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!

A doctor can be forced to violate her religious beliefs in the operation of her practice, according to the Obama Dept. of Justice. Attention must be paid. This is a step beyond the radical DOJ argument made previously in the Free Birth Control Rule cases, e.g., that business owners do not have freedom of religion in the way they operate for-profit businesses. CNS News reported that in this context, Judge Reggie Walton asked an intriguing question. From the court transcript (starting at page 35):

THE COURT: Well, I mean, my wife has a medical practice. She has a corporation, but she’s the sole owner and sole stock owner. If she had strongly-held religious belief and she made that known that she operated her medical practice from that perspective, could she be required to pay for these types of items if she felt that that was causing her to violate her religious beliefs?…

It’s a legal separation. I mean, she obviously has created the corporation to limit her potential individual liability, but she’s the sole owner and everybody associates that medical practice with her as an individual.And if, you know, she was very active in her church and her church had these same type of strong religious-held beliefs,and members of the church and the community became aware of the fact that she is funding something that is totally contrary to what she professes as her belief, why should she have to do that?

The answer is chilling on two fronts, as I will discuss below:

MR. BERWICK: Well, Your Honor, again, I think it comes down to the fact that the corporation and the owner truly are separate. They are separate legal entities.

So, as a business owner, even as a sole proprietor, she would have to violate her religious beliefs in service to the government’s desired morality as set by regulations. (The DOJ argues that a prime purpose of the HHS Mandate is “gender equality,” which is not the point or purpose of health insurance.)

But it isn’t just the corporate shell that matters with regard to the DOJ argument. Elsewhere, government lawyers argued that it is the mere act of seeking profit that eradicates freedom of religion in the context of doing business, an assertion that goes far beyond what might have to be covered in health insurance.

What if the government one day requires all doctors to participate in abortion or assisted suicide, either by doing the deed personally or referring to a doctor who will. That is already the law of Victoria, Australia regarding abortion, so it is clearly not beyond the pale. If a doctor has no freedom of religion in the context of his or her business, then refusing to do an abortion or assist in suicide based on religious beliefs could also be outlawed, simply because the doctor is in business. Anyone who can’t see the tyrannical possibilities doesn’t want to see. 

Transhumanism is a collective of (mostly) naked materialists who hope science and technology will replace the deeper meaning they lost by rejecting metaphysical beliefs. Transhumanists harbor futuristic dreams of making themselves immortal and possessing what would now be thought of as superpowers through technological recreation. Toward those ends, they spend a lot of time and energy discussing and debating arcane issues such as the ethics of uploading consciousness into computers and living forever.

I find it all rather sad. And worrying. Transhumanism harbors blatantly eugenic ambitions and as part of its theology (more on that in a moment) it angrily rejects human exceptionalism. For example, one of the movement’s high priests, J. Hughes, has yearned to enhance a chimp into human attributes to prove we are not special. 

I used the word “theological” above because in many ways transhumanism is a quasi religion. It has dogma, eschatology, and yearns for a material New Jerusalem of immortal life. And if Belinda Silbert is to be believed, they want to be gods. Literally. From, “Transhumanism as a Bridge to Divinity:” 

“What this life is for” is a question that Transhumanists are engaging with all of the time. Most of us wish for longer lives so that we can live up to a potential that has not yet been defined by the confines of the human brain. To “see eternity in a grain of sand” is all very well, but to LIVE in that eternity and to experience it multi-dimensionally (with senses that are not dulled by the confines of the present human paraphernalia) would be true bliss. Responsible Omniscience; Omnipresence; Omnipotence AND Benevolence would be the totality of the sensory apparatus of the new human.

Well, no one can say the movement isn’t ambitious.

OOO will never happen for humans, of course. I can’t think of a theistic religion that so holds. And Buddhism’s concept of enlightenment isn’t the same thing. Moreover, if we had that kind of power, it wouldn’t always be “benevolent,” however the transhumanists would define the term. Considering its eugenic premises, it isn’t benevolent now. Power corrupts. And being omniscient, omnipresent, and omnipotent would certainly corrupt absolutely. 

Silbert closes with a little “humility:”

What then is humanity? I would posit the opinion that humanity is the seed of all potential that could flower into what we have painted as Divinity. The lines will blur. The true revelation will be that Human and Divine are one and the same.

If that is so, how are we not exceptional?  Very confusing. But like I have been saying for years now, transhumanism is religion, and religion depends on faith, the “assurance of things hoped for, the conviction of things not seen.”

I just listened to a fascinating interview on Fresh Air with Dr. Sam Parnia, author of the forthcoming book, Erasing Death: The Science that is Rewriting the Boundaries Between Life and Death. Parnia is the Director of Resuscitation Research at the State University of New York at Stony Brook. Here is an excerpt from the Kirkus Reviews review:

Since it is now possible to resuscitate people who would previously have been pronounced dead, the question then arises: When does death occur? Death is not an event, writes the author, but a process that is sometimes reversible. This idea leads him to question the implications of near-death or after-death experiences. While they do not in themselves substantiate any religious beliefs, there are too many documented cases to be ignored. People from diverse cultures who hold different religious beliefs, including atheism, describe many common features, such as seeing a bright light and a guiding figure, and out-of-body experiences.

A fascinating discussion that addresses medical, moral and social issues and their implications for understanding consciousness, self-awareness and the soul.

Parnia is one of the world’s foremost researchers into the phenomenon of death. Among the interesting and sometimes unexpected statements Parnia made to Terri Gross in the interview:

• He isn’t coming from a religious perspective and doesn’t “have a religion.”
• When the heart stops, the brain ceases functioning.
• People sometimes “remember” what happened to them after their hearts stopped and brain ceased functioning, in about 1% of the cases.
• The “memories” dealt with what happened in the hospital room, often recalled with remarkable accuracy, and what could be interpreted as an afterlife.
• People able to communicate right after resuscitation, are better able to communicate their experiences than those whose brains swelled and were unable to communicate for a period of time. People seem to forget them over time and thus more may be having these experiences than are actually reported.
• Those who “died” natural deaths reported remarkably similar experiences of entering a warm light, encountering a loving being, and reviewing their life experiences–particularly of having a totally empathetic reaction about how their own conduct affected others. In other words, if the person hurt another person’s feelings, the “dead” person personally experiences the hurt.
• The after “death” reports were strikingly similar whether the resuscitated person was a child or an adult, religious or atheistic.
• People resuscitated after suicides reported strikingly different experiences, terrorizing and dreadful. He has no idea why that might be.
• Science cannot yet demonstrate that neurons are capable of generating thought.
• The jury is still out whether the mind’s locus is in the brain or indeed, even in the body.
• The mind may be able to function with no brain at all.
• Parnia’s overall goal in writing the book is to improve and standardize care after cardiac arrest. 

It seems to me that the people who “came back” weren’t really dead, but it also seems clear that their experiences cannot be explained as a purely neurological phenomenon if the brain had ceased functioning. I think I’ll give this book a read. 

Sex selection abortions are a form of eugenics, e.g., they are performed because the gestating fetus is of the wrong “kind.” India, China are in the midst of a demographic crisis because of sex selection and Canada has a problem too. Now, Kansas State Senator Mary Pilcher Cook–a friend and a force of nature–has a bill moving through the KS Senate that would outlaw sex selection abortion.  From SB 141:

Section 1. (a) No person shall perform an abortion with knowledge that the pregnant woman is seeking the abortion solely on account of the sex of the unborn child.

For a change, a father would have some rights in this issue, via civil remedies:

(b) (1) A woman upon whom an abortion is performed or induced, or upon  whom  there  is  an  attempt  to  perform  or  induce  an  abortion,  in violation of this section, the father, if married to the woman at the time of the abortion, and the parents or custodial guardian of the woman, if the woman has not attained the age of 18 years at the time of the abortion, may in a civil action obtain appropriate relief, unless, in a case where the plaintiff is not the woman upon whom the abortion was performed, the pregnancy resulted from the plaintiff’s criminal conduct.

The woman couldn’t be charged criminally, but the abortionist could:

Upon a first conviction of a violation of this section, a person shall  be guilty of a class  A person misdemeanor.  Upon a second  or subsequent conviction of a violation of this section, a person shall be guilty of a severity level 10, person felony.

Anti sex selection abortion laws proclaim that eugenic attitudes are wrong. I wish this bill well.

Good grief. When we are supposedly about reducing health care costs, Senator Dianne Feinstein (D-CA–of course!) pushes legislation that would require us all to get a physician’s prescription to buy Sudafed. From Debra J. Saunders,’ ”God Bless You, Sen. Feinstein,” in the San Francisco Chronicle:

Sen. Dianne Feinstein began her war on allergy and cold sufferers in 2005. In an effort to prevent small-time dealers from buying allergy and cold drugs and cooking them into methamphetamine, she pushed through legislation requiring consumers to show identification before purchasing products with pseudoephedrine – otherwise known as the good allergy drugs, known only to those who know enough to ask for them. Now Feinstein wants to make you get a prescription from a doctor before you buy these drugs.

Think about it. You get a slight cold or an allergic post nasal drip. You have to call your doctor to get a prescription. You have to have the prescription sent to the pharmacy. And then have a pharmacist fill the prescription. Costs going up!  Time wasted spinning wheels! More tying us in bureaucratic knots!

Even if you can obtain such a prescription by phone, the doctor will charge for the service. Those without a personal doctor would have to go to an urgent care or other clinic to get a prescription. Hey, I know! Just require doctors to give the prescriptions for free! That’s what they are doing to insurance companies in the Free Birth Control Rule. 

(Full Disclosure: I am married to Debra J. Saunders.)

At present, there are three small human safety embryonic stem cell studies. All deal with macular degeneration-type conditions. And now, a human trial looks to soon get underway in Japan using induced pluripotent stem cells, that is, stem cells made from a patient’s own skin or other tissues. From the Nature News story:

Having already received IRB approval at her home institution, Takahashi can now move towards the final step before patient recruitment: getting health ministry approval.  She’s expected receive that in time for starting the trials during this fiscal year, ending March 2014. The trial will enroll six patients older than 50 years of age. The researchers will remove damaged pigment epithelium and then implant a small sheet of new epithelium. The sheet will be created by coaxing iPS cells, created from the patient’s body cells, to become epithelium cells.

Takahashi says that apart from a small risk of damage from the surgical procedure itself (sticking a needle in the eye) and a much smaller risk of the stem cells themselves going awry, preclinical studies suggest the procedure to be safe. The clinical trial, meant to demonstrate the safety of the procedure in humans, is not expected to reverse the damage of macular degeneration, but researchers hope that it will at least slow its progress.

I believe that stem cell science is fast catching up with desirable stem cell ethics. That is, we may be able to have all the treatment and curative benefits touted for embryonic stem cells–without the embryo destruction part. That would allow society a common way forward without the contention we saw in the last decade.

Of course, human cloning is what some in biotechnology really want, as it is the necessary technology to enable genetic engineering and other Brave New World technologies. But if IPSCs work as treatments–and indeed, if direct reprogramming, in which a skin cell can be turned into a heart cell, prove effective–it will be pretty hard to sell a wary public on allowing human cloning, much less having the public fund the research. And think of it: Our skin would always have the potential of being used as a powerful healer. Onward!

(Yes, this fulfills another of my predictions in bioethics for 2013.)

Something called the French Medical Ethics Council has recommended allowing euthanasia in “extraordinary” cases. What folly.  France borders on Belgium and Switzerland–and is in easy driving distance from the Netherlands–all of which demonstrate that the culture of death, once unleashed, cannot permanently be controlled. From the AFP story:

France’s medical ethics council said Thursday that assisted suicide should be allowed in exceptional cases when suffering patients make “persistent and lucid requests” in a step forward to legalising euthanasia. Invoking a “duty to humanity,” the body said that this should be permitted upon the “persistent, lucid and repeated requests from someone suffering from an ailment for which the treatment has become ineffective”. But it said the condition should be verified “not by a sole doctor but a medical team”.

Talk about a death panel!

I wonder if the French bioethicists took a close look at the wild euthanasia/assisted suicide occurring with regularity in France’s neighboring countries–each example on the list below is well documented–and if so, how they could seriously think that allowing doctors to kill patients or assist in their suicides will long remain limited:

• Infanticide;
• Euthanasia of the mentally ill;
• “Termination without request or consent;”
• Euthanasia of elderly “tired of life;”
• Euthanasia of anorexic women;
• Euthanasia of the physically disabled;
• Joint euthanasia deaths of elderly couples who don’t want to live without each other;
• Joint euthanasia couple of disabled identical twins in Belgium.
• Euthanasia of the chronically ill;
• Euthanasia of the chronically grieving;
• Doctors teaching suicidal patients how to kill themselves;
• Coupling euthanasia with organ harvesting.

The French ethicists can fool themselves by thinking that the same thing won’t happen in France if it travels Euthanasia Road. Or they might not care what happens, but know that the promise of limitations is needed for public acceptance. Or, they might just be doing the political bidding of the Socialist Party, currently in power, that favors assisted suicide. But France’s neighbors show that the term “limited euthanasia” is an oxymoron.  

Pregnant teenagers, not a good thing. Usually, stories involving children who get pregnant involve the girls obtaining wanted abortions over the objections, or without the knowledge, of parents. But in Texas, a pregnant teenage girl is suing her parents to prevent them from forcing her to have an abortion. From the Court House News Service story:

HOUSTON (CN) – A 16-year-old sued her parents, claiming they are trying “to coerce her to have an abortion.”  R.E.K. sued her parents, Jeffrey Koen and Denise Watts Koen, in Harris County Court.  ”R.E.K., plaintiff, is a 16-year-old girl, who is nine (9) weeks pregnant,” the complaint states. “She does not want an abortion but her mother and father are attempting to coerce her to have an abortion.”   R.E.K. says she lived with the baby’s father, her 16-year-old boyfriend, and his parents, for some time “because her mother routinely does not supervise her, frequently spending her evenings at a local bar, and R.E.K. avoided her father’s presence because of his tendency towards physical violence, which she has observed on multiple occasions.”

Teen pregnancies don’t “just happen,” do they? 

The pressure allegedly got intense, including threats of violence and continual pressure and coercion. And what does the girl want from the court?

R.E.K. seeks an injunction to stop her parents from forcing her to have an abortion, and a declaration that “she has the right, under federal constitutional law, to make her own reproductive decisions, including the decision to carry her child to term and give birth.”

That is the law, it seems to me.

This is a terrible situation, no doubt about it. But regardless of one’s position on the legality of abortion–and certainly teenage parenthood is a daunting thing–at least we can all agree that this girl should not be forced into having her unborn child killed. Right? I mean, “choice” and all that, right?  Right? Right?

I was right. Again. Last month, I predicted that Geron would sell its defunct embryonic stem cell business this year, and the one major ESCR human trial would be on the road to resuming. (Yes, I know there are a few other tiny studies ongoing.) One month later, and it has happened. From the Nature Biotechnology story (subscription required):

Geron’s stem cell assets were given a new lease in early January when former CEO Tom Okarma, now heading a subsidiary of BioTime of Alameda, California, signed a definitive agreement for the latter to take control of the human embryonic stem cell (hESC) program. At the same time, the US Supreme Court ended a recent battle over hESC research when it declined to hear Sherley vs. Sebelius, a case that challenged federal funding for hESCs. James Thomson, professor of cell and regenerative biology at the University of Wisconsin in Madison, and the first to derive an hESC cell line in 1998, says, “Now there will be a way for Geron’s work in this area to move forward,” adding, “after years of controversy there is finally a reasonable policy for stem cell research.”

I suspect that part of that “way forward” will be with my credit card using California Institute for Regenerative Medicine borrowed money. Voters, kill the voracious beast in 2014 before it borrows again!!!!

Oh, sorry. I got a bit carried away: CIRM bitterness aside, I think that stem cell science has substantially moved on, with adult and induced pluripotent stem cells now offering the more immediate hopes of developing safe and efficacious regenerative treatments. Time will tell.

But this was never really a science issue. It was and is a dispute over ethics. Whatever the outcome of Bio Time’s new ESCR efforts, that won’t change.

The implosion of the NHS–caused by sclerotic centralized control–continues. Perhaps the biggest scandal in the history of the service has shaken the UK, with thousands allegedly dead due to poor hospital care. From the Telegraph story:

More than 3,000 people may have died unnecessarily at five NHS trusts in a crisis that could dwarf the horrors at Mid Staffordshire, which were detailed in a devastating report on Wednesday. An investigation began on Wednesday night into excessive mortality rates at the five trusts – the same warning sign that exposed the needless deaths of up to 1,200 patients at Mid Staffs.

The trusts in Lancashire, Essex and Greater Manchester have been “outliers” on an index of expected death rates for two successive years to 2012. Within hours of the publication of a report which described the “disaster” at Mid Staffs as the worst scandal in the history of the NHS, the Department of Health released figures which raise the possibility that the “appalling” lack of care may still be going on at hospitals around the country.

Increased power of the healthcare bureaucracy, I believe, leads to lower levels of professionalism, a concern that is validated by the story:

The report says there was “a failure of the NHS system at every level” to detect problems and take action. Despite between 400 and 1,200 people dying needlessly, and despite five investigations including Mr Francis’s £13  million public inquiry, not one person has been sacked or struck off.

Mr Francis said conditions of “appalling care” flourished because managers “put corporate self-interest and cost control ahead of patients and their safety”. He said patients were “let down” by a “lack of care, compassion, humanity and leadership”, with patients having to relieve themselves in their beds because no one would take them to the lavatory, others drinking water from vases because they were not given drinks and “callous indifference” to their suffering by ward staff. Staff who tried to raise concerns were ignored, bullied or intimidated, and watchdog bodies failed to react to repeated warnings.

We are moving in the same direction with Obamacare’s centralized mandates. It isn’t too late for us–yet. But we had better take warning!

Your daughters are not yours, anymore, they are Mayor Bloomberg’s.. He and school health clinic personnel are now in charge of inculcating values and sexual mores to your daughters, and providing their birth control and abortifacients when they have sex.

How else are we to describe New York City’s ongoing program that distributes morning after pills to girls as young as 14 without parental knowledge or consent. From the USA Today story:

It’s a campaign believed to be unprecedented in its size and aggressiveness: New York City is dispensing the morning-after pill to girls as young as 14 at more than 50 public high schools, sometimes even before they have had sex. The effort to combat teen pregnancy in the nation’s largest city contrasts sharply with the views of politicians and school systems in more conservative parts of the country…New York’s program was phased in at health clinics at about 40 schools in the 1-million-student school system starting about four years ago. Since January 2011, it has expanded to 13 additional schools that don’t have clinics. The little-known program was reported on Sunday by the New York Post.

I really think these people want teenagers to have sex. That debatable point aside, there is no question that parents are losing their rights to parent their own children. When I was young, we were taught that such a thing only happened in totalitarian countries. 

I am a huge supporter of adult stem cell research. But it needs to be done in the right way. Moreover, research subjects should never be charged for their own experiments as part of a for profit business–which, unfortunately, Texas permits legally–but that is not binding on the FDA.

Now, an adult research center that wants to rush (as yet) unproven regenerative treatments to the clinical setting is moving to Mexico. From the Nature news story:

US citizens who had pinned their hopes on a company being able to offer stem-cell treatments close to home will now need to travel a little farther. Celltex Therapeutics of Houston, Texas, stopped treating patients in the United States last year following a warning from regulators. A 25 January e-mail to Celltex customers indicates that the firm will now follow in the footsteps of many other companies offering unproven stem-cell therapies and send its patients abroad for treatment — but only to Mexico.

The stem-cell treatments offered by Celltex involved extracting adult stem cells from a patient, culturing them and then reinjecting them in a bid to replenish damaged tissue. It had been offering the treatment for more than a year — with one of its high-profile customers being Texas governor, Rick Perry — when the US Food and Drug Administration (FDA) wrote to the company on 24 September 2012 advising it that the stem cells it harvested and grew were more than “minimally manipulated” during Celltex’s procedures. As such, the FDA regarded the cells as drugs, which would require the agency’s approval to be used in treatments.

We would expect the FDA to do that if the treatments were embryonic. Adult experiments should be treated no differently.

The slow pace of the FDA can be maddening, but that doesn’t excuse a wild, wild, west approach to medical research–which can be dangerous, non efficacious, expensive, delay a patient from obtaining proven treatments, or all of the above.

Desperate people will take desperate measures looking for cures. It is wrong to take advantage of them. I would advise against traveling to foreign countries in pursuit of unproven treatments. 

For the emerging technocracy, saving money on health care and promoting “wellness” have become the ready excuses for government intrusions into the personal sphere. The UK’s NHS is leading the way on several fronts–rationing, using health care to promote certain social justice ends, and now, to gather mass information on citizens. From the Daily Mail story:

GPs are to be forced to hand over confidential records on all their patients’ drinking habits, waist sizes and illnesses. The files will be stored in a giant information bank that privacy campaigners say represents the  ‘biggest data grab in NHS history’. They warned the move would end patient confidentiality and hand personal information to third parties. The data includes weight, cholesterol levels, body mass index, pulse rate, family health history, alcohol consumption and smoking status. Diagnosis of everything from cancer to heart disease to mental illness would be covered. Family doctors will have to pass on dates of birth, postcodes and NHS numbers.

Confidentially is assured, of course! But then, so are our IRS records that have, from time-to-time in the agency’s history, been leaked against certain political undesirables.

The technocrats are creating a lucrative industry of compiling and analyzing medical information for use in trying to keep healthcare costs down and with which to develop “best practice” guidelines. Thus–HIPAA or no HIPAA–if we continue to follow the Obamacare road, controlling healthcare costs will excuse ever-deeper intrusions by the bureaucrats into our lives. Remember, there is now talk of the government urging doctors to inquire about guns that may be in your house. It isn’t just to tell you to keep the weapon locked in a safe. 

And good grief, with all the record keeping, data compiling, and reporting doctors may have in store, when will they have the time to actually practice medicine?

See Correction Below:

The Obama Administration has really pulled a fast one. In its proposed rule to supposedly provide greater protections to non house of worship religious organizations opposed to contraception, it actually ensures that contraception coverage will be provided to all religious employees–whether house of worship, convent, or school.  In other words, the proposed rule expands the government’s intrusion into religious affairs, rather than reduce it.

Here’s how they plan to do it:

1. From now on no distinction will be made in the rule between “house of worship” employers and general religious organization employers. In order to be exempted from the requirement of providing free contraception, sterilization, and (possibly) abortifacients, under the current rule, the non profit had to be, essentially, a house of worship or a monastic community. That requirement will be deleted.  Under the proposed rule, all bona fide non profit religious organizations will be treated the same. From the Notice of Proposed Rule Making:

For purposes of these proposed rules only, the Departments propose to define an eligible organization as an organization that meets all of the following criteria:  The organization opposes providing coverage for some or all of the contraceptive services required to be covered under section 2713 of the PHS Act on account of religious objections.The organization is organized and operates as a nonprofit entity.The organization holds itself out as a religious organization. The organization self-certifies that it satisfies the first three criteria, as described later in this section.   

On the surface, that would seem better, since the rule will make no distinction between Sisters of Mercy as an order and the Sisters of Mercy High School. That would be true if the exemption originally granted to houses of worship allowing them to not cover birth control at all, had been expanded to include organizations such as charities and schools. But that isn’t what the government is proposing at all.  

2. The existing total exemption for houses of worship, etc., has been eliminated. There used to be two tiers of religious organizations under the rule. The first–houses of worship–were completely exempted from having their employees covered for free birth control. The second, religious organizations, were not exempted. That’s what set off the brouhaha. Now all qualifying religious organizations receive the same accommodation. But it is not an exemption..

3. The Health Insurance Company Must Pay for Birth Control for All Religious Employees: From the text:

These proposed rules aim to provide women with contraceptive coverage without cost sharing and to protect eligible organizations from having to contract, arrange, pay, or refer for contraceptive coverage to which they object on religious grounds…[T]hese proposed rules would provide that, in the case of an insured group health plan established or maintained by an eligible organization, the health insurance issuer providing group coverage in connection with the plan would assume sole responsibility, independent of the eligible organization and its plan, for providing contraceptive coverage without cost sharing, premium, fee, or other charge to plan participants and beneficiaries…

The issuer would automatically enroll plan participants and beneficiaries in a separate individual health insurance policy that covers recommended contraceptive services. 

So, let’s say that the Sisters of Mercy have 150 employees. They must receive birth control coverage. They just don’t pay for it. But simply by being covered with health insurance, their carrier will be required to automatically enroll all employees for birth control under a separate policy on the corporate dime.

Thus, nuns will have birth control coverage whether they like it or not, and a private company will be forced to provide the coverage to religious organizations for free, coverage they can charge for in other contexts. A double dose of authoritarianism. 

I will be looking more deeply into this and writing at greater length. But it seems to me that the Obama Administration has used the contraception controversy to extend its cultural imperialism deeper into the religious realm. 

Update and Correction: I have now had a chance to scour the proposal more thoroughly. Because it is only stated by reference to a tax code section, I made a mistake when said the old narrow exemption was being killed. It still applies. The “accommodation” will be imposed on all other objecting religious organizations, and it triggers free birth control simply by the organization buying health insurance as required by the Affordable Care Act. This means, among other thing, that as I stated above, in many cases, nuns will have to be covered for birth control. No way to opt out for any religious organization not otherwise exempt other than to break the law and not purchase health insurance. 

Is there no end to the medicalization of human problems?  Now, the American College of Obstetricians and Gynecologists wants doctors to screen women for “reproductive coercion.” From the Washington Post story:

When a husband hides a wife’s birth control pills or a boyfriend takes off a condom in the middle of sex in hopes of getting an unwilling girlfriend pregnant, that’s a form of abuse called “reproductive coercion.” While researchers don’t know exactly how common such coercion is, it’s common enough — especially among women who are abused by their partners in other ways — that health care providers should screen women for signs at regular check-ups and pregnancy visits, says the nation’s leading group of obstetricians and gynecologists.

“We want to make sure that health care providers are aware that this is something that does go on and that it’s a form of abuse,” said Veronica Gillispie, an obstetrician and gynecologist at Ochsner Health System, New Orleans, and a member of the committee that wrote the opinion for the American College of Obstetricians and Gynecologists in the February issue of the journal Obstetrics & Gynecology.

Well, reproductive coercion is a two-way street. As Bioedge notes, NPR has reported that about twice as many women engage in RC (8.7%) as men (4.8%).

Reproductive coercion is wrong no matter who does it, of course. But why do I think this is part of a larger overarching ideological agenda to intrude the technocracy into every area of American life–and most particularly, those of women. I mean, for all the talk about how powerful women now are, the technocracy clearly views many as helpless.

How long do you think it will be before this issue becomes part of the Obamacare leviathan? The Free Birth Control Rule already requires that employers provide health insurance that covers free domestic violence screening for women. I can’t imagine it will take long before screening against reproductive coercion is added to the list–all consistent with an agenda I am beginning to see that would expand the purpose of the healthcare system to become a guarantor of “happiness.” Or, as I call it, Happy Face Statism.

And I note that the College seems to have little to say about another form of “reproductive coercion;” men, parents, grandparents, friends, and relatives pushing women into unwanted abortions. You can bet Obamacare will never require screening against that as the HHS drives toward an eventual Free Abortion Rule.  

I began seeing articles claiming that a recent Alabama Supreme Court ruling could undercut Roe v. Wade because it ruled that the unborn come under the definition of the term “child,” and so I decided to take a look for myself.  

It is an interesting–but very narrow–opinion.  Two women were convicted of taking dangerous drugs while pregnant. The facts were not in dispute. The question before the court was whether a chemically-caused “child” endangering statute applied, as in the appealed cases, to the unborn. The Alabama Supremes ruled specifically that it does. From Ankrom v Alabama:

As the [dictionary] definitions cited by the state indicate, the plain meaning of the word “child” is broad enough to encompass all children–born and unborn…Not only have the courts of this state interpreted the term “child” to include a viable fetus in other contexts, the dictionary definition of the term “child” explicitly includes an unborn person or fetus. In everyday usage, there is nothing extraordinary about using the term “child” to include a viable fetus.

Okay. Unborn fetuses are protected in law, including in some abortion contexts preventing late term abortions. So, how is Roe possibly impacted? The court ruled that the term “child” also applies to non viable fetuses:

To the extent that the Court of Criminal Appeals limited the applicability of the chemical-endangerment statute to viable unborn children,…this court expressly rejects that distinction as inconsistent with the plain meaning of the world “child” and with the laws of this state.

Okay, so all unborn children are, well, children. That undercuts Roe, right? Wrong!  

First, the ruling specifically limited the ruling to the statute in question, excluding it from applicability to other areas of law generally, and to any constitutional issues specifically. (A concurring opinion said that the unborn are “persons.” But that is not binding.) In this sense, the case protects all unborn children only in the context of chemical endangerment statute. That is all.

More to the point, even if the Alabama Supreme Court ruled that all embryos and fetuses are persons entitled to the full protection of the law in Alabama–it still wouldn’t impact Roe, which established a federal constitutional right to an abortion in most cases. The Feds trump the State in this regard–similar to the ways that federal anti marijuana laws trump state marijuana legalization (although the comparison is not 100% on point). The only ways to overturn Roe are with another Supreme Court ruling or a constitutional amendment.

Bottom line: The case works for me, but contrary to some pro life commentary, it is not an epochal ruling in the struggle over the legal and moral status of the unborn. 

Meanwhile, the AMA News has published an article jumping to equally overblown conclusions about the case, warning it could criminalize the prescribing of controlled substances to pregnant women.

I used to joke that if global warming hysterics were really serious about their belief that WE’RE KILLING THE PLANET!, they would urge shrinking us to the size of Pigmies so we would use fewer resources.

Remembering my old maxim: If I can make a proposal sarcastically, some radical will propose it seriously; a bioethics professor (of course!) from NYU named Matthew Liao has done just that. First, Liao thinks the crisis is dire. From, “Hand-Made Humans May Hold the Key to Saving the World:”

Human-induced climate change is one of the biggest problems that we face today. Millions could suffer hunger, water shortages, diseases and coastal flooding because of climate change. The latest science suggests that we may be near or even beyond the point of no return.

Dubious, at best. GWHs have been making that warning for almost a decade. And yet, the UK’s Met Office, and even James Hansen, have admitted recently that there has been no statistically significant warming for nearly 20 years and stories are now appearing even among true believers that the warming has been less than first thought.

Liao proposes engineering the human race to save the planet:

Before I explain the proposal, let me make clear that human engineering is intended to be a voluntary activity – possibly supported by incentives such as tax breaks or sponsored healthcare – rather than a coerced, mandatory activity. My colleagues and I are positively against any form of coercion of the sort that the Nazis perpetrated in the past (segregation, sterilisation and genocide).

 If Liao really believes his hysteria, how explain making his proposal purely voluntary? Mass extinction of the human race and other life on the planet would surely justify coerced solutions.

And what, pray tell, are these “human engineering” solutions?

1. Making us intolerant to eating meat:

Some experts estimate that each of the world’s 1.5 billion cows alone emit 100 litres to 500 litres of methane a day…Human engineering could help here. Just as some people have a natural intolerance to milk or crayfish, it is possible artificially to induce mild intolerance to red meat by stimulating the immune system against common bovine proteins. The immune system would then become primed to react to them, and henceforth eating ‘’eco-unfriendly’’ food would induce unpleasant experiences…A potentially safe and practical way of inducing such intolerance may be to produce ‘’meat’’ patches – akin to nicotine patches.

Practical?  Good grief.

2. Make humans smaller:

How could height reduction be achieved? Height is determined partly by genetic factors and partly through diet and stressors. One possibility is to use preimplantation genetic diagnosis, which is now employed in fertility clinics as a means of screening out embryos with inherited genetic diseases. One might be able to use preimplantation genetic diagnosis to select shorter children. This would not involve modifying or altering the genetic material of embryos in any way. It would simply involve rethinking the criteria for selecting which embryos to implant.

Also, one might consider hormone treatment either to affect growth hormone levels or to trigger the closing of the growth plate earlier than normal. Hormone treatments are already used for growth reduction in excessively tall children.

Not good for the NBA.

3. Cognitive enhancing women so they will have fewer children:

In the US, for example, women with low cognitive ability are more likely to have children before age 18. Hence, another possible human engineering solution is to use cognition enhancements, such as Ritalin and Modafinil, to achieve lower birth rates. As with education, there are many other, more compelling reasons to improve cognition, but the fertility effect may be desirable as a means of tackling climate change. Even if the direct cognitive effect on fertility is minor, cognition enhancements may help increase the ability of people to educate themselves, which would then affect fertility and, indirectly, climate change.

That sound you hear is my eyes rolling.

4. Use drugs to make us altruistic: 

Many environmental problems are collective action problems, in which individuals do not co-operate for the common good…Pharmacological induction of altruism and empathy may help here. There is evidence that altruism and empathy have biological underpinnings. For example, test subjects given the prosocial hormone oxytocin were more willing to share money with strangers and to behave in a more trustworthy way…This suggests that interventions affecting the sensitivity in these neural systems could increase the willingness to co-operate with social rules or goals.

Again, I am not proposing that we coerce someone to take up these pharmacological measures. Instead, there might be someone who wants to do the right thing, but owing to a weakness of will, cannot get himself to do the right thing. 

But people who need drugs to be altruistic and empathetic probably wouldn’t have the altruism or empathy to take the drugs. And what’s with the meme that others don’t have the “will power” to do what the hysterics want done?  Too smug by half.

So, we are told simultaneously that the crisis is dire and we are out of time, but rest assured, we will only utilize voluntary technological solutions, which should be noted, will not be doable for decades–if ever–and in any event, would take generations to have any real impact. That’s incoherent.

This is all so silly. And it makes me think that many of the GWHs don’t really believe much of their own hysteria. That may be because climate change is as much a political gambit to empower an international technocracy as it is an urgent scientific scare.

HT: Therese Mackay

The pro choice side of the abortion debate have always been profoundly dishonest, claiming that the unborn are not really “human.” (Well, they’re not Martians. They’re not chopped liver.) But it was deemed a necessary lie in order to protect the abortion license, and that trumps intellectual integrity every day of the week.

But now that the polls are (temporarily) looking better for the pro choice side, Salon writer Mary Elizabeth Williams is ready to come clean. From, “So What if Abortion Ends a Human Life?”

And in the midst of this unique moment [of positive polling], Planned Parenthood has taken the bold step of reframing the vernacular – moving away from the easy and easily divisive words “life” and “choice.” Instead, as a new promotional film acknowledges, “It’s not a black and white issue.”

It’s a move whose time is long overdue. It’s important, because when we don’t look at the complexities of reproduction, we give far too much semantic power to those who’d try to control it. And we play into the sneaky, dirty tricks of the anti-choice lobby when we on the pro-choice side squirm so uncomfortably at the ways in which they’ve repeatedly appropriated the concept of “life.”

What “sneaky, dirty tricks” are those?  Telling the biological truth, which is ironic since pro lifers are accused of coming to their conclusions because of a religious view of life, when they actually have science on their side, while the pro-choicers were the ones who for decades have denied basic biology.

Williams admits that fetuses are human lives, but says, “So what?” 

Here’s the complicated reality in which we live: All life is not equal. That’s a difficult thing for liberals like me to talk about, lest we wind up looking like death-panel-loving, kill-your-grandma-and-your-precious-baby storm troopers. Yet a fetus can be a human life without having the same rights as the woman in whose body it resides. She’s the boss. Her life and what is right for her circumstances and her health should automatically trump the rights of the non-autonomous entity inside of her. Always.

Which means through the ninth month, indeed any moment before the umbilical cord is cut, the human life can be made dead if that is what the mother wants. Taking her words at face value, Williams would permit healthy fetuses to be killed who could have been delivered and lived into infancy. Even Roe v. Wade didn’t go that far. 

Here’s an uncomplicated reality: Williams is right that reducing the moral value of some human lives makes it easier to dehumanize others of us, the necessary predicate to culture of death horrors. Thus, we have seen advocacy for the moral propriety of infanticide, for permission to kill and harvest the organs of profoundly disabled people like Terrie Schiavo, and for euthanizing patients with Alzheimer’s disease–attitudes that, at least in part, often arise out of a belief that abortion is our only absolute right. (Even free speech isn’t an absolute right.) 

I am sorry, but Williams’ moral core seems stunted by her zeal for abortion:

And I can say anecdotally that I’m a mom who loved the lives she incubated from the moment she peed on those sticks, and is also now well over 40 and in an experimental drug trial. If by some random fluke I learned today I was pregnant, you bet your ass I’d have an abortion. I’d have the World’s Greatest Abortion…

And I would put the life of a mother over the life of a fetus every single time — even if I still need to acknowledge my conviction that the fetus is indeed a life. A life worth sacrificing.

Kill the fetus whenever you want, under any circumstance, for whatever reason, and at any time! And yet pro-choicers bridle when critics of the abortion license claim that legalization has profoundly undermined society’s commitment to the value of human life. With this column, Williams owns it.

Obamacare outlawed underwriting by health insurance companies. In other words, if we are diagnosed with cancer, run 10Ks, have diabetes or a family history of heart attacks, we all pay the same price.

Fine. But there is one big exception. Smokers, who can be charged a huge insurance surcharge for their unhealthy habit. From the AP story:

If 1 in 5 U.S. adults smoke, and 1 in 3 are obese, why not just get off their backs and let them go on with their (probably shortened) lives? Because it’s not just about them, say some health economists, bioethicists and public health researchers. “Your freedom is likely to be someone else’s harm,” said Daniel Callahan, senior research scholar at a bioethics think-tank, the Hastings Center…

That’s the rationale for a provision in the Affordable Care Act – “Obamacare” to its detractors – that starting next year allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums. A 60-year-old could wind up paying nearly $5,100 on top of premiums.

Living unhealthy lifestyles has become the new Scarlet Letter. That’s what happens with centralized health care. But once we go down that road, it won’t end there. Smokers today, the obese tomorrow.

This financial stick is entirely political. Notice we never hear experts wanting to “punish” the promiscuous for the cost burden they inflict on the health care system. Yet people who sleep around, like smokers and the obese, cost the rest of us plenty–what with promiscuity leading to sexually transmitted diseases, some cancers, HIV, unwanted pregnancies, mental health issues, etc. Why isn’t what is good for the goose also good for the gander?

That won’t happen because society celebrates promiscuity and the popular culture glamorizes licentious lifestyles the way it once extolled smoking. Consider: Girls. We applaud basketball players who sleep with 20,000 women. We ooh, and ah over Reality TV celebrities, with no talent other than living provocatively before the camera, who sleep around and get very publicly pregnant. We even tend to think something is wrong with virgins who are older than 18.

If we are going to outlaw underwriting, it should apply across the board. But if we are going to punish unhealthy lifestyles with higher insurance premiums, that too should apply across the board. After all, “equality” is the new buzz word, right?  

(Don’t get me wrong: I certainly support incentives for healthier living–as Whole Foods does by giving healthy-living employees deeper store discounts. But financial sticks to the side of the head imposed by Obamacare regulators based, in part, on political correctness? Absolutely not.)

Futile Care Theory claims that doctors and hospital bioethics committees should be empowered to refuse wanted life-sustaining treatment based on their beliefs that the patient’s life is not worth living or too expensive to maintain (or both).  But this flies in the face of patient autonomy, supposedly a prime directive of bioethics theory. 

Over the years I have noticed that autonomy receives the most robust respect in mainstream bioethics when it leads to death, e.g. refusing unwanted treatment (which I support) and euthanasia (which I oppose). But it is impolitic to say autonomy is a one-way street, so futilitarians are always looking for ways to justify withholding treatment they don’t think should be provided without getting their metaphorical hands caught in the cookie jars.

Latest example, an article in the Journal of Clinical Ethics, arguing that doctors could simply withhold information that patients or surrogates need to make an informed choice about life-extending treatment. From, “A Different Approach to Patients and Loved Ones Who Request “Futile” Treatments,” by Edmund G. Howe:

…[T]here may be situations in which the usual logical” ethical priorities may not apply because most patients, as human beings, couldn’t bear the result. Generally, our “lesson” in this,then, is that when care providers face an ethical conflict, they might do well to always start with considering a patient’s emotional, human limitations.They may base what they choose to do on their best estimate of what most patients could bear to hear. The alternative would be to ask a patient to hear what is “too much” to bear,which is most likely not going to “work,” emotionally.16 To consider a patient’s or loved one’s emotional limitations is an approach that care providers might consider when a patient or a loved one wants an intervention that the care provider sees as being futile.

Medical “futility” is not an objective concept. It is a value judgment. In other words, the treatment isn’t stopped because it won’t work, but rather, because it will or might–in circumstances where that is not wanted. (More details here.)  In other words, futilitarians want to change the fundamental purpose of medicine away from maintaining life when that is what the patient desires, to only medically supporting lives of a sufficient quality (to them).

So, we have come full circle to the bad old paternalistic days when doctors decided–only instead of forcing people to live hooked up to machines as in days of yore, they will now deny machines when possibly wanted–but only “for the good of the family” (of course):

Most care providers respect patients’ autonomy by telling them that the preferred treatment is futile, There may be a case, though, for increased paternalistic omission, Care providers may tell a patient what they feel the patient wants or needs to know, but stop short of giving the patient advice.

In other words, just don’t do what the doctor doesn’t want to do. And don’t think that such withholding of information needed for informed consent or refusal would be limited to the extremes. Once the principle was accepted that doctors could keep relevant information to themselves–and given their increasing role as cost containment gatekeepers–lying by omission could seep into other areas of care.

Imposing Futile Care Theory by stealth would be even more dangerous than current approaches to denying wanted treatment–which have the virtue of being imposed openly, some might say brazenly–at least allowing families to fight back in court or the media. But imposing futility by withholding relevant information would deny families and patients even that dignity. It would return us to a time when doctor knows best–when you should die. No thank you!

I live in the San Francisco Bay area, and ruling majority here have zero tolerance for heterodox thinking or activism.  For example, the San Francisco Board of Supervisors once passed a resolution telling pro-life Christians planning a demonstration that they were not welcome in what we call The City.

It is in this “our way or the highway” spirit that Whole Foods CEO, John Mackey, has been receiving grief in the local media because of his criticism of Obamacare as “fascism,” (along with his claim that the climate is always changing, and moreover, that warming could have some benefits).

Mackey has repeatedly walked the word back, but no matter. It is all the news as he is in the area on book tour. Today, he is interviewed in the San Francisco Chronicle, and asked to explain himself. From the story:

Q: There has been much ado about your comments to NPR. So what exactly is the problem you have with the president’s health care plan, which frankly seems to jibe with the philosophies of Whole Foods?

A: I believe in free enterprise capitalism. It’s helping humanity to progress. I don’t see any innovation in industries where the government intervenes. Prior to health care reform, health care was already very regulated by the government. It’s not a system any longer where people are able to innovate; it’s not based on voluntary exchange. I’d like to see health care be like any other business.

Q: Has calling Obamacare fascist affected your business, especially with your liberal customer base?

A: I certainly hope not. I’ve apologized for it 30 times now. I did not mean to offend or harm anyone. It was a poor choice of words.

Of course he did, because in the current politically suppressive climate, the Left doesn’t permit truth telling.

Let me explain. Mackey was asked on NPR whether Obamacare is “socialist.” Here is his answer:

Technically speaking, it’s more like fascism. Socialism is where the government owns the means of production. In fascism, the government doesn’t own the means of production, but they do control it — and that’s what’s happening with our health care programs and these reforms.

Now, if he had meant the jack-booted tyranny led by an evil man with a funny mustache who tortured and slaughtered people in concentration camps–the popular meaning of the term–that would have been wrong and clearly vile. But that popular understanding isn’t the actual meaning of fascism, which–as Mackey said, technically speaking–refers to an economic system. Here’s the Wikipedia definition:

An inherent aspect of fascist economies was economic dirigisme,[4] meaning an economy where the government exerts strong directive influence, and effectively controls production and allocation of resources. In general, apart from the nationalizations of some industries, fascist economies were based on private property and private initiative, but these were contingent upon service to the state.

In this sense, Mackey wasn’t off the mark–although it was clearly a poor choice of words due to the ubiquitous atrocities committed by the 20th century’s fascist states.

But back to the “technically” part: Consider the Free Birth Control Rule under Obamacare that directly controls how businesses allocate their resources for the purpose of achieving a state-desired end, e.g.,–as the DOJ’s legal briefs have repeatedly stated–gender equality. In this sense Mackey was technically accurate in his use of the economic f-word. Not wise, but technically accurate.  

Yes, I apologize.

The NIH has restricted research on chimpanzees, and now is likely to retire all but fifty of available chimps to a sanctuary. From the Nature News story:

The US National Institutes of Health (NIH) should dismantle a decades-old colony of 360 chimpanzees, retiring all but roughly 50 of the animals to a national sanctuary, the biomedical agency was told on 22 January in a long-awaited report. The report, from a working group of external agency advisors, also counsels the NIH to end about half of 21 existing biomedical and behavioural experiments, saying they do not meet criteria established in a December, 2011 Institute of Medicine (IOM) report. “Clearly there is going to be a reduction in the use of chimpanzees in research,” says working group co-chair Kent Lloyd, the associate dean for research at the School of Veterinary Medicine at the University of California, Davis

By protecting these chimps we will be forgoing sources of new knowledge and biological testing!  Some things we might have discovered will now not be known, or known later than would have been had we used the chimps. And as we all know from various science policy debates, that which restrains or inhibits scientific progress is anti-science!

Actually, it isn’t. Science cannot ever be permitted to become the be all and end all. Science is an incredibly powerful method of gaining and applying knowledge. But it is amoral. It can be a life saving tool or a lethal weapon. That is why a beneficent and properly functioning scientific sector requires ethical parameters to prevent it from becoming monstrous. In other words, the “duty” side of human exceptionalism–in this case, adhering to proper animal welfare principles–sometimes trumps naked science. And that’s a good thing.

Thus, those who have pushed so hard over many years to protect research chimps are no more anti-science than those who have pushed to protect embryos in research and wish to prevent human cloning, which are also ethical issues. And that’s the point of this post. 

It is unremitting, the attempts to knock humans off of the pedestal of exceptionalism. But notice that it almost always involves comparing what animals do to us? And now more on chimps being “moral” because they share food and such in a “fairness game,” that for the chimps would have required some training. From the CNN story:

You might think of “morality” as special for humans, but there are elements of it that are found in the animal kingdom, says de Waal — namely, fairness and reciprocity. His latest study, published this week in the journal Proceedings of the National Academy of Sciences, suggests that chimpanzees may show some of the same sensibility about fairness that humans do.

The popular belief that the natural world is based on competition is a simplification, de Waal says. The strength of one’s immune system, and the ability to find food, are also crucial. And many animals survive by cooperating.

Well obviously. Look at lions on the hunt! But that doesn’t mean the behavior is “moral.” 

“Morality” is a distinctly and exclusive human concept because it requires rationality and the ability to make alternative decisions. In other words, being “moral” is a choice. For example, we collectively decided that empathy is more moral in the modern West, a moral attitude that developed over thousands of years. So, we now embrace “tolerance” and “diversity.” It wasn’t always so. Ditto “fairness,” whatever that might mean–and it means different things in different cultures. 

But chimps don’t do anything like that, no matter how they act. They don’t have free will. They don’t weigh and balance and work out moral codes. Indeed, for “morality” to be truly that, acting in the opposite way must be considered immoral. When a chimp steals another’s food, is that “immoral?”  If a chimp refuses to share, is that “immoral?” No. It’s being a chimp. When chimp bands war against their neighbor chimps, it is simply what they do. If we do it, it is now considered imperialism and immoral. It wasn’t always so. But we decided that conquest is wrong. Once, it was considered glorious. 

I suspect the narrative thrust of this story comes from the reporter rather than de Waal, who seems to be looking into how “fairness”–again, a human concept–might have arisen via evolution.  Chimps may act in ways we consider fair. But that’s because we are the exceptional measure. 

Demonstrating my thesis that environmentalism is growing progressively anti human–and showing how unoriginal so many in that movement have become–David Attenborough calls up the cliché that we are a “plague on the Earth” in support of radical depopulation. From the Telegraph story:

The television presenter said that humans are threatening their own existence and that of other species by using up the world’s resources. He said the only way to save the planet from famine and species extinction is to limit human population growth. “We are a plague on the Earth. It’s coming home to roost over the next 50 years or so. It’s not just climate change; it’s sheer space, places to grow food for this enormous horde. Either we limit our population growth or the natural world will do it for us, and the natural world is doing it for us right now,” he told the Radio Times.

Sir David, who is a patron of the Optimum Population Trust, has spoken out before about the “frightening explosion in human numbers” and the need for investment in sex education and other voluntary means of limiting population in developing countries.

Radical depopulation of the kind for which Attenborough and Population Matters (formerly Optimum Population Trust) yearn, isn’t going to come about via sex education, birth control, or other “non coercive” methods.  Heck, look at China’s brutally tyrannical one child policy, which has only slowed the rate of population growth, not actually reduced the numbers. 

To really get the job done would require genocidal means, which I am sure Attenborough would never consider or support. But I worry that less genteel others might not be so hesitant.