Saturday, May 02, 2009

What Experts Know, What Doctors Know, What Moms Know

The controversy sparked by Myah Walker's blog devoted to her anencephalic baby, Faith, raises many interesting questions.

Several commenters said that Faith is basically a vegetable. I've seen even more demeaning comments on other websites.

Many readers conclude that since the cortex is necessary for consciousness, and Faith doesn't have a cortex, she has no consciousness, and is therefore a non-person.

I scoff at such simplistic syllogisms.

Myah does not believe that Faith is that disabled. Critics say that she is in denial for thinking that her baby is as developed as any newborn. They appeal to "common knowledge" about anencephaly and the functions of the brain-- the kind of knowledge that doctors "know" to be true because their textbooks say so, even though it is far from being their specialty, and anencephaly is not widely studied.

Add to the mix that Myah is a strong, Bible-believing Christian. That makes it official: Myah is a self-deluded mental case. Her perception and interpretation of Faith's movements and reactions cannot be trusted because she is a dumb, uneducated, brainwashed Bible Christian who knows nothing about rudimentary neuroscience.

She does not toe the medical line. Her observations are therefore worthless.

But are Myah's obeservations so far-fetched?

For instance, Myah says that her newborn may be even a little more advanced than a typical newborn. Myah claims that Faith can hear.

But she can't be that way, the critics say. Modern Medicine says so!

Well, it turns out that while there is general "line" that anencephalic have no consciousness and are in no way comparable to other newborns, some experts think differently.

For instance, this researcher says:

The evidence and functional arguments reviewed in this article are not easily reconciled with an exclusive identification of the cerebral cortex as the medium of conscious function. They even suggest that the primary function of consciousness – that of matching opportunities with needs in a central motion stabilized body-world interface organized around an ego-center – vastly antedates the invention of neocortex by mammals and may in fact have an implementation in the upper brainstem without it

In other words, the absence of a cortex does not preclude all consciousness.

Another pair of authors write:

The newborn is devoid of cerebrally controlled behaviour patterns so that in the first 6 weeks of life it is hard to distinguish the normal newborn's behavior from that of anencephalic infant.

In other words, when Myah observed that Faith was even more advanced than a typical newborn, allowing for a mother's natural enthusiasm for her own child, that observation was not terribly far-fetched.

One article that is widely cited, published in 1988, written by D. Alan Shewmon, entitled "Anencephaly: selected medical aspects". It is widely cited in the medical literature. Shewmon is a professor of neuroscience at the UCLA Medical Centre. [Full disclosure: I do believe that he is sympathetic to the pro-life movement, as many of his opinions line up with pro-life thought, and he is a member of the Pontifical Academy for Life].

Page 5, 6 and 7 of his article contain many statements that contradict common ideas about consciousness, the brain and anencephalic babies.

Here is a sample passage:

The fact that decerebrate newborns behave much more similarly to normal newborns than to decerebrate adults is already an important distinction that cannot be overemphasized. This is no longer the case by around 2 months of age, when decerebrate infants begin to exhibit the rigidity typical of PVS patients. But at the newborn stage, the essential difference between normal and decerebrate infants is in the area of potential for future development, with only subtle differences in actual, present functioning. Also, associative learning and conditioning, which can occur in some decerebrate newborns, have, to my knowledge, never been reported in older PVS patients.

In other words, when Myah observes that Faith functions just like any newborn, she is stating what at least some experts have come to realize.

Are these articles the final word on anencephaly, consciousness and brain function? Obviously not. My point was not to establish that Faith could actually be conscious.

What I am trying to say is that it is hazardous to make an inference about what a human being's inner state based on "common knowledge" perpetuated by doctors and medical textbooks.

In fact, Shewmon's article mentions that newborn pain was only beginning to be acknowledged at the time of publication-- in the late 80s.

Today no one denies that newborns feel pain.

But denial of newborn pain was based on the same kind of thought process that Myah's critics are using to assert that Faith has no consciousness. It was "common knowledge" that newborns operated on reflexes, therefore they couldn't really feel pain.

Myah's rejection of "common knowledge" provides justification for their belief that Myah is somehow mentally ill because her observations do not line up with medical opinion, AND she is religious.

For pro-lifers, this has wider implications on a number of issues, because such issues as euthanasia and organ donation are decided based on this medical "common knowledge" .

People are very often misled by a lack of facts. The medical community and other people with agendas take advantage of this vacuum to implement ideologically-based measures. The reality is that the science on fetuses, brain function, consciousness and similar issues is relatively young and there are lot of gaps in our knowledge.

These gaps are filled by many erroneous inferences that seem to never die out.

There are still people who think a fetus is a blob of tissue.