As Wesley J. Smith explains, “the reigning cultural paradigm” holds that “a life with profound cognitive dysfunction is not worth living.” The dominant assessment is that a person with a diagnosis of permanent unconsciousness should be allowed to die by withdrawal of food and hydration.
But, as Smith reports in The Weekly Standard, this “reigning cultural paradigm” is colliding with medical reality.
Consider this case:
On October 19, only months after being nearly dehydrated to death when his feeding tube was removed, Jesse Ramirez walked out of the Barrow Neurological Institute in Phoenix on his own two legs. Ramirez is lucky to be alive. Early last June, a mere one week after a serious auto accident left him unconscious, his wife Rebecca and doctors decided he would never recover and pulled his feeding tube. He went without food and water for five long days. But then his mother, Theresa, represented by lawyers from the Arizona-based Alliance Defense Fund, successfully took Rebecca to court demanding a change of guardianship on the grounds that Rebecca and Jesse’s allegedly rocky marriage disqualified her for the role.
The case of Jesse Ramirez should shock Americans into understanding that those diagnosed as profoundly cognitively impaired — and thus considered candidates for death by starvation and dehydration — sometimes recover.
Ramirez is not alone. Consider the case of 12-year old Haleigh Poutre:
Haleigh barely survived terrible child abuse and then was nearly done in by the very people charged with protecting her. Only eight days after she was hospitalized in the wake of a beating, the Massachusetts Department of Public Social Services, acting on doctors’ solemn assurances that she was “virtually brain dead,” requested permission to remove her respirator and feeding tube. This request was approved by the Massachusetts Supreme Court.
But the doctors, social workers, and judges were wrong about Haleigh’s prospects. Just before her life support was withdrawn, she began to exhibit signs of awareness–she picked up a stuffed duck when requested–leading to a last-minute reprieve. Today, while Haleigh’s exact condition is not public information, reports in the media indicate she is awake and aware and able to eat some foods.
Add to these reports what The Washington Post reported on September 8, 2006:
Without any hint that she might have a sense of what was happening, the researchers put the woman in a scanner that detects brain activity and told her that in a few minutes they would say the word “tennis,” signaling her to imagine she was serving, volleying and chasing down balls. When they did, the neurologists were shocked to see her brain “light up” exactly as an uninjured person’s would. It happened again and again. And the doctors got the same result when they repeatedly cued her to picture herself wandering, room to room, through her own home.
That’s right — a woman thought to be without conscious function was found by researchers to be playing tennis in her brain, stimulated by a person saying the word in her presence. She was able to hear and understand the word, and to imagine herself playing the game.
Ironically, Smith reports that researchers have found that the drug Ambien — usually prescribed to assist a person to sleep — has been found to assist some patients to recover brain activity and consciousness.
Smith is profoundly correct in pointing back to the tragedy of Terri Schiavo and suggesting that the nation should have a guilty conscience.
A serious cultural consequence of the Terri Schiavo drama has been the devaluation of the weakest among us into a disposable and exploitable caste. But it is not too late to reverse the tide. Jesse Ramirez, Haleigh Poutre, and the groundbreaking research into the treatment of serious brain injury are powerful reminders that where there is life, there is hope. Those who understand that all persons, regardless of capacity, deserve to be treated as beloved members of the human family have good reason to shake off the Schiavo rout and return to the fray.
Where there is life, there is hope. That is a helpful formula for ethical decision-making in these cases. The fact that Jesse Ramirez is recovering, Haleigh Poutre is alive, and a patient was found to be playing tennis in her head should be enough to shock this nation and to awaken its conscience. If not, what will it take?