What’s airing on Pro-Life Perspective Today? “The Minimally Conscious State,” Part 2

By Dave Andrusko

Editor’s note. There is still time to register for the National Right to Life convention June 28-30 and to reserve a hotel room at the Hyatt Regency Crystal City in  Arlington, Virginia. Just go to www.nrlconvention.org.

Ronald Cranford

Yesterday, in Part one of a two-part series, National Right to Life President and Pro-Life Perspective Host Carol Tobias began a discussion of an influential commentary written by the late bioethicist Ronald Cranford. Cranford was a vocal advocate of withdrawal of food and fluids in high profile cases which Cranford and others argue is merely an attempt to honor the patient’s (unexpressed) “right to die.”  Today Mrs. Tobias looks more closely at the article, “What is a minimally conscious state?” published in the Western Journal of Medicine.

You will want to listen to the discussion at www.prolifeperspective.com, so we’ll provide some highlights here.

“To be accurate Cranford did not explicitly say what should be done with patients labeled as being in a ‘minimally conscious state’ or MCS,” Mrs. Tobias points out. “But judging by Cranford’s history of advocating euthanasia and suggestive allusions, minimally conscious state likely will prove to be a label slapped on a huge new class of cognitively-impaired patients for whom providing food and fluids are, at best, optional.”

It’s interesting that even back then, Cranford conceded that a more severe condition—the so-called “persistent vegetative state”– is not nearly as clear-cut as we are always told it is. Cranford then quickly concedes that the reach of so-called “right-to-die cases” has now swept into its grasp “patients who clearly were not vegetative but were otherwise severely neurologically disabled.” As Mrs. Tobias pointed out yesterday, Robert Wendland involved just such a patient.

Having made the point that there are differences between someone supposedly in a persistent vegetative state and someone who supposedly is in a minimally conscious state, Cranford nonetheless goes out of his way to dehumanize MCS patients. He then makes a shocking conclusion:

“Just as the first quarter-century of the right-to-die movement may be exemplified by the medical, legal, and ethical assessments of brain death and the vegetative state, so the first quarter century of the new millennium may be the era of patients who are substantially neurologically impaired but conscious to a variable degree. Perhaps MCS will capture the essence of this next wave.”

Mrs. Tobias correctly observes

“The ‘next wave’ is a tsunami. At the time, the Aspen Work Group estimated the number of minimally conscious state patients in the United States to be ‘112,000 to 180,000…’ Among this ‘next wave’ are large numbers of patients who are senile or suffering from Alzheimer’s.”

During his lifetime, Mrs. Tobias concludes, “Ronald Cranford advanced a worldview that severely disabled patients are unworthy of care and medical treatment.”

For more about what we are learning that we DON’T know about patients with cognitive injuries, see “Communicating with the ‘Unreachable’–the severely cognitively injured.”