Ha! Hank Campbell, the founder of Science 2.0, wants me booted from NRO. Apparently I am “anti science” because I wrote here opposing three-parent IVF based on moral and ethical concerns. From his tirade:

But there is no reason National Review should be letting an anti-science fear monger take up this charge against science yet again. Conservatives claim to be more rational so there is no reason to embrace the irrational Discovery Institute, yet Wesley J. Smith, Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism and quasi-philosophical lawyer is being encouraged to mask his anti-science agenda under the guise of ethics. Subjective, morally relative ethics, the kind of thing National Review founder Bill Buckley criticized in his book “God and Man at Yale”.

OK. Disagree with me and explain why. That’s what public discourse is all about. But that’s apparently beyond Campbell’s capacities. Rather, it’s jeremiad time!

Basically, Smith hates all in vitro fertilization. Always has, always will, it is a tool of Lucifer or whatever the Discovery Institute thinks about all biology.

Lucifer? I don’t recall ever invoking the specter of Lucifer in my work, nor to my knowledge, have my colleagues at the Discovery Institute. 

But Campbell sure is into strawmen. I don’t oppose all IVF. I don’t want it “banned:” I want it regulated. And my reasons are abundant; the prospect of exploiting women for their eggs, the gestational serfdom of commercial surrogacy, and the moral impact of storing hundreds of thousands of “leftover” embryos on society, as well as all the homeless children out there needing adoption. Moreover, none of what I have ever written about IVF involved religion. 

And get this howler:

What’s so unethical about that? Well, nothing, but Smith is not simply against three-person IVF, it is just the latest salvo in his culture war. He is against all IVF and has been since it started, just like Discovery Institute is against all biology, it is the reason they exist.

Notice he didn’t even try to rebut what I claimed was unethical about 3-parent IVF, merely asserted that ”nothing” is. Moreover,when IVF started. I was a young trial lawyer in the San Fernando Valley working 60+ hours a week to build my practice. I didn’t have time for issue advocacy and frankly, didn’t give IVF a second thought.

But let’s look at the evidence–or better stated, the lack thereof–about Campbell’s other claims, shall we? I mean, that is what real scientists do. 

The DI is certainly not “anti biology.” Indeed, some DI fellows are biologists and engage in biological research. For example, my pal, Dr. Richard Sternberg, has–count them–not one, but two Ph.Ds–one in biology (molecular evolution) and the other in theoretical biology. Judging from this mess of a piece, I’ll bet Rich is smarter and better educated in matters biological than Campbell.

Then there is Dr. Michael Denton, another DI senior fellow, who holds an MD and a Ph.D. Denton’s genetic research led to the identification of several new retinal disease genes including the gene used in the first successful gene therapy trial at Moorfields eye hospital in London, 2009. I’ll wager that Denton is also smarter and better educated in matters biological than Campbell.

Notwithstanding my post from just this year (linked above), in which I explicitly say, “I don’t want IVF banned,” Campbell careens back erratically to my supposed repeated call to outlaw IVF:

I did a quick Google search and took one from 2006, and Smith is arguing that as long as IVF of any kind is legal, mean old unethical liberal scientists will start practicing eugenics again like progressives did 90 years ago. You should not get IVF, you should adopt, he has repeatedly cajoled parents from his sanctimonious perch while insisting government should ban a technology that has helped millions.

So, I hit the link provided above. It is a post entitled, “Ellen Goodman’s 1980 IVF Predictions.” It describes an interaction I had with now retired syndicated columnist Ellen Goodman–in the context of the embryonic stem cell research debate, not IVF. 

Here’s the background: A reader sent me an article Goodman wrote from 1980 supporting IVF, in which she assured readers that we would never treat embryos as discardable, in her words, ”as if they were no more meaningful than a dish of caviar.” And I suggested that those who smoothly promise there will be limits on controversial new technological research always say we will draw lines, but they usually don’t get drawn. From my post’s conclusion:

After I ran across this column, Goodman wrote a column in favor of ESCR. I e-mailed her pointing out that she was supporting a policy that treats embryos as if they were no more meaningful than a dish of caviar, and asked her when she would finally say no.

She wrote back, “My lines have changed.” Indeed. And thus the blithe assurances that we will know where and when to stop are just platitudes. The Establishment has no intention of ever, finally saying no.

In other words, not only did the piece not call for IVF’s legal prohibition, it wasn’t even about IVF!

From there he gets into fracking for some reason and more irrational screeching about the Discovery Institute. Better reboot Science 2.0 into a 3.0 version.

Oh well: If you can’t rebut the message, throw a tantrum and try to censor the messenger. I guess I am being more effective than I thought. 

Update: Here’s Campbell’s rejoinder. Note again, how the man is fact deficient:

Attorney Smith has responded to me and he makes his case the way you expect an attorney to make his case – redefining what “is” is and dodging the question and making tangential claims like that if Discovery Institute hasany biologists, they can’t be anti-science.  But I should clarify something he gets incorrect in his title: I want the Discovery Institute and its nonsense booted from a conservative magazine I respect – if he goes too, that is a bonus. But it will never happen. Smith is only intolerant about science – if he were on a racist rant, they would notice, but demonizing scientists and IVF parents and children is still okay.

So now I have “demonized” scientists, IVF parents, and children? Campbell forgot to mention that I also hate puppies and kittens! Forget Science 3.0, better make it 5.0. Good grief.

A UK Court of Appeals has refused to impose legalized euthanasia on the country. From the AP story:

British appeals court upheld a law against euthanasia in rejecting appeals from two severely disabled men who argued that doctors should be allowed to legally kill them.

The two men – one of whom died of pneumonia last year – claimed their right to “private and family life” as guaranteed by the European Convention on Human Rights was being violated since they were not allowed to choose how and when they wanted to die.

The plaintiff is upset by the ruling that he can’t be killed:

“I am absolutely gutted,” said Paul Lamb, one of the men involved, who was severely paralyzed after a car accident. “I was hoping for a humane and dignified end,” Lamb said in a statement. “This judgment does not give me that.”

I am very sorry Lamb believes his life isn’t worth living. And I hope he is able to find joy again.

But as the court ruled, this isn’t just about him or any individual. Euthanasia (and its advocacy) changes culture. As I have repeatedly demonstrated over twenty years, it devalues human life. Once it is widely accepted, it never stops expanding.

At the very least, if it is going to be allowed, a court should not be the instrument of government so doing.

P.S.: Lamb and Nicklinson are not the first attempt to use the “right to private and family life” to promote euthanasia. It could happen. The right has been interpreted very broadly, for example forbidding a prison sentence to a convicted burglar because of the impact it would have on his family. In other words, the clause could become an excuse in Europe for anything goes.

Evolutionists sure are inventive, always trying to explain everything as caused by natural selection. Now, an anthropological study claims that monogamy “evolved” to prevent infanticide. From the Guardian story.

Scientists in Britain have taken the puzzle of monogamy and boiled it down to one big question: how did it come about in the first place? A new study claims finally to have an answer. 

And what, pray tell, is that?

Next, they [the study's authors] used simulated evolution from 75m years ago to modern day. As the simulation ran, it showed how monogamy rose and fell for different species. Having run the program millions of times, they found that the evolution of monogamy in primates was preceded by one thing only: infanticide by males. “You do not get monogamy unless you already have infanticide, and you do not get a switch to paternal care if you don’t already have monogamy,” said Opie, in research published in the journal Proceedings of the National Academy of Sciences…

Opie says the findings are linked to increases in brain size. In primates, brain size expanded as social groups grew larger, which meant that mothers were infertile for longer and more males were close by. For males, infanticide was a strategy to make females fertile again.

Just what we need: Another rationale for Peter Singer to promote infanticide.

But let’s get real.  Monogamy did not “evolve.” It exists because of human exceptionalism.  

Here’s what I mean: Geese don’t “choose” to mate for life and felines don’t “cat around” because they are immoral. They have no choice in the matter. Their mating methods are instinctual.

In contrast, human societies have differed widely over views on sex and commitment to monogamy, with more ancient societies and some current cultures permitting polyamory. That’s because human cultural norms are not biologically determined, as in animal behavior.

Rather, humans have free will. We create, socialize, and enforce moral and ethical codes. In this sense, we are not slaves to impersonal evolutionary forces in our romantic lives. Indeed, the breathtaking refashioning of Western sexual morality just during my lifetime is a vivid example. 

Still, to be fair, there is a place for monogamy in evolution: If I wasn’t monogamous, my wife would kill me. That’s known as the evolutionary drive to survive!

The world’s professional medical associations overwhelmingly oppose euthanasia and assisted suicide. The World Medical Association reiterated its strong such commitment to the ethical practice medicine this year. From the WMO Resolution on Euthanasia:

Euthanasia, that is the act of deliberately ending the life of a patient, even at the patient’s own request or at the request of close relatives, is unethical. This does not prevent the physician from respecting the desire of a patient to allow the natural process of death to follow its course in the terminal phase of sickness.

The WMO similarly opposes assisted suicide.

Physicians-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically. However the right to decline medical treatment is a basic right of the patient and the physician does not act unethically even if respecting such a wish results in the death of the patient.

The next time suicide pushing organizations such as Compassion and Choices pretend that the medical world is in their camp because some small organization supports legalization, show them the WMA statement. And the AMA’s:

Euthanasia is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.

And on and on it goes.

The UK rubber stamp Embryo Authority–which for example allowed human cloning experiments with animal eggs–is on the verge of permitting the manufacture of three-parent embryos. The process is done by taking the nucleus out of the egg of one woman, putting it into the enucleated egg of another woman, and then fertilizing with sperm. Voila, three biological parents.

The purported reason for this approach is to enable women with mitochondrial disease–who would be the nuclear donors–to bear biologically related children. But you know it won’t stop there. At some point, the process will be used to help, say, polyamorous threesomes or lesbian couples have children biologically related to all partners-that is to facilitate lifestyle desires, not prevent disease.

An article in Real Clear Science by Dr. Alex B. Berezow argues on behalf of the process. Berezow brings up three of the main objections to this procedure and dismisses them. I will respond to each of his claims. From, “We Should Allow Three Parent Embryos:”

Critics say that the safety of the procedure is unknown. That is indeed true. Further study and clinical trials should be conducted. However, a mother with a mitochondrial disease who wishes to have her own children may very well choose to accept the risk. Remember, she has nearly a 100% chance of passing on a disease to her child; this technique would greatly reduce that risk.

Excuse me?  So, even though we don’t know about the safety, we should go where parents have never gone before? No.

Remember, these embryos would literally be made from broken eggs. As we have seen in cloning, that can lead to terrible developmental problems during gestation, and born cloned mammals often have significant health concerns. IVF babies also have worse health outcomes than naturally conceived children. 

Allowing the manufacture of three-parent children when safety concerns remain insufficiently explored would be blatant human experimentation. And isn’t this the bane of our times! Just because a woman “wants” something, that doesn’t mean we should turn ethics on its head so she can have it.

Then Berezow engages in what I call ”double-down ethics:”

Other critics worry about the ethics of destroying embryos. However, it should be kept in mind that standard IVF also destroys embryos. Extra embryos are always made, and the “leftover” embryos are often discarded or frozen indefinitely. It is estimated that some 600,000 embryos sit unwanted in freezers in the United States alone.

In other words, if we have already done wrong Action A–and I do think it was wrong to create excess embryos in IVF destined for destruction or experimentation–then we can also do wrong Action B. That’s just blatant bootstrapping, a way of never saying no.

Back to Berezow:

Finally, some critics worry about genetic engineering and the supposed slippery slope that will lead to creating designer babies. Besides the unconvincing nature of “slippery slope” arguments in general, this criticism is inconsiderate of those people who wish to have their own biological children but are incapable of doing so. For the foreseeable future, genetic engineering will be about curing illnesses, not creating designer babies. We can deal with that issue if and when it arises.

Hardly slippery slope alarmism. More like facts on the ground. For example, in a different context, California already passed legislation allowing a child to have three parents, vetoed by Governor Jerry Brown. I don’t see why that type of proposal would not fit this bill.

Besides, if we have learned anything, biotech very quickly becomes a tool to facilitate lifestyle desires, not just treat medical dysfunction. For example, IVF moved very quickly from allowing infertile married couples to have a baby to a consumerist service used by fertile women to have babies via surrogacy if they don’t want to gestate.

IVF has also become a means of eugenics, for example, couples paying beautiful and brilliant college women for their eggs and embryo selection. I mean is there any doubt that once this is done for women with disease, it will very quickly move on to lifestyle facilitation? Indeed, won’t that eventually become the primary use?

I understand that it is painful not to be able to have a healthy child. But it is even more painful to be a child without a home. Adoption is the answer to such heartbreak–not pushing biotech into the ethical badlands. 

What we do to animals is not equivalent to the same actions being done to people! But animal rights types keep making that false comparison. 

The latest example comes (yet again) from the hand-wringing, self-described hypocrite, New York Times columnist Nicolas Kristof. In today’s episode, Kristof compares our treatment of animals to mass human slaughter in Indonesia and the holding of slaves. From, “Can We See Our Hypocrisy to Animals?”

A NEW documentary explores the human capacity for mass murder. It addresses the Indonesian fratricide of the mid-1960s, in which a million people may have been killed…

The puzzle of such episodes is that otherwise good and decent people were so oblivious to the abhorrence of what was going on. So I was struck that the same section of this newspaper that carried a thoughtful review by A. O. Scott of “Act of Killing” also reviewed another documentary. That one was Blackfish,” and it looks at the SeaWorld marine park and its (mis)treatment of orcas.

Orcas, also known as killer whales, are sophisticated mammals whose brains may be more complex than our own. They belong in the open sea and seem to suffer severe physical and mental distress when forced to live in tanks. Maybe that is why they sometimes go berserk and attack trainers. You or I might also go nuts if we were forced to live our lives locked up in a closet to entertain orcas.

The evil of the mass slaughter of millions in Indonesians is nothing akin to the keeping of orcas in tanks–even if it turns out that it is a form of animal abuse. Nor is it “slavery”–a truly evil abuse of human beings. But don’t tell that to Kristof:

SeaWorld denies the claims, which isn’t surprising since it earns millions from orcas. Two centuries ago, slave owners argued that slaves enjoyed slavery.

Kristof goes on to quote Peter Singer about the treatment of animals. How utterly unoriginal of him–and telling about Kristof’s true moral insensitivity. Singer supports abortion through the ninth month, and into infanticide–as ethical. Why? These humans are supposedly not persons.

He has said there is nothing wrong with bestiality, just two animals rubbing intimate body parts.

And he doesn’t believe in animal “rights,” because he doesn’t believe in rights. What matters is utilitarian outcomes, in which animals are to be given “equal consideration.”

Thus, Singer has both supported using monkeys in medical research for Parkinson’s and said that severely cognitively disabled people should have been used in research into the hepatitis vaccine instead of chimps. You see, monkeys have fewer capacities than Parkinson’s patients,so they can be used instrumentally on behalf of their “betters.” Ditto, people with severe cognitive impairments. 

Back to Kristof: Toward the end of the column, he admits to being a hypocrite:

Look, I confess to hypocrisy. I eat meat, albeit with misgivings, and I have no compunctions about using mousetraps. So what? We have the same inconsistencies, controversies and hypocrisies in dealing with human rights. We may disagree about waterboarding terror suspects, but almost everyone shares a revulsion for genocide, the use of poison gas or the torture of children.

That’s because water boarding and genocide aren’t in the same league either!

How typical of the liberal sensibility. I may do things that later generations will think are bad, but at least I wring my hands about it before I do.  Good grief.

I have written of the very real prospect that the Chinese government has murdered Falun Gong for their organs.

I have also criticized the “artist,” Gunther von Hagens–who plastinizes human cadavers and puts them on display. Not only is this (in my view) appalling decadence, but to prove the point, von Hagens has poised some of his bodies as if they were having sexual intercourse and engaging in other sexual acts. Yes, cadaver porn.

I never really put the two stories together. But now, according to a very disturbing article by author Ethan Gutmann published in the Weekly Standard, some of von Hagen’s bodies may be murdered Falun Gong, perhaps even those killed for their organs. I can’t do justice to the full and carefully researched article in a blog, but here’s a very rough nutshell gist. From, “Bodies at an Exhibition:”

[E]lderly Falun Gong women were patiently informing me that the bodies in von Hagens’s and Sui’s exhibitions are those of Falun Gong practitioners, hideously displayed for people’s amusement. I ignored them. Too melodramatic, I thought. But in Vienna I’m noticing that the liver and kidneys appear to be missing from some of the plastinated bodies on display. Is it conceivable that there were dual-use bodies, the organs harvested before plastination? And could those kidneys and livers still be alive inside aged Chinese and Japanese, Europeans and Americans? 

There is little doubt that the Falun Gong were harvested. But were they plastinized? A very upset at the prospect von Hagens says he cremated his Chinese bodies. But Gutmann thinks the matter still worth pursuing to find the truth about what has been happening in China:

According to medical specialists I’ve consulted, mitochondrial DNA can be extracted from fixed anatomical specimens and used to prove relationships out to third- degree relatives. In other words, one could give the organ-ization Doctors Against Forced Organ Harvesting or some other responsible entity DNA samples from both shows, test the samples from von Hagens’s figures to see if all the bodies are Caucasian, then attempt to match the DNA from any that turn out to be Chinese, as well as DNA from Sui’s displays, against DNA from Chinese families who lost a loved one through an “enforced disappearance”—a PSB arrest for religious or political beliefs—during the years of high plastination…

But for now, DNA testing would require cooperation. Perhaps von Hagens would agree, happy to clear his name of any lingering doubts. If he realized that DNA samples could be taken from his figures without damaging them—any more than a van Gogh is damaged when a tiny sample of paint is taken to prove its authenticity—he might cooperate. And assuming he were exonerated, Dr. Death could rightfully jeer my dark fantasies at the museum, and I would very gladly laugh along with him.

The prospect for mass murder should never be shrugged off. I hope von Hagens leaps at the chance to learn the truth and clear doubts about his ethics.

Until then, It seems to me that anyone who attends these exhibits could not only be engaging in voyeurism, but also unwittingly paying to view the evidence of terrible atrocities as “art. 

Eugenics is evil in that it presumes that some human beings are better than others, and moreover, that we have a duty to control procreation to improve the human herd. In the USA, the first iteration of this great wrong–a political progressive project, by the way–led to hundreds of thousands of involuntary sterilizations. Not coincidentally, North Carolina will be compensating living victims.

Eugenics came into disfavor after World War II, and for obvious reasons. But like a zombie, it is back in a new high tech form. Today’s eugenicists don’t talk about eradicating the human “weeds,” like Margaret Sanger did. Rather, they dream of using biotech to genetically enhance children. It’s all an Übermenschen project–and very dangerous to the moral foundation of society based on universal human equality.

Now, two Oxford (of course!) bioethicists argue in favor of enhancing progeny to benefit society in the Journal of Medicine and Philosophy, in addition to enhancing for the supposed wellbeing of the child. (I always say that if you want to know what could go wrong next in society, read the professional journals.) From, “Procreative Altruism: Beyond Individualism in Reproductive Selection,” by Thomas Douglas and Katrien Devolder:

Some may object to our two-principle model on the ground that it—or at least one element in it (Procreative Altruism)—implies that parents should use their future child as a means to promoting the good of others. The two-principle model could instruct parents to select children with traits that restrict the well-being of the future child, because doing so will promote the well-being of others. This may seem to be an objectionable form of exploitation or instrumentalization.

Yes. But not to worry.

Importantly, however, the two-principle model does not imply that parents should treat their future child merely as a means to promoting the good of others. Indeed, it requires that parents give some weight to the well-being of the future child. It does stipulate that other ends also play a role in reproductive decision making. But this seems appropriate. It is not clear why the well-being of the future child should be allowed to monopolize reproductive decision making. 

What’s love got to do with it? The word is not used one time in the entire article! Telling, no?

The authors worry about a “slippery slope to immoral eugenics.” This is immoral eugenics. Its purposes are the same, its tools just more sophisticated.

And if you can select children “in” for altruistic reasons, it wouldn’t be long before you could be forced to select them “out,”–as currently happens in China’s one-child policy, for example.

The old eugenics was promoted from the top, down–that is from the intelligentsia and academic elite. Ditto the new eugenics. But wrong is wrong, no matter the century.

HT: Bioedge

I have often argued against Futile Care Theory that allows doctors and/or hospital bioethics committees to force desperately ill patients off wanted life-sustaining treatment. I find the whole approach very dangerous because it allows doctors to impose their values on patients and, moreover, it shifts the fundamental purpose of medicine away from sustaining life–when that is what the patient wants–to only doing so if there can be a “meaningful recovery,” or when the costs aren’t too high.

And sometimes, doctors are wrong–as some of my blog posts and columns illustrate.

Moreover, once medical futility becomes part of the bone marrow of medicine–ad hoc health care rationing–the principle will have been established, and as history demonstrates abundantly, it will grow from there. Indeed, when I was researching Culture of Death, I asked a futilitarian what would be next after futile care policies were instituted. He told me, “Marginally beneficial care.” I asked for an example. “An eighty year old woman receiving a mammogram.” See what I mean?

But I also would not want “everything possible done” if I were in that situation. Which is why I have some sympathy for the sentiments expressed by Dr. Ken Murray.

First, he describes a doctor friend, diagnosed with terminal cancer, who refused all treatment. He then writes that doctors tend to refuse extended care when their time comes. From, “How Doctors Die:”

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

That’s their choice. And I get why:

Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. 

Well, that provocative language overstates the amount of patient suffering to some degree. And often, it saves lives. That’s part of medicine. Moreover, when the hard work is being done, doctors often don’t know which way the outcome will go.

But I get it. I don’t plan to have everything possible done to keep me alive, and have an advance directive so stating. But I also want that choice to remain mine or that of my wife. The real answer is patient education and better doctor/family communication, not coerced removals from care. 

Futile care theory is bad ethics and worse public policy. Indeed, I can’t think of a better way to destroy the public’s health in medicine than to allow strangers to decide a patient’s medical fate when requested efficacious treatment isn’t being removed because it doesn’t work, but rather, because it does. 

The culture of death is like a cancer sapping the moral health of western society. And, like a cancer, it never stops spreading.

Here’s how:  I wrote earlier today about Oxford bioethicist Julian Savulescu supporting palliated self starvation as a manner of dying. To get to that conclusion, he uses the right of people to refuse tube feeding–legal because it is deemed a medical treatment–as the multiplyer to grow the death agenda.  From, “A Simple Solution to the Puzzles of End of Life? Voluntary Palliated Starvation:”

The process of withholding or removing artificial feeding from patients as young as newborns to elderly people has been commonplace in medicine in many parts of the world.

That’s what happened to Terri Schiavo, and to Tony Bland in a famous UK case. 

In the UK, a paralyzed man capable of eating named Tony Nicklinson sued for the right to commit assisted suicide. After he lost the case, he stopped eating and died of pneumonia. Savulescu uses Nicklinson’s death as a point of reference to spread the death agenda:

Now if doctors, courts and family members can make a decision that a person’s life is no longer worth living and feeding should be stopped, why can’t the person, like Tony Nicklinson, make that decision, and it be acted upon? Surely the person who has the most right to decide whether life is tolerable is the person who must live that life.

So it seems to me that ethically Tony Nicklinson had the right to die by starvation. And if other patients received palliative care in the form of analgesia and sedation as a result of decisions made by courts, doctors and their families, then Tony Nicklinson had an equal right to such palliative care as he died.

Did you notice the intellectual prestidigitation? Savulescu misdirects us with the right to refuse medical treatment,which, abracadabra, suddenly becomes a right to be made dead by self-starvation–even though when the tube feeding refusals were being advocated, we were told that wasn’t the point.

That’s not medical care, it is suicide facilitation.

And then comes the punch line:

But what, you might ask, is the difference between Tony Nicklinson dying by starvation, perhaps unconscious, over a period of weeks and him being given a lethal injection that would kill him in seconds, painlessly? In both cases, he will certainly die. Surely it is more humane, in these circumstances, to give him a lethal injection than to allow him to starve himself to death?

This is the argument of course from suicide, to assisted suicide, to euthanasia. That is, it seems that if one has a right not to eat, then one has a right to euthanasia,at least as far as morality is concerned.

The right to refuse treatment = a right to starve oneself to death with a doctor’s help = a right to be lethally injected.

And that, my friends, is a classic example of how the culture of death metastasizes. By destroying principle, deconstructing definitions, and blurring ethical boundaries. 

Is there no end to the fixation on getting people dead? Now, in the Journal of Medical Ethics, the publication that brought us “after-birth abortion,” comes Julian Savulesu–aka Peter Singer, squared–arguing that doctors should help suicidal patients starve themselves to death. From, “A Simple Solution to the Puzzles of End of Life–Voluntary Palliated Starvation:”

Should people be assisted to die or be given euthanasia when they are suffering from terminal medical conditions? Should they be assisted to die when they are suffering but do not have a ‘diagnosable medical illness?’ What about assisted dying for psychiatric conditions? And is there a difference morally between assisted suicide, voluntary active euthanasia and voluntary passive euthanasia?…

I will argue that there is, within current medical ethics and human rights, a method of assisted suicide which could fall within the limits of the law.

By which he means voluntary self starvation–also pushed in the euthanasia movement as VSED (voluntary stop eating and drinking).

Understand, Savulescu is not talking about those situations in which an elderly or dying person’s body starts to shut down and they reject food and water as a natural part of the dying process. In such cases, it would be wrong to force nutrition on the patient because it will do no physiological good. Indeed, it would cause harm and is not medically indicated.

What about people who refuse food and water as a way of killing themselves? The law generally states that as a general principle (outside of prison), doctors cannot force feed those refusing food because that would be compelling them to receive medical treatment they do not want.  

Whatever the merits and demerits of that view, not allowing forced feeding doesn’t mean that doctors should help people kill themselves via starvation/dehydration by providing medical treatment making the process less onerous, thereby making it less likely that the patient will his or her mind. That’s facilitation any way you look at it.

Claiming that assisting people starve themselves to death isn’t assisting suicide is pure sophistry. Or to put it another way: What do they call assisted suicide in slow motion? Answer: Assisted suicide. 

Politico is reporting that the proposal to explicitly pay doctors for end-of-life care discussions with patients has again been put in the Congressional hopper. Some called this a “death panel” aspect of Obamacare, as a consequence of which, it never made it into law.

As I noted back then, that wasn’t true. The potential death panels are the yet to be instituted cost/benefit boards of “experts” that could act like the NHS’s rationing board. Indeed, powerful voices have called for such a panel as part of the cost containment aspects of Obamacare.

Of course, I believe doctors should discuss these issues with patients–and I am a bit stunned that there should be extra pay for what should be a normal part of the physician/patient relationship. Be that as it may, despite the clear impetus for end of life discussions to save money on the assumption that people will refuse care, Politico reports accurately that such patient decisions can go either way. But that and two bucks will buy you a cup of Starbuck’s coffee. From the story:

But he’s [Republican co-author Phil Roe of TN) been reaching out to colleagues, trying to explain that this end-of-life medical consult legislation isn’t Obamacare. It’s about getting people the care they want and helping document their wishes, which may change over time. Both lawmakers noted that an advanced directive doesn’t mean a do-not-resuscitate order. People can and do opt for very aggressive do-everything care.

Talk about naive! You see, the prevailing opinion among the medical intelligentsia views patient “choice” as a one-way street. Choose to die, and the decision is sacrosanct. Ask to live and–well, it depends on what the “experts” think.

For example, Futile Care Theory seeks to grant hospital bioethics committees and physicians the right to veto such patient decisions. So, in a different way, would health care rationing–surely on deck if Obamacare sinks its teeth into the country’s bone marrow. Laws have already been passed allowing doctors to fill out POLST orders that impose a DNR order on a patient’s chart without consent. Heads we win, tails you lose.

It is also worth noting that the assisted suicide advocacy group Compassion and Choices bragged that it was a key player in creating the original proposal. That doesn’t make it bad, per se. But it sure does make it suspect–meaning that the details of the proposal need going over with a very fine toothed comb.

This is an important issue that has generally been ignored in the popular media about assisted suicide and the practice of doctors refusing wanted life-sustaining treatment. Physicians who legally cooperate in patient suicides or who refuse wanted care have almost absolute protection from lawsuits and criminal culpability, while their colleagues who provide medical end-of-life treatment face can be held liable if they violate the usual legal “standard of care.”

Thus, S.B. 303 in Texas this year–which I helped defeat–would have granted virtually absolute immunity for doctors who imposed a “do not attempt resuscitation” (DNAR) order on the patient’s chart without consent. Laws allowing doctors to assisted suicide in Oregon, Washington, and Vermont provide almost absolute protection for doctors prescribing lethal overdoses to dying patients.  Ditto most proposals to permit the imposition of futile care theory, in which doctors refuse wanted and physiologically efficacious life-sustaining treatment.

The futilitarian and law professor, Thaddeus Mason Pope, wants more immunity for doctors on the side of death. Why? Apparently because centralized bureaucratic control over healthcare–increasingly the bane of American medicine–necessitates that course.

In support of this supposition, Pope quotes a European Court of Human Rights case involving midwives as his illustration. From Pope’s post, “POLST: Need for Statutory Immunity” (my emphasis:)

[T]he background assumption of classical liberalism does not necessarily work in the contemporary welfare State, especially in the medical environment. In this welfare system practically everything is regulated; regulation is the default, and only what is regulated is considered safe and acceptable. Suddenly, in the absence of positive regulation, what was a matter of uncontested private choice becomes unusual and uncertain. In a very densely regulated world some disadvantages emerge for freedoms without regulatory endorsement. . . .

Where regulation is the default, as in the medical context, lack of enabling regulation may be detrimental to the exercise of the right, and traditional non-interference will not be sufficient. This may be one of the many unpleasant consequences of living in an overregulated world. It is here that an affirmation of a liberty in positive law is warranted. . . . [A] freedom may necessitate a positive regulatory environment which will produce the legal certainty providing the right to choose with effectiveness. Without such legal certainty there is fear and secrecy . . . .

There is no reason why a doctor that facilitates suicide or imposes his or her values about dying on patients deserve greater legal protection than doctors who provide life-sustaining or palliative medical treatment. Indeed, granting legal immunity to those engaging in the former could promote death-over-caring decision making.

On the broader note discussed by the European Court: Think Obamacare and the ubiquitous regulation it will impose if permitted to continue on its current course.

It is also germane to the issue of medical conscience: If people have a “right” to abortion or assisted suicide, interference with that “positive” right by refusing to participate or refer based on the professional’s conscience simply will not be permitted. 

Pro choicers who advocate for the right to kill viable fetuses based on disability, often claim it is only done in cases of severe abnormality. Baloney. Down syndrome isn’t a “severe” abnormality. Nor is dwarfism, conditions that often lead to late term abortions. Alas, 90% of our brothers and sisters with such conditions aren’t allowed to ever see the light of day.

 But cleft palate?  Apparently so. From the Telegraph story:

Abortion laws should be urgently reviewed amid evidence that pregnancies are being terminated up until full term simply because of cosmetic flaws, according to a committee of MPs and peers. A parliamentary commission has concluded that the rules allowing foetuses to be aborted as late as 40 weeks on grounds of disability are outdated and could amount to “discrimination”.

Parents are being “steered” towards aborting babies with disabilities without proper information on the alternatives available to them, it adds. In extreme cases it has led to foetuses being aborted purely because screening has detected a cleft lip or club foot, conditions which can be dealt with after birth, according to the committee.

“Could” amount to discrimination? Good grief! It’s outright bigotry.

There is now talk of outlawing abortion based on disability in the UK. I’m all for it: But see what happened in Texas with a bill to limit abortion after 20 weeks. Pretty soon, BBC pro choice TV hosts will be wearing tampons for earrings in protest against any limitations on the abortion license.

Things have come to a pretty pass: Our eugenic quest for perfection–and a growing sense of entitlement to have the baby we want–are contributing substantially to collapsing the moral foundation of Western society.

India allows its most destitute women to be exploited as if they were brood mares. A surrogacy industry recruits illiterate women, and pays them a pittance to gestate babies on behalf of well off (mostly) Westerners who can’t (or don’t want to) bear their own children.

A new Indian study on the industry illustrates some of the serious problems associated with this form of biological colonialism–including forced abortion, sex selection, and baby abandonment. From, “Surrogate Motherhood: Ethical or Commercial“(My emphasis):

Surrogacy degrades a pregnancy to a service and a baby to a product. Experience shows that like any other commercial dealing the customer lays down his/her conditions before purchasing the goods.The surrogate may be forced to terminate the pregnancy if so desired by the contracting couple and she will not be able to terminate it if it is against the desire of the couple. She has difficulty in keeping her own baby. There have been instances where the contracting individual has specified the sex of the baby as well, refused to take the baby if it is not normal, and filed a suite against the surrogate saying she had broken the contract.

Where is the morality in that? What I see are foreign people wanting what they want and they don’t care who gets hurt so long as they get it. More from the report:

Most of the surrogate mothers we interviewed were not willing to answer questions on how they felt after relinquishing the child; however field level observation notes that the surrogate mothers would feel attached to the babies even though they were not biologically there own children.

Of course they get attached! That’s part of the biological process of gestation. Then, they have to pretend they did not, since it won’t matter anyway. That’s part of the cruelty.

For those who claim it is just the marketplace in action, and a deal is a deal, check this out:

As it was discussed earlier, in 50% to 60% of cases the surrogate mothers and their husbands were illiterate or with primary education which leaves no chances for them to understand the medical jargons or complicated procedures that might affect the health and well being of the surrogate mother. The clinics often avoid signing such written agreements/contracts, which can hold them accountable in future. Moreover, the clinics even did not leave a copy of the agreement with the surrogate mother, who is a signing party in the agreement, to have any evidence either of her pregnancy or the surrogacy arrangement.

The women are depersonalized:

The surrogacy arrangement contract rarely addresses issues related primarily to the well being and health of the surrogate mother. It is only the health issues related to the fetus when the health of the surrogate mother becomes a prerogative.

Gestational serfdom. That’s what it is.

In our age, the living bodies and functions of human beings are becoming commoditized for the use and benefit of the rich and connected.  Indian surrogacy serfs are just one example. 

Sigh. Human exceptionalism isn’t about biological distinctions between us and other species. It is about differences that are morally relevant, such as moral agency, creativity, rationality, the quest for meaning, etc. The elephant’s trunk may be exceptional, but it doesn’t add or subtract to its moral value. Our unique capacities–whether in kind or in quality, since the quality is so vast it is akin to kind–matter.

HE is under constant attack these days. Latest example: A book review in the Wall Street Journal of a new tome (How We Do It) that traces the apparent similarities between human and primate reproduction, by ecology professor Marlene Zuk. (This post is about the review, not the book.) From, “Human Exceptionalism:”

Rather than develop stories about how human sexual behaviors might have been adaptive in the past, Mr. Martin persuasively argues that understanding the diversity of reproduction across mammals is essential to understanding it in humans. He repeatedly whisks away our smug sense of human exceptionalism and at the same time links many seemingly unrelated aspects of our biology to reproduction. 

How is HE “smug?”

Even if human females went into heat (as it is popularly called) like animals, that wouldn’t take away a jot or tittle of our exceptionalism. Only we have duties, for example. Only we can be held morally (and often legally, a unique human concept) to account for abuse.

Indeed, there is much about our behavior that would seem to surpass evolutionary whipsawing. From a piece I wrote for First Things:

Recognizing our special status is essential, in my view, to the creation of a better world. Take, for example, our moral impulse to prevent cruelty to animals. This is certainly not genetically determined. Indeed, it seems to me that preventing cruelty to animals is distinctly un-evolutionary—in the purely materialistic sense of that term. Why should we even concern ourselves with what happens to other species so long as it does not harm us? Elephants care very much whether a lion tries to kill one of the herd’s calves but are quite indifferent when the same lion rends the zebra. It takes a special and exceptional species to care enough about “the other” that we will sometimes even protect them from human harm when it makes our own lives more difficult. (For example, California sea lions are protected in law despite the fact that they compete fiercely against us in exploiting the salmon fishery.)

Zuk takes another shot at the uniqueness of man:

Why, for example, do women have a single-chambered uterus, compared with the two chambers more commonly found in other mammals (even those that, like humans, typically produce only one offspring at a time)? And why does the fertilized egg implant deep in the uterine wall rather than simply adhering to the surface? Scientists still don’t know the answers, perhaps because until someone like Mr. Martin comes along to contrast humans with our primate and other mammalian relatives, they might not have even seen a problem to be solved. It’s in viewing ourselves along the continuum of primate evolution that our own uniqueness—and lack of it—becomes apparent.

When a chimp can write a book review, and be held morally to account for tearing the face off a woman, come talk to me about how we are just another animal in the forest.

The smell of a deep misanthropy is in the air. Many evolutionists (among others) want to tear us off the pinnacle–even though doing so would have catastrophic consequences for human freedom and thriving (as I have written elsewhere).

The progress on induced pluripotent stem cells continues. Until now, the only way to turn a skin cell into a stem cell was to use genes to “reprogram” the cell. Now, it has been done with chemicals in mouse studies. From the Nature story:

Scientists have demonstrated a new way to reprogram adult tissue to become cells as versatile as embryonic stem cells — without the addition of extra genes that could increase the risk of dangerous mutations or cancer. Researchers have been striving to achieve this since 2006, when the creation of so-called induced pluripotent (iPS) cells was first reported. Previously, they had managed to reduce the number of genes needed using small-molecule chemical compounds, but those attempts always required at least one gene, Oct4.

Now, writing in Science, researchers report success in creating iPS cells using chemical compounds only — what they call CiPS cells…

If it the technique is found to be safe and effective in humans, it could be useful for the clinic. It does not risk causing mutations, and the compounds themselves seem to be safe — four of them are in fact already in clinical use. The small molecules can easily pass through cell membranes, so they can be washed away after they have initiated the reprogramming.

No embryos. No cloning. Already good for use in drug and disease testing. 

The step I am hoping for–already done experimentally–is direct reprogramming from skin cell to, say, heart cell.  Wouldn’t it be great to be able to say, “Stem cells? We don’t need no stinkin’ stem cells!”?

Scientists have learned how to “turn off” the extra gene that leads to Down syndrome. From the Guardian story:

Scientists have corrected the genetic fault that causes Down’s syndrome– albeit in isolated cells – raising the prospect of a radical therapy for the disorder.

In an elegant series of experiments, US researchers took cells from people with DS and silenced the extra chromosome that causes the condition. A treatment based on the work remains a distant hope, but scientists in the field said the feat was the first major step towards a “chromosome therapy” for Down’s syndrome.

Opponents of human exceptionalism and its corollary–the equal moral worth of all people–often challenge me about Down. I strongly oppose eugenic abortion that is currently taking the lives of 90% of our brothers and sisters with Down. So, they say: “Well, would you treat it if a way was found? And if so, aren’t you saying it is better for the person not to have Down than have it? And if that is true, don’t people with Down have lesser value?”

Yes. Yes. And, emphatically no.

Down is a medical condition, a disability caused by a wrongly working gene. If the gene could be fixed, it would be no different than repairing a severed spinal cord restoring ambulation, or restoring intellectual ability to someone with a brain injury. It would be no different than learning to turn off the gene that causes Huntington’s disease, thereby preventing the disability and death that condition causes.

But by all means, people with those conditions don’t have lesser value. Indeed, they may have a greater claim on our love, time, resources, and treasure to make their lives easier. The problem isn’t them, but a society that increasingly closes its heart to those who need special (and expensive) care. 

I have discussed the very disturbing and pain-causing mental illness of body integrity identity disorder here several times before. We have had spirited discussions about whether it would be appropriate to cut off healthy limbs because the ill person is obsessed with becoming an amputee. I have opined that it would be wrong to cut off health limbs, and warned that if it’s okay to cut off legs and arms as a “treatment” for a mental illness, why not render someone a paraplegic or quadriplegic if that is what they obsesses over. 

Some told me it would never come to that. Now, just that situation has emerged. From the Daily Mail story: 

A Cambridge University educated research scientist is so desperate to live the life of a wheelchair-bound person she is prepared to pay a doctor help her become disabled. Since childhood, Chloe Jennings-White has made several attempts at injuring herself so she can finally climb into her own wheelchair. In 2010 she even found a doctor overseas willing to help her become disabled by cutting her sciatic and femoral nerves, but she could not afford the £16,000 costs…

The Cambridge graduate believes both of her legs do not belong to her and dreams of being paralysed from the waist down.’Something in my brain tells me my legs are not supposed to work,’ she said. ‘Having any sensation in them just feels wrong.’

It’s just “choice,” right? No!

Germany is creating a memorial to the 200,000 + victims of the euthanasia Holocaust, in which doctors enthusiastically killed disabled babies and adults between the years 1939-45. From the BBC story:

Work has begun on a memorial in Germany for the 300,000 people murdered by the Nazis for having mental and physical disabilities or chronic illnesses. A 30m (100ft) long glass wall is being built in the centre of Berlin, near the former site of the Nazi-era office that organised the “euthanasia” programme. “>In 1939, Adolf Hitler told officials that people “considered incurable” should be “granted a mercy killing”.

It is a misnomer to say that these helpless people were “Nazi” victims. The doctors who killed disabled people were not necessarily Nazis and certainly weren’t forced by the government into murder. Rather, they were eugenics enthusiasts who truly believed that killing was a “healing treatment” that was best for the patient, family, and Reich.

If that sounds familiar, it should. Today, the Netherlands permits the infanticide of babies because they are seriously disabled as an act of “compassion,” and “after-birth abortion” is promoted in the most respectable medical and bioethics journals. Eugenic abortion is an epidemic, with 90% of Down and dwarf fetuses never being permitted to see the light of day. We dehydrate to death people with profound cognitive disabilities by removing sustenance from them.

Suicide clinics are operating in Switzerland and in Belgium euthanasia is coupled with organ harvesting. Assisted suicide/euthanasia has been redefined into “aid in dying” or “death with dignity.” This would all be familiar territory for the eugenicists of the early to middle 20th century.

Calling the euthanasia Holocaust a “Nazi” issue is a defense mechanism that enables us to pursue pernicious policies–with some different motives and without the hate speech, to be sure–and not see that a log is also in our own eye. For as Dr. Leo Alexander–the noted psychiatrist and medical investigator at the Nuremberg Trials–warned in the 1949 pages of the New England Journal of Medicine:

Whatever proportions these crimes finally assumed, it became evident to all who investigated them that they had started from small beginnings. The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans. But it is important to realize that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude toward the nonrehabilitable sick…

The killing center is the reductio ad absurdum of all health planning based only on rational principles and economy and not on humane compassion and divine law. To be sure, American physicians are still far from the point of thinking of killing centers, but they have arrived at a danger point in thinking, at which likelihood of full rehabilitation is considered a factor that should determine the amount of time, effort and cost to be devoted to a particular type of patient on the part of the social body upon which this decision rests. At this point Americans should remember that the enormity of a euthanasia movement is present in their own midst.

And here’s an irony: The NEJM actively supports many of the policies against which Alexander warned. The utilitarian and eugenic “quality of life” attitudes that intellectually enabled the medical Holocaust–and indeed, which were advocated within the medical intellegentsia long before the Nazis were a dark cloud on the horizon–are more than present in our own midst. They are in danger of prevailing–and without the backing of a despotism.