Medical Morality Requires Equally Valuing Unconcious Patients

A neurologist named Dr. Rohan Ramakrishna tells of a potential treatment for persistent vegetative state.  From the MSNBC report:

Researchers from the University of Munich recently reported that they were able to awaken an 82-year-old woman who’d been in a persistent vegetative state by using injections of her own immune cells. The woman, who had suffered a stroke, had been cared for at home by her family and a home health nurse — for nine long years. Then her doctors proposed an experimental new treatment, offering to give the octogenarian intramuscular injections of her own immune cells, specially activated in the laboratory to produce substances thought to modulate brain activity.

Remarkably, after starting the weekly injections, the patient began to respond to commands and even regain some movement in previously weakened limbs. She opened her eyes and turned toward people entering the room, grabbed the hands of her grandchildren (with both hands) and looked at them, and would voluntarily move her tongue when her teeth were brushed. Although she’d been on a feeding tube for years, her swallowing reflex even began to return. The implications of her awakening are truly astounding.

Great news, right?  Not necessarily to the doctor.  He notes the patient died by aspirating—which is not really relevant to the issue of stem cells helping revive unconscious people.  But then, note this disturbing text:

It also reopens the debate regarding the care of patients in coma. For example, is a person really alive if they are unable to meaningfully interact or comprehend the outside world? How you answer that question is a topic of much controversy, as it brings in religion, politics, medicine and culture (the Terri Schiavo case is a perfect example of how complicated — and heated — this issue can become).

Another pertinent question: Is being alive the same thing as being human, a sentient being? If it isn’t, how do you reconcile the societal cost of medical care for persons who are alive but no longer awake? How do you reconcile the human cost? Does your answer to these questions change if there is a treatment that offers a tiny chance of improving the patient’s comatose condition?

It is not the doctor’s job, much less society’s, to determine whose life is and isn’t worth living.  Indeed, go down that discriminatory utilitarian road and it will be impossible to maintain a moral and ethical health care system.