This is the first in a series of posts in which I will discuss the medical and ethical aspects of persistent vegetative state (PVS). As I noted in an earlier post, I believe that the emergence of PVS as an accepted medical diagnosis is in part a consequence of the emergence of strict materialistic theories of the mind in the late 20th century, especially the theory called “functionalism,” which is the theory that the mind is what the brain does, in the same way that running a program is what a computer does. If the mind is entirely caused by the brain, in a way analogous to the running of a software program on a computer’s hardware, it stands to reason that there would be situations in which damage to the brain would cause the “mind program” to irreversibly crash. This leads to rather obvious ethical implications. Ideas have consequences, and the materialist understanding of the mind has had direct and disturbing consequences for the medical treatment of people handicapped by severe brain injuries. I will explore this connection between philosophy of the mind and clinical medicine in a future post.
PVS came to wide public attention with the death in 2005 by dehydration and starvation of Terri Schiavo, a young woman with severe brain damage caused by a cardiac arrest (probably from an electrolyte imbalance) in 1990. She died because her feeding tube was removed by court order at the request of her husband, who claimed that she had told him that she would have wanted to be deprived of nourishment under these circumstances. The deprivation of water and nourishment to a handicapped person, even with the pretext of accommodating that person’s wishes, obviously raises ethical issues, and I’ll discuss them in future posts. I’ll address primarily the medical and neurological issues in this post.
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