Language Matters: Court Did Not Authorize Euthanasia in South Korea
One of the great difficulties we have in debating important cultural and ethical issues is the lack of a common frame of reference. Or to put it another way, when language is used very sloppily--whether negligently or intentionally--it becomes almost impossible to adhere to precise definitions and understand crucial distinctions that are prerequisites to informed and rational debate.
Sometimes this is an advocacy tactic. Thus, proponents for unfettered embryonic stem cell and cloning research intentionally changed the language of the debate in order to win public support--aided and abetted by a completely in the tank media. Thus language describing embryonic stem cell research and therapeutic cloning issues was intentionally devolved into mere "stem cell research." As a consequence, adult stem cell breakthroughs, also called "stem cell research," are often thought to be embryonic. Stories about the need for human eggs for "stem cell research" often do not let readers know that the issue involves the creation of human embryos via somatic cell nuclear transfer. This directed corruption of language is also a corruption of science and is profoundly disrespectful of democracy.
Sometimes, however, it is just a matter of sloppiness. Such is the story out of South Korea, headlines about which in several outlets have announced that a court has authorized "euthanasia." No it hasn't. It authorized removal of a patient from life support--a very different thing. From the story:
Two inapt terms leap off the page in this short quote. First, it seems the patient is unconscious, not "brain dead." Second the issue is about whether life support can be removed from such people, not whether they can be actively killed. Sometimes life support is removed from people in PVS and the don't die (unless that life support is food and fluids).A court on Friday approved a request for euthanasia for the first time in South Korea, telling doctors to take a brain-dead woman off life support at her family's request...The landmark ruling acknowledged an individual's right to die for the first time here, but rekindled debate on euthanasia. The current law bans any form of assisted suicide and sees the removal of a respirator from brain-dead patients as murder.
These issues are international and need a consistent use of language and terms. Otherwise, we will have chaos rather than informed and rational ethical debates. Indeed, the language of bioethics at the popular level is already so muddled by sloppy language, rank redefinition, and euphemistic argument ("aid in dying") that engaging these crucial issues in the public square is already near the point of futility.
posted by Wesley J. Smith @ 9:34 AM
4 Comments
4 Comments:
"Brain dead" and "persistent vegetative state" ("pvs") constantly get confused with one another. PVS itself is an imprecise term on which there is not agreement on definition, and which is often applied to people who are not in PVS. Then there is "coma." Then there unconscious, then there is someone just being very sick and weak and considered to be in one of these states. Then there are people in comas who wake up, and in "pvs" states who are not, turn out not to have been, and/or recover, and people who have been declared brain-dead when they are not, and who wake up and recover (e.g., not too long ago, the young man injured in a motorcycle accident in Texas who was declared brain-dead and whose family had given permission for the harvesting (same term as used for (plant/vegetable)crops, and I understand the point SHS would raise about that) of his organs, which was about to begin when he woke up and told them he'd heard everything that had been going on the whole time. If anyone knows how little science/medicine really "knows" about these things (and why should it be able to know, or give itself or be given credit for knowing, about these "non-life," "end-of-life," etc. states when it cannot even know what causes the creation of life, other than the mechanical manipulation of fertility science which at one end of the life spectrum is analogous to this other end, where again there has been mechanical intervention, but life and death still are matters of God, not science?), and how incompetent, arrogant, and deliberately dishonest doctors can be in throwing all this imprecise terminology around, and what happens when the wording gets into courts of law, the media, and the court of public opinion, I do. As for "euthanasia," I was just thinking today how inappropriate it is to describe what happens to a person who is removed from a ventilator (especially when they want to continue to live) with that word while I was sending an email to the "Gray Panthers" organization to tell it that it should be ashamed of itself for having taking the position in 1997 that yes, they know how dangerous it is to ratify assisted suicide, euthanasia, or whatever it was being called, but they think it should be legal. (And have since faded into ignominy; so little has been heard about them since that I'd forgotten of their existence; one expects better from a bunch of feisty old ladies; instead, the old ladies are out (wearing hats) protesting the Iraq war (Bush values life, and freedom...) at the same corner a couple of blocks from my house every Sunday, with their effete wierdo-bierdo male compatriots.) Yes, sometimes people are removed from ventilators and live, and don't have to go back onto the ventilator, but not usually without a weaning process, and the "if God wants him/her to live s/he will breathe on his/her own" argument is a way to hide behind the bifurcation of Catholic doctrine on this issue. Speaking of imprecise and deliberately misleading terminology, the "guardian" whose job was to carry out the hospital's agenda and kept telling me how "compassionate" the doctors seemed and may actually have believed that these same doctors whose gross negligence had caused my mother to end up on a ventilator in the first place deserved respect because they are doctors (this is a very provincial town; my telling her that compared to what's available in New York and elsewhere in the world they were 'veterinarians' (I know, I know, SHS, but it has a good ring to it) seemed genuinely to shock her), anyway, the first time they "met" with me, she kept calling such abrupt disconnection, which could be fatal, "weaning." Absolutely there has to be consistency of terminology -- as well as knowing what the terms really mean, and honesty. Having seen it, I can tell you that disconnection from a ventilator of someone who has awareness and wants to continue to live, ventilator or no, is not "euthanasia," or merely "disconnection," but actual killing and real murder, and I believe that the same would apply to disconnection from other forms of life support such as nutrition and hydration. Those people now hold the status of and right to life on life support, which is life, just as human exceptionalism holds that human life includes the "special," "additional," quality of being able to make moral judgements, having a more sophisticated was of "doing ethics" than the other animals, and being capable of evil, and even just as "pro-lifers" consider those who live via the "life support" of being in a uterus. As for "brain dead" to be in possession of and entitled to life. The one thing doctors and nurses told me that I do believe is that when someone really IS brain dead, they die, ventilator/life-support or no (and it's not pretty).
You know what I think is really scary and off-base? That there even IS a "field" called "bioethics." We need an additional "field," now, to "discuss" things which even to discuss is an insult to life. People with ethics don't need to have committees and meetings about it. It's sort of like letting a salesperson get one into a discussion. Either one wants to buy or one doesn't; allowing oneself to be drawn into discussion about whether one should enter the transaction leads to one's integrity being compromised; if one wanted to buy one would have decided to do it on one's own and the salesperson wouldn't be trying to get one to "talk" about it. Same with "bioethics" -- it's a red herring designed to further the death culture. People are supposed to think that these must be very wise people, with degrees, scientific knowledge, wisdom, morality, ethics, benevolence, etc., just as they believe doctors are. It just allows doctors not to be held accountable; now that's the job of "bioethicists." The same as pharmaceutical companies urge people to "ask your doctor" about the "miracle drugs" it is their business to profit by drugging us with, as if the doctor isn't supposed to be telling us about it, not the advertisement. And no one says anything. Not unlike Singer being termed "really a very compassionate man" whose "side of the story" we should hear. I think it's better to abjure from "bioethics" and make it clear that the emperor has no clothes than to lower oneself and allow oneself to be dragged into its muck and operate on the playing field the death culture has chosen.
Wesley, you say:
First, it seems the patient is unconscious, not "brain dead."
Did you just make that up, or is it based on something beside your opinion? From the article you quote there is no data at all that shows that she is "unconscious" as opposed to "brain dead". (The article you link to also contains no information suggesting that she is "unconscious".)
Joshua: Basic deduction and you don't have to be Sherlock Holmes. It is from the length of time she has been unconscious. That is since last February. People who are truly brain dead, with very rare excpetions, and these are all young people as far as I know, cannot be maintained for ver long because their bodies begin to break down anyway. Also, if she is brain dead, e.g., dead, how can she have a painful existence? We have seen the same misnomer used frequently in the Terri Schiavo case. It could also be a translation issue.
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