Saturday, October 24, 2009

There is a person who is in the hospital in a persistent vegetative state. He can breath on his own but eats through a feeding tube. There is only...

The problem here is that analyzing the utilitarian calculus of happiness in this case depends on an assumption about Patient X, the person in the vegetative state. The problem is that persistent vegetative state, or PVS, is a complex diagnosis. If it is caused by certain types of trauma to the brain or sustained oxygen deprivation there is no chance that Patient X would regain consciousness. In other circumstances, where "locked-in syndrome" may have been misdiagnosed as PVS, there may be a possibility of gaining consciousness. Before one can make ethical judgments, it is important to ascertain all the facts. 


The next question of fact is whether Person X is experiencing happiness or well-being. If not, a utilitarian would see no ethical dilemma in removing life support. If the person was not experiencing some form of happiness, then the parents' economic well-being would take priority. Of course, that does not solve the issue of how one can determine the degree of happiness experienced by someone who cannot communicate. 


The next issues are ones of definition. Of one believes that well-being requires awareness, a PVS patient cannot experience well-being and therefore should not be kept alive if there is no chance of recovery. In some religious traditions, though, the soul is considered the seat of well-being and is considered independent of "mind". In such traditions, as long as the soul has not left the body, the utilitarian calculus would favor keeping the person on life support. 


What the complexity of these issues suggests is that all people should think carefully about what they would wish were they to be in such circumstances and write out legally binding advance directives specifying their wishes so that they do not burden relatives with having to make such painful decisions for them. 

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