Human Exceptionalism

Life and dignity with Wesley J. Smith.

Our Modern Terror of Rhythm of Life


My friend, the San Francisco Chronicle columnist Caille Millner, has a good column out today about the “Slow Reading” movement. I’ll let her tell you about it. From, “Learning How to Read Again, This Time Slowly:”

Like the earlier movement for Slow Food, the idea behind Slow Read is that our current approach to something fundamental is making us unhealthy. If Slow Foodies were convinced that McDonald’s hamburgers were killing off culinary traditions and making us all obese, Slow Readers are suspicious that reading “thought pieces” on our mobile devices are making us shallow and stupid. They want us to sit down and read books, preferably without digital interference.

Reading is good. But I am not sure about focusing on reading as an issue of health and wellness:

More: It seems to me that pushing reading as a health issue reflects how fearful we have become amid our incredible societal successes. We live longer, healthier, and more prosperously than at any time in history–and it is never enough. We are scared of limits and morally offended by the prospect of natural decline.

Before enjoying Millner’s column, I read a long story about Peter Thiel in the Telegraph. He wants to “cure death.” From the story:

The ‘life extension project’, Thiel says, is as old as science itself. ‘It was probably even more important than alchemy. Finding élan vital, the water of life, was of greater interest than finding something that could transmute everything into gold…

On a fundamental level, the question is whether ageing can be reversed or not…If it is possible to understand biological systems in informational terms, could we then reverse these biological processes, including the process of ageing? I do think that the genomics revolution promises a much greater understanding of biological systems and opens the possibility of modifying these seemingly inevitable trajectories in far more ways than we can currently imagine.

I am not against researching to find treatments for diseases, of course. But this obsession with somehow “curing death” seems rather pathetic. To me, it is an indication of such worry–of death, of limitations, of decline–that it moves into a denial of reality.

Ironically, many who proclaim the mantle of “rationality”–and disdain those who find their hope in faith–are the most devoted to the search for an unfindable Fountain of Youth. Interestingly, the wisdom of the great faiths urge memory of our coming deaths as the key to finding the best ways of living.

Thiel is part of the transhumanist movement, fueled by terror of death and so disdainful for of human limitations that it wants to “seize control of human evolution”–as if we have the wisdom–to achieve immortality and the ability to recreate ourselves in and our own image:

I’m gonna live forever

I’m gonna learn how to fly (High)

I feel it coming together

People will see me and cry

The other day, I posted about Ezekiel Emanuel’s stated desire in The Atlantic to die at 75. The entire piece reeked of abject terror of decline and limits:

The fact is that by 75, creativity, originality, and productivity are pretty much gone for the vast, vast majority of us…Dean Keith Simonton, at the University of California at Davis, a luminary among researchers on age and creativity, synthesized numerous studies to demonstrate a typical age-creativity curve: creativity rises rapidly as a career commences, peaks about 20 years into the career, at about age 40 or 45, and then enters a slow, age-related decline…

How do we want to be remembered by our children and grandchildren? We wish our children to remember us in our prime. Active, vigorous, engaged, animated, astute, enthusiastic, funny, warm, loving. Not stooped and sluggish, forgetful and repetitive, constantly asking “What did she say?” We want to be remembered as independent, not experienced as burdens.

I’m 65. Certain changes have already started. Am I happy about that?  No. Sometimes, I get depressed. More often though, I laugh about being on the downside of the mountain.

But I think working to stay healthy and agile–and emotionally adjust to the world being run by those younger than me, perhaps the hardest part–is much better than pounding my head vainly against reality:

For the rhythm of life is a powerful beat

Puts a tingle in your fingers and a tingle in your feet

Rhythm on the inside rhythm in the street

And the rhythm of life is a powerful beat

Back to Millner: She concludes her piece on Slow Reading on a far healthier note:

Reading isn’t dieting. Who needs to feel more shame about what they’re not doing right? Who needs yet another reason to feel inadequate?

Speaking for myself, I know why my philosophy reading group has made me happy, and it’s nothing to do with my health…Instead, what worked was pleasure: the social pleasure of talking about something serious with people whose opinions I respect, the ecstatic pleasure of wrestling with something impossible until it becomes clear, and the bodily pleasure (we always pick places with good wine) of the experience. It counteracts all the disgust I feel from being hit by a tsunami of Internet foolishness every day.

So that’s my advice to the Slow Read movement — do what the Slow Food people did and emphasize pleasure, not the fact that it’s good for us…

Ahh. Don’t you feel better already?

Exactly. At some point we have to set aside the fear and just live the ride.

Standing Against Human “Dignity Deniers”


I devoted my biweekly column at First Things to an article by Charles Foster in the Cambridge Quarterly of Health Care Ethics in support of human dignity.

I start by noting that mainstream bioethics rejects the objective equal value of human life. From, “Standing Against the Human ‘Dignity Deniers’:”

Today’s dominant cultural voices argue that an individual’s moral worth should be predicated upon his or her individual capacities of the moment. This view is most acutely expressed in bioethics, the field that wields tremendous influence over health-care public policies and in the ethical protocols of medicine.

The potential that denying human dignity has to oppress, exploit, harvest, and kill the weakest and most vulnerable among us hangs in the air like malodorous evidence of a ruptured sewer line.

Examples? Of course:

In recent years, prominent bioethicists have proposed various moral status formulas to justify allowing “after-birth abortion” (otherwise known as infanticide), non-voluntary euthanasia of Alzheimer’s patients, and the use of profoundly disabled humans in dangerous medical experiments—just to name a few of the policy proposals that would obliterate our inalienable right to life.

I note that there has been scarce push back to an “undignified bioethics” outside of religious bioethical circles, which exerts little way. And then I quote Foster: 

Our main concern should be not abstract human thriving but the thriving of a particular human being. It is her humanization that should be the object of ethical discussion.

How refreshing, promoting greater humanization rather than depersonalizing the most vulnerable among us. For example, Foster answers the dignity deniers’ objection that part of a good life is altruism—so why not, as has frequently been proposed in bioethics, harvest the unconscious patient’s organs?

Everyone, in fact, has a dignity interest vested in this particular patient. The criminal recognizes that society as a whole is damaged by, for instance, a murder. This is not merely or mainly because, if murder goes unpunished, murders will proliferate and the risk of each one of us being murdered rises. More important is what the fact of the unpunished murder says about the zeitgeist—about the ethical water in which we all have to swim. A society that tolerates murder is toxic, and the toxicity affects the ability of us all to thrive.

The moral heft of the adverse cultural impact of denying intrinsic dignity is also relevant to other lethal bioethical matters such as euthanasia and abortion.

Human exceptionalism–of which our intrinsic dignity is merely a part–is THE issue of the 21st century. Our rights, our liberty, perhaps our very lives, depend on defending it.

That is why I think Foster’s article is an important contribution. We need all the help we can get here in the Alamo.



Should Teenagers Plan End-of-Life Care?


I think the drive to get us all talking about dying may be getting a little out of hand. A new 500 page report funded to the tune of $1.5 million by an anonymous donor–would love to know who that was–has recommended that end-of-life medical care be discussed with teenagers. From the New York Times story:

The panel, which included doctors, nurses, insurers, religious leaders, lawyers and experts on aging, said Medicare and other insurers should create financial incentives for health care providers to have continuing conversations with patients on advance care planning, possibly starting as early as major teenage milestones like getting a driver’s license or going to college.

Come on! Do these “experts” really think that healthy teenagers will be able to maturely and soberly reflect on what they might want if they became seriously ill/injured, or when and under what circumstances they would want to die? 

Methinks that the technocratic obsession with death and pushing us to accept less care in order to save the system money just jumped the shark.

Ezekiel Emanuel: Die at 75


Can we say, “death panels?” 

Ezekiel Emanuel says he wants to die at 75, with an extended list of woes about old age more than implying that we should too.

Make no mistake: This is the mindset of the medical intelligentsia and technocratic elite, and will be the intellectual predicate of their public policies.

I provide more details over at The Corner.

View to a Kevorkian Kill


I believe that America’s embrace of the ghoul Jack Kevorkian–that is not name-calling, see below–is a portentous symptom of cultural dissipation.

The current First Things contains a vivid article about one of K’s deaths–who was found to have no illness upon her autopsy–illuminating the real Kevorkian behind the myth.

Psychiatrist Kalman J. Kaplan was contacted by letter several times by Martha Wichorek–doomed to become K’s 70th customer–and had several phone calls with her. (These poor people were not in any real sense ”patients.” K was an unemployable pathologist with no experience after medical school in treating living people.)  

The elderly woman wasn’t ill or disabled, but rather, terrified about a potential future “miserable life.” Despite initiating the contacts, she refused meetings and efforts by Kaplan to reach out. (I have met such people many times in my 21 years fighting assisted suicide. As sad as it sounds, I have found that for some, becoming dead gives their life purpose.)

After a brief hospitalization, Wichorek ceased all communication. Then, Kaplan read of her death in the newspaper. From, “The Death of Martha Wichorek:”

Her autopsy revealed that the late Martha Wichorek had no anatomical evidence of disease. Nor, it turned out, had she been in any pain, other than that connected with some mild age-related arthritis. People who knew her said that up to the end she had been very active, even participating in her church’s fall cleanup. She had raked leaves, helped in painting a basement, and seemed to be generally cheerful. Why, then, had she availed herself of the services of Dr. Kevorkian?

Wichorek was one of five Kevorkian customers found to have not been ill or disabled. This was a consistent pattern throughout K’s assisted suicide/euthanasia campaign. (The first was Marjorie Wantz who complained of pelvic pain, his second death.)

Kaplan lays out the truth about assisted suicide–as seen particularly in the Netherlands and Belgium, which have fallen farther down the cliff than us:

Martha’s case raises broader issues: the availability of assisted suicide to physically sound but depressed individuals; the “quick” solution of death for the elderly when they feel useless; thinking of death as a “right” rather than a fact; and too much social concern with the legal rather than the psychological condition of those contemplating suicide.

He concludes by casting light on Kevorkian’s true evil:

One thing more: Martha Wichorek saw her death as a heroic martyrdom for the cause of euthanasia. Kevorkian, as we know, not only encouraged this kind of thinking but served as its most sanctified prophet. He preached to the very first woman he assisted to her death that the world would thank her for her heroic gesture. Martha had been seeking to give some new kind of meaning to her life. Thanks to Jack Kevorkian and his minions, she succeeded in standing directly on its head the very thing she had 
hoped for.

Precisely what I have observed after discussing K deaths with their relatives. I also experienced the same horrid phenomenon in the suicide of my friend Frances, prematurely dead under the influence of the Hemlock Society, which gave her moral permission to kill herself and taught her how to do it. (I described her death in “The Whispers of Strangers” for Newsweek, my first of–so far–hundreds of anti-euthanasia columns. Frances’ suicide changed my life, causing me to move away from my fulfilling work with Ralph Nader to fight assisted suicide.)

In the end, Kevorkian and Hemlock–now, Compassion and Choices–didn’t deliver meaning, but the end of meaning.

I promised at the top of this already too lengthy post to explain my continuing loathing of Kevorkian. Here’s cold the truth: Kevorkian didn’t care about the people he helped kill. They were merely means to a ghoulish end–obtaining a license for K to vivisect people he was euthanizing.

It’s right there in Kevorkian’s book, Prescription Medicide on page 214:

I feel it is only decent and fair to explain my ultimate aim . . . It is not simply to help suffering or doomed persons to kill themselves” that is merely the first step, an early distasteful professional obligation (now called medicide) . . . What I find most satisfying is the prospect of making possible the performance of invaluable experiments or other beneficial medical acts under conditions that this first unpleasant step can help establish, in a word, obitiatry.

What experiment? On page 34, he expressed an intense desire to “study all parts of the intact, living brain.” Toward what end? On page 243, he explained, “If we are ever to penetrate the mystery of death, even superficially, it will have to be through obitiatry.”

Please reread the above quotes and see how–if–it affects you. It scares me that many will just shrug.

By the time he was released from prison for murdering ALS patient Thomas Youk, Kevorkian was again on top of the world. Rather than being repulsed by his death-obsession and cold utilitarian mindset, the retired obitiatrist was extolled widely in the media as a quirky fighter for compassion and transformed by Hollywood from the cold-blooded exploiter of despairing people, that he really was, into a harmless Muppet figure. He was even played by A-Lister Al Pacino in an HBO movie that the moral ciphers of Show Business buried with awards. 

Kevorkian, like all good sociopaths, knew what moves people. In this sense, Kevorkian is a mirror. What do you see in the reflection?


Chimps are Vicious Killers


Animal rights activists and others sometimes act as if chimpanzees and bonobos are somehow better than humans, not violent like us.

That was certainly the implication of studies conducted to determine if chimp violence was our fault. Nope. They are vicious killers–not only of prey like monkeys–but each other. From the New York Times story:

Are chimpanzees naturally violent to one another, or has the intrusion of humans into their environment made them aggressive? A new study, published Wednesday in Nature, is setting off a new round of debate around this question. The study’s authors argue that a review of all known cases when chimpanzees or bonobos in Africa killed members of their own species shows that violence is a natural part of chimp behavior and not the result of actions by humans that push chimp aggression to lethal attacks.

The researchers say their analysis supports the idea that warlike violence in chimps is a natural behavior that evolved because it can provide more resources or territory to the killers, at little risk. Critics say the data shows no such thing, largely because the measures of human impact on chimpanzees are inadequate.

Methinks the critics want it to be our fault as that would promote the anti-humanism we see among some chimp boosters, such as blatant anthropomorphist, Jane Goodall.

Don’t get me wrong. Chimp violence isn’t wrong behavior. It isn’t immoral. Chimps can’t act “right” or “wrong.” They are not moral beings. That is beyond their capacities. 

Only humans possess moral agency. That is one of the factors that make us exceptional. And that is why we cast harsh aspersions on those among us–as we should–who act as viciously as chimps or bonobos. 

Euthanizing a Typical Teenager


There is much piercing truth in this Onion satire:

Best line: “We can give her eyes to someone who will actually read a book.”

Another Conscious “Vegetable”


As regular readers of this blog know, I loathe the V-word used for human beings instead of peas. 

So, why did I deploy it in my headline? Because another case of a supposedly unconscious man, found to be  actually aware, has apparently been discovered–and many would have denigrated him as nothing but a V before he went into the scanning machine. From the Nature News story:\

A dozen volunteers watched Alfred Hitchcock for science while lying motionless in a magnetic-resonance scanner. Another participant, a man who has lived in a vegetative state for 16 years, showed brain activity remarkably similar to that of the healthy volunteers — suggesting that plot structure had an impact on him. The study is published in this week’s Proceedings of the National Academy of Sciences

What we don’t know about the brain, the mind, and their workings should make us humble about presuming to dismiss anyone as unconscious and unaware.

And it should make us loathe to dehydrate these helpless people to death. 

P.S. The Nature reporter used the term “brain dead” as a synonym for diagnosed as unconscious. They are not the same thing! A science publication writer should know better. 

Cruel and Unusual Death with Dignity Strikes Again!


You just can’t make this stuff up.

Belgium is opposed to capital punishment.

Belgium allows widespread euthanasia.

A rapist/murderer–who once would have been subject to execution–now wants to die.

He isn’t sick but wants euthanasia because he doesn’t want to spend life in prison.

The Belgian judiciary said, “Sure!”

So, a doctor will lethally inject a prisoner, but it won’t be considered capital punishment.

Cruel and unusual death with dignity strikes again!

Pushing Back Against Human “Dignity Deniers”


Human dignity should not need defending. But Jefferson’s “self evident” truths are deemed so no longer. 

That’s frightening because, if nothing else, it is impossible to defend universal human rights if we don’t perceive human beings as having unique dignity simply and merely because they are human.

That is why I was glad to see an article in the Cambridge Quarterly of Healthcare Ethics rebutting the “dignity deniers” in the context of an article about why–as one example–it is wrong to use a human ear as an ashtray. From, “Dignity and the Ownership and Use of Body Parts,” by Charles Foster (abstract):

Dignity, then, is objective human flourishing.

The “status” I refer to in my formulation of dignity should not be misunderstood. It does not depend on any notion of the imago dei (although I don’t at all discount the possibility that the imago dei might generate a result similar to mine), or on any account of human specialness that asserts that humans are intrinsically better than nonhumans. I deal only with human status, because this is an article about how humans should behave in relation to other humans.

When a defender of intrinsic human dignity can’t assume that humans have greater value than animals, it demonstrates how deeply Peter Singer-type thinking has penetrated bioethics. Cause for much alarm, but back to Foster:

The suggestion that there is such a thing as objective human flourishing sounds contentious. But isn’t it obvious enough? There are some things that are good for us (such as companionship and the absence of disease), and some that are not (such as isolation and arsenic). I remind myself of the overstated dangers of the is-ought gap…and contend that it is possible, at least in principle, to determine empirically what constitutes human thriving.

Of course, “thriving” is subjective. But Foster uses the term sufficiently broadly to make a more objective point (my emphasis):

Our main concern should be not abstract human thriving but the thriving of a particular human being. It is her humanization that should be the object of ethical discussion…

The self is part of the context in which the thriving must happen, and the body is inextricably tangled with that self. Another part of the context, of course, is the set of circumstances in which the person finds herself.

All of which boils down to the proposition that human dignity is objective thriving in the biological, societal, geographical, and other circumstances in which the individual finds herself

In other words, the human being who is profoundly disabled and the athelete each have intrinsic dignity and must be treated in ways that recognizes their best potential thriving in their respective circumstances. This is in direct contrast to many bioethicists who would create an invidious distinction between the athelete and the profoundly disabled person based on invidious quality of life distinctions. 

Indeed, Foster (mostly) defends the dignity of the permanently unconscious patient:

Is there any sense at all in which she can be said to be thriving? Yes, and two points can be made in support of this conclusion. First, her story (which in many ways is her) continues. The story is the necessary substrate for any ethical considerations that concern her.

And second, there are good stories and bad stories, and it is better for her (a betterness accurately described in terms of thriving) for her story to be a good one. That is why we rightly say that it would offend her dignity were her body to be used by medical students to practice rectal and vaginal examinations.

He also gets into a point relevant to the Terri Schiavo case:

There are the interests of her family and friends. The patient might be incapable of appreciating her relationships, but that does not mean that she does not have relationships, or that the appreciation of those relationships is not an important part of the thriving interests of others. Going to see her each day might be the only thing that keeps her parents going.

Foster writes that part of a good life is altruism, so why not use the unconscious patient for organs–as has frequently been proposed in bioethics. Because the patient’s dignity is inextricably connected with ours:

​Everyone, in fact, has a dignity interest vested in this particular patient. The criminal recognizes that society as a whole is damaged by, for instance, a murder. This is not merely or mainly because, if murder goes unpunished, murders will proliferate and the risk of each one of us being murdered rises.

More important is what the fact of the unpunished murder says about the zeitgeist—about the ethical water in which we all have to swim. A society that tolerates murder is toxic, and the toxicity affects the ability of us all to thrive.

That last point goes well beyond killing for organs.

Foster next proposes a weighing and balancing formula that best protects human dignity in individual cases, more than I can discuss in a blog.

Foster’s prescription isn’t sufficiently protective because it still makes distinctions based on the capacities and quality of life of the individual. That is always dangerous.

But at least he pushes back forcefully against the dignity deniers who would essentially strip the most weak and vulnerable of their humanhood toward the end of killing and/or using their body parts and functions for utilitiarian purposes.


Rampant Sexism in “Free Thought” Paradise?


I have always howled at the ”Free Thought” movement’s aggrandizing self-desecription.

I mean really: If so-called free thinkers really think so freely, how come I can predict almost their every opinion?

Atheism?  Increasingly, yes!

Evolution as the explainer of everything? Yes! 

Abortion? Absolutely!

Assisted Suicide? It is the “ultimate civil right!”

Transhumanism? Bring it on!

Eugenic manipulation of embryos: Go for it!

Human Exceptionalism? No! We are just animals.

In short, free thinkers are as predictable in their beliefs as any other orthodoxy you could name. Perhaps, more so. For example, orthodox Catholics disagree about some major issues, such as the proper role of government in pursuing social justice.

But are “free thinkers” sexist? Apparently, some are viciously so. From the Buzz Feed News story (warning, crude language and vivid descriptions of sexual harrassment):

The reality of sexism in freethought is not limited to a few famous leaders; it has implications throughout the small but quickly growing movement. Thanks to the internet, and to popular authors like Dawkins, Hitchens, and Sam Harris, atheism has greater visibility than at any time since the 18th-century Enlightenment.

Yet it is now cannibalizing itself. For the past several years, Twitter, Facebook, Reddit, and online forums have become hostile places for women who identify as feminists or express concern about widely circulated tales of sexism in the movement. Some women say they are now harassed or mocked at conventions…[in ways that] are so vicious that two activists I spoke with have been diagnosed with post-traumatic stress disorder. One of these women has been bedridden for two years.

Hmmm. Maybe evolution made the Alpha Males bully females as a throwback to the days when men did whatever it took to ensure their genes advanced to the next generation, or some other such cockeyed explanation for human behavior we often hear from behavioral Darwinists.

In any event, if half of the story is true, free thinkers had better get their own house in order before casting aspersions at the supposed knuckle-draggers of a more socially conservative bent. 

Transhumanism’s Dictatorship of AI Machines


Transhumanists, being mostly materialists, desperately yearn for something more; immortality, biotech that grants super-human powers and capacities, a life beyond being human.

Many look to machine artificial intelligence–AI–as the means of fulfilling their eschatology of post-human greatness. Here’s the prophesy: Technology will become so sophisticated it will reach a Big Bang point–known as”The Singularity”–after which transhumanism will become an unstoppable Moses leading humankind to the post-human Promised Land.

Me? I don’t think any of that will happen. But, as I have often written, I do worry that the movement’s values–and zeal–are distinctly Utopian. For example, up-and-comer transhumanist, Zoltan Istvan, has said that preventing transhumanist striving could justify war,

Contrary to the movement’s self-perception, it is also malodorously authoritarian. Case in point:Reason’s science reporter Ronald Bailey–a fan of transhumanism–interviewed movement guru Nick Bostrom about AI machines. Bostrom warns they could become quite dangerous because of their power and potential to function independently of our control.

I agree, which makes me wonder why transhumanists still want to turn them on!

Rather than reject artificial intelligence, Bostrom believes we should program AI super machines to act benignly in the common interest as the Singularity explodes. From, “Will Super Intelligent Machines Destroy Humanity?”

Rather than directly specifying a final goal, the Bostrom suggests that developers might instead instruct the new AI to “achieve that which we would have wished the AI to achieve if we had thought long and hard about it.”

This is a rudimentary version of Yudkowsky’s idea of coherent extrapolated volition, in which a seed AI is given the goal of trying to figure out what humanity—considered as a whole—would really want it to do. Bostrom thinks something like this might be what we need to prod a superintelligent AI into ushering in a human-friendly utopia….

He argues for establishing a worldwide AI research collaboration to prevent a frontrunner nation or group from trying to rush ahead of its rivals. And he urges researchers and their backers to commit to the common good principle: “Superintelligence should be developed only for the benefit of all humanity and in the service of widely shared ethical ideals.

Community “as a whole” doesn’t exist. Neither do “widely shared ethical ideals.”

That means that the ”decision” AI machines “make” would almost surely reflect the materialist utilitarianism of their creators–making them potential authoritarian masters of those among us who believe differently. 

Or what if our AI machines overlords became “fundamentalist” in the belief that enforced moral conformity would most benefit mankind by eliminating the violence and divisions often sparked by cultural diversity?

Either way, you are looking at a potential dictatorship of machines.

Utopianism never ends well. Think French Revolution. Think Russian Revolution. Think the jihad that we now confront.

Transhumanism’s version would be no different. Indeed, Bostrom’s supposed AI corrective reflects that precise dystopian potential.

Psychiatrist Surrenders to Assisted Suicide


When you begin to redefine terms to permit some suicides, you have surrendered to suicide.

Case in point: In Psychiatric Times, Psychiatrist H. Steven Moffic advocates renaming assisted suicide and redefining some with intense suicidal ideation as having a “terminal illness.”

From, “Suicide and Our National Day of Mourning” (registration required):

The dates 9/10/14 and 9/11/14 are interrelated not only by one day following another, but by different manifestations of suicide, or at least different uses and meanings of the term suicide as it is currently used. What can we – the public and professionals – try to do to prevent suicide, ranging from our individual relationships to international relationships?

Okay. And then he has good ideas about how to prevent suicides–such as being “vigilant for people at suicide risk,”before careening off the rails:

Be part of the conversation about so-called physician-assisted suicide. Reconsider when the term suicide is appropriate, as perhaps suicide bombers (or flyers, as in 9/11/01) should be called homicide bombers, or as perhaps physician-assisted suicide should be called physician-assisted dying.

Most suicides, as the term was traditionally used, have an unbearably painful, untreated, or inadequately treated depression at the source. Occasionally, clinical depression can be a terminal illness in the sense that suicide is a likely outcome: we can do much better at preventing that.

In other words, we can lower the rate of suicides by changing the name of some suicides?

Or, does Dr. Moffic actually support killing some psychiatric patients? It seems so to me. That’s what they do in Netherlands and Belgium. 

This is one reason I call it “Invisible Suicide Prevention Week.”

If the last ditch defenders of life give up the fight, some people will have no defense.

Alzheimer’s: To Love and Care or Kill?


Sometimes I get emotional whiplash.

On one hand, we see very prominent bioethicists say that we should starve Alzheimer’s patients to death if they asked to be killed in an advance directive.

Compassion and Choices teaches oldsters how to commit suicide by self-starvation.

People like Peter Singer claim we should be allowed to lethally inject Alzheimer’s patients non-persons even if they never asked–despite having cared very well for his so afflicted mother.

Then, there is the story of the man who gave his beloved wife, dying of Alzheimer’s, his last breath. Literally. From the KFOR story:

An elderly couple, who had been together for more than 60 years, was found dead inside their home. Investigators say Dave Molter died trying to give his wife, Corrine, CPR; giving his wife his last breath.

Brandy Williams broke down, talking about losing a couple she called best friends. “Just wonderful people. I’ve never met anybody like that in my life,” said Williams.

Williams was the caregiver for Dave and Corrine Molter.

Corrine had advanced Alzheimer’s and Dave waited on her hand and foot. “Just being there and seeing it with my own eyes, it’s like true love like no other. It’s the kind you see in movies, not the kind you see in real life,” she said

We used to take Mr. Molter’s kind of devotion, if not for granted, at least as more of a general expectation. 

Today, not so much: Far more media and societal attention–and validation–go to those who support their very ill loved ones in committing suicide. Indeed, sometimes I think the new ethic is to put the very sick out of our misery.

Change isn’t a synonym for progress. 

Advance Planning Yes, Bureaucracy No


I was flattered to be mentioned in the New York Times today by Brendan Nyhan in a piece about paying doctors to engage in end-of-life conversations with patients, and how these talks are not “death panels.” From, “Can We Have a Fact-Based Conversation About End-of-Life Planning:”

Support for covering voluntary end-of-life planning is actually remarkably strong across the political spectrum. In addition to the American Medical Association panel’s recommendation, both private insurers and states such as Colorado and Oregon are now offering coverage for these consultations.

Even critics of President Obama’s health care plan such as National Review’s Wesley J. Smith and Senator Johnny Isakson, Republican of Georgia, are in favor of advance planning.

I am not sure why the word “even” is in there. Surely one can adamantly oppose Obamacare–as I do, primarily because it opened the door to centralized bureaucratic control–and believe that doctors should discuss these matters with patients: Walking and chewing gum at the same time.

But to say that one is “for conversations” isn’t enough. The circumstances in which the talks occur matter too. So, to be clear, these are my positions:

- Doctors should discuss these matters whether they are paid or not. It is part of the job of physician.

- The conversations should be an ongoing dialogue, not a one off.  Some worry that paying for the talks will dictate when the discussions occur. I don’t think the talks pay enough for that, but it is a reasonable concern.

- The talks should not be designed to convince people to refuse treatment based on costs. The doctor should not represent “society” in these discussions. That would be a conflict of interest.

- We should not bureaucratize these conversations ancillary to paying for them. Thus, I wrote against a Senate bill that would have dictated the hoops through which doctors and patients had to jump to make the conversations compensable–and even established a federal advisory board, appointed by the president and the leaders of Congress. Good grief.

- These discussions should be with doctors if they are to be paid by insurance or government, and not with special interest groups. In this regard, I have warned that the assisted suicide advocacy organization Compassion and Choices–which bragged about being behind the failed Obamacare proposal to pay doctors or specialist organizations–wants to become the Planned Parenthood of death. That can’t be allowed.

- Talk isn’t enough. Everyone should sign an advance directive appointing a surrogate in the event of incapacity. Stating that you don’t want to be pushed out of the lifeboat makes it harder to push you out of the lifeboat.

- Rather than pay doctors to have these discussions, better to raise physician compensation generally with the understanding that the “talks” are expected as part of the compensation package. Think of the saved paperwork!

End-of-life conversations are controversial because people know that technocratic types hope to cut costs by restricting access to care to the most expensive patients, particularly those deemed to have a low quality of life–which is why the “death panel” warning resonated so deeply.

But silence is the wrong strategy. Discussing these issues openly make a death panel outcome more difficult to impose.

Invisible World Suicide Prevention Day


Today is World Suicide Prevention Day! 

Did you know that? I’ll bet you didn’t.  From the International Association of Suicide Prevention Website:

Efforts to prevent suicide have been celebrated on World Suicide Prevention Day – September 10th – each year since 2003. In 2014, the theme of World Suicide Prevention Day is ‘Suicide Prevention: One World Connected.’ The theme reflects the fact that connections are important at several levels if we are to combat suicide.

And yet, suicide prevention organizations refuse to grapple with and/or oppose suicide promotion by the euthanasia movement. Time.  After time. After time.

Indeed, I searched the IASP site: There is basically nothing opposing suicide promotion by assisted suicide advocates, or much at all on the issue.

The media is, except for a few minor stories, silent. Again. And if it wasn’t for Robin Williams, I’ll bet there would be even less coverage–as I have documented in past years.

That’s too bad. Suicide takes a terrible toll. From the World Health Organization:

Over 800,000 people die due to suicide every year and there are many more who attempt suicide. Hence, many millions of people are affected or experience suicide bereavement every year. Suicide occurs throughout the lifespan and was the second leading cause of death among 15-29 year olds globally in 2012.

Notice the difference between the attention given to suicide prevention–very little–and suicide facilitation–cheers and clapping. Pushing suicide almost always garners headlines, even TV shows showing real suicides as “taking control.”  Popular shows and movies also push the pro-suicide meme.

Prevention, mostly the sound of crickets.

That is because we are increasingly a pro-suicide culture. Saying it’s okay for people with cancer but not for a mother whose child died doesn’t work.

Sex Selection Abortion Ban Racist?


One would think that liberals–so opposed to real (and imagined) discrimination–would oppose abortion based on sexism. Nope.

San Francisco–where else?–could go on record opposing protecting female (mostly) fetuses from being aborted because they are the wrong gender. From the San Francisco Examiner story:

San Francisco would become the first jurisdiction in the country to go on record opposing sex-selective abortion bans if a resolution stating they perpetuate racial stereotypes, being introduced by Supervisor David Chiu today, is adopted by the Board of Supervisors.

Sex-selective abortion bans prohibit terminating a pregnancy on the basis of sex, and doctors who perform such abortions can face fines, jail time or lawsuits. The bans “encourage racial profiling of women by some medical providers,” according to Chiu’s resolution, and can lead to women being denied services.

“Lawmakers across the country have successfully advocated for sex-selective abortion bans by perpetuating false and harmful racial stereotypes that such laws are necessary to stop an influx of Asian immigrants from spreading this practice, and that Asian American communities do not value the lives of women,” states the resolution, which Chiu will announce at City Hall today.

I wonder if pro abortion types would oppose banning eugenic gay-selection abortion if a test could detect the sexual orientation of a gestating fetus.

Close call, but in a culture of death, abortion trumps all. 

We Shouldn’t Have to Pay Doctors to Talk


I oppose Futile Care Theory–aka medical futility–because it authorizes the unilateral withholding of wanted efficacious treatment.

What is efficacious? A proper understanding would be treatment that accomplished its purpose. Hence, a ventilator facilitates respiration and helps keep the patient alive. 

Futile care is when–in the above example–the wanted ventilator is removed because it is working–not because it isn’t–based on the perceived quality of the patient’s life.

This is sometimes called “qualitative futility.” In other words, in qualitative futility the patient is being declared futile, which is why the efficacious treatment is withdrawn. That’s why it presents such an acute danger to ethical medical practice. 

But there is also something known as physiological futility, that is, a situation when the intervention objectively does not provide efficacious benefit. To use an extreme example, no doctor should perform an appendectomy for an ear ache. 

From this story in the LA Times, it appears that some Alzheimer’s medications don’t work at the end stages of the disease. From the story:

Alzheimer’s disease drugs, which are virtually ineffective in patients with severe dementia, were the questionable medications most commonly given to nursing home patients with advanced disease.

Prescriptions for Alzheimer’s drugs such as donepezil (better known by its commercial name, Aricept), rivastigmine (Exelon), and memantine (Namenda) are commonly initiated for patients in the early stages of the disease and may slow the rate at which they become unable to care for themselves.

There’s little evidence they improve memory or mental performance in people in late stages of the disease, however.

Should doctors refuse such medication in end stage patients, even if wanted? It depends on the meaning of the term, “little evidence.”

But the bigger point is that it should never–or only very rarely–come to disputation. Most families will not want their loved ones to undergo greater discomfort for no or very minor efficacious gain. Ongoing dialogue is the best way to avoid such unfortunate outcomes and avoid futility disputes.

This is why I am worried that the varying plans to pay doctors for these communications–once a year or once every five years, whatever–miss the mark. If we bureaucratize these essential and ongoing dialogues, the doctor/patient/family relationship could easily become sclerotic.  

Better to raise doctor’s general pay in the understanding that their overall compensation includes end–of-life talks whenever they are needed and wherever they occur. 

We Are Bigoted Against the Old


How often have we heard our elderly brothers and sisters say they don’t want to be “a burden.” Who made them think such a thing? We did!

A great column in the Daily Mail by Stephen Glover indicts the UK culture for its blatant ageism–a condemnation that applies equally to the USA. From, “Why Today’s Elderly are Old Age Pariahs:”

It can scarcely be disputed that people in their 70s, 80s and 90s are increasingly made to feel they are part of a burdensome minority which is more or less surplus to requirement. What is particularly disturbing is that the kind of prejudice expressed recently by Jeremy Paxman — who said Britain has too many elderly people, and that there should be a Dignitas [the Swiss suicide] clinic ‘on every street corner’ — is now widely shared, particularly by the agencies of the State.

It’s an interesting reflection that if Paxo had said he hated Africans, the disabled or even the young, there would have been an uproar. But the elderly are easy game, and he can be rude about them with impunity. He may have been joking, but it was in poor taste to say the least — particularly given that only a few weeks earlier the House of Lords had debated Lord Falconer’s Assisted Dying Bill, which raises the prospect of overbearing relatives putting pressure on the elderly to do away with themselves for fear of being a burden.

President Obama said the elderly should often take pain pills instead of receiving curative care.

Meanwhile, the death pushers at Compassion and Choices promote suicide by self-starvation for the elderly–and are treated as a respectable patients rights group by the media and medical intelligentsia.

Glover is absolutely right: We are bigoted against the old. Shame on us!

Obama Will Never OK Over Counter Birth Control


The Democrats took a non-issue–contraception–and turned it into cynical “war on women” demagoguery in 2012.

Similarly, Obamacarians used birth control pills as a bludgeon to undermine religious liberty with the contraception mandate, which they seek to impose on religious groups and business owners that see birth control as a sin,

But what would happen if birth control pills were available over-the-counter? Planned Parenthood supports that course, and now, in response to being accused falsely of trying to keep women from taking birth control pills, some Republicans think the time has come. From a Washington D.C. Examiner column by Byron York:

The most intense debate over the idea has taken place in Colorado, where Gardner unveiled a birth control TV commercial last week. “What’s the difference between me and Mark Udall on contraception?” Gardner asked in the ad. “I believe the pill ought to be available over the counter, round the clock, without a prescription — cheaper and easier, for you.” Udall, Gardner said, would “keep government bureaucrats between you and your healthcare plan,” resulting in “more politics, and more profits for drug companies.”

It seems to me that Republicans are responding to cynicism with cynicism. But that’s politics, I guess.

The question should not be based on politics, but safety. On that question, I have no opinion.

I do believe that over-the-counter birth control–if ever approved–should be behind the pharmacist’s counter for adults only to prevent minors from taking a powerful drug without parental knowledge. (I know, I am old fashioned that way.)

The Republicans are on to one thing from a political perspective: Over-the-counter birth control pills would no longer be covered by Obamacare. That, in turn, would prevent the present government from using contraception as a means to attack religious liberty, rally the secularists’ vote against “the theocracy,” and use the specter of unavailable birth control to scare single women to the polls.

And that is precisely why the Obama FDA will never approve over-the-counter birth control pills. The good politics–from the administration’s perspective–trump science and proper public policy.

Yes, I believe Obamacarians are that radical and the president that demagogic. 


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