Google+

Human Exceptionalism

Life and dignity with Wesley J. Smith.

Researching for Dollars



Text  



More evidence that science is becoming a special interest: Governor Matt Blunt of Missouri wants to spend $300 million of taxpayer's money on biotechnology. But this is the same Governor Blunt who cut Medicaid so deeply that feeding tubes may not be covered in some cases. Priorities, Governor, Please!

Haleigh Poutre Moved to Rehab Center



Text  



Rather than being dehydrated to death, 11-year-old Haleigh Poutre is being moved to a rehabilitation center where she will receive care to maximize her capacities. Haleigh was beaten nearly to death by her mother and step father last September, suffering a catastrophic brain injury. The state guardian got the Massachusetts Supreme Court to order both her respirator and tube-supplied food and fluids terminated. But Haleigh unexpectedly breathed on her own and seemed to react. She now has a chance for life.

I will say it again: We need to reconsider the issue of food and fluids as just another medical treatment. Removing nutrition will result in death. As Haleigh proved, this is not always true of other forms of care. Therefore, we should be loath to remove medically appropriate "artificial nutrition and hydration," barring a written advanced directive or clear and convincing evidence that it would be in the patient's best medical interest. In other words, we should never decide that someone else's "quality of life" is such that we won't even permit them to have food and water.
ADVERTISEMENT

Ralph Nader’s Mother has Died



Text  



My good friend Ralph Nader is grieving the loss of his mother, Rose Nader, who died of congestive heart failure just days short of her 100th birthday.

Mrs. Nader was a pure delight. She always had smile on her face and a kind word on her lips. Her deep love for family was clearly evident to all who saw her interact with her children, grandchildren, and great grandchildren. It was even more clear from the intensity of love they all gave back to her.

Mrs. Nader's life and accomplishments are worth pausing to remember. A high school teacher, she immigrated to the United States from Lebanon in 1925 after marrying Nathra Nader. The couple eventually settled in Winsted, Connecticut where they ran a successful restaurant and raised their four children: Shafeek, Claire, Laura, and Ralph.

The Naders instilled in their children a deep love of country and a sense of duty to participate in civic affairs. Shafeek Nader (who died in 1986) was the principal founder of Northwestern Connecticut Community College. Claire Nader is a Ph.D. In addition to being Mrs. Nader's primary care giver in recent years, she has been deeply involved in foundation and educational work, including heading the anti-human cloning organization, The Council for Responsible Genetics. Laura Nader is an internationally renowned anthropologist and professor at UC Berkeley. Ralph Nader founded the consumer movement and is a former presidential candidate.

Rose Nader lived a great life. The world is better for her having been among us. She epitomized the American Dream.

More on Weakening of Hippocratic Oath



Text  



This is the AMA's Declaration of Professional Responsibility. It too has removed crucial and specific patient protections and replaced them with platitudes and vague terms, the meaning of which can vary from physician to physcian. I plan to write a more extended piece on the undermining of the Oath and what it might portend. Stay tuned.

Media Bias? What Media Bias?



Text  



This on-line headline in The Telegraph for a woman who traveled to Switzerland to kill herself takes the cake. "Doctor Dies With Dignity." Swallowing poison pills is "dignity," meaning I guess, that dying naturally is something else. This is really an insidious message that undermines the value of human life.
ADVERTISEMENT

Loma Linda University Also Has Weakened the Hippocratic Oath



Text  



I received a strong reaction to the post about Cornell Medical School weakening the Hippocratic Oath. Today, I heard from a LLU alumnus, concerned about the LLU Medical School's weakening of the Oath. It purports to be a Christian version (no swearing to Apollo, etc., which is appropriate). Unfortunately, the LLU Physician's Oath doesn't just contain pabulum, but could also turn out to be applied in an anti-patient manner in some cases:

This is the provision I have the most concern about: "Acting as a good steward of the resources of society and of the talents granted me, I will endeavor to reflect God's mercy and compassion by caring for the lonely, the poor, the suffering, and those who are dying."

This provision does away entirely with the doctor having his or her sole duty to the wellbeing and health of the patient. It seems to place a dual mandate on doctors, to husband resources first, as he or she cares for patients. Indeed, this statement would seem to justify health care rationing, thereby placing the swearing doctor into a potential conflict of interest with his/her most ill, elderly, or disabled (most expensive) patients.

This is not to say, of course, that it is wrong for physicians to be concerned about proper use of resources. They should be. But not at the expense of the proper care of the individual patient, to whom physician should owe the highest duty of loyalty as an individual. Dual mandates, if you will, are dangerous precisely because resource management could easily come to trump the patient. The clause would also justify imposition of Futile Care Theory, (aka, medical futility).

"I will maintain the utmost respect for human life. I will not use my medical knowledge contrary to the laws of humanity. I will respect the rights and decision of my patients."

Well, this is a complete cop out. Why not explicitly promise not to kill patients, regardless of what the "laws of humanity" might state? In the Netherlands, the law will soon permit the active infanticide of disabled and terminally ill infants. Under this oath, a doctor could comply and not be in violation. After all, the Dutch doctors who commit infanticide state they do so because they respect the humanity of the patients they kill, who they claim, do not have "livable lives."

"I will lead my life and practice my art with purity, and honor; abstaining from immorality myself, I will not lead others into moral wrong doing."

This replaces the promise not to have sexual relations with patients. Since it comes from a presumably conservative Christian context, it may pass muster. But absent that, it is entirely vague. Why be coy?

I would be interested in other examples of modern medical oaths. This trend to do away with robust patient protection is alarming, to say the least.

It Looks Like Arnold Would Not Sign a Bill Legalizing Assisted Suicide in California



Text  



These quotes from California Governor Arnold Schwarzenegger about assisted suicide, according to Reuters:

"I personally think that this is a decision probably that should go to the people, like the death penalty, or other big issues. I don't think that we -- 120 legislators and I -- should make the decision.."

And:

"It's irrelevant what I think about this because I would never want to force my opinion on something like that."

California had an initiative to legalize euthanasia/assisted suicide in 1992. It began with 70% or so support in the polls and lost 54-46%.

Investigating Decision to Remove Feeding Tube



Text  



Governor Mitt Romney of Massachusetts intends to investigate the decision by the MA Supreme Court to permit the public guardian to remove the feeding tube from a 12-year-old abuse victim named Haleigh Poutre. She is now, apparently, reacting to her environment (not that I believe reactivity should be a requirement to receive food and water).

And let there be no complaints by those who believe cognitively disabled people should be dehydrated, about the "state" imposing its views on family. This was a decision pushed by the state through a public guardian, and approved by a court.

By all means: Investigate. And let us hope that the conclusion is reached that food and water should not be removed from people based solely on "quality" of life considerations in the wake of a catastrophic brain injury.

Combating Cloning Lies in Iowa



Text  



I don't claim a monopoly on wisdom about the issues about which I advocate (some would say, obsess). But I can't stand it when advocates just lie in support of their position. I have blogged on Iowa Governor Tom Vilsack's false assertions that advances in cloning medical treatments require a change in Iowa's ban on all human cloning. But I thought it needed further analysis. Here it is, from today's Daily Standard.

Cornell Medical School Turns Hippocratic Oath to (Mostly) Pabulum



Text  



Cornell Medical School has rewritten the Hippocratic Oath. Gone is the proscription against abortion. No surprise there: Foreswearing that particular act was discarded from the Oath decades ago (although it is interesting how recent newspaper stories report that few doctors today are willing to perform abortions).

Now, Cornell has also erased the prohibition against assisted suicide ("I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.) Killing is not a medical act. Hippocrates understood that. Moreover, putting that power in the hand of a doctor is to give the doctor too much power, given the reliance patients place in their physicians. Hippocrates understood that, too.

The new oath doesn't even require doctors to foreswear sexual relations with patients, another form of potential abuse and imposition. Illustrating the difference between the rich patient-protecting orientation of the original and the mostly non-specific pablum of the Cornell version, compare Hippocrates with Cornell:

Hippocrates: "Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves." The clear call here is active, requiring doctors never to act in a way that would take advantage of patients, with one specific example, e.g. sexual relations.

Cornell: "That into whatever house I shall enter, it shall be for the good of the sick. [Forget for the moment that most doctors don't make house calls.] That I will maintain this sacred trust, holding myself far aloof from wrong, from corrupting, from the tempting of others to vice." This is a far more passive and vague approach. What does holding oneself "aloof from wrong" mean, anyway? Indeed, what does "tempting others to vice" mean in the context of today's anything goes society?

I do appreciate this addition to the Oath, however: "That I will not withdraw from my patients in their time of need." Never abandoning patients is an important part of being a professional.

Cornell's oath is a pale comparison to the great original. It contains few specifics. It is wide-open to any interpretation any doctor may wish to place upon it.

What a shame. The Oath is seen by patients as a significant protection of their interests. When I tell audiences that few physicians take the Oath anymore, but instead recite watery facimiles, primarily as a "rite of passage" (as described in the Cornell press office story), they always gasp in unhappy shock.

This latest rewrite continues this sad decline.

Assisted Suicide: Consider the Deadly Context



Text  



In the wake of the Supreme Court ruling in Gonzales v. Oregon, I have a piece in today's San Francisco Chronicle addressing the context in which assisted suicide would be conducted. Context can be everything, and in a regime of legalized assisted suicide, it would be deadly.

Truth in Advertising



Text  



The old photo posted on the site was about 6 years old, so I have updated it with one taken about 2 months ago. I am so middle aged! How did that happen?

Another Fraudulent Scientific Paper



Text  



This time, in the Lancet. It would seem that the current methods of peer review definitely need reviewing.

Comments about Gonzales v. Oregon from Dr. Eric Chevlen



Text  



My co-author of Power Over Pain wrote me an interesting note about the recent SCOTUS opinion on assisted suicide: "I began to read the Gonzales decision last night. I noticed something very interesting in the first few paragraphs of the majority opinion. It refers to Oregon as being "the first" state to legalize PAS. I would have written "the only" rather than "the first." The latter formulation carries a tacit expectation that more will follow...I think that that choice of words revealed the heart's desire in Justice Kennedy's heart. He also refers to the CSA controlled substances in question as being used, in lower doses, to treat pain. The fact is that nearly 100% of the people who die via PAS die from an overdose of barbiturates, not of opioids. Barbiturates are not analgesic. Thus is another myth perpetuated."

This would substantiate my suspicion that the decision was somewhat result-oriented. It also demonstrates that the courts (and media) are often wrong on basic facts.

Another Case of Bad Reportage



Text  



I am quoted in this Christian Science Monitor story about the Supreme Court assisted suicide decision. What irritates is that I pointed out this Pew Poll result to the reporter who interviewed me, noting that to support and opposition to assisted suicide was evenly divided 46-45%. (I blogged this poll a few days ago.) Instead of citing the poll question about assisted suicide, which would have been accurate, the reporters instead cited a different question about the "right to die," which was defined in the poll as the right to remove unwanted life support--a completely different issue. They noted 84% support.

But this question is irrelevant to the subject of the story, and seemed designed to rebut my assertion that the assisted suicide movement has been moribund. In other words, they cited the wrong poll number, making it appear that assisted suicide is far more popular than it actually is.

Clueless or biased? You decide.

It’s Not Over ‘Till It’s Over



Text  



This story demonstrates why we should be very wary of removing feeding tubes. An eleven year-old little girl named Denise Monteiro was apparently beaten by her step-father. She was diagnosed as PVS. Doctors said she would never improve. The court ordered her removed from respirator and tube feeding. She breathed on her own and apparently is beginning to respond. New tests have been ordered.

Whether or not Denise improves, it seems to me she should not be removed from food and water, based solely on her cognitive capacity. Nutritional termination can only have one result: Death. As a consequence, I believe the decision to withdraw or withhold such care should be treated differently than other such decisions. Benefits of doubt should go to providing nutritional sustenance. Indeed, in my view, absent clear written instructions by the patient or the presence of other urgent medical issues, dehydration should never be done based on the decisions of others, particularly if they are steeped in quality of life considerations about the lack of a life worth living.

More Bad News From Korea: This Time About Umb. Cord Blood Experiment



Text  



The woman who was paralyzed for 19 years and had partial movement and feeling restored through umbilical cord blood stem cells has had a terrible setback. The story says it was an infection, but it also appears that she may be the victim of unethical human experimentation. The bottom line: Today she is worse off than she was before receiving the experimental treatments.

This brings up an important point I try to adhere to: I always point out that one apparent successful treatment does not a cure make. I have said this about Dennis Turner, who apparently received a substantial remission from Parkinson's with his own brain cells. I said so about this woman. These are early experiments. The promise seems real. But we must not hype adult stem cells in the way proponents of cloning and ESCR have too often hyped those approaches.

The First Calls Are Heard for Robert Klein’s Head



Text  



Robert Klein, the primary mover behind Proposition 71, made a big mistake by becoming the head of the California Center for Regenerative Medicine. Now, he is in growing political trouble. The Center is beset with problems, including lawsuits and a distinct tendency toward arrogance and hubris. Now, the Center for Genetics and Society, a liberal group involved with biotechnology, is calling on Klein to step down. The Center is right. But he won't. And that will be to the benefit of those who oppose Proposition 71.

Gonzales v. Oregon: Much Less Than Meets the Eye



Text  



The media is touting Gonzales v Oregon as some huge victory for assisted suicide. It is a victory for that agenda, I admit, but not a big one. As I noted yesterday, the ruling was quite narrow and all of the puffing and spinning in the world won't change that. Besides, I don't see people marching in the street demanding that doctors be given the right to kill their suicidal patients. My prediction (and I am usually right in such matters, but not always), is that this opinion will only have a mild impact on the debate.

For my extended views, read my article on National Review Online.

The Constitutional Right to Clone



Text  



I have been warning anyone who will listen, that the intellectual foundation is being laid to create a constitutional right to conduct scientific research. A new book, Illegal Beings, is touted by its publisher as advocating something akin to that approach. Specifically, the book argues that there is a constitutional right to engage in reproductive cloning.

Science has entered upon a trajectory of anything goes. The primary question thus becomes: Does society have the will to properly regulate science? We had better. Otherwise, science will dominate society.

Pages

Sign up for free NRO e-mails today:

Subscribe to National Review