Uspeakable horror… but let us speak of it anyway
Occasionally I get to thinking that the FDA should be an advisory-only agency, usually when I consider stupid actions like banning the Chinese herb ephedra because a few people with heart defects took 5x the recommended dose and then turned out for high school football.
But then I read something like Neurophilosophy’s Rise and fall of the prefrontal lobotomy. (The article is not for the squeamish) There’s a clear description of how the operation evolved during the time it was practiced, and some context; for instance I was not aware that John F. Kennedy’s sister Rosemary had the operation, and was completely incapacitated by it. And there are a few stories – most notably that of Howard Dully, who was lobotomized at the request of his stepmother because she found him a disobedient child. It is not easy reading.
Previous cultures have held that the soul resides in the heart. But the heart is a pump; a person does not become a machine while on a heart-lung machine. If there is a soul, its surely resides in the brain. In the top, the front, of the brain, where in the 1940’s and 1950’s a few doctors performed thousands of acts of ignorant vandalism. There could be no operation more invasive to the person on which it is performed.
In recent years I have heard people make overheated comparisons between such horrors, and giving Ritalin to kids who have ADHD. Instinctively I recoil from the staggering disproportion between the two – it is like comparing school detention to the Gulag Archipelago. But there is a discussion to be had. In short, the two are not at all comparable along the axis of irreversibility, or of effect. But by way of illustration and example it is worth discussing if the problem is really with the child, or with the school and family. We’re awfully quick to try to change the child.
In the end, we may look at new medical technologies and give the green light. For example that seems to be the outcome with stem cell research and therapies in most of the world except here (where cells apparently have souls). We’re squeamish about selling organs, too, for no reason I can quite discern. And if informed autonomy is the core of medical ethics, I’m left without any explanation for the ban on medicinal (or any other) use of marijuana, or the ban on euthanasia.
Why speak of lobotomy all? Because, now that the operation is all but forgotten, so is the ethical range of comparison. We’re introducing new medical procedures and technologies at a pace undreamed of in the middle of the last century when lobotomies were all the rage, and we need well-maintained tools for discussing their ethical implications. If nothing else, when someone makes too strained a comparison (usually involving Nazis) we know what has happened here, and how it differs from giving someone a pill that will wear off in four hours. And, how other things fit in between.