Actually, there probably is. A fetus, even a fetus one day before birth, exists in a low oxygen environment. The cerebral cortex doesn’t work so well in a low oxygen environment. If you put an adult in an unpressurized airplane at 30,000 feet they will loose conciousness very rapidly. So regardless of the fetus’ neurological development, the cortex may not be operating yet. Additionally, the uterine environment is low stimulus. The main stimulus a fetus experiences is the sound (quite loud, apparently) of blood rushing through the placenta. It may be dimly aware of light and the amniotic fluid may taste different depending on what the mother ate, but those sensations are quite limited. Compare that to the experiences of a newborn: bright lights, different noises, the faces of its parents and birth attendants, the smell of colostrum (and possibly meconium), etc. Can a conciousness exist in the absence of stimulus? Adults go crazy very quickly if not given adequate stimulus (see poor Jose Padilla, for example). Perhaps fetuses don’t go crazy because they do not have the level of awareness that necessiates stimulus and companionship yet.

That’s always the question in medicine: do the benefits of the proposed intervention outweigh the risks of vice versa? In this case, Ashley’s parents and her doctors, people who know her and care for her, decided that the benefits outweighed the risks. As far as the hysterectomy is concerned, the main long term problem she is likely to face is abdominal scarring which will make any future abdominal surgeries slightly more difficult. Since (I think) they took the appendix out at the same time, there’s a reasonable chance that she’ll never need any further abdominal surgeries. Again, I don’t know that this was “the” right decision, and probably isn’t the best solution possible in the ideal world, but I think it may well have been a right decision for Ashley and her family given the options available.

On the subject of menstral discomfort, are the people who say that menstration is no big deal taking into account the fact that she is essentially immobile? One of the best non-pharmacologic methods of decreasing menstral pain (for me and others I’ve talked to at least–I haven’t seen any formal studies of this) is movement. Frankly, menstation while being unable to move, with or without ibuprofen, sounds hideous to me. But that may be just me.

I am all for a grand unified personhood theory that makes sense, but every one I have read breaks down somewhere. I don’t think there is a meaningful difference in the cognitive ability of a baby a day before birth and a day after birth.

It’s all slippery slope.

the idea of a 3-month-old’s personhood even being questioned

I don’t understand why questioning anything would be wrong. What possible definition can there be of “personhood” that isn’t sometimes problematic?

Ack! I meant to write “It’s not just the likelihood…”

I am all for a grand unified personhood theory that makes sense, but every one I have read breaks down somewhere. I don’t think there is a meaningful difference in the cognitive ability of a baby a day before birth and a day after birth.

it stands to reason that feeling menstrual pain, even if slight, might bother her more than a normal sibling, who can put it in context and who derives pleasure from many, many other aspects of life and can overlook the discomfort more easily.

. . . and who can understand that there’s an emotional component to menstruation as part of sexual maturity, and who are able to derive pleasure from their sexuality, and who understand that the pain is temporary . . .

The only pleasures Ashley really gets in life are sensual (in the sense of — senses) — being in a pleasing or comforting visual environment, perhaps smelling familiar smells, listening to familiar voices/music, being warm, fed, comfortable, and free from physical discomfort. And since whatever subjective happiness she derives is so based on those sensual dimensions, it seems rather important to keep them as stable as possible. An imperfect analogy, but I bet her family focuses on keeping her out of drafts more so than her siblings - not only because she can’t move away from a draft, but because her pleasures are so limited that the least they can do is keep her draft-free. Being in a draft likely bothers her more than it does a normal sibling - so it stands to reason that feeling menstrual pain, even if slight, might bother her more than a normal sibling, who can put it in context and who derives pleasure from many, many other aspects of life and can overlook the discomfort more easily.

It’s the just the likelihood that something might happens that determines whether you prevent it from happening. It’s also how bad you think the consequences of it happening will be, and the relative benignness of the preventative measure.

If you know that menstruation can be Very Very Bad, then a hysterectomy might not seem so radical.

Ah, but all the cool kids are talking about autonomy and personhood…

People have pointed out that comparing Ashley to a “3 month old” is inaccurate–because despite perhaps having those limitations, she’s a “3 month old” with 9 years living experience.

For an adult to be put into a situation like Ashley’s would also be different. You’d be dealing with an adult with however many years experience living a “normal” life, experiencing a extreme situation which takes away their physical and mental abilities. It’s not the same as Ashley’s situation, and cannot be the same as Ashley’s situation. That adult is being deprived of abilities which pre-existed, while Ashley never had those abilities and thus cannot be deprived of them.

Maybe this should be a call for those of us with living wills to look at them and make sure we understand what they are saying. I’ve already been through this with my father–he underwent surgery around the time of the Terri situation, and he and his doctors made sure that WE (him, his family) understood what his living will actually meant. Many living wills will come into effect in situations less extreme than Terri’s; situations that might leave us like Ashley.

I am comfortable with that. We hear about the “miracle” survivals and recoveries, but there is a reporting bias there. We don’t hear about all those who don’t have miracle recoveries.

I, personally, am against many extreme medical procedures. If I ended up in a situation where a transplant was required, I would probably not go forward with it. That does not mean that I think that others shouldn’t–if someone else is comfortable with that type of medical intervention, that’s their choice.

And, ironically, I am a stated organ donor.

As for Ashley: it appears that she enjoys the life she has, that her treatment will allow her to continue to enjoy that life as she has. And I think that’s wonderful.

The point of the pro-choice argument isn’t dependency. It’s a special kind of dependency that exists almost exclusively in the case of fetuses.

I understand the distinction. I even agree with it. But I don’t understand why you seemingly believe that the distinction you’re making is completely immune from other people reinterpreting it and slippery slopes. Making any kind of dependency a moral factor brings up the possibility of a slippery slope, as far as I can tell.

You know, it’s funny you mention this, because as Michael Berube has pointed out, arguments about the non-personhood of women and black people were rooted very definitely about ideas about the relationship between cognition and moral status. There was, of course, ample evidence that white men were smarter than everyone else. Literacy rates, success in business, art and the sciences… all sorts of indicators bore this out. And when people like Mary Wollstonecraft and later Frederick Douglass argued that this achievement gap was rooted in culture, not biology, they were laughed out of the room by folks armed with the best scientific evidence, which used all sorts of measurements and statistics to prove that women and Africans just weren’t as well-endowed in the brain department as white men were.

And how did that turn out, in the long run? Would you say that the widespread consensus nowadays is that blacks and women have no personhood at all? Obviously not; although racism and misogyny remain widespread problems, in the long run the views of Wollstonecraft and Douglas won the cultural debate. No one except KKK-style extremists nowadays would argue that blacks and women are unable to think and therefore have no human rights, and even racist politicians nontheless favor legal equality between the races and the sexes. [*]

The idea that intelligence and personhood are related did not cause racism or sexism to come about. Rather, racists and sexists used these concepts in a post hoc manner to justify their already existing biases.

(They also used the concept of dependence quite a lot, by the way; slaves were said to depend on their masters for survival and civilizing, and because of that dependence couldn’t be freed. And the pernicious ways dependence was used to keep wives in their place are, I trust, too well-known to require me to go over them.)

Historically, ideas can be used for good or ill. That a warped misrepresentation of an idea has been used for ill, does not prove that the idea is wrong.

([*]I don’t deny that there are still people, like the authors of The Bell Curve, who argue that blacks and/or women are less intelligent than white men, but they don’t argue that therefore rights should be taken away from blacks and women.)

If it were me, and my primary pleasure in life was being held and carried by my parents . . . and I had testicles that I would never use (and could never use ethically). . . I would give them up in a quick damn minute to preserve my happiness.

Just as I would give up my tonsils or my appendix.

There’s nothing special or sacred about my sex organs aside from their function and the use to which they are put.

I completely agree that expanding the “Ashley treatment” to standard of care for all severely brain damaged children is inappropriate. It may be right for some children, but it certainly isn’t for all or most cases and the decision needs to be made on a case by case basis and only after careful consideration and evaluation of the situation. As an option, it is fine. As the option, it is terrible.

Speaking as a woman with really big boobs, I’d really like to talk about whether there’s a way to design harnesses and other assistive technology for women with large breasts, since I may someday need them and would prefer not to have my boobs removed

Me too. But AFAIK, there isn’t any such device and it wouldn’t make the development of such a device any more likely if Ashley kept her breasts. She’d just be among those suffering for its lack.