Cotard’s Syndrome and bioethics
by Xavier Symons | 8 Oct 2016 |
Bioethicists spend a lot of time writing about patients who want to die. But what about those who think they are already dead?
Cotard’s Syndrome is a rare mental condition that has among its symptoms delusions of being dead or not existing, and the sensation that one’s blood and internal organs are putrefying. The condition, which is typically found in people already suffering from mood or psychotic disorders, has received significant attention in the popular media, in addition to being the subject of various interdisciplinary enquiries.
The condition is believed to be associated with cognitive-malfunction in regard to awareness of one’s person and body.
The Syndrome has significance for the field of philosophy, and in particular, understanding the popularity of sceptical lines of thought in the history of ideas. The condition may also may provide significant insights for the development of artificial intelligence technology, as was highlighted in a recent article in Quartz.
At a practical level, the Syndrome presents a salient example of when clinicians would be warranted in overriding a patient wishes for the cessation of treatment. Though in a bioethical climate where mental illness is being removed as an obstacle to euthanasia, it might perhaps be interesting to see how bioethicists treat a case of severe and incurable Cotard Syndrome.
British actress Sally Phillips has made a magnificent documentary about Down Syndrome for the BBC. (You can watch it here on a dodgy YouTube link.) Her own son Ollie has Down Syndrome and Ms Phillips is convinced that Ollie has been a jolly good thing for her and her family. It grieves her to see that most mothers treat a diagnosis of Down Syndrome as a catastrophe. In the UK about 90% of women abort their Down Syndrome child after screening; in Iceland 100% of mothers do. That's 100%.
Ms Phillips tells the camera, as she chokes back tears, “The type of characteristics that these people share are so benign. It’s like when the Western explorers encountered the dodo. This nice, curious bird comes up and gets … wiped out. Through not being suspicious enough. Or violent enough.” This makes her concerned about what the Brits call NIPT (non-invasive pre-natal testing) which is being rolled out across the country.
The documentary is unashamedly emotional. That’s the way it should be. Thank God somebody has the courage to feel emotional about Down Syndrome people. I started to get angry when I read a scathing review in the New Statesman dismissing the doco as “profoundly anti-choice”. But there’s no point in being angry with someone whose attachment to an ideology blinds them to the splendour of being human.
Michael Cook
Editor
BioEdge
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