Body Parts

A War on Christmas?

Is there a "war on Christmas"  in the US, as Bill O'Reilly is claiming there is? Yes (setting aside the hyperbole of "war", which is only a metaphor here), there is a concerted campaign by the well-known culprits, the ACLU, principally, to curtail governmental sponsorship or acceptance of display of Christmas symbols and to prevent their display on public property. They conduct their campaign in the name of constitutional provision that the federal government shall not establish a state religion. But I think the fundamental issue is larger and not constitutional at all. What is at issue is whether American public culture shall be completely secular, as the ACLU and secularists desire, or shall have a significant ethically religious component. "Christmas" is just one of many symbols around which this struggle coalesces (Terri Schiavo's case was another).

The basic principles upon which ACLU and secular opposition to Christmas displays is based are the moral equivalence of all religions and the falsehood of all religions. Secular humanists see all the major religions--Judaism, Christianity, Mohammedanism, Hinduism, Buddhism mainly--as a group as an underlying historical source of conflict and division between peoples. They also see all religions as equally mythological and scientifically false. Religions are acceptable only in restricted situations as sources of ethnic identity (as legacy speech acts and rituals uniting Jews, for instance) and as personal therapy and sources of personal strength for victims (such as Christianity for African American slaves and Gospel music for Black women today).  With these assumptions, the secularists desire to demote Christianity by elevating other religions. This elevation would make no sense if all religions were not equally false.

The social and political controversy occurs now, because President Bush mobilized, that is, politicized, evangelical Christians in the 2000 and 2004 presidential elections. They are using their voice and political leverage to push back against the secularization campaign, which has been going on since 1945.  What many Christians want is  not only to halt secularization, but also to bring religious morality back into American public culture. Their desire is based on the notion that not all religions are equivalent; some religions are true as religions (Judaism and Christianity), while other religions are false religions (some thinkers would put Mohammedanism in this category) or not religions at all (some thinkers would put Buddhism and Confucianism in this category).

The war on Christmas is therefore a profound struggle over the basic character of American public culture. It involves moral re-armament. Some Americans, many Evangelical Christian Americans, are pushing American public culture to re-acquire the values and ethical beliefs it needs to engage in a long struggle against evil in its contemporary form--Islamist terrorism and totalitarianism. This struggle cannot be engaged and won if Americans are unable to discriminate between good and evil, between freedom and totalitarianism, between religion and a sectarian warfare ideology falsely dressed in the symbols of religion, and between religious freedom and secular subservience to Islamic fascism.

The Law and Abuse

The release of the autopsy of Terri Schiavo has been greeted with disbelief by some, because there was no evidence of physical abuse. Abuse of Terri by her husband was alleged by her parents and speculated about in the blog world by opponents of her husband. Despite disbelief, there are good reasons why the allegations of abuse were false. Some of these reasons are based in the law.

Family law is rife with custody disputes. The law, as in California, enumerates the causes for which a judge can change custody arrangements. High on the list of causes is abuse--physical or emotional. Divorced parents often fight over their children, and these fights often focus on custody. Since the law provides that abuse by one parent is grounds for giving custody to the other parent, one parent always has an incentive to allege abuse of the children by the  other parent.

In other words, the law creates allegations of the behavior which the law is  intended to prevent and deal with. A supervising judge of family law,  whom  I know personally, says that undoubtedly over half of the allegations of parental child abuse by the other parent are false. The allegations are lies told to try to get custody. All allegations are investigated by clinical workers; but when half are false, we can see the enormous waste of court money.

A similar situation undoubtedly prevailed in the case of Terri Schiavo. The parents wanted to take custody away from the husband. They had to base their request for change of custody on the grounds permitted by Florida law. I will bet, dollars to donuts, that custodial abuse is a ground for a judge to change custody. So, the parents let the allegations fly. And over time probably convinced themselves of their truth.

Any Lessons from Schiavo Case?

As I reflect on the Schiavo case, I conclude that we have, as a nation, a long way to go in public ethical discussion.  There were thoughtful professional comments and critical explanations of ideas as the public debate unfolded in broadcast media and in blogs from academic and medical ethicists, from religious leaders with seminary training, and from lawyers trained in law school in debating legal issues. But when you jumped to general opinion expressed in letters to the editors, street interviews, sound bites from legislators, guest commentators on  television news shows, and many unprofessional blogs, discussion was often absent; rather, opinion consisted of assertions, often accompanied by inflammatory accusations ("murderer", "bigot"), rather than reasoning, appeal to principles, and documents (such as the legal proceedings). I gained the impression that many persons believed they were thinking and reasoning when they recited a slogan. Such ethical opinions are at the level of the early political discussion about whether the U.S. should invade Iraq ("No blood for oil", etc.). I do not think this popular situation is inevitable. I do not think it is acceptable in a democracy. Recitation of slogans handed down by leaders is simply authoritarianism. We can do much better with education. Traditionally in the U.S., the middle class took the lead in popular education - Chautaugua and reading clubs are examples. Similar, free public programs of brief courses of study might be sponsored by public institutions (libraries, inter-faith cooperation groups, hospitals, bar associations, e.g.) on outstanding issues of the day. Many commentators remarked that the news about the Schiavo case awakened many Americans about end-of-life legal and medical issues. Actually, except for children and young adults, most Americans were already awake to these issues. No middle-aged woman or man  is lacking in awakened concern about such issues, regarding their elderly parents, for instance. The need is not to awaken. The need is to develop greater intellectual sophistication about the issues.

Ending Contention at End of Life

Advanced directives, living wills, and power of attorney declarations are being presented by many legal advisors as solutions to the problem of end-of-life situations, such as that of Terri Schiavo. With a written, explicit statement of a person's wishes, it would be easier for guardians, physicians and hospitals, and courts to know what to so. I suppose that would be the case for uncontested instructions. I am not an attorney and I have not read case law; but I would think that such legal instruments would not prevent contention over courses of action. When different people disagree over what is appropriate and are sufficiently strong-willed to contend matters, what to do in Terri Schiavo type situations would still end up on the courts, with judges and juries making inferences and drawing conclusions. Why would written advance directives be inadequate to squelch contention?

First, it is impossible to specify all conditions under which specific actions should be taken. Genuine confusion and ambiguity will arise in many, maybe most, end-of-life medical crises. Suppose you say that, if you cannot breathe on your own, you do not want artificial assistance in respiration to maintain your life. How would such inability to breathe on your own be defined? Would you insist that paramedics not provide breathing assistance when you are rushed by ambulance to an emergency hospital? If you would insist, how would paramedics know? Would tattoo your instructions on your chin? Would you post a laminated copy of the directives beside your front door? Or would failure to breathe on your own begin after one hour of emergency hospital treatment? Or after a week in a hospital? Suppose a new drug is invented that could stimulate you to breathe without requiring a mechanical device. You did not know about the new drug when you wrote your directive. Does your directive prohibit physicians and your guardian from giving the new drug to you?

Second, it is impossible to keep written advanced directives sufficiently up to date to say that a directive would represent your most recent wish. Suppose you have advanced directive that no heroic measures should be applied to keep you alive in such-and-such a medical crisis; but the directive is one year old when your crisis occurs. Suppose, as in the Schiavo case, someone - your parents or grandparents, perhaps - do not want the directive applied. They claim that you verbally, on several occasions in the most recent year, expressed optimism about the advance of medicine and were excited about the ability of physicians to prolong life and restore persons to quality of living. You changed your mind but neglected to change your written directive. Such cases would end up in the courts with the judges and juries decided by looking at evidence and drawing conclusions as to what your last wishes were and whether you really intended them to supersede your written instructions.

Third, people lie. You go all your relatives. You ask them not to contest your wishes and they lie to your face saying they won't. The instant your wishes should be followed, they contest them. People lie often, lie under oath, and change and alter their lies to fit their latest impulse. Religious people, upstanding business people, and honorable professional people lie just as readily as low-life scumbags lie. They lie freely when they are directly instructed by a judge to tell the truth. They lie to their attorneys trying to represent them. They lie to news reporters, lie in front of cameras, lie to legislators. People lie through their teeth even as their lives hang by a single strained thread of truth. People also change their minds, then lie about it. People behave from conflicting motives; but lying, deny this common fact. People often do not know what they want, even though they say, lying, they do. People will be contentious for reasons that have little to do with respecting your wishes. They will exercise their rights to take their claims to court and prevent your wishes from being followed. In the court, they will lie about everything. Judges and juries will still have to decide who is credible and who is not, who is lying and who is not. They will still have to decide what your last wishes really were. No advance directive, no power of attorney, no living will shall prevent such contention, for we are lying, contentious people; this is why we have courts.

(Revised.)

Conservative Jewish Perspective on Terri Schiavo

I asked my son for his conservative Jewish perspective on the case of Terri Schiavo. He wrote as follows.

I cannot believe we're letting that woman die. What they're doing is wrong on a Jewish level. It is wrong on a Torah level. It is wrong on a Halachic level.

It is wrong on a human level.

In the Torah there's this concept of 'fences'. The great sages who wrote the Talmud made 'fences' around the various commandments given to the Jews.

What does this mean?

According to Torah, strictly, Chicken is not considered meat. It's never listed as a meat. Chicken and fowl is never listed as milk or meat, meaning chicken is parve, or neutral.

So, technically, a Jew could eat chicken with milk - a Chicken-and-Cheese sandwich. Never the less, the great Rabbis decreed that we must treat Chicken as meat, since it is so similar to beef that Jews may make a mistake and accidentally eat beef and milk together.

They built a 'fence' around the commandment to separate milk-and-meat so that it could never be violated.

Now, applying 'fences' to the Schiavo case.

In their pursuit of ethnic purity, the Nazis killed all the mentally and physically handicapped children in Germany. They believed that if they weeded out all the genetic failures, they'd produce a stronger Aryan race.

America is FAR from a Nazi state, however, you'd think we'd do everything in our power to never head down that road. We'd build a FENCE around our democracy by emphasizing LIFE. We would want to protect ourselves from ever becoming a State that sponsors murdering the disabled, so we'd build a FENCE around our laws. However, here we sit. That woman is entenced to death simply for being sick. For being injured.

Most American Jews are so 'Reformed' from their Judaism and any basic sense of morality that they feel this woman MUST die. How anyone can be pro-Terri-Death but anti-Death Penalty is beyond me.

I must admit that I've gotten emotionally invested in the Schiavo case. I feel like I don't recognize the world around me. At what point did we stop valuing innocent human life? What part of 'thou shalt not kill' don't people understand?

Slippery Slope

I think the political controversy over the Terri Schiavo case is good for the body politic. I hold this opinion separately from my views on how Terri Schiavo's situation might be resolved (readers of this blog know that I think Michael Schiavo and the courts have acted appropriately and properly). In society at large, as European history demonstrates, liberalism driven by Left proclivities tends to slide down the slippery slope of the ethically permissible. Liberalism has no moral brakes. It starts by saying that it is okay for guardians to pull the feeding tubes from persistently vegetative patients; then it is okay for physicians to pull the tubes, regardless of guardians' wishes; then it is okay for general euthanasia of less disabled patients; then it is okay for physician-assisted suicide, partial-birth abortion, and so on. How can we arrest the slide down the slope? At the social level, we need religious absolutists and zealots screaming and demonstrating (of course, within the limits of legal politics), against each extension of voluntary death.  They say they do it, because human life is an absolute value and only God should determine when a person dies; okay, if that's what it takes to motivate them, great. Let them organize, too, and press their case in the legislatures. We all benefit from oppositional politics. We will understand the moral dimensions of policy and will make better social decisions from these controversies and confrontations, than we would by following "the evolving standards" of a soulless European liberal morality.

Don't Like What Is Happening to Terri Schiavo?

Set aside the rhetoric and listen. What is happening to Terri Schiavo is happening because her husband is following her wishes, as established in a Florida trial court, according to standards and procedures established by statute of the state of Florida. You don't like it? There is a legal solution: change the law in Florida (and in other states). If you want the state to have the authority and power to set aside the personal liberty of American citizens in Terri Schiavo's medical situation, and take guardianship and power of attorney away from whomever they have designated, write a law specifying the standards and procedures for this use of state power. Appropriate money for the tens of thousands of individuals for whom the state will take responsibility for the rest of their natural and sustained lives. This is all you have to do. Once you have done it, and assuming the statute passes the expected constitutional challenges, the trial courts will enforce your will as expressed in your statute. You will have no more Terri Schiavo cases.  But when you are finished, I will bet you won't like it, because you will not want your personal liberty taken away from you.

Thank Goodness: Politics As Usual

Some political observers have complained that politicians are playing politics with the Schiavo case and Social Security. Their notion is that these situations are so serious that politics is inappropriate to solving them, or maybe they think that politics is preventing sober rationality from solving them. What do we expect in an electoral democracy? Politics is the framework in which these situations were created, is maintained, and shall, one way or another, be resolved. This is as it should be. Do we wish to have someone else make our decisions for us? Or maybe we should have some absolute monarch giving us orders and arranging our affairs for us?

Dr. Cheshire's Observations of Terri Schiavo

A story in the Los Angeles Times gives us additional information about Dr. William P. Cheshire's report of his observations of Terri Schiavo and his conclusion that she is aware of her surroundings. Dr. Cheshire observed Mrs. Schiavo for 90 minutes. He states that he observed her respond to persons and sounds. She also held his gaze for 30 seconds. Setting aside the problem that the language used in the Times report assumes the existence of the phenomena whose existence are being investigated, it is clear that Dr. Cheshire's observations do not rise to the level of scientific credibility. The consensus scientific/medical claim is that Mrs. Schiavo's face makes random movements caused by brain stem stimulation rather than activity directed by self-consciousness in response to external stimuli. The only way that random movements could be distinguished from directed movements would be in an experiment. Such an experiment would reasonably require more than 90 minutes, would require controls, and probably should involve multiple observers. A record would have to be made of the number of times Mrs. Schiavo did not respond to stimuli from her surroundings, exhibited movements unrelated stimuli, and the number of times she appeared to respond to stimuli from her surroundings. There are simple statistical tests to determine whether the data thus obtained are different from random. Dr. Cheshire's observations did not, from the information provided in the Times article, rise to this scientific level. His observations therefore were simply quick, personal impressions. Such impressions are invariably influenced by what we want to see.

Is Terry Schiavo Conscious?

The Terri Schiavo case has raised a wide discussion about the nature of consciousness and what consciousness might be attributed to her. As a general reader, I would like to offer my understanding of current scientific knowledge about consciousness. I invite comments and corrections.

What is consciousness? To start, we define consciousness simply as awareness. We do not further define awareness with words, but point to the common experience of awareness so that we know what we are talking about. There are three, qualitatively different kinds of consciousness. All kinds of consciousness are products of neurological systems. Organisms without nervous systems, such as trees, do not have consciousness of any kind. The differences between the kinds of consciousness are related to differences in complexity of the nervous systems of organisms (more about this relationship between awareness and neurology below).

The three kinds of consciousness are sentience, located consciousness, and empathy. Sentience is the most elementary form of awareness. It is simple feelings, such as pressure, pain, and heat. Sentience accompanies neurological activity, so it exists in all organisms with nerves. A decapitated frog, for instance, whose nervous reflexes still worked, would be sentient in its leg when stimulation of a foot reflexively causes the leg to withdraw aware from the source of stimulation.

Located consciousness (my term) is positional awareness of environment. The organism is aware of its surroundings. It is aware of objects in its perceptual space. Positional awareness requires a centralized nervous system with some brain functions. It does not require the full panoply of brain capabilities of a human. Locational consciousness exists in different degrees of complexity in different organisms, depending upon brain complexity. We can distinguish degrees of brain complexity among animals. Given sufficient brain complexity, positional awareness can include self-consciousness.

Empathy is awareness of the awareness of other animals. Empathy is not uniquely human, but other animals, e.g., higher primates, do not have brain complexity sufficient to experience empathy to the degree that we do. Brain physiologists and psychologists have identified specific, distinct regions of cells that produce self-consciousness and empathy. Still other cellular regions are responsible for simple positional awareness.

Because there is a general scale of increasing complexity among vertebrates, we may say there is a scale of increasingly complexity of awarenesses. Starting at the "bottom" and most simple and going to the "top" and most complex, these consciousnesses are: sentience, located consciousness, self-consciousness (which I classify as a kind of located consciousness), empathy.

I stated that the three kinds of consciousness are qualitatively different. By qualitative difference, I mean that, based on having one kind of consciousness alone, we would not be able to imagine what it would be like to experience another kind of consciousness. If an organism has only sentience, it cannot imagine what it would be like to have positional consciousness. (Without higher brain functions, it would not have the brain capability for imagination, so this a speculative example.) If an organism has self-consciousness, but not capacity for empathy, it would not know that other organisms have self-consciousness and it would not be able to put itself in their place when they suffer (which is what empathy enables us to do). Qualitative difference means that there are significant differences between the kinds of awareness.

It is the possession of self-consciousness and our experience of our own self-consciousness that raises confusion in understanding Terri Schiavo's condition. Here is how I understand the issues involved. I readily admit my explanations are suggestive and speculative. I am going to make some analogies, in explaining the issues, but these are only for clarity and do not denigrate Terri Schiavo's humanity.

Some organisms have located consciousness, but lack self-consciousness, for instance, fish. A fish has orientation in its watery environment, but the fish lacks awareness of itself as a "self". It doesn't name itself, for instance. When another fish attacks it and inflicts pain or eats part of it, the fish under attack feels pain; but, because it does not have a sense of self, it does not know that it, "this fish, Ralph," is hurting. This example can be extended to us humans. Pain can exist without being your pain; as a result, you do not suffer. In the Nazi concentration camps, when prisoners were tortured, some prisoners could separate their self-consciousness from their positional consciousness and from their sentience. They endured torture because their selves did not experience the pain. For instance, they imagined that they were standing aside from their bodies (they disowned their bodies, so to speak) and were watching the torture of "someone else". There was pain, but their selves did not feel it.

We have been analyzing consciousness by working up a scale of complexity and adding kinds of awareness. We can work backwards, too. We can substract degrees of complexity and organization, thereby substracting kinds of consciousness, because the neurological basis is not present. This is pertinent to analyzing Terri Schiavo's condition.

In the case of Terri Schiavo, Mrs. Schiavo is sentient. Most doctors say she does not have located consciousness (she is unaware of her environment). Without located consciousness, she is unable to have directed attention. Without directed attention, she cannot have self-consciousness. When she is described as in a persistent vegetative state, I believe this is what is meant. Some doctors say she does have located consciousness.  If she has located consciousness, she has consciousness, but - this is the point - she does not necessarily have self-consciousness. Finally, without self-consciousness, she does not have empathy.

Without self-consciousness, Terry Schiavo does not have a self. This statement sounds terrible and flies in the face of religious belief that the self is anchored in distinct, unitary, nonmaterial entity. But neurologically, the self is a neurological function enriched by experience gained within positional awareness. Pain, as a form of awareness, could exist in her neurological system, but she would not know it and, therefore, she would not suffer from it. You, yourself, cannot suffer, if you do not have a self to experience pain and do the suffering. For this reason, the medical opinion that her dying due to lack of food and water would not involve suffering has a high credibility. Withdrawal of her feeding tube would not be cruel, because it does not inflict suffering. Mrs. Schiavo's brother-in-law, who has visited Terri Schiavo in her room since her feeding tube was removed, stated on CNN that Terri Schiavo is peaceful. There is much medical and scientific evidence to confirm that his personal observation is true.

(Revised.)