Classification of Permanent Vegetative Patients as Dead

Question: Discuss about theClassification of Permanent Vegetative Patients as Dead. Answer: Introduction Some brain injured patients end up in a permanent vegetative state (PVS) meaning they irreversibly lose their consciousness but retain some physiological functions such as unaided breathing, thermal and cardiovascular regulation (Wade, 2001). With the advancement of technology and treatment procedures in the medical field, it is now possible to sustain patients in a permanent vegetative state. However, there exists a debate over the ontological state of persons PVS patients. Are PVS persons alive or dead? This paper explores the ethical and legal perspectives of patients in a permanent vegetative state and provides an argument for regarding PVS patients as dead. Moral Issues Regarding the Treatment of PVS Patients As far as the consciously based argument is concerned, death for people is the permanent loss of consciousness which occurs when parts of the brain responsible for consciousness are completely damaged (Jennet, 2002). The philosophical issues surrounding the interrelationship between patients in permanent vegetative state and death stem from the level of brain destruction. The Australian and New Zealand intensive care society (ANICS), defines death as the irreparable cessation of respiratory and circulatory functions or irreparable cessation of brain functions particularly irreversible damage to the brain stem (Dalton, 1999). Contrary to this, some bioethicists argue that the destruction of the cortex is criterial for death which means that PVS patients would be considered as dead. From a neurological point of view, there is extensive damage to the upper brain of a PVS patient while the brain stem remains intact. Regardless of the extent of damage to the brain, a majority of patients in a permanent vegetative state may not want their family members to deplete family resources while death is inevitable. The explanation of PVS as subjective death could be explained using the contemporary mainstream approach to death. Based on the current mainstream approach, death is considered as an irreversible damage and loss of consciousness to the entire brain which contradicts the PVS definition of death as permanent damage to the upper brain (Kastenbaum, 2000). The organismic definition of death states that death is the irreversible loss of functioning of an organism as a whole. The mainstream approach fails to completely adhere to the organismic concept in the sense that a complete brain damage does not constitute to the death of a person as a whole. Davis and Souza, (2009) argue that persons in a permanent vegetative state are occasionally awake and their bodies function normally but their lack of consciousness subjectively renders them dead. Thus, this discredits the whole-brain approach as relevant criteria for death of a person paving way for PVS as a suitable criterion for death. Laine, (2006) elucidates that although breathing and heartbeat typically point to life, they do not constitute life. (Laine) further, explains that life involves cohesive functioning of a whole organism. According to the higher-brain line of reasoning, human death is the irreversible cessation of the capacity for consciousness (Truog, 2007). The capacity for consciousness dictates that presences of neurological activity encompassing persons in a reversible coma or a dreamless sleep are alive. This suggests, somewhat fundamentally, that PVS patients are categorized as dead in spite of continued brainstem function that permits unprompted cardiopulmonary function. The higher brain approach to death focuses on the essence of human beings in a stringent ontological sense. From this viewpoint, human beings are regarded as beings with a capacity for consciousness. Larriviere and Bonnie, (2006) explain that loss of consciousness for PVS patients translates into the loss of the important aspects of life thus death. The higher-brain approach further appeals to the personal identity of individuals. The personal identity strategy argues that being in a permanent vegetative state translates to a loss of consciousness that makes up an individuals uniqueness. The Legal Nature of PVS and its Impact on the Treatment of Patients Given the reservations, a growing legal consensus argues against maintaining patients in a permanent vegetative state. The legal argument of PSV in Australia and other countries dictates that a person in a persistent vegetative state has to create a living will to consent to any form of treatment in the event that they are victims of an incapacitating injury. Patients lack the ability to decide their fate while in a persistent vegetative state thus the form of treatment given to them considers their best interest (Bacon et al, 2007). The deliberation of PVS patients as being in a state of subjective death may be explained through court decisions made in previous cases of individuals in a permanent vegetative state. One such case that originates from England and Wales is the Airedale NHS Trust v Bland where the House of Lords consented to the fact that nasogastric hydration and nourishing could lawfully be withdrawn from a young individual in a permanent vegetative state (Jennet, 2005 ). This means that the court deemed it necessary to consider PVS patients as dead given the irreversible nature of the condition. In the US, the internationally recognized case of Terri Schiazo illustrates how the husband to a 39-year-old woman has the legal right to die. In the highly contentious case, most Florida courts continuously affirm Mr. Shiazos legal right to stop artificial nutrition and hydration to his wife (Quill, 2005). However, the supreme court of Florida contests the decision to use passive euthanasia which was done in the interest of individuals seeking political office (Sudore et al, 2008). A Study to Understand Prognoses and Preferences for Outcomes and risks of treatments (SUPPORT) conducted by John Horgan in 1995, reported substantial shortcomings in care for seriously ill hospitalized adults (Murphy and Cluff, 2004). The fact of the matter is Terri Schiazo exists without the possibility of ever recovering from the permanent vegetative state that she is in, thus the reason why passive euthanasia proves to be the only option. Conclusion There exists a lot of uncertainty regarding the recovery of a person in a persistent vegetative state thus the best course of action is to implement passive euthanasia by withdrawing artificial nutrition and hydration to the PVS patient. The irreversibility nature of PVS places and emotional and financial strain on the family members of victims, thus passive euthanasia relieves the suffering of both patients and family members. References Wade, D.T., 2001. Ethical issues in diagnosis and management of patients in the permanent vegetative state.British Medical Journal,322(7282), p.352. Jennett, B., 2002. The vegetative state.Journal of Neurology, Neurosurgery Psychiatry,73(4), pp.355-357. Dalton, V., 1999. 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