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Human Exceptionalism

Life and dignity with Wesley J. Smith.

Wisconsin Democrats Endorse Assisted Suicide



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Disability rights activists are, generally speaking, part of the Democratic coalition. They also, generally speaking, are the country’s most effective opponents of assisted suicide.

I hope my disability rights activist friends take note that the Wisconsin Democratic Party has now explicitly endorsed assisted suicide. From the 2014 Wisconsin Democratic Party Platform:

We believe in freedom of reproductive choice, family planning, and the individual’s right to choose death with dignity including physician‐assisted end‐of‐life.

I have always thought that opposing assisted suicide should be a major liberal agenda item, as liberals used to be about protecting vulnerable populations. Some, like Robert P. Jones, still do.

Too bad that the WI Democrats have, instead, embraced the culture of death.

Dutch MDs: Prepare to Kill More Alzheimer’s Patients!



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A Dutch report shows that Alzheimer’s disease will cause more deaths soon than lung cancer. From the story:

Dementia will be the biggest cause of death in the Netherlands by 2030, overtaking lung cancer, the public health institute RIVM says in a new report…

Lung cancer accounted for 8% of deaths in 2012, followed by dementia and heart problems. In 2030, dementia will be behind 12% of deaths while lung cancer will account for 9%, the RIVM figures show.

Dutch doctors now kill Alzheimer’s disease patients in the Netherlands under the euthanasia law. I guess the time has come for them to order increased quantities hypodermics and the poison with which to keep up with the demand!

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Presbyterians OK with Killing Born Babies



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The Presbyterian Church USA General Assembly has been making a lot of news on the same sex marriage issue. But this vote has my eyebrows raised. The convention voted no on protecting babies born alive after a failed abortion. From the failed motion:

1. Call for the Presbyterian Mission Agency and member congregations to enter a two-year season of reflection upon the plight of children unwanted by human society, both born and not-yet born, and to purposefully seek to enter the pure worship of God by offering aid, comfort, and the Gospel to those responsible for the care of our most desperate orphans (including those who survive abortion procedures): parents, siblings, church and community leaders, and the medical profession.

2. Direct the Moderator of the General Assembly and the Stated Clerk to issue statements that denounce the practice of killing babies born live following an abortion procedure, such as was revealed in the Dr. Kermit Gosnell clinic in Philadelphia.

There was more to the motion, which supported a pro-life perspective. But it is breathtaking that the Church wouldn’t even agree to “reflect” on protecting the lives of born babies and denounce Kermit Gosnell-style murders.This is akin to refusing to oppose the terminal neglect of unwanted infants, even infanticide.

This isn’t a matter of protecting “reproductive rights.” A baby that is born is no longer in his or her mother’s body and thus nothing is being done to interfere with her privacy or autonomy.

Peter Singer believes that unwanted infants can be killed in the same manner as they can be aborted. Apparently, so does the Presbyterian Church, USA.

No to Coerced Vasectomy



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A Virgnia plea deal is coercing a man into a vasectomy. From the CBS story:

A Virginia man who has fathered children with several women has agreed to get a vasectomy to reduce his prison term by up to five years in a child endangerment case that has evoked the country’s dark history of forced sterilization.

None of the charges against Jessie Lee Herald, 27, involved a sexual offense. Shenandoah County assistant prosecutor Ilona White said her chief motive in making the extraordinarily unusual offer was keeping Herald from fathering more than the seven children he has by at least six women. “He needs to be able to support the children he already has when he gets out,” she said, adding that Herald and the state both benefit from the deal, first reported by the Northern Virginia Daily.

There may be–nay, is–good cause for not wanting Herald to sire any more children. But coercing someone into surgery and sterilization as part of a criminal justice case is just plain wrong.

This isn’t the same as force-feeding prisoners on hunger strikes, which I support if and when their health is materially compromised or their lives endangered. That is about protecting health and welfare of the prisoner, which is the job of the prison authorities.

This is using surgery as a form of punishment and/or a utilitarian benefit to society. We should not go down that road.

Facts about “Voluntary Stop Eating and Drinking”



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The invaluable Patients Rights Council (for whom I am a paid consultant) has published a badly needed fact sheet on the newest craze in suicide advocacy–self starvation/dehydration–known in death promoting parlance as Voluntary Stop Eating and Drinking, or VSED.

Here are some excerpts from the PRC Fact Sheet:

2. Is VSED suicide? Yes. VSED is intended to cause death. Suicide is defined as “the  act or an instance of taking one’s own life voluntarily and intentionally especially by a person of years of discretion and of sound mind.”

Suicide advocates often pretend that suicide isn’t really suicide. But starving oneself to death is as much suicide as self-hanging or jumping off the Golden Gate Bridge.

Suicide, of course, is not against the law. But unlike other methods of suicide, it is almost impossible for authorities or doctors to prevent the death. Example: You can stop a person from jumping off a bridge or cut them down when they are hanging. But you can’t force feed people because that is medical treatment, which they have the right to refuse.

(One day, I fear, it will be illegal for doctors to save the lives of suicide victims if they state they don’t want medical treatment. One day? It already happened in the UK to Kerrie Woolterton, who swallowed anti-freeze and was allowed to die by her doctors without treatment)

Back to the Fact Sheet:

6. I’ve read that VSED is painless. How can that be true when the symptoms of dehydration are so gruesome? Many advocates of VSED say it is painless, however their claim is based on the requirement that individuals receive medical supervision including pain and symptom control as they dehydrate to death… Without powerful sedatives and other palliative measures (and, sometimes even with such measures), dehydration deaths have been described as horrific. 

How bad can dehydration be? Well, Kate Adamson said it was worse agony than having abdominal surgery with inadequate anesthesiahorrors that she experienced.

9. Can health care providers refuse to support VSED? If a competent person stops eating and drinking, health care providers cannot force feed that person (either orally or by tube feeding). To do so could legally constitute the crime of battery. 
However, health care providers are not compelled to provide drugs to deal with the symptoms of death by dehydration. Instead, with kindness and firmness, they can explain their willingness to alleviate those symptoms through the effective and simple means of providing food and fluids. 

That’s precisely what they should do.

One of the worst things about promoting VSED is the potential for confusion. Patients sometimes stop eating and drinking when they have entered the active dying process. At such times, it is medically inappropriate to force sustenance upon the patients.

VSED promotion can make the families of such naturally dying people believe that forbearing from forced feeding is akin to assisting their suicides–leading to inappropriate actions that harm the loved one, or unnecessary guilt. Indeed, I am often approached by such people who worry (inaccurately) that they helped kill grandma.  

Promoters of VSED are causing great harm–all in the name of “compassion,” of course.

For more on my views about this controversial issue, hit this link.

 

 

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Same Media that Ignored Gosnell Push Dead Babies in Septic Tank Lie



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Remember when the media ignored en masse the mass murderers/late term abortions of the monster Kermit Gosnell? Remember the empty seats at the trial? Remember the important stories that were never written?

In that highly newsworthy circumstance, the media knew what it didn’t want you to know. 

But notice how quickly this same media spread the word–nay, ​breathlessly reported one unsubstantiated local Ireland story–that the bodies of long-dead babies were found discarded in a septic tank at a long closed home for unwed mothers run by nuns. Example, the Washington Post.

In a town in western Ireland, where castle ruins pepper green landscapes, there’s a six-foot stone wall that once surrounded a place called the Home. Between 1925 and 1961, thousands of “fallen women” and their “illegitimate” children passed through the Home, run by the Bon Secours nuns in Tuam. Many of the women, after paying a penance of indentured servitude for their out-of-wedlock pregnancy, left the Home for work and lives in other parts of Ireland and beyond.

Some of their children were not so fortunate. More than five decades after the Home was closed and destroyed — where a housing development and children’s playground now stands — what happened to nearly 800 of those abandoned children has perhaps now emerged: Their bodies were piled into a massive septic tank sitting in the back of the structure and forgotten, with neither gravestones nor coffins.

One itty-bitty problem: It isn’t true. From a commentary in Forbes by Eamonn Fingleton

Today the Irish Times has published a reader’s letter that has further undercut the story. Finbar McCormick, a professor of geography at Queen’s University Belfast, sharply admonished the media for describing the children’s last resting place as a septic tank. He added: “The structure as described is much more likely to be a shaft burial vault, a common method of burial used in the recent past and still used today in many parts of Europe…

The one “fact” that turned all this from a disturbing national story into a screaming global sensation is one that is almost certainly false.

The Post (which ran two stories on the “septic tank” babies) and other outlets have been forced to issue correctives.

So we are left with an interesting question: Why would real murders of babies–that took place in the present day–be all but ignored, while a false report of disrespectfully discarded bodies from many decades ago be reported high profile internationally?  

Answer: The former story reflected badly on abortion, so beloved by most in the media, while the latter validated their anti-Catholic bigotry–particularly their disdain for that church’s views toward sexual morality and pro-life activism.

This is one example of why the public’s trust in the media is in the, well, septic tank. They earn every ounce of our disdain. 

Total Brain Failure is Death



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The Jahi McMath controversy–the subject of my post yesterday and much subsequent heated discussion–brought the brain death controversy back into the news.

It’s a difficult concept, and so I wrote a piece for Human Life Review explaining why I think that properly determined brain death is the demise of the patient.

In researching the article, I turned to a white paper written by the splendid President’s Council on Bioethics–with stellar pro-life scholars on board such as Robert George and William Hurlbut–about the question. It was very helpful. From my “Total Brain Failure is Dead:”

Part of the continuing intensity of the brain-death controversy may be due to nomenclature. According to a white paper put out by the President’s Council on Bioethics in 2008, the term “brain-dead” causes much public confusion. First, this term (like heart death) wrongly implies that there is more than one kind of death:

Whatever difficulties there might be in knowing whether death has occurred, it must be kept in mind that there is only one real phenomenon of death. Death is the transition from a living mortal organism to being something that though dead, retains a physical continuity with the once-living organism. (My emphasis.)

Second, describing a deceased person as brain-dead “implies that death is a state of cells and tissues constituting the brain.” Rather, “what is directly at issue is the living or dead status of the human individual, not the individual’s brain.”

Finally, the Council noted that death “is a clinical state or condition made evident by certain ascertainable signs.” In other words, there are measurable indicia of life—or its absence—that can be determined in the clinical setting.

The Council recommended replacing the term “brain death” with the more comprehensible “total irreversible brain failure,” or “total brain failure,” for ease of wording. This is very helpful and elucidating: Just as a patient has unquestionably died when her heart and lung functions have irreversibly collapsed, so too has the human being ceased to be once her brain has totally failed.

I understand why some people believe brain death is a subterfuge to allow the instrumental use of catastrophically cognitively disabled patients. As I have noted often, some bioethicists definitely want to go there with regard to unquestionably living patients in conditions like Terri Schiavo’s.

But I still believe the evidence convincingly demonstrates that total brain failure is dead. Whether or not you agree, I hope you will find the article helpful. It intends to remove confusion about what the concept of brain death describes–and what it doesn’t–toward the end of helping facilitate an informed debate.

 

What if Jahi McMath is Alive?



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A news story reports that Jahi McMath, declared dead by the State of California, is being maintained at a Catholic hospital in New Jersey. More, that she may be becoming responsive. From the San Jose Mercury News story:

KPIX reported that she is receiving round-the-clock care and has responded to commands, moving specific parts of her body when asked. Attorney Christopher Dolan, who represents Jahi’s family, would not comment on her location.

In a statement to Bay Area News Group, he said that “Jahi’s physical condition is much better than when she was at Children’s Hospital,” adding that predictions that her organs would shut down and her heart would cease pumping had not come to pass. “I have seen Jahi and none of what Children’s (Hospital) said would happen to her as inevitable physical death has occurred. I have seen much more movement in Jahi, response to her mother’s touch and voice and what appears to be movement in response to voice command.”

We should be cautious here. But if​ these changes are indeed occurring–which will need to be demonstrated by objective medical testing–she isn’t dead.

What might that mean?

First, that she would become entitled to receive benefits for her care. To prevail, in my opinion, Jahi’s mother would have to prove evidentially that her daughter is alive by demonstrating, for example, that she has reflexes that originate in the brain.

Second, it would challenge the concept of brain death in the minds of many, forcing the medical community on the defensive. At the very least, I think it would lead to universal and rigorous mandatory criteria for its determination, something now sorely lacking. It might also require application of the more sophisticated brain scanning techniques now coming on line, which have shown that many people thought to be in a persistent unconscious condition, are actually aware.

Third, it would create a nightmare firestorm for Children’s Hospital of Oakland, not only legally but with regard to the trust in which it is held by the local community.

Fourth, it would validate Judge Evilio Grillo’s wisdom–achieved via a settlement–that sometimes it is better not to coerce dissenting families in medical controversies to give up their quest for the “miracle.” In this regard, it would also validate the work of Bobby Schindler and the Terri Schiavo Life and Hope Network, who and which, stuck their necks out pretty far in this case to help Jahi’s family.

Fifth, and ironically, it would empower those bioethicists who want to expand organ harvesting from the dead to the profoundly cognitively disabled. Dead isn’t what matters, these advocates say, but the loss of “personhood.” They would make Jahi’s case as a battle flag to pressure society to stop worrying about brain death and start harvesting unquestionably living people like Terri Schiavo.

But let’s not get ahead of ourselves. The bodies of young people who are brain dead sometimes last far longer than those of adults. The key question is whether she has demonstrable brain function. If so, there will be hell to pay.

Surrogate Asked to Abort and Sex Select



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I am not a fan of surrogate mothering. I am particularly opposed to commercial surrogacy, as it reduces gestation to a matter of breeding and can, in particular, lead to the profound exploitation of the surrogate mothers–known in the dehumanizing industry parlance, as ”gestational carriers.”

The Daily Mail has a story about a surrogate who had two feel-good experiences, but then got out of the trade because she came to see its dehumanizing aspects. From the story:

In more recent times, she entered into a third arrangement, this time with a ‘well known’ and ‘mega rich’ couple from the entertainment industry, who she can’t name for legal reasons – and who were due to pay her a ’significantly higher’ fee than she had been offered previously. ‘It was like hearing the neighbor’s kid crying. I think it would have been harder for me if I hadn’t bonded with the dads’

Unlike with the first two couples, she found it impossible to ‘bond’ with these people, who treated the process like ‘a business transaction’; so much so that Ms Szalacinski started referring to herself as a ‘commodity.’

Actually, no matter how nice the biological parents might be, as they said in The Godfather, “It’s not personal, it’s business.”

Back to the story:

Not only were the couple initially insistent on having a boy – testing the embryos five days after fertilization for gender – but when they eventually settled on two female embryos, they asked Ms Szalacinski to ‘reduce’, or terminate, one of them if they both ‘took,’ because they didn’t want to raise twins.

“Reduction” is the industry euphemism for targeted abortion. In other words, if one of the twin fetuses had been killed, the other child would still be a twin, but with a dead sibling. Imagine knowing that there but for where the forceps went would be thou!

Then came the eugenics that is rife within the industry:

Additionally, the picky couple were eager to choose a ‘particularly attractive’ egg donor, despite the fact that her eggs were ’sub-par’, because, according to Ms Szalacinski, they were ‘obsessed with looks.’ ‘I couldn’t believe that this kind of misogyny exists. My moral compass kept flicking off and I had to walk away,’ she says.

Good for her. But women who really need the money may not have that strength and might find themselves participating in actions they consider wrong and immoral–with potentially devastating emotional consequences.

This story reflects the ultimately crass nature that lurks at the bottom of the baby-making industry. Not only do many buyers believe they have a right to a child by any means necessary, but to the child they want.

Sometimes, surrogate mothers are collateral damage, and few care. See the Center for Bioethics and Culture’s (for which I am a paid consultant) excellent documentary, Breeders. It’s not all peaches and cream!

Adopt. Adopt. Adopt.

Push for Child Assisted Suicide in Scotland



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Fresh off of Belgium’s legalizing euthanasia for children, child “advocates” in Scotland seeks to enable dying kids to commit assisted suicide. From the London Times story (subscription pay wall):

In a submission to MSPs, the group called Together (Scottish Alliance for Children’s Rights) states: “In the consideration of the age threshold of 16 proposed in the bill, the health and sports committee should note that terminal illnesses do not discriminate based on the age of a person and accordingly, neither should health care.

“The UN committee on the rights of the child is clear that a child who is capable of forming his or her own views should be assured the right to express those views freely in all matters affecting the child. “The views of a child must be given due weight in accordance with their age and maturity.”

In essence, the argument here is that assisted suicide is a human right. (Some death advocates call it the “ultimate civil right.”) If so–as I have noted frequently over more than 20 years–there really is no way to limit access to suicide facilitation. Human rights apply to all, not just some.

Note. Assisted suicide for adults isn’t yet legal in Scotland, and they are already pushing it for children. What does that tell you? (The legalization proposal is so radical it would allow for the creation of a new profession of non medical euthanasia/suicide facilitators.) 

Assisted suicide advocates used to promise that it was going to be restricted to the adult, terminally ill for whom nothing else could be done to alleviate suffering (a false premise).

Mendacity!

We Should Have Right to Consent to “No CPR”



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This is pretty bad when it is considered a  landmark victory! 

A court in the UK has ruled that competent patients have the right to be “told” when they are going to be denied CPR. From the Cambridge News story:

The Court of Appeal has ruled the human rights of a terminally-ill patient were violated when a “do not resuscitate” notice was placed on her records at a Cambridge hospital without her being consulted.

Care home manager Janet Tracey was 63 when she died following a transfer to Addenbrooke’s after breaking her neck in a car crash in 2011 – two weeks after being diagnosed with terminal lung cancer.

Lawyers acting for her family have described it as a “landmark judgment” clarifying that NHS trusts have a legal duty to tell patients with mental capacity that a Do Not Attempt Cardiac Pulmonary Resuscitation (DNACPR) order has been placed on their medical records – and to involve them in the decision-making process.

Hello! “Told” is only half the job. Patients should normally have the right to consent to no resuscitation before it is put on a chart. 

Studies have shown that many doctors have different values when it comes to such matters than their patients. But so what? Their views should not trump the patient’s except in very extreme cases where CPR would be physiologically ineffective and/or so onerous as to be torture with no prospect of life-extension.

And don’t think if current trends continue that the decision to save money won’t be factored into the equation under a ”doctor decides” system, as physicians are increasingly being told their true master is “society.” 

And before CPR can be denied in a “futile care” imposition, the patient should have rights to object, with the strong legal presumption that the patient’s view prevails.

Doctors have greater power in the UK to make the final call than here in the USA. But bioethicists and medical technocrats are striving mightily to push us in that direction.

There is such a thing as putting oneself under a doctor’s care. But that should not make him or her the determiner of your life or death.

Euthanasia Booster’s Game of Let’s Play Pretend



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None are so blind as those who refuse to see.

A bioethicist named Tony Hope supports Belgium’s new child euthanasia law as if we have no history of how loosely doctor-administered death has actually been applied in that morally collapsing country. While claiming the mantle of empirical analysis, Hope actually engages in a game of “let’s play pretend.”

 First, he sets forth his moral principles to justify euthanasia. I disagree, but let’s skip that for now. 

I want to focus here on how the list of Hope’s supposedly “empirical assumptions”​ about the desirability of child euthanasia aren’t really emperical. From, “Morality, Science, and Belgium’s Child Euthanasia Law,” at the Practical Ethics blog

Empirical assumptions

1.There are some situations in which children with a terminal illness suffer so much that it is in their interests to be dead.

2. There are some situations in which the child’s suffering cannot be sufficiently alleviated short of keeping the child permanently unconscious.

3. A law can be formulated with sufficient safeguards to prevent euthanasia from being carried out in situations when it is not justified.

The first assumption isn’t “empirical,” which means, “relying on experience or observation alone often without due regard for system and theory.” What might or might not be in a sick child’s “interests” is not a matter of objective observation. Rather, it is entirely subjective and ideologically premised. Hence, it is not an empirical assumption. 

There may indeed be rare times in which a child’s suffering can only be alleviated by palliative sedation. But that isn’t a matter of conscious or unconscious. Done correctly, the level of awareness can be titrated up and down to the benefit of the patient. Moreover, the implication in the second empirical assumption is that killing is preferable to unconsciousness. But that is a subjective assumption, not an objective observation. 

But the third supposedly empirical assumption is the real howler. Belgium’s law for adults has not prevented euthanasia from being carried out in situations where it is “not justified” under the letter of the law (ignoring that what constitutes ”justified” can often be in the non-emperical eye of the beholder).  

Indeed, the letter of the law has been repeatedly shattered in Belgium, and without legal consequence, including, but certainly not limited to:

- Joint euthanasia killings of elderly couples;

- Joint euthanasia killings of identical twins who were losing their eyesight.

- The euthanasia killing of a transsexual disappointed with her sex change surgery;

- The euthanasia killing of a psychiatric patient in despair because she was sexually predated upon by her psychiatrist. 

That isn’t “slippery slope” argumentation, as Hope would state. It is a verifiable recitation of facts on the ground!  

More to the point, Hope shovels the usual false euthanasia advocacy trope that child euthanasia will be limited to cases in which nothing can be done other than induced coma or euthanasia to alleviate suffering. In fact, the terms of the Belgian child euthanasia law does not limit doctor-administered death to such few cases! Thus, that’s mere selling puffery, the opposite of reaching an objective empirical conclusion.

But more to the point, whatever the law may state about a child having to be terminally ill to be euthanized, there is no “empirical” reason to believe that the guideline for children will be obeyed any more than have adult euthanasia guidelines. Indeed, the very first legal euthanasia in Belgium broke the legal guidelines, and it has gone steadily downhill from there.

The same steady expansion of killable categories will take place with children–an assertion based on empirical observation of what has actually transpired in the country over the last 14 years!

Indeed, how could it not? The Belgian culture–as well as the law–has accepted the poisonous premise that killing is an acceptable answer to human suffering. With that as the true moral foundation, the implacable force of logic will lead Beligum to ever-expanding categories of accepted, if not legal, child “mercy” killings. That’s what’s known as an “empirical assumption” with a compelling evidentiary basis. 

Melinda Gates Right About Abortion



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Melinda Gates, who with her husband gives millions to pay for women’s health care, says that the Gates Foundation will not fund abortion internationally because it isn’t “health care.”  From the World story:

Abortion should not be confused with women’s healthcare, philanthropist Melinda Gates wrote on June 2 in a blog post applauded by pro-lifers around the world. Gates, a long-time supporter of international women’s health, wrote the comments following a two week trip to Geneva, London, Berlin, and Toronto. Gates and her husband, Microsoft co-founder Bill Gates, have declined to fund abortion through their philanthropic organization, the Bill & Melinda Gates Foundation. Instead, the organization focuses on making contraceptives available to 120 million poor women.

“We should provide all women the information and tools to time and space their pregnancies in a safe and healthy way that works for them,” Gates wrote. “This approach is simple, it works, and it saves lives. The question of abortion should be dealt with separately.”

Gates is absolutely right. A normal pregnancy is not a disease. A fetus is not a tumor.

Abortion that ends a healthy pregnancy is not health care, nor is fetus killing in such circumstances a medical act. It is what I call a “consumerist” procedure that uses medical means for a non-medical purpose.

If the “international community” would go along with Gates’ wisdom, many policy conflicts over family planning–which need not involve contraception, allowing devout Catholic couples to participate–would go away. Such a separation would substantially benefit the poor women of the world because it would allow those with implacably different views on the matter of abortion to row in the same direction.

Casey Kasem a New Terri Schiavo?



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I have been on vacation in Europe for the last two weeks, doing my best to forget the culture of death. But it hasn’t been easy. I have been barraged by readers and media about questions of how and why Casey Kasem can be denied tube feeding.

This can be a delicate and highly nuanced matter, dependent on the fact circumstances of each situation. Moreover, I don’t want to comment on his particular case because I don’t know all the facts. Pay attention to the italicized part of the CNN story I quote below:

He’s suffering from dementia and bedsores, and his body is shutting down at a hospital in Washington state, court documents say. On Wednesday, a Los Angeles County judge gave daughter Kerri Kasem the authority to have doctors end his infusions of water, food and medicine.

The ruling reinstates the 82-year-old’s end-of-life health directive. Kasem doctor concluded that continuing the artificial nutrition and hydration would only “at best prolong the dying process for him and will certainly add suffering to an already terribly uncomfortable dying process,” said Kerri Kasem’s lawyer, Troy Martin.

The key factual and ethical question here is whether his body is shutting down as part of the natural dying process. In that situation, people often stop eating and drinking spontaneously. In such cases, it can be medically inappropriate to force sustenance into a body that can’t process it. Not knowing about Kasem’s individual circumstance, I will not opine about his particular case.

Second, if Kasem’s advance directive said he did not want tube-supplied food and water under these circumstances–whatever we each might think of the morality of that–he had the legal right to so instruct because tube-feeding is considered a medical treatment.

But let’s look at the broader issue. There has been increasing advocacy of late to deny tube supplied–or, as I have recently noted, even spoon feeding–to Alzheimer’s patients who can process sustenance. What about them?

Many bioethicists, and some doctors who treat Alzheimer’s patients, increasingly argue that these patients should be denied sustenance as a matter of supporting their best interests.  I am not referring to decisions made in accordance with an advance directive, but to the increasing assertion that the standard of care should be to deny feeding tubes. From the position paper of the American Geriatric Society:

Percutaneous feeding tubes are not recommended for older adults with advanced dementia. Careful hand-feeding should be offered for persons with advanced dementia, hand feeding is at least as good as tube-feeding for the outcomes of death, aspiration pneumonia, functional status and patient comfort. Tube feeding is associated with agitation, increased use of physical and chemical restraints, and worsening pressure ulcers.

Rationale: The current scientific evidence suggests that the potential benefits of tube feeding do not outweigh substantial associated treatment burdens in person with advanced dementia.

Recommendations are one thing. Labeling feeding tubes in late-stage Alzheimer’s patients as “inappropriate care” to allow bioethics committees to impose the death decision under a “futile care” protocol is another. And that is where I think we are headed–just as we are in patients with long-term diagnosed persistent unconsciousness.

So, I can’t say whether Kasem is a new Terri Schiavo–because her tube feeding was clearly medically appropriate as she was not otherwise dying. Thus the question in her case involved “quality of life” and egregious conflicts of interest on the part of Terri’s husband.

In contrast, I can say that Alzheimer’s patients generally are being looked upon increasingly as people who should not be sustained nutritionally after a certain point, even if that is what the patient or family wantsAlso, under Obamacare’s eventual cost/benefit protocols, I believe a time will come in which sustaining such patients will not be a covered procedure. Ditto, people with long-term profound cognitive disability.

Bottom line: Alzheimer’s patients in all fifty states who can process food and water are denied medically supplied food and water. Such decisions are legal and deemed “ethical” by many, an opinion with which I dissent.

Post Script: Kasem died shortly after the court ruling described above. It would thus appear that he did not dehydrate to death.

Asking Awake ICU Patients To Harvest Organs



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Pick your cliche: Give them an inch and they will take a mile; in for a penny in for a pound, etc. In bioethics, there is never a permanent boundary beyond which the utilitarian impulse will not take them.

Now, advocacy is beginning to ask conscious patients who want to stop life-sustaining treatment for their organs. So far, this “non-heartbeating cadaver donor” process has only been done with the profoundly cognitively disabled.  But now, that line is under assault. From an article by Dutch ethicists–euthanasialand!_in Clinical Ethics (201 3 Volume 8 Number I​):

In a medical community in which withdrawal of lifesustaining measures in unconscious and in conscious ICU patients is accepted, where organ donation after death is common practice, and in which there is a shortage of organs for transplantation, there can be no moral objection to ask certain conscious ICU patients to donate their organs after death.

Although withdrawal of mechanical ventilation on request of the patient on the ICU is rare and therefore the number of organs that come available is limited, it is still well worth considering. We argue that there are no valid moral and legal objections against it; it is ethically feasible and practically possible to ask the patients for organ donation after death.

Well, here’s one: I can think of few things more dangerous to the weak and vulnerable than to allow people having trouble going on believe that their deaths have greater value than their lives.

How about another? Letting society think that same thing.

Next stop: Asking suicidal people for their organs. It already happens in Belgium euthanasia.

 

Why Can’t Deacons Mercy Kill Like MDs?



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A Catholic deacon has been arrested for killing hospital patients in Belgium. I am puzzled why: His motive was mercy! From the Bioedge story:

News reports are sketchy, but it appears that Poppe was reported to the police. When they investigated, he admitted his responsibility. According to one report, he smothered the patients, some of whom were relatives, or gave them an overdose of insulin. The police believe that his statements are credible. He apparently recorded the deaths in a notebook.

“My client acted out of compassion for people who were in a hopeless situation,” his lawyer has told the media. It has been reported that Poppe told police that he was motivated by a desire to end patients’ unbearable suffering — but it does not appear that the “euthanasia” was voluntary.

Wait a second! Belgian doctors kill patient without request or consent all of the timeand for the same purported reason–with nothing done about it. Why should having an MD after your name make murder okay, but not being an ordained deacon?

I mean to paraphrase a famous American politician, at this point–death–what difference does it make?

Don’t get me wrong: If he did it, put him in jail. Just do the same to doctors!

Human Exceptionalism Shown by Babies



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I haven’t read Neanderthal Man: In Search of Lost Genomes, but a comment in Forbes about its content caught my interest.

Apparently, human babies quickly develop an interest, not only in surrounding objects, but also in what others think about them. From, “Neanderthal Man and the Science of Human Uniqueness,” by John Farrell:

One study, for example, reveals that, until about ten months of age, there are hardly any detectable cognitive differences between young humans and young ages: “However, at around one year of age, humans start doing something that the ape youngsters don’t: they start to draw others’ attention to objects of interest by pointing at them…It is the very act of directing the attention of another person that is fascinating to them…It seems that by about one year of age, they have begun both to discover that other people have a worldview and interests not so dissimilar from their own and to take steps toward being able to direct the attention of others. (p. 205)”

This compulsion to direct the attention of others, Pääbo goes on to suggest, is one of the first cognitive traits that emerge during childhood development that is truly unique to humans. Even more interesting is the fact that it’s not directly related to intelligence, so much as it is to a theory of mind, an appreciation that other individuals have different perceptions than one’s own.

This is relevant to the weave of human exceptionalism.

Only we make moral distinctions. Only we develop world views and come to differing opinions. Only we have the ability care about what others think about the same subjects.

This dramatically distinctive aspect of–yes, human nature–clearly develops early because it is hard-wired somehow into us. We all possess it, and it will express unless remaining latent due to immaturity or is disabled somehow by catastrophic illness or disease. 

From this important element of our being flows the streams of unique value and moral accountability–which rank high among the exceptional hallmarks of man.

Scientists Don’t Tell Truth About Weight



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I have called obesity “the new global warming,” an issue that is often as much about politics as it is about the science of weight.

A new study supports my hypothesis. Apparently, long-term weight loss is very rare, that most of the pounds lost in diets soon return. Moreover, there isn’t much that can be done about it.

But here’s an intriguing angle to the story: The scientists don’t tell that apparently well-known truth to the public. From the CBC News story:

So if most scientists know that we can’t eat ourselves thin, that the lost weight will ultimately bounce back, why don’t they say so? Tim Caulfield says his fellow obesity academics tend to tiptoe around the truth. “You go to these meetings and you talk to researchers, you get a sense there is almost a political correctness around it, that we don’t want this message to get out there,” he said. “You’ll be in a room with very knowledgeable individuals, and everyone in the room will know what the data says and still the message doesn’t seem to get out.”

In part, that’s because it’s such a harsh message. “You have to be careful about the stigmatizing nature of that kind of image,” Caulfield says. “That’s one of the reasons why this myth of weight loss lives on.”

Health experts are also afraid people will abandon all efforts to exercise and eat a nutritious diet — behaviour that is important for health and longevity — even if it doesn’t result in much weight loss.

At best. this is paternalism. But I think Caulfield hit on the larger truth in the quote I italicized: At least some scientists are afraid that if they tell the politically incorrect truth, their grant money will dry up, they will be called “deniers” or some such  pejorative, accused of being Luddites who thwart progressive public policy. In short, they will be treated as badly as global warming scientists who question the reigning alarmist orthodoxy.

The bigger point here, I think, is that people know that “science” has become substantially politicized: Too often, “studies” are generated to “prove” precisely what the authors or sponsors wanted.

In other words, science is sometimes science. But sometimes it is actually political or cultural advocacy pretending to be “science.”

And isn’t it interesting that those who call most loudly castigate those who disagree with them on policy or ethical issues as somehow “anti-science,” are often the most hyper-political players in the public square?

Active Euthanasia Comes to North America



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The poison has jumped across the Atlantic from Netherlands and Belgium: Quebec has legalized active euthanasia.

I have discussed the contents of new law at length previously and I don’t want to repeat myself.  However, the bill did undergo some changes since I wrote about it, and there are certain sections of the new law that need to be emphasized, so here goes:

The euphemism for homicide in the law is “aid in dying,” which in turn, is defined as part of “end of life care.

Receiving “end of life care”–including euthanasia–is now a positive right. From the law (my emphasis):

RIGHTS WITH RESPECT TO END-OF-LIFE CARE: 4. Every person whose condition requires it has the right to receive end-of-life care subject to the specific requirements established by this Act.

Such care is provided to the person in a facility maintained by an institution, in a palliative care hospice or at home.

This isn’t just the right to ask and receive suicide assistance from a willing doctor, with no guarantee you will get it–as in Oregon. It is the positive right to be subjected to lethal-injection euthanasia or terminal sedation at the hand of the doctor you asked or someone his supervisor finds to kill you. 

This means every institution that cares for the seriously ill, elderly, and injured must offer euthanasia:

7. Every institution must offer end-of-life care and ensure that it is provided to the persons requiring it in continuity and complementarity with any other care that is or has been provided to them.

Those eligible for euthanasia must:

(2) be of full age and capable of giving consent to care;
(3) be at the end of life;
(4) suffer from a serious and incurable illness;
(5) be in an advanced state of irreversible decline in capability; and (6) experience constant and unbearable physical or psychological suffering which cannot be relieved in a manner the patient deems tolerable.

Loose terms that will easily be subject to interpretation. I don’t believe for a second that these “limitations” mean anything much at all, except perhaps at first. So, within a few years, expect Quebec horrors similar to those I have repeatedly discussed from the Netherlands and Belgium.

Doctors and nurses must be complicit. That is they must inform their supervisors if they refuse to provide aid in dying. That supervisor or executive must then find a doctor willing to kill. I suspect many Hippocratic believing doctors will soon hear the words, “You’re fired!” or have some other limitations imposed on his or her practice.

And get this! Doctors, nurses, and pharmacist organizations are required to establish how-to-kill-your patients classes!

33. The council of physicians, dentists and pharmacists established for an institution must, in collaboration with the council of nurses of the institution, adopt clinical protocols for continuous palliative sedation and medical aid in dying. The protocols must comply with the clinical standards developed by the professional orders concerned.

Imagine you are a doctor, nurse, dentist (?!), pharmacist–even a hospice or nursing home administrator: You went into medicine to be a healer. You are now told that also have to be part of a bureaucratic killing system. And if you object? Prepare for professional ostracism, possible loss of position and/or license, and you can kiss any promotion goodbye.

Quebec’s reverse two-and-a-half somersaults, tuck dive into the doctor-administered death abyss is a glaring symptom of a deadly parasitic social affliction that is sucking the true meaning of compassion, professionalism, and righteousness clean out of our culture.

 

More Than 100 Washington Assisted Suicides



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Assisted suicide is on the rise in Washington.  From the Seattle Times story:

More than 100 people died in Washington last year after requesting and taking a lethal prescription through Washington’s Death with Dignity law, the state’s Department of Health reported Wednesday.

Officials said that 173 people requested and received lethal doses of medication in 2013, a 43 percent increase from the year before.

And in every one of these deaths, the doctors were legally required to lie on the death certificates that the deaths were from natural causes. That’s downright corrupting of the medical system.

Assisted suicide is sold with vivid tales of unbearable pain that can’t be controlled. But, as in Oregon, that is proved a typical assisted suicide lie:

Most of the people who asked their doctors for a lethal prescription told them they were concerned about losing autonomy, dignity or the ability to participate in activities that made life enjoyable. 

They key here is for doctors to declare their offices “assisted suicide free zones.” I think plaques to that effect should be made to be hung on office walls.

I would also like to see physicians attend demonstrations and publicly take the Hippocratic Oath. Just because something is legal, doesn’t make it right.

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