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Within the rational field is not only the ‘just is’ evidence, but also methods of technical
rationality. Seedhouse explains that for centuries we have wanted to split reason and
passion (2005, p. 3). To achieve this end, theorists have developed methods which
supposedly eliminate emotion from reason, for example, utilitarian methods, logical
analysis and economic calculations (2005, p. 62). However, this split is artificial and
incorrectly perpetuates the myth that decisions can be made with reason alone. By
placing modes of logic which aim to achieve reasoning unsullied by emotion or
subjectivity within the rational field, we can see them in perspective. In the same way
we evaluate the ‘just is’ evidence, so when we use methods of technical rationality, our
values, classifications, environment and instincts have an integral and necessary role.
Decisions cannot be made on the strength of rationalism or evidence alone. We create a
frame drawn from our moral preferences, our emotions, our life experience, our
upbringing, our professional cultures, our environments and so on, through and with
which we make sense of our social worlds and devise strategies to achieve goals.
Applying the theory to best interest determinations
During the 1990’s there were a number of cases in multiple jurisdictions brought before
the courts to establish the legality of withdrawing life sustaining food and hydration
from patient’s with persistent vegetative state. The first, and perhaps most well known
and closely scrutinised, was the case of Anthony Bland.
Anthony Bland who was a victim of the Hillsborough football stadium disaster in
England in 1989. In the tragedy, Anthony Bland’s lungs were crushed and the supply of
oxygen to his brain was interrupted. As a result, he suffered catastrophic and
irreversible damage to the higher centres of his brain resulting in a condition known as
persistent vegetative state (PVS). Someone in PVS breathes unaided and digestion
continues to function. But, although his eyes are open, he cannot see. He cannot hear.
The patient is incapable of voluntary movement and can feel no pain. He cannot taste or
smell. He cannot speak or communicate in anyway. He has no cognitive function and
can thus feel no emotion, whether pleasure or distress. The space which the brain
should occupy is full of watery fluid. With skilled nursing and close medical attention a
young and otherwise healthy PVS patient may live for many years. Anthony Bland
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