PVS patients and personhood

This is very disturbing. The person Wesley Smith is talking to and about in this article is bioethicist Bill Allen, who shares similar views on PVS and personhood as Dr. Ronald Cranford, one of the five doctors who examined Terri Schiavo. I’m bringing this up to discuss the repurcussions of what could happen should persons in a PVS state stop being considered human beings:

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.”

Allen’s perspective is in fact relatively conservative within the mainstream bioethics movement. He is apparently willing to accept that “minimal awareness would support some criterion of personhood” — although he doesn’t say that awareness is determinative. Most of his colleagues are not so reticent. To them, it isn’t sentience per se that matters but rather demonstrable rationality. Thus Peter Singer of Princeton argues that unless an organism is self-aware over time, the entity in question is a non-person. The British academic John Harris, the Sir David Alliance professor of bioethics at the University of Manchester, England, has defined a person as “a creature capable of valuing its own existence.” Other bioethicists argue that the basic threshold of personhood should include the capacity to experience desire. James Hughes, who is more explicitly radical than many bioethicists (or perhaps, just more candid), has gone so far as to assert that people like Terri are “sentient property.”

So who are the so-called human non-persons? All embryos and fetuses, to be sure. But many bioethicists also categorize newborn infants as human non-persons (although some bioethicists refer to healthy newborns as “potential persons”). So too are those with profound cognitive impairments such as Terri Schiavo and President Ronald Reagan during the latter stages of his Alzheimer’s disease.

Personhood theory would reduce some of us into killable and harvestable people. Harris wrote explicitly that killing human non-persons would be fine because “Non-persons or potential persons cannot be wronged” by being killed “because death does not deprive them of something they can value. If they cannot wish to live, they cannot have that wish frustrated by being killed.”

Allen isn’t the only one who believes this. Dr. Ronald Cranford, one of the three doctors who diagnosed Terri Shiavo with PVS, doesn’t believe that some patients who are in a PVS should have Constitutional rights:

HANNITY: Did you once say that people in vegetative states should have no constitutional rights? Did you once, sir, say that patients with advanced Alzheimer’s Disease, it makes no sense at all to put a feeding tube in them? Did you say those things?

CRANFORD: I think I did write an article on constitutional rights many years ago with another constitutional scholar about the constitutional rights in a vegetative state…

HANNITY: So you said it?

CRANFORD: Yes. Yes, I did.

HANNITY: So people with Alzheimer’s Disease, sir, it makes to sense at all to put a feeding tube in them and that people in a vegetative state have no constitutional rights? You said those things?

CRANFORD: Those are two things. With the second thing, with the advanced Alzheimer’s, if it’s advanced Alzheimer’s it doesn’t make sense to put a feeding tube in them because if they can’t — they’re at a point where they need a feeding tube, they’re so severely demented…

I don’t need to tell you that this is scary stuff. I think we’re a long way down the road from the kind of thing that Cranford and Allen suggest, but we need to remain ever vigilant against these types. After all, taking someone’s personhood status away from them as well as their Constitutional rights means that person or group’s life will have to be devalued and dehumanized in some way. That’s an extremely slippery slope that we need to be watchful against.