Academic journal article Journal of the Evangelical Theological Society

Feeding the Dead? Rethinking Robert Rakestraw on the Persistent Vegetative State

Academic journal article Journal of the Evangelical Theological Society

Feeding the Dead? Rethinking Robert Rakestraw on the Persistent Vegetative State

Article excerpt

This year marks the tenth anniversary of the death of Terri Schiavo, a Florida woman whose plight ignited an intense national debate over the practice of withholding artificial nutrition and hydration (ANH) from individuals diagnosed as being in a persistent vegetative state (PVS). According to public opinion surveys that stretch back to the early 1990s, the majority of evangelical Christians are opposed to indefinite ANH in the case of PVS.1 Few have been willing to publicly stake that position to the claim frequently advanced by secular ethicists that patients deemed persistently vegetative are, in fact, dead. Among those who have, however, is Robert V. Rakestraw, who, in a 1992 JETS essay that continues to be reprinted in his widely used introductory text on Christian ethics, argued that vegetative patients are "theologically dead" on account of a "completely and permanently destroyed" cerebral cortex.2

Though advocating a "major redefinition of death" with significant theological and ethical implications, Rakestraw's essay surprisingly garnered no response in JETS. Indeed, one has to search far and wide for an engagement of his proposal. Biola ethicist Scott Rae cites Rakestraw's proposal in multiple publications, but the engagement is brief as Rae is chiefly focused in those efforts to deliver a philosophical critique against the larger target of personhood bioethics.3 More substantial is the interaction from Dónal O'Mathúna in a 1996 essay published in Philosophia Christi.4 O'Mathúna's critique was chiefly theological, but he also raised in barebones fashion a separate objection that, more fully developed, proves devastating to Rakestraw's argument. Specifically, it is the challenge of empirical warrant, and in this essay, we shall develop the objection, arguing that in constructing his ethical analysis, Rakestraw relied upon a severely flawed analysis of the medical data- judged both by sources available at the time of his writing and by more recent research. The conclusions reached are significant for any approach to the ANH-PVS question that grants decisive influence to the claim that PVS patients are, en masse, permanently unconscious.

I. FRAMING THE ISSUE

Writing in 1992, Rakestraw extended an argument he offered one year prior in a lay-level publication while debate over the ethics of withdrawing ANH from vegetative patients was raging in the wake of the United States Supreme Court's decision concerning Nancy Cruzan.5 In that case, the Court affirmed with some constraints ANH withdrawal as a legal option in the case of PVS, and in so doing it infuriated many pro-life advocates who viewed the practice as categorically immoral. Rakestraw did not share the latter group's opinion and makes that fact abundantly clear in the opening paragraph of his 1992 essay as he complains of those who in opposing ANH withdrawal "wrongly allege the intention to kill ... on the part of all who allow the practice."6 In error, he contends, they view the practice as "euthanasia" and so conflate it with "the deliberate termination of the lives of conscious yet severely disabled persons."

At the outset, then, Rakestraw gives his reader some indication of where he will land on the ANH-PVS issue, but with his next preliminary move, he lays his position bare. Surveying the moral terrain, he identifies only two possible positions on the moral question, one of which he has just rejected. The only alternative to the euthanasia approach, he insists, is to view ANH withdrawal as ceasing ministration to the dead.7 In removing the feeding tube, either we commit homicide or we initiate the proper disposition of mortal remains. Inclined to the latter view, Rakestraw devotes the remainder of the essay to arguing that vegetative patients are, in some real sense, deceased. On this proposition, he believes, the morality of ANH withdrawal truly hinges. As he states, "If we can determine that the PVS individual is dead, then we need not hesitate to withdraw food and water. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.