Greetings Economists, Lou's forward was interesting for various reasons. The posting was thoughtful and understanding of the various issues raised. I appreciate that part. I'd like to subject the letter to what I know of the Disabled Rights perspective.
Generally speaking, Disabled People get pigeon holed by the medical view of their disability. That's often referred to as medicalization of Disabled People. This concerns the Disabled Rights Movement primarily in the sense that institutions like nursing homes take over and define the lives of disabled people. I'm not saying that about the Doctor, Andy Coates. The Doctor clearly is aware of the issues that are involved from a left perspective. Rather, that the larger community be aware that the framing of disabled people in medical context often seems to drain disabled people of their whole being as a person. That they are not just a medical diagnosis, but that they have 'rights' as a whole human being that sometimes are diminished by how certain social institutions function. Keeping that in mind here are some juicy quotes from the NY Times, This article had a picture of a young African American Woman leaning against the wall in an institutional setting where she is being forced to let go of her baby to a medical decisions she had resisted. NY Times, March 27, 2005, By PAM BELLUCK, Even as Doctors Say Enough, Families Fight to Prolong Life "But at least three states, Texas, Virginia and California, have laws that let doctors refuse treatment against the wishes of a family, or even a patient's advanced directive in certain circumstances. In other states, like Wisconsin, doctors are seeking such laws." ... "Medical advances give people greater expectations, and they're not willing to accept that death is inevitable; somebody somewhere can save Mom," said Dr. Forrow, of Beth Israel in Boston, said. "They have way more belief that the decision about that is partly up to them: my business, my body, my mom's body. Fifteen years ago, it was the doctor's purview alone." Some are wary that doctors may be truncating treatment because of soaring medical costs, and Dr. Dianne Bartels, associate director of the Center for Bioethics at the University of Minnesota, said: "Sometimes there's also mistrust of the medical system. A doctor might have said, 'Your husband's never going to make it' and he's already survived two or three times, so why should they believe the doctor?" ... "Medical advances give people greater expectations, and they're not willing to accept that death is inevitable; somebody somewhere can save Mom," said Dr. Forrow, of Beth Israel in Boston, said. "They have way more belief that the decision about that is partly up to them: my business, my body, my mom's body. Fifteen years ago, it was the doctor's purview alone." Some are wary that doctors may be truncating treatment because of soaring medical costs, and Dr. Dianne Bartels, associate director of the Center for Bioethics at the University of Minnesota, said: "Sometimes there's also mistrust of the medical system. A doctor might have said, 'Your husband's never going to make it' and he's already survived two or three times, so why should they believe the doctor?" Doyle, Part of the issue in this whole Schiavo Disability Rights issue is the social aspect. Let's just take medical ethics. These committees are formed in hospitals to address these issues. They are paid for by the corporation that owns that medical facility. In other words the social issue of who controls the 'ethics' of the situation comes to the fore. One sees the ubiquitous medical ethicist (Peter Singer is a good example of the type) commenting on what is the humane way to see Schiavo's death. For example the concept of starving to death is now touted as the most humane way to deal with of the end of life issue. This presents a contradictory thought though that why not the eugenicist view of taking a shot that puts the patient to death quickly and painlessly? Why this peculiar adherence to the principle of starving to death as if that was the best alternative. Who gets to debate that issue? Why not lawyers, or philosophers, or teachers, or cops? Or the people? The key issue is how the working class is represented here. Are experts going to replace the choice that people have right now in terms of family rights? It is not written in stone that the right of family is being protected by resort to the ethics of the hospital that purports to protect the family rights. Rather corporate rights can trump family rights in the name of humane considerations. NY Times, April 5, 2005 Inside the Injured Brain, Many Kinds of Awareness By BENEDICT CAREY ... "In medical terms, they become persistently vegetative, a diagnosis first described in 1972 by Dr. Fred Plum of Cornell University and Dr. Bryan Jennett, a neurosurgeon at Glasgow University in Scotland. In a sense, the description of the diagnosis began the modern study of disorders of consciousness. "Before 1972 people talked about permanent comas, or irrecoverable comas, but we defined a different state altogether, with the eyes open, some reflex activity, but no sign of meaningful psychological responsiveness," Dr. Jennett, now a professor emeritus, said in an interview. In an exhaustive review of the medical histories of more than 700 persistently vegetative patients, a team of doctors in 1994 reported that about 15 percent of those who suffered brain damage from oxygen deprivation, like Ms. Schiavo, recovered some awareness within three months. After that, however, very few recovered and none did so after two years. About 52 percent of people with traumatic wounds to the head, often from car accidents, recovered some awareness in the first year after the injury, the study found; very few recovered after that. "It's the difference between taking a blow to the brain, which affects a local area - and taking this global, whole-brain hit," said Dr. Joseph Fins, chief of the medical ethics division of NewYork-Presbyterian/Weill Cornell hospital. Yet these statistics cannot explain the stories of remarkable recovery that surfaced during the debate over Ms. Schiavo's fate. There was Terry Wallis, a mechanic in Arkansas who regained awareness in 2003, more than 18 years after he fell into unconsciousness from a car accident; Sarah Scantlin, a Kansas woman who, also a victim of a car accident, emerged from a similar state after 19 years; and several others, whose collective human spirit seemed to defy the experts, and trump science." ... "In Dr. Schiff's study comparing M.R.I. activity of minimally conscious with normal subjects, the researchers also found a striking difference. The overall rate of energy consumption was significantly higher in the normal brains than in the minimally conscious ones. This difference in idling speed may be crucial to maintaining conscious awareness, Dr. Schiff and others suggested. Because signaling between brain cells requires one cell to overwhelm the other, Dr. Schiff said, a lower idling speed may make the signaling threshold harder to overcome - effectively damping activity throughout the brain. "The idea is that maybe if you were to activate that substrate, you may cross the threshold and generate enough activity" to produce more awareness, he said." ... "New research, by laboratories in New York and Europe, has allowed for much clearer distinctions to be made between the uncounted number of people who at some time become comatose, the 10,000 to 15,000 Americans who subsist in vegetative states and the estimated 100,000 or more who exist in states of partial consciousness." ... Doyle, The statistic above says we are dealing with 10,000 people. Do we frame this debate in terms of how soon to euthanize them? Or something else? That's the challenge for Disabled Rights. To talk about what is consciousness in this area that affects many hundreds of thousands of people. To move the goal posts to cover those areas which Disabled Rights ought to consider in terms of the 'social' framework not the corporate framework. thanks, Doyle
