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For Freedom in PVS Decisions

The Terri Schiavo case has caused many people to consider death and persistent vegetative state (PVS) issues. Should a person in a PVS have the right to allow the body to die? This is the fundamental question that must be answered. In Christian circles, many feel the only obvious answer is "no." Harming oneself is prohibited, not only in the Ten Commandments, but also in preserving the body as the Lord's temple. So, is it a foregone conclusion that ending a life in a PVS is a sin? Here are my thoughts on this.

There are many misconceptions about the PVS condition. A person in a PVS has lost all higher level thinking and reasoning capabilities. The cerebrum is damaged. CAT scans can be used to verify damage to the brain. They have no awareness. They cannot remember. The cerebrum can become like spinal fluid. The brain stem can continue to function, keeping the heart beating, and sleep-wake cycles ticking. There might be in involuntary movements, that appear to be meaningful to the untrained eyes. However, long-term objective analysis will usually indicate these to be random. An amazing number of body functions are simply reflexes.

http://w3.dwm.ks.edu.tw/bio/activelearner/40/ch40c1.html

There is no documented case of recovery by anyone that has been in a PVS for a few months. Claims of rehabilitation are just quackery.

http://www.reason.com/links/links102303.shtml

Current diagnosis of PVS are usually very accurate. Trained experts can distinguish between a minimally consicous state versus a PVS. If there is any doubt, I agree that we should err on the side of prolonging life. However, once it is concluded that a person is in a PVS, we must move forward with what is most compassionate, based on legal provisions.

Most Christians agree that it is not a sin to remove life support from a person who is brain dead (flat EEG). Otherwise, we would all be forced to keep brain dead people alive indefinitely. This opens up whole other set of ethical problems, such as "Is it a sin to not go into debt keeping a brain dead person alive as long as possible?"

A machine (ventilator, heart-lung machine) can keep the body alive, even though the brain is completely non-functional. There is no practical reason to do that, and thus, most agree that it is not a sin to remove life support to brain dead persons.

However, there is some resistance in applying the same logic to a person in a PVS. I argue here that the case above (brain dead person kept alive by machines) is identical to a person in a PVS. The only difference between the two is that a machine is keeping the body alive in one, and the brain stem in the other. Why does that matter? The "person" is no longer there.

We need to define "death". Spiritually, what does it mean? When does the spirit leave the body? Does it remain as long as any part of the body is still alive? Can we hold the spirit hostage by putting the body on life support? What about by transplanting parts of it?

My contention is that a person's spiritual journey on earth is over if they are in a PVS. Such a person cannot accept Christ. He cannot sin. He cannot commune with God. He cannot grow. His eternal destiny is sealed. In short, the soul has departed. The body is still there, but it's just a shell. Regardless of whether it's being kept alive by a machine or a brain stem, the person is dead, for spiritual purposes.

Of course, this is all extrapolation and I freely admit that. The bible is not clear on these topics, and I openly admit that my confidence is not 100%. However, given the data that I have now, I'm pretty certain of my position. I am not close minded, howerver. My position can change as we learn more about the brain, or as God leads.

Specifically to the Schiavo case, there has been so many ridiculous claims made. Many logical fallacies espoused. So what if Michael Schiavo is not an angel? It has nothing to do with the rights of a person in a PVS (ad hominem fallacy). Claims of abuse were unsubstantiated. The parents refuse to agree to a binding agreement based on any additional testing. What is the right answer? Only the one that satisfies their wishes? The only sane voice in all this is the court appointed guardian. Read his report.
http://www.orlandosentinel.com/media/acrobat/2005-02/16435770.pdf

Therefore, let's not be mindless in these decisions. Be compassionate to those in these difficult situations and allow freedom where God allows. May God guide us in our decisions.

posted by B Mathew @ 9:07 PM