New technology changes the euthanasia debate

February 8, 2010 by Nathan Warner 

Invention finds consciousness in some vegetative patients, clouds discussions of “pulling the plug”

Technological development introduces yet another ethical dilemma: how new developments in the ability to communicate with vegetative patients changes the euthanasia debate.

We all know that many times, technological advancement presents us with as many questions as it answers.

A recent New York Times article, “Trace of Thought is Found in ‘Vegetative’ Patient” discusses the advent of new technology that is beginning to establish limited communication with a percentage of patients in “vegetative states.”

According to this article, the new technology allows patients to learn to signal yes or no responses to their doctors by activating certain areas of the brain.  Not all patients in vegetative states are able to communicate this way, and it is not applicable at all for patients who are comatose due to brain damage induced by oxygen deprivation, as in the infamous Terry Schiavo case in 2005.

At first glance, such technologies appear to be medical breakthroughs, allowing us to reach out to those who are literally trapped inside their own bodies.  But as with some other medical technologies and discoveries, this new discovery comes with its own baggage of ethical considerations.

Our impressive medical progress over the last 50 years has led to no shortage of similar ethical dilemmas.  Familiar (and extreme) examples include abortion, cloning and stem cell research.

In this case, medical progress has created its own problems.  With life support systems and feeding tubes, doctors can now keep comatose patients alive indefinitely.  In older times, patients who reached this stage most likely died and no ethical ramifications were involved.

Today, there has been much disagreement over how long vegetative patients should be kept alive and who should have the authority to end his or her life by removing life support (see Schiavo case referenced above).

With this new imaging technique, doctors now have the ability to ask some patients yes or no questions — including, most controversially, whether the patient would like to end his life. Of course, this question brings up a whole new set of issues.

Oregon recently became the first state to permit doctor-assisted suicide for terminally ill patients.  If the comatose or vegetative are considered terminally ill, then they could have the legal right to remove their own life support.  Even so, there are more questions, primarily whether this new imaging technique is reliable enough to authoritatively ascertain whether a person is capable of making such a decision.

Pro-life activists may argue that the question shouldn’t even be asked nor the act even considered.  Indeed, it is possible that technology may soon adapt and develop new methods of communicating or healing such patients.

Then again, who really knows what such patients are going through? One form of unresponsiveness, locked-in syndrome, leaves the victim cognitively intact but totally paralyzed and unable to move or communicate in any way.  It is easy to see why such patients may prefer death than continuing to live as prisoners in their own minds, even with an eventual hope of relief.  The right-to-die debate is its own controversy. I will not rehash it here.

Rather, my point is only to encourage dialogue about a new application of the issue and our own technology.  This technological progress and its subsequent implications return us to greater questions about what our responsibilities are to each other and to humanity in general.

It surely is a good thing that, in this case, we have established communication with those previously thought incapable of expressing themselves. This is surely better than keeping them alive and not communicating with them.

The question now is what to do with this information. How do we treat those who are in a situation that we can hardly comprehend? Who are we to judge their decisions, or make those decisions for them?

What are we giving away when we give doctors the right to interpret decisions and act on them? Better yet, who, besides doctors, is adequately qualified and with vested interest to make a better decision?

The benefits of technology are indubitable, especially in medical care.  We can cure diseases and conditions that used to be life threatening.  People across the Western world are living better and for far longer.

But technology will never solve all of our problems and may often create as many problems as it solves.  We as a society, and the medical field as a profession, will, at least for the time being, continue to have to make tough decisions about how to resolve the moral dilemmas that technology creates.