Continuing a series on pro-life advance directives by Jim Cole, MRL General Counsel.
VI. Diagnoses of patients’ mental states (such as PVS) are uncertain judgment calls
The diagnoses of “persistent unconsciousness,” “persistent vegetative state,” “no reasonable expectation of . . . recovery from a seriously incapacitating or terminal illness or condition,” and the like, lack definiteness. They are labels without much content, much like “neurasthenia” a century ago. At best they are diagnostic judgment calls that there is little or no consciousness at a particular time. Judgment calls are sometimes wrong. Experience has shown that some people who were thought to be in an irremediable "vegetative state" a quarter century ago may actually have been perfectly conscious but in a "locked in" state that prevented communication with the outside world.
The story of Martin Pistorius represents a rather dramatic example. At the age of 12, Martin was diagnosed with a form of meningitis, and within weeks he sank into a coma. His doctors told his parents that he was as good as a vegetable, and they should let him die. Instead, his parents spent long hours that turned into long years feeding him and providing for his needs. In four years, Martin's brain recovered sufficiently so that he regained full consciousness. But he did not recover the ability to move, so it was another long eight years before he was able to let others know that he was awake and alert. Martin is married now and has authored a book about his experience, Ghost Boy: My Escape From A Life Locked Inside My Own Body.
If persons choose to deny themselves treatment in the future because they "don’t want to live like that," they ought to be warned of the consequences. Advance directives that contain a prohibition against nutrition and hydration can harm patients if they find themselves in a conscious but locked-in condition. A prohibition on receiving any nutrition or other treatment may well doom them to a drawn-out, painful death—just the opposite of what they intended.
