My debate about Terri Schiavo’s case with Florida bioethicist Bill Allen on Court TV Online eventually got down to the nitty-gritty:
Wesley Smith: Bill, do you think Terri is a person?
Bill Allen: No, I do not. I think having awareness is an essential criterion for personhood. Even minimal awareness would support some criterion of personhood, but I don’t think complete absence of awareness does.
If you want to know how it became acceptable to remove tube-supplied food and water from people with profound cognitive disabilities, this exchange brings you to the nub of the Schiavo case–the “first principle,” if you will. Bluntly stated, most bioethicists do not believe that membership in the human species accords any of us intrinsic moral worth. Rather, what matters is whether “a being” or “an organism,” or even a machine, is a “person,” a status achieved by having sufficient cognitive capacities. Those who don’t measure up are denigrated as “non-persons.”
Allen’s perspective is in fact relatively conservative within the mainstream bioethics movement. He is apparently willing to accept that “minimal awareness would support some criterion of personhood”–although he doesn’t say that awareness is determinative. Most of his colleagues are not so reticent. To them, it isn’t sentience per se that matters but rather demonstrable rationality. Thus Peter Singer of Princeton argues that unless an organism is self-aware over time, the entity in question is a non-person. The British academic John Harris, the Sir David Alliance professor of bioethics at the University of Manchester, England, has defined a person as “a creature capable of valuing its own existence.” Other bioethicists argue that the basic threshold of personhood should include the capacity to experience desire. James Hughes, who is more explicitly radical than many bioethicists (or perhaps, just more candid), has gone so far as to assert that people like Terri are “sentient property.”
So who are the so-called human non-persons? All embryos and fetuses, to be sure. But many bioethicists also categorize newborn infants as human non-persons (although some bioethicists refer to healthy newborns as “potential persons”). So too are those with profound cognitive impairments such as Terri Schiavo and President Ronald Reagan during the latter stages of his Alzheimer’s disease.
Personhood theory would reduce some of us into killable and harvestable people. Harris wrote explicitly that killing human non-persons would be fine because “Non-persons or potential persons cannot be wronged” by being killed “because death does not deprive them of something they can value. If they cannot wish to live, they cannot have that wish frustrated by being killed.”
And killing isn’t the half of it. Some of the same bioethicists who have been telling us how right and moral it is to dehydrate Terri Schiavo have also urged that people like Terri–that is, human non-persons–be harvested or otherwise used as mere instrumentalities. Bioethicist big-wig Tom Beauchamp of Georgetown University has suggested that “because many humans lack properties of personhood or are less than full persons, they…might be aggressively used as human research subjects or sources of organs.”
Such thinking is not fringe in bioethics, a field in which the idea of killing for organs is fast becoming mainstream. In 1997, several doctors writing for the International Forum for Transplant Ethics opined in The Lancet that people (like Terri) diagnosed as being in a persistent vegetative state should be redefined as dead for purposes of organ procurement:
If the legal definition of death were to be changed to include comprehensive irreversible loss of higher brain function, it would be possible to take the life of a patient (or more accurately to stop the heart, since the patient would be defined as dead) by a lethal injection, and then to remove the organs needed for transplantation subject to the usual criteria for consent.
Knowing that this kind of thinking predominates in contemporary bioethics, I decided to bring up the matter in my Court TV debate with Bill Allen.
Wesley Smith: If Terri is not a person, should her organs be procured with consent?
Bill Allen: …Yes, I think there should be consent to harvest her organs, just as we allow people to say what they want done with their assets.
Put that in your hat and ponder it for a moment: If organ harvesting from the cognitively devastated were legal today–thank goodness, it isn’t–Michael Schiavo would be the one, no doubt sanctioned by Judge Greer, who could consent to doctors’ “stopping” Terri’s heart and harvesting her organs.
Think that’s a horrid thought? Well, ponder this: More than ten years ago, transplant-medicine ethicists Robert M. Arnold and Stuart J. Youngner painted a disturbing picture of the kind of society that the bioethics movement is leading us toward: literally a culture in which organ procurement is a routine part of end-of-life care and “planned deaths.” The ethicists predicted that in the not-too-distant future:
Machine dependent patients could give consent for organ removal before they are dead. For example, a ventilator-dependent ALS patient could request that life support be removed at 5:00 P.M, but that at 9:00 A.M. the same day he be taken to the operating room, put under general anesthesia, and his kidneys, liver and pancreas removed…The patient’s heart would not be removed and would continue to beat throughout surgery, perfusing the other organs with warm, oxygen-and-nutrient-rich blood until they were removed. The heart would stop, and the patient would be pronounced dead only after the ventilator was removed at 5:00 P.M., according to plan, and long before the patient could die from renal, hepatic, or pancreatic failure.
Know this: There is a direct line from the Terri Schiavo dehydration to the potential for this stunning human strip-mining scenario’s becoming a reality. Indeed, as Arnold and Youngner put it so well, “If a look into such a future hurts our eyes (or turns our stomachs), is our discomfort any different from what we would have experienced 30 years ago by looking into the future that is today?”
–Wesley J. Smith is a senior fellow at the Discovery Institute, an attorney for the International Task Force on Euthanasia and Assisted Suicide, and a special consultant to the Center for Bioethics and Culture. He is the author most recently of Consumer’s Guide to a Brave New World..