Thursday, May 01, 2008
Thursday, March 24, 2005
Eye tracking and Emotional responses are the most common ways of determining whether a patient is responding, and therefore no longer in a vegetative state. The first sign of a patient emerging from PVS is the localizing of the eyes on a visual stimulus. This can be observed because persons in a vegetative state are unable to track moving objects or fixate their vision on an object, and as a patient recovers they regain this ability. This type of a response if most often detected by family members or caregivers that have worked directly with the patient. Eye tracking is not necessarily enough to show that a person is recovering from PVS because patients may not show any other evidence of other meaningful response to the environment.
More difficulties with eye tracking may come into play because of the possibility of other neurological or ophthalmological damage that may prevent a patient from tracking stimuli. This means that a patient may actually have a degree of recovery that will be missed because it cannot be detected through eye tracking.
Emotional response is also difficult to determine because a response must be directly related to specific stimulus. This can be difficult because patients in PVS can scream, cry, grunt or have other actions associated with emotional responses, which are not done in response to stimuli. Therefore significant testing must be done to determine that emotional responses are not being done randomly, but are performed as responses.
A patient recovering from PVS usually recovers in a progressive manner where they move into a post vegetative state. Some patients have recovered significantly. Individuals with relatively short periods of time in PVS have been able to regain nearly normal physical and mental capabilities. There has also been documentation of individuals recovering from periods of PVS lasting over a year who have been able to regain the ability to think, communicate and recover a fair level of physical independence (move without a wheelchair, and feed themselves) (CRA 54).
Wednesday, March 23, 2005
The crucial issue in deciding whether one would want to intervene to keep her alive is whether there is, as one bioethicist put it to me, "anyone home." Her parents, who see her often, believe that there is. The husband maintains that there is no one home. (But then again he has another home, making his judgment somewhat suspect.) The husband has not allowed a lot of medical testing in the past few years.
I have tried to find out what her neurological condition actually is. But the evidence is sketchy, old and conflicting. The Florida court found that most of her cerebral cortex is gone. But "most" does not mean all. There may be some cortex functioning. The severely retarded or brain-damaged can have some consciousness. And we do not go around euthanizing the minimally conscious in the back wards of mental hospitals on the grounds that their lives are not worth living.
Tuesday, March 22, 2005
The phrase "public square" evokes images of the political arena with its partisan games and intense debates over public policy. Lewis did occasionally, very occasionally, address what are ordinarily called political issues. One thinks of his reflections on the Second World War, on pacifism and belligerency, on laws regarding obscenity, and on the nature of criminal punishment. But, for the most part, Lewis is understandably viewed as a determinedly apolitical, even private, man. Indeed, in many ways he took his stand, and encouraged others to take their stand, over against politics—especially politics as dominated by the machinations of the modern State. He was on the side of reason, myth, splendor, and virtue, in the hope that such vital elements of life might "still trickle down to irrigate the dust–bowl of modern economic Statecraft." This might be called the C. S. Lewis trickle–down theory of politics.
Tuesday, March 15, 2005
The church's "pre-millennial" view of history, which asserts that humankind is moving inexorably toward the "end times," when the world will go through a series of cataclysms before the second coming of Christ, is not uncommon among evangelicals. Dr. Meredith preached in a recent sermon broadcast internationally that the apocalypse was close, warning members to pay off credit-card debt and hoard savings in preparation for the United States' coming financial collapse.
Hmm. I don't know about you, but if the end is really that close, the last thing I'm going to be worrying about is my credit card debt. Then again, perhaps this explains the motivation behind the tough new bankruptcy reform bill currently making its way through Congress.
(Hat tip: Evangelical Outpost.)
Like many theological questions, this is not the sort of question that can be answered in a few paragraphs. But in my own thinking about the issue, one thing I've found especially helpful has been the realization that doctrinal change has been a constant feature of church history from the beginning (see, e.g., the evolution in the church’s stance toward the continuing validity of Jewish law as recounted in Acts 15 and Galatians 2). As the Catechism of the Catholic Church puts it, "even if Revelation is already complete, it has not been made fully explicit; it remains for Christian faith gradually to grasp its full significance over the course of the centuries” (No. 66).
Of course, the mere fact that doctrine develops over time does not mean that any given proposed change is legitimate. How, then, do we know what is corruption and what is authentic?
Father Richard John Neuhaus suggests an answer to this quetion that offers both Catholics and Protestants much to ponder:
"Recall Cardinal Newman’s reflection on the development of doctrine, a reflection that has been incorporated by magisterial teaching. He suggested seven marks of authentic development: authentic development preserves the Church’s apostolic form; it reflects continuity of principles in testing the unknown by the known; it demonstrates the power to assimilate what is true, even in what is posited against it; it follows a logical sequence; it anticipates future developments; it conserves past developments; and, throughout, it claims and demonstrates the vigor of teaching authority.
“And thus it is, said St. Vincent of Lerins in the fifth century, that in authentic development of doctrine nothing presents itself in the Church’s old age that was not latent in her youth. Such was the truth discovered by Augustine, a truth ‘ever ancient, ever new.’”
This last point expresses well the task that gay and lesbian Christians must be prepared to accept as we come to the church asking it to bless our unions. In short, we must be willing to show our brothers and sisters why, despite the fact that gay marriage appears to be and indeed is a novum or new thing, it nonetheless represents an authentic development of doctrine that affirms and even underscores the church's ancient understanding of what marriage is and what it is for.
This is an issue that I have already discussed here, here, and here. But next week I will offer a third installment in this series that will attempt to bring these arguments together in a more systematic way.
Monday, March 14, 2005
Friday, March 11, 2005
Since sex is between two consenting adults and everyone's standards of moral obligation are different, we do not have the right to tell someone who is HIV+ or HIV- what they are allowed to do behind closed doors. We can give information and listen to people's needs. From there an answer and lasting solution will come to this problem that has plagued our community for so many years.
Ah yes. That most venerable of heresies, gnosticism, rears its ugly head again, still claiming after all these centuries that knowledge alone is sufficient to solve every problem. The only trouble is that experience suggests a rather more complicated explanation of human behavior is in order, one that neither denies the existence of the human will (i.e., one that concedes we can change our behavior) but that also does not fall into the trap of presuming we sin out of ignorance.
Consider the AIDS epidemic among American gay men. Most of us know what HIV is, how it is transmitted, and what steps (abstinence, monogamy, use of condoms) can be taken to reduce its spread. In short, we have been given knowledge about the disease, and most of us have received it. Yet still the (largely self-inflicted) plague continues. All of which would seem to confirm the psychological--if not the soteriological--truth of St. Paul's confession to the Roman church:
I do not understand my own actions. For I do not do what I want, but I do the very thing I hate. (Rom. 7:15).
Paul's answer to this dilemma, of course, was to turn for help to the One who created us:
For the mind that is set on the flesh is hostile to God; it does not submit to God's law, indeed it cannot; and those who are in the flesh cannot please God. But you are not in the flesh, you are in the Spirit, if in fact the Spirit of God dwells in you... (Rom. 8:7-9a)
But then this answer to the problem of HIV is not likely to be taken seriously by those who think knowledge or gnosis is the answer to everything. After all, Paul's approach would require people to get down on their knees for some purpose other than indulging sexual "needs." And this, in turn, would involve making a moral judgment against promiscuity, a definite no-no in this age of moral relativism--even, it would appear, when the only alternative is quite literally death.
Exposing the sins of an unrepentant individual to others, far from being a wrongful act, is actually required of the church member in good standing. Since such exposure is a virtuous act under Biblical principles, it cannot and should not be viewed as something negative, much less as the basis for a crime.
Where to begin. First note that no scripture references are cited to support this rather unconventional conclusion. In fact, the New Testament denounces both the spirit of busibodiness that leads some to expose the sins of others as well as the greed that actually motivates those who engage in blackmail. This does not mean there is no time or place for "exposing the sins" of others, of course, but the underlying motive is never to be either financial gain or exposure for the sake of exposure. Consider, for instance, this passage from the Sermon on the Mount:
"Why do you see the speck that is in your brother's eye, but do not notice the log that is in your own eye? Or how can you say to your brother, 'Let me take the speck out of your eye,' when there is the log in your own eye? You hypocrite, first take the log out of your own eye, and then you will see clearly to take the speck out of your brother's eye."
Notice the two main concerns of Jesus here. First, we are to focus on our own short-comings. Second, we are to turn our focus onto the sins of others only after we have first removed our own sins and then only for the purpose of helping our brother to see clearly (i.e., to help him "sin no more," as in the story of Jesus stopping the attempted stoning of the woman caught in adultery; see John 8 & especially v. 7: "Let him who is without sin among you be the first to throw a stone at her." ).
Then there is the general framework for handling disputes among believers set forth in Matthew 18:
"If your brother sins against you, go and tell him his fault, between you and him alone. If he listens to you, you have gained your brother. But if he does not listen, take one or two others along with you, that every word may be confirmed by the evidence of two or three witnesses. If he refuses to listen to them, tell it to the church; and if he refuses to listen even to the church, let him be to you as a Gentile and a tax collector."
Notice that disputes are to be worked out in private if at all possible. If that fails, then a small number of others may be brought in to help reach a resolution. Only if that step fails is the entire church to be brought in, and then the remedy is to cut ties with the person, not to cause scandal or financial harm through blackmail.
(1) Gen. 1:27:
So God created man in his own image, in the image of God created he him.... (KJV)
So God created man in his own image, in the image of God he created him.... (RSV)
So God created man in his own image, in the image of God he created him.... (NIV)
So God created human beings in his own image, in the image of God he created them.... (TNIV)
(2) Psalm 23
(a) v. 3:
"He restoreth my soul; he leadeth me in the paths of righteousness..." (KJV)
"...he restores my soul. He leads me in paths of righteousness..." (RSV)
"he restores my soul. He guides me in paths of righteousness..." (NIV)
"he refreshes my soul. He guides me along the right paths...." (TNIV)
"the valley of the shadow of death" (KJV)
"the darkest valley" (TNIV)
Note from Strong's: "from 'tsel' (6738) and 'maveth' (4194); shade of death, i.e. the grave (figuratively, calamity):--shadow of death."
(3) 1 John 2:9ff:
9 He that saith he is in the light, and hateth his brother, is in darkness even until now. 10 He that loveth his brother abideth in the light, and there is none occasion of stumbling in him. 11 But he that hateth his brother is in darkness, and walketh in darkness, and knoweth not whither he goeth, because that darkness hath blinded his eyes. (KJV)
9 He who says he is in the light and hates his brother is in the darkness still.... (RSV)
9Anyone who claims to be in the light but hates his brother is still in the darkness.... (NIV)
9 Those who claim to be in the light but hate a fellow believer are still in the darkness. 10 Those who love their fellow believers live in the light, and there is nothing in them to make them stumble. 11 But those who hate a fellow believer are in the darkness and walk around in the darkness; they do not know where they are going, because the darkness has blinded them. (TNIV)