* that it is a living organism. Conversely, if you want to intubate or spoon feed or IV a dead body (by my definition) and nothing will happen other than packing stuff in to a thing. This seems to me the most obvious, empirical, scientific, and valid definition of death. The body stops working. It stops processing nutrients and hydration and oxygen. We can do all sorts of wonderful things through science and medicine to help people whose organs have shut down and no longer work -- dialysis for instance -- but even with dialysis the body still processes the blood, we just replace the filtering mechanism they need to keep doing that so that they don't poison themselves. Again, you can hook up a dead (by my definition) body to a dialysis machine, pump the blood, and the cells won't respirate. They are "inanimate". This is how we know they are dead. |
| The dogma lives loudly within me. | |
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| ivorythumper | Nov 17 2012, 10:59 PM Post #64 |
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I am so adjective that I verb nouns!
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Why is this a problem? There is no way that the person would have been kept alive indefinitely (assuming you mean limitlessly, and not just unknowably or an unspecified amount of time). Eventually the body dies and the functions stop. Machines are good. The time to turn off the machine is when the body no longer processes these things. It is obvious that people cannot be kept on life support indefinitely -- even if all the vital functions are being assisted mechanically eventually the body will die. Machines are not a path to immortality. So, yeah, if you take someone off a machine that they need to keep them alive for the basic purposes of nutrition, hydration and oxygenation, you're killing them -- regardless of how much you love them or think that is what they would have wanted. It's no different than snuffing them with a pillow, and just as predictable in causing their death. |
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| ivorythumper | Nov 17 2012, 11:00 PM Post #65 |
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I am so adjective that I verb nouns!
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| Moonbat | Nov 18 2012, 03:01 AM Post #66 |
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Pisa-Carp
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Brain states specify mental states i.e. conscious experience is ultimately some aspect of a brain interacting with an environment. Thus there can be no mystical 'unphysical' soul that floats away after death. Where is the contradiction in thinking this and talking about conscious experience/minds?
I don't understand the phrases you use. E.g. An isolated system is one that does not exchange matter or heat with it's surroundings - no organisms are isolated systems. So when you say we are 'radically isolated' you must mean 'isolated' in another sense, but we are social organisms that are continually interacting with one another, so I don't know what you're trying to say. In terms of what I think - I think the atomic hypothesis is true.
It's an empirical fact that humans can predict what specific other humans will choose in various specific situations (i.e. what they would want) with accuracy vastly better than chance, thus the claim that we cannot know anything about what specific people want is empirically false. p.s. meaningless != wrong. bandwidth != average |
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| Moonbat | Nov 18 2012, 03:25 AM Post #67 |
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Pisa-Carp
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Processing oxygen involves many different steps and one of them is transport. If you want to say death does not occur until every single step involved in 'processing oxygen' no longer occurs then everyone declared clinically dead is still 'alive' because new molecules of ATP are still being produced in the lenses of their eyes.
This 'animation' remark is significant. If there were a singular animating force that was present in the living and not in the dead then your perspective would make sense. But, given the modern view sketched out in physiology and biochemistry textbooks across the land it doesn't: there is no precise line you can draw to define death. |
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| John D'Oh | Nov 18 2012, 09:02 AM Post #68 |
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I disagree completely. Switching off the machine in many cases is allowing nature to take it's course. Shoving a pillow over somebody's face is something very different, and not something that would happen 'naturally'. |
| What do you mean "we", have you got a mouse in your pocket? | |
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| ivorythumper | Nov 18 2012, 09:10 AM Post #69 |
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I am so adjective that I verb nouns!
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I disagree completely. Switching off the machine in many cases is allowing nature to take it's course. Shoving a pillow over somebody's face is something very different, and not something that would happen 'naturally'.[/quote]What you propose is no different than locking someone in an airtight room and depriving them of food and water -- they will die for exactly the same reason --- nature will take its course as you so blithely put it. This is why we actually have a duty of care in medical ethics to provide essential things for patients who are unable to care for themselves: nutrients, hydration, oxygen, care of wounds and alleviation of pain. we do it because they can't. If their body cannot process these things, they die, but we have done our duty by them. So no, shoving a pillow over someone's face is not something very different -- it is just quicker and more direct. |
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| ivorythumper | Nov 18 2012, 09:13 AM Post #70 |
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I am so adjective that I verb nouns!
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At this point the obvious question is "why are you quibbling"? Are you actually looking for the point at which you can ethically treat a human being as a mere thing? It seems to me that is what you are doing -- which means you know what the stakes are ethically. |
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| John D'Oh | Nov 18 2012, 09:17 AM Post #71 |
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MAMIL
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IT, you messed up the quoting so bad we're arguing each others points 
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| Axtremus | Nov 18 2012, 09:20 AM Post #72 |
HOLY CARP!!!
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We can pay for them when they can't, too. Single-payer universal healthcare FTW! |
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| John D'Oh | Nov 18 2012, 09:30 AM Post #73 |
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MAMIL
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Well, if I'm ever in this situation, I hope somebody uses a nice soft pillow. I was reading about Israel Sharon, who a doctor claimed was effectively dead, but whose son claims is responsive after 6 years in a coma. To be honest, I hope for Sharon's sake that it's the doctor who is right. The thought of being stuck in a body that can't communicate for 6 solid years and being conscious strikes me as absolutely horrific. |
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| ivorythumper | Nov 18 2012, 09:48 AM Post #74 |
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I am so adjective that I verb nouns!
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You confuse metaphysical with mystical. Aristotle's metaphysics do not rely on theism per se, and the language of "float away" is obviously metaphorical (do you *really* think it is spatial such that it would float away?) It is obvious that I am discussing something other than a thermodynamically isolated system in that sense. Your biomachine is radically isolated as a self functioning system -- it is an independent "island" (insula, whence isolate) -- like an atomic unit (radical) that only interacts with others according to the laws of physics. There is no common humanity, no human nature that binds us. You have rejected these already. There is no such thing as human dignity -- you have reject this as well. By your account of anthropology (which is a term that you can only use analogously since there is no such thing as "anthropos" -- it is just an imposed taxonomical category of energy and matter) there is no difference between two people and two bricks -- each has its own set of chemicals and the laws of physics operate on all the same way. Bricks are inanimate, biomachine are animate. But all bricks are also radically isolated in the same sense that all biomachines are. So "radically isolated biomachine" seems to be the most accurate and value neutral terms to describe what you are really talking about. Even with your addition of specific , it doesn't matter in the least. You are free to predict and act upon what to get your mother for her birthday that she might want -- you have no moral right to deprive someone of something by some statistical recourse to what you predict they might want. You can predict all you want -- you still can't get to a point of moral certainty. |
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| ivorythumper | Nov 18 2012, 09:50 AM Post #75 |
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I am so adjective that I verb nouns!
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Please explain. Spoon feeding a baby is also a mechanical means of assistance for someone unable to feed themselves. Not spoon feeding them will also kill them, and you can't appeal to "letting nature take its course". |
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