Up to ninety percent of babies–ninety!–diagnosed with Down syndrome in pre-natal testing never see the light of birth. (Ditto other genetic conditions such as dwarfism.) Every once in a while, in the face of this carnage, a loving parent of a Down child takes to the media to defend their child’s worth and to share the challenges and joys that come with raising their son or daughter with special needs.

The Atlantic, publishes the latest such article, in which college educator Theo Malekin writes to laud the spectacular medial care and supportive services his daughter Hazel has received, and to tell others that children with Down have lives worth living–and parenting. From, “A Generational Shift in Understanding Life With Down Syndrome:”

I cannot think of any parents of a child with Down syndrome who would give them up for anything. Love has a way of making statistics irrelevant, and it brings its own kind of knowing. I do not love my daughter any less because she has Down syndrome. Her diagnosis says very little about who she is. She is not a disease or a syndrome but an individual: affectionate, naughty, infuriating at times, stubborn, self-willed and utterly charming. Certainly she has medical problems and developmental challenges not faced by other children. I’m not saying those don’t exist. But they’re one part of a much bigger picture…

You cannot know if someone else’s life is worth living without asking them and without even knowing them. A disability does not necessarily stop you living a full, satisfying life. Oddly enough, I’m not sure that disabilities have anything to do with living full satisfying lives. When it comes to Hazel, her life is not a burden to her family but an unending source of delight. For my part, I cannot imagine life without her. But most importantly, her life is valuable to herself, and definitely worth living.

That’s great, but predictably inadequate: Whether because of belief, desire not to judge, or simply not wanting to get into a sticky wicket, Malekin doesn’t bring the logical thrust of his argument all the way home:

This is not intended as an argument against abortion. It is an argument for giving prospective parents of children with Down syndrome a full picture of what their life will be like. 

But it should be an argument against eugenic abortion!  We have no hesitation telling people in other contexts that certain legal behaviors are wrong. We do it all the time: We tell people not to smoke, not to get fat, not to own guns, not to generate greenhouse gasses. Surely, we can tell people they really shouldn’t abort babies because they have Down syndrome.

If a happy father of a Down daughter won’t make that important argument, who will? So I applaud Malekin for speaking out about the value of people with Down and for deeply loving his Hazel. But more is needed–a robust, unapologetic, and rousing call to, “Let these live!”  

I had an article in the Weekly Standard last week warning that the international ruling class wants to “define torture down” to include mere policy differences with those favored by the Cultural Left–particularly around abortion, transgender issues, “sex workers,” drug use, and the like.  

Now, almost on cue, the International Commission of Jurists castigates Malta (of all places) for purported human rights abuses based on precisely such policy differences. First, Malta is pro life!. From the ICJ Submission to the Universal Periodic Review of Malta: 

Malta’s Criminal Code prohibits the termination of pregnancy, specifying that both women who procure miscarriages and medical professionals who perform or assist them may be held criminally responsible. The terms of the law do not envisage any exception and as a result even abortion for therapeutic purposes, such as to save the life of a pregnant woman, is subject to this prohibition. These provisions undermine Malta’s compliance with its obligations to ensure women’s enjoyment of the rights to life and highest attainable standard of health, and freedom from torture and cruel, inhuman or degrading treatment, as enshrined in the Convention on the Elimination of Discrimination against Women (CEDAW), the ICCPR, the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention against Torture. 

One can disagree with pro life laws, but torture and inhuman treatment? No. 

Also, Malta doesn’t let transgenders marry!

Under Maltese law, transgender individuals are not permitted to marry their opposite sex partners.41 In May 2011, the Constitutional Court affirmed the decision of the Director of Public Registry that a woman named Joanne Cassar, who was identified male at birth but had subsequently undergone gender reassignment and had changed her sex in her birth certificate, could not marry her boyfriend. The Court ruled that Joanne Cassar could not legally be considered a woman for purposes of marriage. The Constitutional Court thus rejected the applicability of Goodwin v United Kingdom, in which the European Court of Human Rights had held that States must recognize a change of gender identity and protect the right to marry for individuals who have changed their gender. 

Again, one can think such a law is wrongheaded, un-empathetic even. But heterodox social policies should not be conflated with most profound human rights abuses, such as disappearing political opponents or having official rape rooms as a tool of regime coercion.

The political left—which includes the U.N. bureaucracy and NGOs such as the ICJ—tactically redefines words and terms that have specific meanings so as to stigmatize controversial policies and positions with which it disagrees. By wielding the T-word like a political cudgel in order to shame countries like Malta to legalize abortion and get on the LGBT policy bandwagon, however, these internationalists demonstrate a depth of intellectual dishonesty that provides abundant reason for Malta (and the U.S.) to hold on tight to their national sovereignty.   

(This report by the pro life NGO, C-FAM, provides deeper context.)

Do women have a right to a dead  fetus baby? Apparently so, according to a Florida Planned Parenthood official who testified that if a baby is born alive in a botched abortion, the mother should decide whether the abortionist should kill or care for the newborn. From the Weekly Standard story:

Florida legislators considering a bill to require abortionists to provide medical care to an infant who survives an abortion were shocked during a committee hearing this week when a Planned Parenthood official endorsed a right to post-birth abortion. Alisa Laport Snow, the lobbyist representing the Florida Alliance of Planned Parenthood Affiliates, testified that her organization believes the decision to kill an infant who survives a failed abortion should be left up to the woman seeking an abortion and her abortion doctor. 

“So, um, it is just really hard for me to even ask you this question because I’m almost in disbelief,” said Rep. Jim Boyd. “If a baby is born on a table as a result of a botched abortion, what would Planned Parenthood want to have happen to that child that is struggling for life?”

“We believe that any decision that’s made should be left up to the woman, her family, and the physician,” said Planned Parenthood lobbyist Snow.

Remember, Peter Singer was appointed to the most elite bioethics chair in the world at Princeton–not in spite of, but because–he preaches for the propriety of infanticide. And despite all the fuss over the pro “post birth” abortion article published in the Journal of Medical Ethics awhile ago, many of the most mainstream bioethicists support the agenda because they oppose human exceptionalism and believe that humans with low present capacities lack full moral value.  

Thus, I don’t know why anyone is surprised about the PP endorsement. It is just another indication that infanticide continues its slow movement toward respectability. 

By the way: If a baby born during a botched abortion can be killed, why not also an unwanted baby born in the usual manner?

As the technocrats seriously ponder imposing health care rationing, government bureaucrats have raised a trial balloon that could result in Medicare and Medicaid paying for sex change surgeries. From the Center for Medicare and Medicaid Services announcement:

CMS opens this reconsideration of the NCD on Surgical Treatment for Gender Identity Disorder. Section 140.3 of the NCD Manual. The initial 30-day public comment period begins with this posting date, and ends after 30 calendar days. CMS considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the topic under review. Surgical Treatment for Gender Identity Disorder (formerly referred to as transsexual surgery in 140.3) is currently noncovered under the Medicare Part A and Part B programs. The existing policy, which became effective in 1981, states that transsexual surgery is considered experimental.

Surgical sex change is a consumerist, not a medical procedure. It shouldn’t be covered by tax payers whether or not it remains experimental. And pay close attention to this: If Medicare and Medicaid covers it, believe me, Obamacare won’t be far behind. 

This is how the Left intends to use health care to advance its social agendas. Talk about busting the bank! “Social justice” is killing our society.

Thanks to CNS News for disclosing this in this report. The MSM wouldn’t. 

Discover has the latest in a long series of science writers claiming that the growing ease of genetic tests will open the way for a new eugenics. But not to worry, the new version of the old evil won’t be forced by the state. No, no: It will be a choice eugenics. From, “The Inevitability of Eugenics…as Preventive Health,” by Razib Kahn:

The real fundamental issue here is that genes are at least somewhat in the picture, and genes are mystically powerful. But modern eugenics is really just part of the broader portfolio of preventative health. SinceNeuroskeptic’s post on the “new eugenics” a few years back there has been great advancement, such as noninvasive prenatal screening for chromosomal abnormalities. There has been moderate controversy, but in a world of routine in vitro fertilization and occasional surrogacy this does not rise to the level of alarm or salience. The primary point here is that the “new eugenics” is not going to be about a top-down agenda about remaking the genome of the human race and producing a lineage of Übermensch. It is going to come into being through a collective series of choices by couples and individuals in terms of what their vision is for a healthy and happy child. It will happen piecemeal, in banal and unnoticed steps.

“Preventive health” was the point of the original eugenics; improving the human herd to prevent “the idiots” and “unfit” from dragging the free thinkers “fit” into a societal and financial sink hole. It was called “racial hygiene” in 1930s Germany, which passed eugenics laws based on those then in existence in California.

Not only that–and pay very careful attention here–the old evil had the enthusiastic backing of “the scientific consensus” and members of the progressive ruling elite of that era. So, I believe, does the new eugenics, and the euphemistic relabeling as  ”preventive health” should have us all taking warning! Eugenics as preventive health won’t remain any more voluntary than the original eugenics. 

If you doubt me, think Obamacare. Think about how the Free Birth Control Rule already forces business owners and religious organizations to violate their faith precepts to accomplish the overarching moral purposes of the progressive coalition and ruling elite. More, think about the cost control imperative we see developing like a violent thunder storm. Have you noticed that the technocrats and our betters in government happily dictate our personal behaviors to promote “wellness” and save money on health care?

Anyone who thinks that in such a cultural paradigm, “preventive health” eugenics would long remain voluntary hasn’t noticed–or agrees with–the outright statism that Obamacare has unleashed. And we are barely into the “liftoff” stage.

Animal rights, properly understood, is not animal welfare: It is an ideology that creates moral equality between people and fauna.

PETA is the most famous–but actually, not the most dangerous–purveyor of this anti-human ideology. It recently made news by attacking a 14-year-old boy, who wants to sell a cow to raise money for a field trip to the UK. From the FNN story:

When 14-year-old Logan Ward came up with the idea to raffle off a cow in order to raise money to go with a non-profit group on a trip to Europe, he never expected it would mean he’d be receiving antagonizing emails from PETA. But that’s exactly what happened. The animal rights group not only sent Logan nasty messages, but also photos like the one shown here, depicting women wearing lettuce as underwear.

The original email, from PETA’s Whitney Calk, read in part: “It just seems a little strange to me that you feel that someone needs to die for you to go on your school trip… I feel like we can both surely agree that there are several other humane ways to fund raise these days that don’t involve a dead, chopped up corpse.”

That’s mild compared to PETA’s usual style. For example, it hands “comic” books to children attacking “mom” for wearing fur and “dad” for fishing. As I reported in my book, A Rat is a Pig is a Dog is a Boy: The Human Cost of the Animal Rights Movement:

[I]n its second “PETA Comic,” Your Daddy KILLS Animals!, an anti-fishing diatribe the cover of which vividly depicts an “evil daddy” wearing a hat affixed with lures and fish hooks (and a skull and crossbones) eviscerating a fish.  In lurid large red letters, the cover states: “Ask your daddy why he’s hooked on killing!” On the inside, the children are told: “Imagine that a man dangles a piece of candy in front of you.  So you reach for it.  But, as you grab the candy, a huge metal hook stabs through your hand and you are ripped off the ground…You’d feel really scared wouldn’t you?  That would be an awful trick to play on somebody, wouldn’t it?”  Then, comes the anthropomorphism so thick it can be cut with a knife. “Fish may not be cuddly or cute like kitties and puppies, but fish are really smart.  They learn from each other and can remember things for a long time. Just like people, fish eavesdrop to get info and they can even use tools!”  And it wouldn’t be a PETA Comic without warnings against parents killing pets. “Until your daddy learns that it’s not ‘fun’ to kill, keep your doggies and kitties away from him.  He’s so hooked on killing defenseless animals that they could be next!”  

Can you imagine telling a child that if their dad fishes, he might kill the family cat?

PETA activists–as distinguished from many of its naive contributors–are zealots and bullies. They are not about “being nicer to animals,” but about ending all animal domestication of every kind. They have apologized to the kid–because sometimes even bad publicity isn’t good publicity–but the attack on a boy raising money for a field trip is a small example of the true nastiness of this awful organization. 

P.S. PETA has killed adoptable cats and dogs. 

There is an ongoing–and potentially lethal–discussion ongoing in bioethics and moral philosophy that would redefine death from the irreversible cessation of cardio/pulmonary function or neurological function, to a diagnosis of permanent unconsciousness. But the unconscious breathe and their bodies function, meaning that they are clearly not biologically dead.

But logic and accuracy are impediments to the agendas being pursued. Indeed, redefining death would break the back of the sanctity/equality of life ethic permitting the fulfillment of several (dire, from my POV) long-time utilitarian societal goals: 

• Destroy human exceptionalism by denying intrinsic human dignity;
• Make the value of human life subjectively depend on quality of neurological function. e.g., “personhood theory;”
• Allow the profoundly cognitively disabled to be organ harvested before biological death, in essence killing for organs;
• Allow experimentation on living human bodies under the pretext that they are mere cadavers;
• Stop all medical care, as now happens with those declared dead, to save resources.

Now, I can add a sixth purpose (or consequence); breaking the general prohibition against active euthanasia.

Heretofore, the redefine death crowd have primarily limited their targets to those with profound and permanent cognitive disabilities caused by injury or disease, such as the late Terri Schaivo. But now, an article published in the Journal of Medicine and Philosophy, (38: 190–204, 2013) by Samuel H Lipuma, argues that permanently sedating a dying patient–a legitimate palliative technique, rarely required–is the same thing as euthanasia. From the article:

The thesis being defended here is not just that there are many similarities between CSD [continuous sedation until death] and PAS/E physician-assisted suicide/euthanasia] but rather that CSD is equivalent to PAS/E. CSD, as it has been defined and clarified here, is the permanent elimination of consciousness from a patient. To have one’s consciousness permanently eliminated is to die. It is a death of higher brain functioning.

Note that it isn’t as if the patient’s consciousness couldn’t be restored. It is that doctors don’t plan to do so because the patient would be in intractable pain. (Also note that most cases–perhaps all, I don’t know–of palliative sedation don’t actually require permanent sedation until death as a matter of medical necessity. That it is sometimes done that way, doesn’t mean it has to be.) Also note that the sedated patient’s body continues to function, often without medical assistance such as a respirator. Thus, by any objective measure, the patient is not dead.  

Nor is permanent unconsciousness the same thing as “brain death,” since death by neurological criteria requires that every function of the brain and each of its constituent parts cease functioning as a brain (not that every brain cell be dead). The brain of a sedated patient has not ceased functioning as a brain. The drugs have merely rendered the patient unconscious.

Not only that, but supposed permanent unconsciousness isn’t necessarily unaware. There have been many recorded instances of unconscious patients, with no seeming higher brain function, recalling precisely what happened during that time. And recent neurological screening breakthroughs have shown that some supposedly permanently unaware patients are able to interact.  Heck, we don’t actually know what consciousness is!

Back to Lipuma. He, and his ilk, seek to redefine death from a biological into a sociological meaning, from a condition that can be determined (at least theoretically) objectively through medical means, to a subjective approach in which death to one person is not death in another. From his conclusion: 

The thesis being defended here does not involve moral evaluation. It claims that CSD is indistinguishable from PAS/E. To say that CSD occurred would be to say that killing occurred. That does not make it immoral because context determines when killing is or is not justifiable. Self-defense involves killing but is morally justifiable. CSD is also morally justifiable because it rests on the principles of respect for patient autonomy, mercy, compassion, and physician nonabandonment…

The present concern is to demonstrate the claim that no significant differences can be made between acts of CSD and those of PAS/E. For those insisting that life and death should be understood biologically,the case could be made that CSD is not death. This can only be done at the expense of a definition of death based on consciousness and all other human awareness and instead forces us into a much less desirable “one size fits all” notion of death. This does not do justice to being human and the significance that consciousness and all other human awareness abilities have to human life. Identifying CSD with higher brain death is a more precise and accurate characterization of what occurs. Clarifying our actions to the greatest possible extent should help us improve the care of the immanently dying. That is the fundamental inspiration behind this analysis.

Like I always say: If you want to see where the culture is going wrong, just read the professional journals.

The researchers are busy creating computer models and testing hypotheses to see if they can predict mortality accurately–as a way, I suspect, of justifying health care rationing. My concern was heightened by a study just published as a letter in the March 6 Journal of the American Medical Association, in which the authors claim that they were able to predict likely mortality 10-years out. From, “Predicting 10-Year Mortality for Older Adults:”

Extending the index from 4 to 10 years did not diminish the model discrimination (validation cohort,C statistics 0.817 vs 0.834; P= .35), suggesting that the risk factors important for 4-year mortality prediction are also important for 10-year mortality prediction. The model compares favorably with other mortality indexes that predict mortality beyond 7 years…Patients identified by this index as having a high risk of 10-year mortality may be more likely to be harmed by preventive interventions with long lag times to benefit, whereas patients identified as having a low risk of 10-year mortality may be good candidates for such interventions.

Thus, (say) if a colonoscopy is identified as not having a positive cost benefit for seven or more years (as the article indicates), such screening for those whom the computers predict are likely to die within ten years might not be covered. Why? Both because the potential immediate risk of harm from the test or a false positive is deemed more likely than an actual health benefit, and because your lower overall predicted life expectancy means that the statistically unlikely chance of catching a cancer among your cohort is not worth the cost of all those screening tests. 

In essence, this approach would seem to be pointing toward an “expected life years” form of rationing (let’s call it) under Obamacare, with decision-making based in large part on cohort membership and computer model projections.

If an expected life years form rationing is ever accomplished, the next step will be the even more subjective quality adjusted life year rationing model, already in use in the UK. Fasten your seat belts, it’s going to be a bumpy ride. 

Bill Gates is offering $1 million to the inventor that can build a better condom. From the FNN story:

Philanthropist and Microsoft founder Bill Gates is offering start-up funds of $100,000 to anyone who can come up with the “next-generation condom,” according to Grand Challenges in Global Health. The Round 11 of Grand Challenges Explorations initiative through the Bill and Melinda Gates Foundation is aimed at improving the lives of the world’s poorest people – and a new, innovative condom could do just that. The condom must be effective at lowering the chance of transmitting sexually transmitted diseases, and offer incentive for men and women to use it.

If chosen, the Foundation would continue to fund the condom up to $1 million. “To overcome persistent health and development problems, we need new, game-changing ideas,” Chris Wilson, director of Global Health Discovery & Translational Science at the Foundation, said in a press release.  “Inspiration can come from anywhere, and we are hopeful that this new round of Grand Challenges Explorations will uncover innovative approaches to improve lives around the world.” According to the press release, the new condom will “preserve or enhance the pleasure so as to increase uptake and also promote its regular use.”

I still believe that relying on the condom as the primary diseases inhibitor works at cross purposes with the goal of better public health outcomes. It is like telling people they really don’t have to stop smoking, just use a filter or a water pipe to reduce disease.

If we want to spread the devastating HIV and STD epidemics, telling people that they can have an exuberant sex life and safety too seems less wise than trying to create a sense of sexual restraint and probity as both the cool and responsible approach. But issuing a clarion call for self control is disfavored because the international community disdains moralism and sees open sexuality as a liberty right. And yet, the ABC approach (abstinence, be monogamous, use condoms.) worked very well in Uganda–at least until they backed off from the A and B.

If you build a better condom will they beat a path to your door?  I doubt it. The problem is that pushing enhanced sexual sensation in a condom also pushes more sex, and the only reliable answer to lowered rates of infection is less sex other than with an uninfected mutually monogamous partner.

But then, I am an old guy who believes that we have the capacity to control our hormones, if not because it is “right,” at least because it is best for our health.  

Washington State may require all insurance policies to cover abortion. From the AP story:

The Reproductive Parity Act, as supporters call it, would require insurers in Washington state who cover maternity care — which all insurers must do — to also pay for abortions. The bill passed the state House earlier this month by a vote of 53-43, though it faces an uncertain future in the Senate. A similar bill in the New York state Assembly has been introduced each session for over a decade but has never received a public hearing. “This is a core value for Washingtonians,” said Melanie Smith, a lobbyist for NARAL Pro-Choice Washington. “We should protect it while we still have it and not leave access to basic health care up to an insurance company.”

Non therapeutic abortion isn’t basic “health care,” for as I pointed out here, it is a “consumerist” rather than a “medical,” procedure.

That point aside, passage of the law will force business owners who are religiously and morally opposed to abortion into a hard position–one that could deleteriously impact their employees: Cover abortion against their beliefs or drop coverage and pay the Obamacare fines. That will then force religiously or morally opposed individuals into the same dilemma. Some employers would even leave the state.

Alas, the Religious Freedom Restoration Act–which so far seems to be protecting most business owners religiously opposed to contraception–does not provide a safe harbor for state laws. Thus, business owners and insurance purchasers would have to litigate against the law based on the First Amendment. Alas again, precedent would not be on their side because the law would be of general application and not aimed at religious expression. 

Obamacare means centralized control of health care. Centralized control of health care means patients are viewed as members of categories instead of as individuals. The end of patients being viewed as individuals results in the deprofessionalization of medicine. The deprofessionalization of medicine leads to the reign of high-paid bureaucrats, technocrats, and academics, as they write arcane, jargon-filled reports designed to justify dictats from on high to the trench workers in hospitals and at the clinical setting. And that leads to a meltdown of the system, as is happening in the UK’s National Health Service. 

Here’s a small example: A new article published in the British Medical Journal analyzes how the UK’s rationing board–the National Institute on Health and Clinical Excellence (NICE)–applies ”quality adjusted life years” (QALY) to end of life care decisions. QALYs involve cost-benefit analyses with “quality of life” the determining factor. (See what I mean about arcane jargon?) 

From, “NICE’s End of Life Decision Making Scheme: Impact on Population Health:”

Our analysis shows that use of NICE’s end of life criteria has resulted in substantial QALY losses. We have assumed that the cost of end of life drugs is met entirely through displacement of other services or treatments in the NHS. Although we do not know whether this has been the case, as the NHS budget is under increasing strain, it seems reasonable to assume that disinvestment will be required. To put the losses into context,the £549m that we estimated has been spent on the nine end of life treatments each year is more than the £505m it cost to provide dialysis for the 21,544 patients with kidney failure in England in 2009.

What does society want? The reallocation of resources to end of life interventions maybe acceptable if society truly values QALYs gained through an extension of life when a patient has a terminal illness more highly than those gained at any other time of life. In this case it would be valid to apply weights to QALYs for end of life treatments, and the QALY loss would represent societal preferences.

Talk about eye-glazing! Talk about a bore fest! And therein lies the danger: Talk about losing the humanity of the decisions being discussed! 

But note, what an individual might want with regard to end of life care seems irrelevant. What matters is quality of life and supposed “societal” preference:

Our analysis has shown that if society does not place a higher value on QALYs obtained at the end of life, the application of the NICE end of life criteria is likely to have resulted insubstantial QALY losses and budgetary pressures to the NHS and population in England and Wales, as cost effective interventions are displaced in favour of less cost effective interventions. If society does give more value to QALYs gained by people at the end of life the cost effectiveness threshold may need to change to reflect this.

That’s the kind of dehumanized system that the Obamacarians intend for us. It’s a technocrats full employment law that treats patients as mere potter’s clay. 

British novelist Julian Barnes says he contemplated suicide over his wife’s death–and still does. From the Telegraph story:

“The question of suicide arrives early, and quite logically,” he writes. “I knew soon enough my preferred method – a hot bath, a glass of wine next to the taps, and an exceptionally sharp Japanese carving knife. I thought of that solution fairly often, and still do.” But he decided his end would be akin to a second death of his wife, since he was “her principal rememberer”. He says he is now equipped with a “firm argument” against suicide, but admits the temptation remains.

And he seems to believe that the suicidal should be assisted if they want:

Last month, Barnes spoke out in favour of assisted dying, telling The Daily Telegraph: “I always thought it was every human’s right to kill yourself if you want to and I think it’s terrible that people have to go to Switzerland and have their relatives threatened with lawsuits or criminal prosecution when they are obviously of sound mind but terrifyingly unsound body.”

But why should such a “right” be limited to the ill? Why not the grieving?  Indeed, such a “right” might have cost Barnes his life.

Not coincidentally, the dying always aren’t. A former doctor-prescribed death supporter in Oregon thanks her doctor for not assisting her suicide–twelve years after being told she had less than six months to live. 

In short all suicidal people should be treated the same; with love, compassion, and suicide prevention. No exceptions. 

The quest for the “perfect child” knows almost no bounds. From the Washington Post opinion blog by Melinda Henninger:

 “Exceptional egg donor needed,” said a recent ad in the Harvard Crimson. The couple looking for that donor, it said, is working with a “prestigious Los Angeles IVF clinic,” in search of a “100% Korean woman” with an excellent education, “outstanding” test scores, “extremely healthy family history,” plus an “altruistic nature,” and a “slim build.” The Nobel Prize in Physics is only optional, I guess, since the ideal candidate sought in such notices must also be under 28.

Apropos of my First Things column today about emotions too often trumping principle, today many believe they not only have a “right” to a child but to the child they want.

But the good news is that the Post commentator–wonder of wonder, miracle of miracles–actually sees the eugenics! And the danger to the “donor!” The column even quotes Jennifer Lahl of the Center for Bioethics and Culture (for which I am a paid consultant):

Jennifer Lahl, who’s spent the last three years traveling from college to college showing her documentary film “Eggsploitation” — interviews with women who did have serious complications as a result of egg donation — says she often feels like a latter-day opponent of Big Tobacco, outmatched by an lobby that’s “strong, wealthy and powerful.”

What she wants is what Big Tobacco finally had to provide: A warning label. A major survey of egg donors in 2008 found that one in five was unaware of any health risks, though with cash on the table, it’s easy to understand how the small print might have been overlooked. Can you even have informed consent with money at stake?

This is a rare case of the MSM actually presenting an issue from the heterodox side of the street–and without letting the emotional centrifuge trump all. Hooray!

Never has so much hype been shoveled than the CURES! CURES! CURES! propaganda that sold embryonic stem cell research to the American public.

That hasn’t worked out so well in actual practice, but the white elephant that is the California Institute for Regenerative Medicine–with a renewal election coming up next year–has spent some of our (Californians’) borrowed money to teach stem cell scientists how to hype the product. From the San Francisco Chronicle story:

The best way to talk about stem cells may be to not talk about stem cells. Instead, scientists are probably better off glossing over the details and avoiding terms like “embryonic” and “pluripotent” stem cells, and focusing instead on what they’re trying to accomplish and who they hope to help someday. Stem cells, after all, are complicated stuff.

That’s one of the lessons gleaned from an exercise Wednesday aimed at helping scientists learn how to sell their research to an unscientific public with a short attention span. The state’s stem cell funding agency hosted an informal contest during which nearly 60 scientists gave video “elevator pitches” – super-fast presentations that are supposed to grab a listener’s attention in just 30 seconds.

That’s the way to avoid the ethical issues. Hype!  

That may mean pulling on people’s heartstrings and talking about devastating diseases like Alzheimer’s or Huntington’s, neither of which has a cure, and both of which are being heavily studied by stem-cell scientists. Trounson and other stem cells experts draw people into their research by talking about real-life implications first, and the lab work later…

And there were some unexpected darlings in the contest. A young researcher from UC San Diego won laughter and the undivided attention of judges for coughing and panting his way through a pitch about his work in repairing and regenerating lung tissue. “Even though no one can live forever, everyone deserves to breathe,” Dr. Asaf Presente said at the conclusion of his pitch, to applause from the judges.

It’s critical that stem cell scientists learn how to talk clearly and engagingly about their work, because their careers – and the field as a whole – depends on public support, Trounson said.

This, from an agency that has been mismanaged and rife with conflicts of interest. But it wants billions more on our credit card, and CURES! CURES! CURES! will be needed again, so now’s the time to teach “the scientists” how to shill like Mad Men. 

I just returned home from Austin, Texas, where I testified against SB 303–a very bad bill that would permit doctors to force DNAR orders on patient’s charts without consent, requiring the patient to “appeal.” (“Do Not Attempt Resuscitation,” aka, DNR, Do Not Resuscitate.”)

More on my testimony later. But relevant to the question, a new study shows improved results from CPR. From, “New Data to Consider in DNR Decisions,” by Judith Graham in the New York Times:

What has not been clear is what happened to older hospital patients who left the hospital after a cardiac arrest. Now a new study in The New England Journal of Medicine of 6,972 elderly people who survived in-hospital cardiac arrests between 2000 and 2008 gives some answers. A year after exiting the hospital, 58.5 percent of these older patients were still alive. Of this group, 48 percent had little or no neurological impairment, while 52 percent had moderate or severe neurological damage. Forty percent of older patients who survived CPR returned to life at home; the remaining 60 percent went to nursing homes, rehabilitation facilities or hospices.

And some of that data is more than ten years old, a long time in the medical field in which advancements come exponentially. Indeed, I am reading a fascinating book entitled Erasing Death, which is, among other issues, about the vast improvements in rehabilitation science and how innovative approaches are leading to amazing recoveries with restored function in people who would once have been “not only merely dead, but really most sincerely dead,” as the Wizard of Oz song lyric had it.

Germane to the Texas mess, Graham quotes a physician who properly notes that the issues of CPR and DNR are for patients to decide:

Older people and their families may want to use findings from this report in discussions about end-of-life care and preparing advance directives, which can include “do not resuscitate” orders.“I think physicians should discuss these results with patients and ask what their wishes are should their hearts stop,” Dr. Chan said. Unfortunately, there is no research on how elderly survivors of cardiac arrest rate their quality of life and whether they would choose resuscitation again if they had the opportunity, he noted.

“One of the most important questions to ask is, what is the older person’s current level of functional ability and cognitive status,” Dr. Abella said, observing that “elderly patients with good precardiac arrest function tend to do much better. If an older patient is cognitively intact and in reasonably good health, he or she might want to consider allowing resuscitative care,” Dr. Abella said. “But ultimately, this is a very personal, individualized decision.”

That is the very point I and other opponents of SB 303 made forcefully Tuesday in Austin: The DNR decision should be the patient’s, not the doctor’s or that of strangers meeting in a secret ethics committee deliberation!

Texas supporters of SB 303 claim they only want to prevent patient suffering. Fine. But I also think this has a lot to do with money. With Obamacare coming down the pike, I am not so sure that improved resuscitation results for elderly and other expensive patients will be a welcomed development among our Health Care Technocratic would-be overlords. 

I can’t imagine President Bush’s Council on Bioethics ever countenancing this, but President Obama’s bioethics advisory commission has given conditional approval to test anthrax vaccine on children! From the Reuters story:

“We have to get this precisely right,” panel Chair Amy Gutmann, president of the University of Pennsylvania, said at a news conference. “Many significant steps would have to be taken” before a pediatric anthrax vaccine trial could be considered, she said. But she added that it is important “to develop the knowledge needed to save children’s lives” in the event of an anthrax attack. Balancing the need to protect children against the need to know, for instance, the safe dose of the vaccine, made this “one of the most difficult ethical reviews a bioethics board has ever conducted,” Gutmann said.

Activists said the board was wrong not to oppose unequivocally testing the anthrax vaccine in children. Vera Sharav, founder of the Alliance for Human Research Protection, predicted that such a study would cause “moral harm for us as a nation and suffering for the children. They should have said, ‘thou shalt not.’”

This is non therapeutic testing in that the children are healthy and their lives and health will be put at risk. Children could definitely be harmed in these tests:

Federal regulations set a high bar for research on kids. If the chance of their benefiting is minuscule or nil, and the potential risk even minimal, children are usually off-limits. The presidential bioethics panel conceded that “there is no prospect of direct benefit to children” who participate in an anthrax-vaccine study, Gutmann said. According to the biodefense board, children in such a study would face more than minimal risk (defined as a risk no greater than that in daily life or at a check-up), mostly because the side effects of the vaccine in children are unknown.

So who’s children will be put forward as the guinea pigs? If they go forward, I suggest the first to volunteer be the children or grandchildren of the council members. I’ll bet there would be no takers.

Jack Kevorkian’s first death was of Janet Adkins, who had early stage Alzheimer’s, but was so fit she beat her son at tennis a few days before she died. (He actually murdered her by lethal injection, according to his own statement to Larry King). Now, one of the Swiss suicide clinics is apparently to host the suicide of a man with Alzheimer’s. From the Daily Mail story:

An 83-year-old dementia sufferer plans to die at the Dignitas assisted suicide clinic, it was claimed yesterday. The British professional man would be the first to end his life at the Swiss clinic purely because of dementia. His plans were publicised by Michael Irwin, a campaigner nicknamed Dr Death, who says he has helped at least 25 people who have died at Dignitas and advised many more. Mr Irwin, 80, has been investigated in the past  over assisted suicide – an offence carrying a 14-year jail sentence – but has never been arrested.

Irwin is a self-promoter and ideologue for the culture of death from way back. (I once debated him on the BBC.) That’s why I am so sure that every effort is being made to help this poor man find a different way, such as interventions and suicide prevention. I mean, that’s what a truly compassionate person would do. 

Compassion? Why that’s Irwin’s middle name!

’The severely disabled and the elderly with medical problems should be equally well discussed nowadays, especially with an ageing population,” Mr Irwin said. “The desire to stop being a burden on one’s family and to avoid squandering financial resources perhaps better spent on grandchildren’s further education could become the final altruistic gesture, especially when combined with a wish to stop prolonging a life that is both futile and very unpleasant.”

But back to Switzerland. Their suicide clinics seem to accept all comers, and the Swiss refused to shut the suicide tourism down. Which is why I call it Kevorkian as a country. 

Culture of death, Wesley? What culture of death?

Neo eugenicists and would-be genetic engineers often claim that those of us who oppose their intention to engage in biological alchemy do so for strictly religious reasons. Not me. I oppose eugenics in all its forms because it violates the fundamentals of human exceptionalism by assuming that some people can be better than other people based on heightened capacities. The new eugenics merely deploys a kinder, gentler lexicon for the same inherently invidious distinctions described in the vile distinctions that used to be made between the so-called “fit” and “unfit.”

Eugenics has always had a tie-in to Darwinist philosophies–as opposed to the biological theory–which those of that persuasion either deny or get angry about. I don’t want to get into that fight here, but it is good to see biologist and science writer, Stuart A. Newman, giving purely Darwinian reasons for opposing the manipulation of the human embryo for engineering or transhumanist purposes in the Huffington Post. From, “The British Embryo Authority and the Chamber of Eugenics:”

Perhaps the most insidious factor in calls for acceptance of the idea of genetically engineering humans is the profound misconception of the nature of living organisms that underlies it. Organisms differ from machines or computers by being products of evolution rather than design. But complexity that has accumulated over billions of years does not come with blueprints or instruction books, and cannot be reconfigured with predictable outcomes.

Fair enough. But by opposing genetic engineering and eugenics, Professor Newman finds himself in uncomfortable company (from his perspective). So, he has to assure his readers that he remains on the side of scientific righteousness:

Although rejection of the realities of evolution is generally considered to be a sign of scientific ignorance, it unfortunately characterizes the thinking of some professional biologists who are strongly influenced by engineering disciplines. For example, the bio-entrepreneur Craig Venter has claimed that there is “no difference between digital code and genetic code”, and the Stanford University (formerly MIT) “synthetic biologist” Drew Endy asked a New Yorker reporter ”What if we could liberate ourselves from the tyranny of evolution by being able to design our own offspring?”. This showboating, promoted by think tanks and major media outlets, deceives the general populace by promoting the notion of science as magic, and the scientist not as a cautionary Dr. Frankenstein, but as a valorously adept Harry Potter.

The ironic lesson of the new drive toward DNA-based eugenics (of which the mitochondrial replacement techniques would be the thin end of the wedge), is that despite its being the special initiative of an avowedly progressive sector of biomedicine, it actually brings together some of the most regressive strains of traditional and modern society: valuation of people according to their biological characteristics, parental proprietorship, the marauding entrepreneur and evolution denialism. 

That’s funny. Newman is trying to shame his progressive friends out of their folly. Good luck with that. Progressives hubristically believe that “experts” have the answers and can perfect anything. They aren’t going to stop because Newman tries to put them in bed with supposed regressives.

By the way, that last crack is a hit on my intelligent design pals at the Discovery Institute, such as John G. West, who fight eugenics within the context of the Center for Science and Culture. Glad my colleagues are on Newman’s mind. They are not regressive in the least. But that’s okay. I guess Newman is a bit embarrassed to be on the side of the angels for a change. (Joking!) 

But isn’t it nice to see a Darwinist biologist standing against the coming neo eugenics tide.

The atheist proselytizer Richard Dawkins has decided to rattle the cages by claiming on Twitter that a pig is more human than a human fetus. From his Tweet:

With respect to those meanings of “human” that are relevant to the morality of abortion, any fetus is less human than an adult pig.

Dawkins just wants to upset pro lifers by using the “pig” as the example. He should grow up and get a life. And of course, biologically–which is Dawkins’ field, it is utter nonsense. Indeed, he’d fail high school biology with this Tweet:

“Human” features relevant to the morality of abortion include ability to feel pain, fear etc & to be mourned by others.

Idiotic. The ability to “feel pain” has nothing to do with “being human,” biologically or morally. All mammals feel pain. And, of course, fetuses can be–and are–mourned by others, which again isn’t an exclusively human trait. 

He applies junk biology to call a human fetus only “potentially” human:

Of course potential to be human is among fetus’ qualities. But my pig comparison was careful to specify “relevant to morality of abortion.”

Any embryology text book will tell Dawkins that is nonsense. A human fetus is fully “human.” So is a human embryo. So is a human zygote. As Human Embryology and Teratology (page 9) puts it:

[U]nder ordinary circumstances, a genetically distinct human organism is formed when the chromosomes of the male and female pronuclei blend in the oocyte. This remains true even though the embryonic genome is not actually activated until 2-8 cells are present, at about 2-3 days…

Despite the various embryonic milestones, however, development is a continuous rather than a saltatory process, and hence the selection of prenatal events would seem to be largely arbitrary [in determining whether a human organism is "a human person in the philosophical sense."]

I would assume that also includes the time when a fetus can feel pain.

And typical of this line of sophistry, he claims his fingernails are “human.”

My hair and fingernails are human but don’t feel pain when I cut them. Embryo before brain develops doesn’t feel pain. Late fetus? Pig?

No, they are human cells that come from an organism that is a member of our species. A human being is an organism of our species. Dawkins is no more human today than when he was a one-celled organism in his mother’s Fallopian tube. Perhaps no more morally astute, either. 

I could not believe my eyes: A judge has ordered the Aurora killer to be injected with a truth serum to test the veracity of a “not guilty by reason of insanity” agreement. From the Guardian story:

Legal and medical experts are questioning the decision of a judge in Colorado to allow James Holmes, the suspected gunman in the Aurora cinema shooting, to be tested with a “truth serum” should he plead not guilty by reason of insanity. Judge William Sylvester ruled that in the event of Holmes pleading insanity his prosecutors would be permitted to interrogate him while he is under the influence of a medical drug designed to loosen him up and get him to talk.

The idea would be that such a “narcoanalytic interview” would be used to confirm whether or not he had been legally insane when he embarked on his shooting spree on 20 July last year. The precise identity of the drug that would be used has not been released, other than a statement that it would be “medically appropriate”, but it would most likely be a short-acting barbiturate such as sodium amytal.

Medically appropriate?  This isn’t treating any medical condition. It is a form of coercion, permitting a plea in return for questioning under a non-efficacious medication, of questionable effectiveness, that moves us toward the kind of interventions one used to see in the Soviet Union. No ethical medical practitioner should have anything to do with it.

If Holmes was legally insane, let him prove his case it in open court. 

The NHS is a disaster, squared–caused by socialized systems, rationing, and centralized control.  Over the years, I have reported here on women giving birth in hospital hallways, people being kept waiting in ambulances before entering ERs in order to permit hospitals to comply with waiting time directives from on high, and myriad other horrors.

An especially egregious debacle even got the attention of Prime Minster David Cameron. From the PM’s statement:

What happened at The Mid-Staffordshire NHS Foundation Trust between 2005 and 2009 was not just wrong, it was truly dreadful. Hundreds of people suffered from the most appalling neglect and mistreatment. There were patients so desperate for water that they were drinking from dirty flower vases. Many were given the wrong medication, treated roughly, or left to wet themselves and to lie in urine for days. And relatives were ignored or even reproached when pointing out the most basic things which could have saved their loves ones from horrific pain or even death. We can only begin to imagine the suffering endured by those whose trust in our health system was betrayed at their most vulnerable moment. And that is why it is right to make this statement today.

Donald Berwick, given a recess appointment by President Obama to head Medicare where he served for about two years, loves the NHS. He has extolled it above the American system. He supported its centralized manners and rationing of care. In fact, he so loved rationing that the Democratic-controlled Senate didn’t hold a hearing which would have permitted him to be asked about it–and Obama made the appointment to mask Berwick from politically uncomfortable questions.

And now, he gets to be a part of it! From the PM’s statement:

Quality of care means not accepting that bed sores and hospital infections are somehow occupational hazards and a little bit of these things is somehow ok. It is not ok. They are unacceptable.That’s what zero harm means. So I have asked Don Berwick – who has advised President Obama on this issue – to make zero harm a reality in our NHS.

Good luck with that, Dr. Berwick. You love the NHS mess, now let’s see if you can fix it. 

Tasmania’s ruling party seeks to force all doctors to be complicit in abortion by forcing objecting doctors to refer to abortion-friendly colleagues. More than that, the bill would essentially obliterate pro-life crisis pregnancy counseling by forcing anti abortion pregnancy councilors to refer women to counseling that supports abortion. (Victoria, Australia already has an anti-conscience law requiring all doctors to be complicit in abortion.) From the REPRODUCTIVE HEALTH (ACCESS TO TERMINATIONS) BILL 2013:

7. Obligations on medical practitioners and counsellors:..

If a woman seeks a termination or pregnancy options advice from a medical practitioner and the practitioner has a conscientious objection to terminations, the practitioner must refer the woman to another medical practitioner who the first-mentioned practitioner knows does not have a conscientious objection to terminations.

If a woman seeks pregnancy options advice from a counsellor and the counsellor has a conscientious objection to terminations, the counsellor must refer the woman to another counsellor who the first-mentioned counsellor knows does not have a conscientious objection to terminations.

Remember, if they can do this with non therapeutic abortion–which is a consumerist, not a medical procedure–they can to it with assisted suicide too. (Not coincidentally, Tasmania is seeing a big assisted suicide legalization drive.)

If it can happen there, it will be tried here. The pro abortion lobby really does want to drive all medical professionals unwilling to take human life out of the medical profession, and they especially want to obliterate pro life crisis pregnancy counseling. But like I always say, the culture of death brooks no dissent. 

An elderly woman residing in an independent living center collapsed and a nurse refused CPR–because of the facility’s “policy.”  This seems like a real scandal, but it needs a little unpacking. From the LA Times story:

Bakersfield fire dispatcher Tracey Halvorson pleaded with the woman on the other end of the line to start CPR on an elderly woman who was barely breathing. “It’s a human being,” Halvorson said, speaking quickly. “Is there anybody that’s willing to help this lady and not let her die?” The woman paused. “Um, not at this time.”

According to a 911 tape released by the Bakersfield Fire Department, the woman told Halvorson that she was a nurse at Glenwood Gardens, a senior living facility in Bakersfield. But the nurse refused to give the woman CPR as directed by the dispatcher, saying it was against the facility’s policy for staff to do so, according to the tape.

Sounds utterly damning. But a word of explanation: Had the woman signed a Do Not Resuscitate order, the proper course would have been to comfort the patient but not try to revive–and, by the way, not call 911. But that was not the case here. Rather, refusing to resuscitate was facility policy:

Jeffrey Toomer, executive director of Glenwood Gardens, issued a statement on behalf of the facility, extending his sympathies to the Bayless family. But Toomer also defended the nurse, saying she followed policy. “In the event of a health emergency at this independent living community our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives,” he said. “That is the protocol we followed. As with any incident involving a resident, we will conduct a thorough internal review of this matter, but we have no further comments at this time.”

The Gardens is apparently not a nursing home, per se. Perhaps the facility feared a lawsuit if CPR was done inexpertly. But a “blanket” do not resuscitate policy regardless of the circumstances?  When dealing with elderly clients or patients? Big trouble potentially on the way.

I think it would be worth knowing if this kind of policy is ubiquitous within the industry, and if so, whether regulatory engagement is required. On a human level, this policy seems hard to justify.

Here we go again. A woman committed suicide and it is depicted in the press as a positive–”on her own terms.” And note, she was not terminally ill, the usual excuse for supporting suicide. From the Globe and Mail story, “A Social Activist’s Ultimate Legacy: Advocating for the Right to Die:”

Ruth Goodman died the way she lived – on her own terms. She campaigned for social justice all her adult life: by training as a welder to earn the same wages as men in wartime shipyards, by speaking out for freedom of expression during the McCarthy era, by picketing napalm manufacturers in Seattle during the Vietnam War and by challenging the abortion laws in Canada after she and her husband moved north to Vancouver with their young sons to evade the voracious American military draft.

Why should life be prolonged for an aged social activist who believed the right to die was the ultimate human choice? That’s the question raised in the aftermath of Ms. Goodman’s death by her own hand and in her own bed on Feb. 2. “People are allowed to choose the right time to terminate their animals’ lives and to be with them and provide assistance and comfort, right to the end. Surely, the least we can do is allow people the same right to choose how and when to end their lives,” she wrote in a suicide note made public by her now middle-aged sons…

This impacts others, who may be on the edge of suicide and reading the story of suicide as a positive could push them over. That’s why the WHO urges media not to publish pro suicide stories–not that it probably even crossed the minds of the reporter and editors of the Globe and Mail.

That point aside, this is where we now are–thanks in large part to the euthanasia/assisted suicide movement and a complicit media that extols many suicides these days as a matter of social justice. Suicide is being transformed into a human right before our very eyes. But if it’s a “right” that means for anyone and any reason:

Death on demand. Reader take warning!

The hyper-drive to control human population leads to tyranny and abuse. The most infamous example is China’s “one child” policy, which has seen forced abortion, female infanticide, and eugenics. Now, some among the radical environmentalist crowd, want it spread around the world.

If they like the one child policy, they will delight at the concerted drive to sterilize Indian women–which apparently includes paying the destitute to be made sterile. So, we now see the ugliness of mass sterilization days that seem akin to what we sometimes see in the USA involving dogs and feral cats. But the dogs and cats here are apparently treated much better and humanely than some of the women there. For example, how about a mass sterilization and subsequent dumping of the women into a dirt field?  From the Hindustan Times story:

Scores of women were dumped unconscious in a field after a mass sterilization because there was no room in hospital for them to recuperate, medical officials said on Thursday.The women had all undergone surgical procedures at a hospital in the Malda district of West Bengal, around 360 kilometres north of Kolkata, which officials admitted was not equipped to accommodate such a large number of patients.The scandal came to light after news channel NDTV aired amateur footage of unconscious women being carried out of the hospital Tuesday by men and then placed on open land.Local health officials acknowledged that the patients’ treatment was unacceptable and promised an inquiry.“Over 100 women, mostly poor, came to the camp for the surgery. Immediately after the procedure, the doctors asked the helpers to move each of them to the adjacent field,” Biswa Ranjan Satpathi, West Bengal’s director of health services, told AFP in Kolkata.“This is inhuman and we have ordered a probe into the incident,” he added.Medical experts also voiced shock over conditions at the hospital, where four doctors carried out a total of 106 sterilizations in one day.

This is the kind of thing that can happen when humankind is declared the enemy of the planet. Centralized control puts pressure on local officials, and voila. Radical Malthusian ideology leads to denigration, objectification, and abuse. 

And why are the women being mass sterilized? Much easier and less risky for men: snip, snip. But women, particularly poor women, usually pay the price in matters such as this. 

India needs to get its act together. Biological colonialism is rife, with destitute women and girls used (and occasionally dying) as brood surrogates and sources of eggs, and the subjects of unethical medical experimentation. Human exceptionalism is violated any time a human being is used as an object rather than respected as a subject.

HT: Bioedge

The Liverpool Care Pathway was created to ensure that dying patients are treated properly in NHS hospitals. But it got caught up in centralized care dysfunction, with bureaucrats setting targets and suggestions for payment incentives, etc.. That led to some patients being subjected to check list medicine, in which they are dealt with as category members instead of as individuals–which was not the Pathway authors’ intent.

Bad press followed when non dying patients were put into comas and dehydrated to death, as just one example.  Well now, a survey shows that many medical professionals blame the media for reporting the problems instead of the actual cause, e.g., the manner in which the Pathway has been too often misapplied. From the British Medical Journal story:

Overall, 57% (321/563) of the doctors thought that recent negative press coverage had led to the Liverpool care pathway being used less (fig 1⇓). This rose to 74% (136) for palliative medicine consultants, supporting concerns made by leaders in the specialty.8 Among those doctors who said there was less use of the pathway, 60% (194) said patients and relatives had asked them not to use it and 80% (258) said staff were apprehensive about relatives’ complaints. One palliative medicine doctor said, “Negative press regarding LCP [the pathway] has caused additional distress for relatives at an already distressing time when their loved one is dying. This has caused a dilemma in judging if discussing the LCP will cause more distress than the benefit of being on the LCP for coordination of care in the dying phase.”

But that’s because many of the horror stories were and are real! That’s not the Pathway’s fault–it was written to ensure the individual needs of each patient were met. But once it became a bureaucratic imperative, the point of individualized care got lost in the memorandum and target document weeds.

Some still have a “blame the messenger” mentality:

One doctor said that this “scare mongering” was “putting end of life care back about twenty years, where dying patients were hidden inside rooms and not seen by a consultant.”

If so, look in the mirror! The bad things happened! That’s the cause of discord, and the reason for the negative stories.

The reports of very serious problems in the implementation and misapplication of the LCP are not scare mongering. The Pathway was not intended to put most dying patients into comas. It was meant to be nuanced and individualized, with care provided based on the exigencies of each case. Again–and please forgive me for being a broken record–that is the fault of the deprofessionalizing of medicine caused by increasing bureaucratization.

(For you younger readers, “broken record” is an archaic reference to a phrase repeating endlessly because of the phonograph needle hitting a scratch in the vinyl record. Today, we would call that a loop.)

A bill authored by my pal Sen. Mary Pilcher Cook that would establish a stem cell center in Kansas–no embryonic research allowed–has passed the Kansas Senate. From the legislative summary:  

The bill would state that all funds and facilities of the Center must be dedicated to treatments and research with adult, cord blood and related stem cells and non-embryonic stem cells. The bill would specifically prohibit the use of funds or facilities involving embryonic or fetal tissue cells.Finally, the bill would establish definitions associated with the creation of the Midwest Stem Cell Therapy Center, including the terms “adult, cord blood and related stem cells,”“embryonic stem cells,” “facilities,” “fetal tissue cells,” and“non-embryonic stem cells.” 

The stem cell controversy concerns deep disagreements about core ethics. That’s why all the screaming. This idea allows a common way forward by focusing on areas of agreement rather than discord. Nice. Let’s hope the Kansas House sees that as a virtue.

“Persistent vegetative state” is the only medical diagnosis I know of that contains a pejorative. No human being is a carrot. And the more we learn about these persistently unconscious patients, the more we  seem to be discovering that they may not be “gone” after all. Now, a study shows that they may experience pain. From the New Scientist story:

IT IS a nightmare situation. A person diagnosed as being in a vegetative state has an operation without anesthetic because they cannot feel pain. Except, maybe they can. Alexandra Markl at the Schön clinic in Bad Aibling, Germany, and colleagues studied people with unresponsive wakefulness syndrome (UWS) – also known as vegetative state – and identified activity in brain areas involved in the emotional aspects of pain.

Yikes. Some changes in care may be needed:

Nonetheless, Kotchoubey is confident that the way people with UWS are cared for will change, even if their diagnoses remain the same. “I know that many doctors working with such patients have been instructed to treat their patients as if they can understand them and perceive at least something in the environment, perhaps pain, pleasure, or emotion,” he says.

But not all people are treated this way. Prior to the study, one of the people in Markl’s study was given no anesthesia before a tracheotomy, which involves an incision in the neck to allow breathing without using the nose or mouth. As people with UWS are clinically considered unable to understand pain, doctors do not have to give an anesthetic.

Dehydrating to death over 14 days would also hurt. Terri Schiavo died that way without benefit of anesthesia, indeed, not even allowed ice chips on her lips.  Her cruel case aside, don’t expect the practice to stop. They will just be anesthetized while their bodies drain of fluids (some already are) or lethally injected. 

Social Darwinism/eugenics is making a comeback. In the UK, a local politician said that disabled children should be “put down” due to the expense of their care, and created a furor! From the This is Cornwall story:

A CORNWAL councillor has apologised but refused to resign after telling a disability charity that all disabled children “should be put down”. Collin Brewer, independent councillor Wadebridge East, made the comments to Disability Cornwall at County Hall when the group had an information stand at an event to allow councillors to meet equalities organisations and understand some of the issues they face. At the event, which took place in October 2011, Mr Brewer approached the stand and was told how the group helps parents of children with special educational needs. He responded by saying: “Disabled children cost the council too much money and should be put down.”

Now, one might be tempted to believe that Councillor Brewer is just an aberration. He’s not. Across the Western world there is much advocacy for permission to “put down” the disabled. 

Take Peter Singer of Princeton, who wrote in Rethinking Life and Death that parents who don’t want a Down child should be able to put the baby down:

Both for the sake of “our children,” then, and our own sake, we may not want a child to start on life’s uncertain voyage if the prospects are clouded. When this can be known at a very early stage of the voyage we may still have a chance to make a fresh start. This means detaching ourselves from the infant who has been born, cutting ourselves free before the ties that have already begun to bind us to our child have become irresistible. Instead of going forward and putting all our efforts into making the best of the situation, we can still say no, and start again from the beginning.

Not only did Singer not resign, but he is at the top of the world’s academic elite because of these views, not in spite of believing that it is perfectly fine to “put down” (some) disabled.

It’s already being done from coast to coast. We dehydrate profound cognitively disabled people to death in all fifty states in the USA–a death that comes slowly over about a two week period, often resulting in tissue cracking and even bleeding.  We dress it up in nice clothes by claiming we are merely withdrawing unwanted medical treatment. But when the “treatment” is basic sustenance, not only are we intentionally causing death, but symbolically, we are saying that the dehydrated person’s life is so unworthy of being lived, we won’t even give them proper food or water. Or to put it another way, we “put down the disabled.”

In Belgium, people with disabilities such as caused by MS are looked to as splendid sources of organs if they ask for euthanasia, giving society a utilitarian stake in, quite literally, “putting down the disabled.”

I could go on and on: Jack Kevorkian has been lionized for committing about 130 assisted suicides (and at least 1 euthanasia). About 70% of his deaths did not involve terminally ill people, but disabled and despairing people. Yet, despite his having “put down the disabled,” he not only became popular, but had a hagiographic biopic made with Al Pacino starring as Kevorkian.

Of course it won awards!  Films that depict a compasssionannnate friend, loved one, or doctor who “puts down the disabled,” usually do. Think Million Dollar Baby.

So, people are outraged that a local politician would advocate putting down the disabled!  I think they should be. But no one should be surprised.  It’s already being done.

Oh, oh. NYU Bioethicist Art Caplan seems to suggest–in the context of a story about former Israeli Prime Minister Ariel Sharon–that we should not maintain people like Terri Schiavo and others, who are either in a persistent vegetative or minimally conscious state–this even though new research suggests that at least some are more aware than thought previously. From the PRI story:

What these new technologies can reveal about brain activity is important, Caplan said, but it’s important not to overstate their importance, because people end up in a comatose state for different reasons. “Even though people see certain things going on in someone in a permanent vegetative state, there are some reflexes there. They are digesting their food, they’re not dead, there’s some brain activity, we have to realize the quality of life can be awful,” he said. In Sharon’s case, Caplan said, he’s in a state that’s starting to be called “minimally conscious.”

“But in all these situations, let’s keep in mind, people of goodwill, loving family members, partners, friends, they could still say ‘I don’t care if his brain is active, he would not want to be bed-bound, in a minimally conscious state. That’s not a situation I want to prolong with technology,’” he said. But the sort of care that’s needed for these people can be incredibly costly. It can also take up valuable spots in hospitals and intensive care units. Caplan says family members should consider alternative means of caring for their relatives, if they find them in such a state. “We shouldn’t have 5,000 to 10, 000 people in intensive care in the United States alone, when we can barely provide basic care for our children,” he said.

The term “intensive care” in the last sentence is inaccurate in many–perhaps most–cases, since the vast majority of such patients are not hooked up to “machines” in the ICUs of hospitals–at least in the long term–but already receive skilled nursing or in-home care rather than remaining in hospital. Moreover, quite a few don’t even need respirators, just food and water, warmth–and hey, how about a little love–like Terri Schiavo’s family wanted to give her.

But to Caplan’s last point: If we “shouldn’t” have these patients draining our finances, what should be done to prevent it, particularly since we don’t permanently maintain most of these patients in ICUs now? Sounds like implied death panel talk to me!