Mad Mel to the rescue

I hadn't appreciated how far Mad Mel's breadth extended, in that she has appointed herself an expert not only on international relations, the Middle East problem, religion and ethics, but environmental policy too, as a member of the Scientific Alliance.

As transmitted by Medialens, George Monbiot and colleagues are asking in Nature what qualifies the likes of Mel for this role? More on the influence of the Scientific Alliance (inc Mad Mel) here, here and here.

I'm becoming addicted to the Moral Maze, surely a sign of presenility, largely to gawp at Mad Mel. This week she argued for links between church and state (as she would), a very difficult position to defend. Her utopia has us all segregated into discreet, non-overlapping religious/ethnic/authoritarian states so that law or justice become entirely relative and regional. Quite how this system will cope with atheists, bastards of mixed origins like myself, or other miscegenistic progeny has not been made clear by Mel.


Her timely article in this week's Daily Mail on Schiavo's case- 'Killing the Sick' 30/3/05- is almost as good as she gets, with her latest diary entry 'Killing the Disabled' in equally hysterical tones.

Poor Terri Schiavo died this afternoon, her parents' last judicial appeal to replace her nasogastric tube denied this morning. I'm sad and relived simultaneously, and hopeful that Terri can now become a person again, and not an issue. I also hope that this event can help her parents to start to grieve for the daughter they lost as a 26-year old in 1990, and let her rest now instead of being dressed as a grotesque teenage/middle-aged puppet in broderie anglaise. Her brain probably stopped functionally in any pragmatically human manner some 15 years, when her bulimia was the likely cause of an electrolyte imbalance leading to cardiac arrest and cerebral anoxia.

This case has impressed upon me the importance of making wills of various kinds, and for the record I wish-
* To avoid resuscitation and strenuous interventions if I am beyond medical help
* All my assets to be divided equally between my children
* Any donatable organs/tissues to be culled from my body

Addendum
Both sides of the Schiavo-Schindler case have assented to a post-mortem examination to try to delineate the extent and severity of Terri's central nervous system pathology. This may bring some resolution, especially if it shows a clear brainstem or mesencephalic bleed. But my hunch is it's unlikely to supply any cut-and-dried answers about Terri's cognitive/emotional/conscious state before she died.

A passing acquaintance with neurology and neuropathology, which included assessing cerebral MRI scans of alcoholic and demented patients, proved just how little cortex- thinned, water-logged, displaced- one can possess and still function both in self-care and socially. Terri's CT scan on www (if indeed it's hers) is not dissimilar to some I've seen in walking, talking and conscious, although neurologically impaired, individuals.

The worst fear, clinically, would be that she was not in a PVS but experiencing a locked-in syndrome. However, this latter neurological syndrome is often characterised by localised strokes or emboli in the motorsensory cortex around the Sylvian fissure, causing generalised paralysis of motor function *without* an altered level of consciousness and cognitive processing. This remains a possibility for Terri, and the core Schindler's and their supporters belief, but not very likely given her global and disseminated atrophy, widened sulcii, expanded ventricles and cortical thinning of her pre-mortem scan.

So the issue of the ethics and morality of this case are unlikely to die with Terri, nor this or future similar cases to be retrospectively solved by PMs. For a start, there's the imprecision linking neuroanatomical features and clinical status, and for seconds the issue was not about Terri's state-of-consciousness but about the wishes of her, her husband and her parents over ownership of her living will.

Unlike Mel, I wish to keep these sorts of decisions in the hands of individuals, and not the state. If Jerry Fallwell and Il Papa wish to be kept on artificial support in perpetuity, that's their prerogative and I'm pulling no tubes. However, when I'm no longer able to pull the tube out myself, I hope a good friend will take that responsibility and action for me.