Tay-Sachs Disease

[UptonStellington]

Okay, thank you David. I was confused because I just assumed you agreed with that part of Watkins' essay and was trying to figure out where I was making the mistake in understanding the difference.

Now I have a simple question. Rights stem from man's identity as man, do they not? They stem from a recognition of what it means to live qua man, and to respect those actions necessary to sustain that life.

Why then, do we grant rights to those who cannot properly perform the actions it takes to live qua man? ... I mean to ask, is there another argument besides the slippery slope objection of, "when do we draw the line at defining WHO is able to properly live qua man?"

[DavidOdden]

Why then, do we grant rights to those who cannot properly perform the actions it takes to live qua man? ... I mean to ask, is there another argument besides the slippery slope objection of, "when do we draw the line at defining WHO is able to properly live qua man?"

More specifically, it's because we must articulate enforceable objective principles aimed to guarantee that men can survive qua men. The burden of proof for rights denial must be extremely high, thus it's more than a slippery slope, it's a catastrophic plunge to deny rights to men when we have doubts about their ability to use their rational faculty.

[D'kian]

I've known children with mild to sever mental retardation. All of them had a rational faculty, even if a very limited one. They can all converse rationally, some can even read. I don't think there are any people with a working brain who lack a rational faculty.

People who've suffered extensive brain damage are another story (BTW Tay Sachs is deadly and painful, but as far as I know it doesn't imapir any cognitive abilities). Many of you will know some people who've had a stroke, which casues mild to severe brain damage. I knew a man who ended up with aphasia, meaning he could no longer speak; but he could still read and write (odd!) and thus he could communicate perfectly well.

Cases like that of Terry Schiavo, for example, who no longer posses a working brain, cannot communicate and may not even be aware of themselves or their surroundings any longer, people who are effectively dead, are so rare and unlikely that I see no need for a broad principle to evaluate them. An ad-hoc basis ought to suffice.

This might include people in a deep comma. Such unfortunate ones usually remain unconscious for years. Sometimes there is some recovery, most time none. But that is more a medical issue than a moral one.

In the film "Awakenings," patients who'd been unresponsive for years or decades suddenly, through medical treatment, awoke and were capable of living once more. Eventually the treatment fails and they go back to their previous state. But having shown their cosciousness remained latent, it's clear they are in full posession fo a rational faculty. saying they ahve no rights would be utterly ridiculous.

[UptonStellington]

In the film "Awakenings," patients who'd been unresponsive for years or decades suddenly, through medical treatment, awoke and were capable of living once more. Eventually the treatment fails and they go back to their previous state. But having shown their cosciousness remained latent, it's clear they are in full posession fo a rational faculty. saying they ahve no rights would be utterly ridiculous.

Interesting! I've never heard of that film.

D'Kian -- just so I can make sure we're on the same page, could you please define "rational faculty" as you're using it?

[UptonStellington]

And AH! Not necessarily related to TAY-SACHS, but annoying and relevant nonetheless. David, maybe you could clear this up for me in regards to the concept aspect.

I listened to one of Peikoff's podcasts where he speaks about the definition of "man" (podcast 2).

He says:

... You could just as well ask if a baby is a man -- he doesn’t yet have a reasoning mind, but we know that living entities grow from the beginning. and when we seek their essence, we don’t imply, “they’re not what they are until they reach 18 years old” One could even ask if a corpse is a man, and it is a possibility within the concept of a living entity -- its not an inanimate object. All of these identities, corpse, mental retard, coma patient, are possible or necessary to a rational being -- they are part of the potentiality of being a rational being, and are therefore, not incompatible with being a man.

That makes great sense to me. The thing that I can't find congruence with now, is not the Tay-Sach's issue, but abortion. I'm not posting in the abortion thread because this question still pertains to my problem with the concept of "man" which I can then apply to Tay-Sach cases.

If we are subsuming under the concept "man" these things that are part of the potentialities of existing as a rational being -- corpse, baby, coma patient... why don't we put "fetus" in that category, too?

... I thought I understood this, because she was talking about sacrificing an ACTUAL person's right to life with a POTENTIAL person's right to life. But if we are to say that man has rights because of his identity as man, and we are including under the concept "man" all those potentialities, without making exceptions, as you warned against, David, how is this reconciled?

Edited February 29, 2008 by UptonStellington

[DavidV]

In the film "Awakenings," patients who'd been unresponsive for years or decades suddenly, through medical treatment, awoke and were capable of living once more. Eventually the treatment fails and they go back to their previous state. But having shown their consciousness remained latent, it's clear they are in full possession of a rational faculty. saying they have no rights would be utterly ridiculous.

That story is a fictional account of victims of a real epidemic of encephalitis lethargica. It is a rare disease that has not recurred aside from isolated cases since 1928 and so is hardly representative of catatonic patients.

With functional neuroimaging, it is straightforward to determine whether someone's brain is in a persistent vegetative state (PVS) or in a minimally conscious state. There's also a difference in behavior, as people in a minimally conscious will still move, make sounds, and talk without regaining consciousnesses.

Without continued use, a dormant brain will begin to atrophy, so that after a year or so, recovery becomes impossible. (Actually, this is true for everyone.)

Edited March 1, 2008 by GreedyCapitalist

[UptonStellington]

As I'm sure you're aware, in bioethics there is a giant debate over when to declare a patient dead. For the longest time, the standard was something along the lines of "the cessation of blood circulation and heart beating," until the Harvard Brain Death Committee came along and... you guessed it... sought to define death as "brain death," which eventually caught on everywhere. Anyways, there's all sorts of accusations that the reasons for defining a person dead through brain death is for utilitarian reasons, making it easier to harvest organs, opening up hospital beds and other hospital resources that, if we considered a person who still had circulation alive, could be taken up for years.

Of course, defining someone as "brain dead" gets harder and harder with advances in medical knowledge. For example, we learn that under the definition of "brain death" held several years ago, there is still secretion of hormones, and when coroners go to cut the patient open, the heart rate spikes... obviously leading people to wonder if this is REALLY a good way to define death.

I'm sure innovations like functional neuroimaging have helped to make tremendous progress in determining brain death... for better or worse, depending on how badly someone wants someone else's organs.

[DavidV]

(It should be noted that the shortage of organs and hospital beds is entirely due to the socialization of healthcare and organ transplants.)

[UptonStellington]

(It should be noted that the shortage of organs and hospital beds is entirely due to the socialization of healthcare and organ transplants.)

Indeed it should -- and I'll be arguing that point ad nauseum in my bioethics class, where a dichotomy between "medicine" and "business" has been forced.