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Human Exceptionalism

Life and dignity with Wesley J. Smith.

Andrea Clark has Died: Family Issues Statement



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The family of Andrea Clark has announced that she died peacefully, surrounded by her loved ones:

"Andrea passed away peacefully a little before 3pm today, with her family and her friends at her bedside. We love her so very much and we are going to miss her terribly. We hope that the battle that we fought for our sister will bring to light and bear witness to the horrible acts committed in the name of ethics in hospitals across the state of Texas.

The fact that we had to fight this battle is both frightening and a sad commentary on the so-called 'ethics' now being practiced in medical facilities in this state. The battle for life is a difficult one, in the best of situations, but when a family is put through what we had to go through at such a time, it is especially agonizing.

We wish so much that we could have spent more time at our sister's side, when she was living and fighting for her life, rather than having to visit our attorney's office, give interviews to radio and television stations to let the public know of the atrocity about to befall Andrea, and literally stand outside the hospital and beg them not to kill our sister. In attempting to deprive Andrea of the most basic of her human rights--life--St. Luke's Hospital managed to deprive her family and her of that which is most dear to us all, when we are faced with the death of a loved one: a proper goodbye.

How, in the name of God, anyone can call putting someone to death when they are at their most helpless and begging for their lives 'ethical,' we cannot imagine."

Some people might say that since Clark died, the initial decision to unilaterally refuse wanted life sustaining treatment by St. Luke's made sense. But the opposite is true. The family's statement is bitter. But imagine the depth of bitterness, anguish, and uncertainty that would have been generated had Clark died because of being forced off life support.

My sympathies to the family and gratitude for fighting for the intrinsic equal moral worth of Andrea Clark's life.

Animals to be Litigants in Texas Court?



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I have been warning for years now that the animal rights movement is seeking to create moral and legal equality between humans and animals. One tactic is to have courts permit animals to become litigants in court, with animal liberationists as their guardians ad litem. In other words, the animal would be treated the same as an incompetent person or a child for purposes of the legal proceeding.

I mention this in my speeches and people laugh. I understand why: It seems ludicrous. People just do not get how serious and committed liberationists are to the cause of human/animal equality. And they underestimate the willingness of the intellectual class to dismantle venerable principles and moral values.

The audience laughter is way of saying: "Oh, that is just too dumb. It will never happen." But people should not be so sanguine. A chimp was permitted to get an injunction in his own name in Brazil. Spain is pondering giving primates the rights of persons. New Zealand already has signed on to much of the Great Ape Project, which advocates that great apes be granted what are today called human rights.

People need to be aware that the old rules and moral standards that they take for granted--which are all based in the principle of human exceptionalism--are under intense and sustained ideological assault on several fronts, one of which is animal rights/liberation. The time has come for the laughter to stop and the defense of the unique importance of merely being human to begin.

Potential case in point: This story out of Texas seems to be reporting that animal liberationists are attempting to have primates named as litigants in a lawsuit over the suitability of a primate sanctuary. If so, it must not be permitted. Animals are not persons and should not be allowed to bring lawsuits in their own names. If the sanctuary is not up to par, that is for humans to hash out as a manner of protecting animal welfare.

I will keep an eye on this and try to find out the exact nature of the proposed litigation.
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Bush: Science Should Serve Humanity and Not the Other Way Around



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This seems an interesting speech by President Bush on the promises and perils of science. Among the President's thoughts:

"Science offers the prospect of eventual cures for terrible diseases--and temptations to manipulate life and violate human dignity."

"With the Internet, you can communicate instantly with someone halfway across the world--and isolate yourself from your family and your neighbors."

"My advice: Harness the promise of technology without becoming slaves to technology. My advice is that science serves the cause of humanity and not the other way around."

I have always thought that the rap on Bush as "anti Science" was bum, particularly since most of the issues which have caused his critics to level that charge are not really science controversies, but rather, moral and ethical arguments. (I know, I know: global warming. But whatever the merits or demerits of the criticism about his stance on Kyoto, that issue is not part of what we discuss here at Secondhand Smoke.) In any event, it looks to me as if Bush has put more thought into some of these issues than many of his critics.

UCSF to Try Human Cloning



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A few years ago UCSF tried to clone human life and failed. This story indicates that they are going to give it another try.

One of the reasons I posted the link is that the misleading headline aside (eggs are not cloned, cloning creates embryos), the reportage by Chronicle science writer Carl Hall actually gets the science right, e.g., human SCNT creates cloned human embryos.

This is now admitted in CA, since a constitutional right to clone has become part of the state constitution. But during the campaign over Proposition 71, proponents sued the opposition when it claimed that the measure would create a constitutional right to do human cloning and fund the experiments. That lawsuit was thrown out of court.

Similarly, today in Missouri, proponents of that state's cloning legalization initiative claim that SCNT isn't cloning and that no embryo is created. (What is it, chopped liver?) Such disingenuous advocacy is parroted by the biased media, which also uses the term "early stem cells" in place of "embryonic stem cells" as propounded by the pro-cloning forces.

But this story admits that cloning creates a human embryo. Now, if we can only get the Kansas City Star to read it and report accurately from now on. As if!

Ode to Representative Mary Pilcher Cook



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Mary Pilcher Cook is a Kansas State Representative who is about as indomitable and dedicated a legislator as I have ever met. She is honest, committed, and moral. One of her primary causes is to outlaw all human cloning in the great state of Kansas, an issue that has made her a lot of political enemies.

This commentary about her is, it seems to me, grudgingly complimentary. In part it slams Cook, as anti-choice, anti-science, and the usual rubbish aimed at opponents of cloning. But it is actually an homage to her character and integrity.

Still, the author, Loren Stanton, somehow omits telling her readers exactly what it is that Cook seeks to outlaw. Readers are told: "Last year she sponsored legislation that would have made it illegal to conduct certain kinds of stem cell research in the state." Why not be specific? Perhaps because if Stanton told the whole story, most of her readers would agree with Cook.

Consider the whole picture: Cook merely wants Kansas to follow the recommended public policy from the UN General Assembly, and that adopted in recent years by such progressive countries as Canada, Norway, France, and Germany.

I have worked with Mary for several years on issues of mutual concern. I have never ceased to be impressed by her energy and can-do attitude. She is the kind of legislator about whom all Americans can be proud. You read it here first: Mary Pilcher Cook is an up and comer about whom much will be heard in the years to come.

People wanting to contribute to Pilcher Cook's tough political campaign for re-election should hit this link.
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Senators Specter and Santorum Move to Fund “Alternative Methods” Stem Cell Research



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Now this is interesting: Two senators, both from Pennsylvania and on opposite sides of the therapeutic cloning debate, have co-sponsored legislation to fund research into ways to obtain pluripotent stem cells without creating and destroying embryos. Research pursuing my friend Bill Hurlbut's idea of altered nuclear transfer (ANT) would undoubtedly be one of the methods that would be funded. There are other ideas, too, all worthy of a good look to see if we can heal the ethical rift that divides us about human biotechnology.

Hopefully, a trend has started in this regard. First, unanimous agreement was achieved to fund a federal umbilical cord blood stem cell bank. And now, perhaps, the Feds will pay for research into "alternative methods," as they are sometimes called. I wish the PA Senators success in their new joint venture.

National Civil Rights Group Opposes Assisted Suicide



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The National League of United Latin American Citizens (LULAC)has voted to opposes assisted suicide and California's AB 651 that would legalize Oregon-style medicalized killing.

Here is the gist of the press release from LULAC announcing its position:

"According to Angel G. Luévano, state director of California LULAC, the reasons for opposing doctor-assisted suicide go beyond moral and religious objections. 'Latinos are the least likely to have medical insurance,' says Luévano. 'Many will say, 'I don't have the money and don't want to be a financial burden to my family.' Latinos will be the most likely to be steered into this option.'...

'The Latino community doesn't want assisted suicide. The disability community does not want assisted suicide. The poor and uninsured do not want assisted suicide. The majority of us are Democrats and we want our representatives to focus on issues like health care, education, and immigration rights - not assisted suicide,' says Luévano."

LULAC's position reflects the beliefs of California's Latinos, according to a recent poll. A recent survey of California Latinos, conducted in February, 2006 by the Democratic polling firm, Fairbanks, Maslin & Associate, found that 64 percent of Latinos oppose doctor-assisted suicide.

A Right to “Self Preservation”



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A Court of Appeals has ruled that terminally ill people have the right to access experimental drug treatments that might save their lives. Ruling that dying patients have a basic "right of self-preservation," the court held that experimental drugs that have passed the first phase of FDA review -- which determines whether a product is safe -- should be made available to a dying patient if the drug might save their life.

This is interesting. Supporters of futile care theory claim that dying patients don't necessarily have the right to non experimental life-sustaining treatment if the bioethicists or doctors determine that their quality of life is not worth living. Much of this is based on money and on an ideologically belief in at least an implied duty to die when a patient reaches a certain level of impairment. Yet the fundamental premise underlying the court's ruling--a right to self preservation--would seem to point the law in the exact opposite direction.

I believe strongly that the time has come to stomp on futile care theory in legislation and the courts. This case (ignoring for the moment the important issue of whether this is an example of judicial overreach) shows where the benefits of the doubt should lie.

Behind the Spin: US NOT Falling Behind in ESCR



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I have blogged on this before, but Eric Cohen has published a full article debunking the notion that the USA is falling behind in ES stem cell research due to President Bush's funding restrictions. Cohen notes that "more than 85 percent of all the published embryonic-stem-cell research in the world...used the lines approved for funding under the Bush policy." Not only that, but as I blogged previously, the USA was number 1 in the number of papers published in the world (42%)

Interestingly, Germany was number 2 with 10% of all published papers. Cohen doesn't get into this, but Germany's public policy regarding ESCR is more restrictive--some would say protective--than that of the USA. In Germany, it is against the law to destroy embryos for their stem cells (or other research purposes). German scientists are allowed to import ES cell lines if created before January 1, 2002. This is the Bush approach (no public funding of ESCR for lines derived after 8/9/01) squared, since it actually outlaws private parties from destroying embryos--which is completely legal here.

The bottom line, is that Germany and the USA provide more than half of all ESCR published papers. Falling behind my left, er, nostril.

Cohen notes that the paper supposedly demonstrating that the USA is falling behind--and which Cohen proves shows we actually dominate the field--was promoted by its authors and in the compliant media in a fallacious manner. I am not surprised. The public campaign to promote ESCR and cloning is the most dishonest and disingenuous public policy effort that I have ever witnessed in my nearly 20 years as a public policy activist. And the shameful part is that it is being conducted in the name of protecting science, which is corroded when scientists claim that spin and subjective advocacy is actually objective science.

Good for Cohen for taking the time to break down the numbers to give an accurate picture--not that most media are interested in accurate pictures.

The Suicide Senator



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Dianne Feinstein has endorsed AB 651, which would legalize physician-assisted suicide. Reading her letter is a case study in spin and ignorance--exactly what we see from Senator Feinstein in the cloning issue--as I describe fully in Consumer's Guide to a Brave New World.

And now, she pushes for California to give its seal of approval to some suicides. Here, in part, is what she wrote:

"When terminally-ill patients are considering their-end-of-life options, they want to discuss them with their family, friends and their physicians--people they trust--and government should not stand in the way."

Government doesn't stand in the way now. People can talk about "options" all they want. But doctors cannot intentionally help kill their patients. That is not the same thing at all. Indeed, if someone is suicidal, they should discuss it with their doctor so interventions can help ease the suicidal desire. Moreover, with assisted suicide, people may go to doctors whom they have never met before in order to get lethal prescriptions when their own doctors say no--as they often do now in Oregon. That is pure Kevorkianism.

"Recently, in Oregon v. Gonzales, the Supreme Court established that State legislatures have the prerogative to enact laws on certain end-of-life issues,"--by which she means assisted suicide. Hogwash, as I have written at length. Indeed, the Court ruled that the Feds could outlaw the use of controlled substances for use in assisted suicide.

Then Feinstein mouths the usual platitudes about death with dignity and safeguards to protect against abuse, the usual propaganda. I keep thinking I like Senator Feinstein. I just can't figure out why.

Andrea Clark: The Bigger Picture



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This piece of wisdom was sent to me by Steven Drake, one of the movers and shakers in the disability rights movement. I agree with his point about the Andrea Clark "victory" wholeheartedly:

"This [my previous post] is definitely a cause for celebration, but I think that is much too optimistic. Too many people will walk away from this, thinking somehow this 'proves' that the system "works.

Meanwhile, the law is still in effect, Yenlang Vo's [another futile care case]life is threatened in Austin and we really have no idea how many patients and families are being pressured--families not quite so vocal, knowledgable or determined. The ones that die quietly.

It's the *statute* that needs to die. Until it does, any victory is a fleeting one."

Stephen Drake
Research Analyst
Not Dead Yet

St Luke’s To Do the Right Thing



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I have just heard from Jerri Ward: St. Luke's has agreed to continue to provide Andrea Clark life sustaining treatment under the auspices of the new doctor. Here is her letter:

"I want to let you know that St. Luke's is doing the right thing in this case now. The physician team met with the new attending and it went well. The team is on board and the medical futility procedure has been stopped. For the time being, Andrea will continue to receive life-sustaining and appropriate treatment at St. Luke's.

St. Luke's, and the involved physicians, are to be commended for reconsidering and deciding to continue Andrea's care."

Hat's off to Jerri and Andrea's family for their indomitable defense of the intrinsic worthiness of the life of Andrea Clark. And to those people who cared enough to let the world know that futile care theory is not going to be swallowed without a fight.

Senator Talent Againt Missouri Cloning Initiative



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The Missouri initiative to legalize human cloning (phonily called stem cell research), is being opposed by MO Senator James Talent. He should not only oppose it, but use his megaphone as a senator to educate people as to why it should be opposed. That would also help in his reelection campaign where he alienated many of his core supporters by taking his name off of the Brownback federal human cloning ban.

Suicide Classes



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See the truth of the euthanasia movement: Despite talk of "medical models," this is the true face of much of the grass roots euthanasia movement. More how to commit suicide classes. Philip Nitschke, who will be a faculty member, supports suicide for troubled teens. And many a dead teenager has been found to have committed suicide with the aid of Derek Humphry's book Final Exit.

“Do Not Stop Life-Sustaining Treatment:” demands Andrea Clark Attorney



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I have been contacted by Jerri Ward, the attorney for Andrea Clark's family. She has informed me that a new physician has agreed to treat Clark and that the doctor and the family want her life-sustaining treatment to continue while they look for another hospital to provide care under the auspices of the new physician. Ward has written a letter to St. Luke's Episcopal Hospital in Houston, Texas, directing, on behalf of the family, that Clark's life-sustaining treatment be continued.

In any event, this is an abridged version of that letter. I have omitted an allegation about Clark's care that I didn't feel I should publicize since I only know about it as it is set forth in this letter. I have also excised the names of the doctors for obvious reasons:

"Re: Andrea Clark

Dear Sirs and Madam,

As you know, I represent Andrea Clark and her family. On behalf of the family and Andrea, I have been authorized to convey treatment decisions made by the family with regard to her care. Because Andrea is heavily sedated and is limited in her ability to communicate treatment decisions to her physicians and the hospital, the family is empowered under law to make such decisions on her behalf. The family is united in its decision that life-sustaining treatments should NOT be withdrawn or withheld from Andrea Clark pending transfer to another physician or facility.

On behalf of Andrea, the family, acting as a unit, has made the following treatment decisions:

1. Life-sustaining treatment should continue pending transfer as referenced above.

2. Dr. [name #1] should, in the exercise of reasonable care, prepare an interim summary of his findings and diagnoses to enable other physicians to have sufficient information in order to make a decision as to whether or not to take on the care of Andrea. It is unconscionable to this family that Andrea's primary attending physician has made himself unavailable to the patient during this trying time--even though he has delegated care to Dr. [Name #2].

3. It is the family's position that Andrea is not a "futile case". Under the provisions and privacy regulations of HIPAA, the family is entitled to have erroneous information in Andrea's medical chart corrected. Because, it is at least one physician's opinion that a diagnosis of futility and decision that life-sustaining treatments are inappropriate, the family requests, pursuant to HIPAA, that the medical chart be corrected and that the discontinuation of life-sustaining treatments on the basis of inappropriateness not be entered into her chart. The decision that Andrea's case is "futile" has placed seemingly insurmountable obstacles to transferring Andrea's care to other providers. It is repugnant to notions of justice and fairness that Andrea's life be threatened because you have unilaterally determined a disputable outcome that impedes her chances of finding another health provider.

4. The family has decided that the regimen of pain medication be reassessed and the dosage appropriately decreased so that a proper assessment of Andrea's condition can be made by physicians other than the ones to whom this letter is directed.

5. The family withdraws consent and authorization from the attending physicians and the hospital to discuss with, disclose to or elicit opinions from Dr. [Name #3] regarding protected health information concerning Andrea Clark. It is the family's opinion that Dr. [3's] actions and opinions in this matter are informed solely by his personal philosophies regarding "futile care theories" and that he has not taken an objective approach in this matter. Furthermore, it is the family understands that Dr. [3] is an ob-gyn, and not a cardiologist. Thus, the family questions Dr. 3's seemingly active role in affirming treatment decisions of Andrea's treating physicians.

Moreover, it is the family's opinion that Lanore Dixon and Charles Clark were treated with rudeness, insensitivity and disdain during an ethics committee meeting which focused on pain management for Andrea. The family felt that its positions were ignored and ridiculed by Dr. 3. Moreover, the report Dr. 3 wrote as a result of that particular ethics committee meeting was rife with misstatements of the facts. For instance, Dr. 3 wrote: "...The specific question asked concerning that belief is when, if ever, her sister told her that she wanted to exist in a state of pain and suffering to achieve that goal. That question was never answered.' Lanore Dixon strongly disputes this and asserts that she did; indeed, state 'that Andrea did tell me that she wanted all measures to be taken to save her life unless she was brain dead.'

It is the family's decision and desire that Dr. 3 recuse himself from consideration of this case and any decision regarding Andrea's care. The family will be exploring its recourse under the law and under the enforcement mechanisms of HIPAA to this end.

6. The family requests that the ethics committee be convened on a day and time convenient for the family, their attorney and their medical experts to discuss Andrea's care.

7. The family insists that Dr. 3, or any other hospital staff member desist from any attempts to unduly or unreasonably persuade, intimidate or bully any potential treating physician into accepting Dr. 3's opinion that life-sustaining treatments should be withdrawn. The family, again, withdraws any consent or authorization from the parties in this matter for Dr. 3 to receive or discuss protected health information regarding Andrea Clark

8. The family insists that it be made privy to any conversations between representatives or case managers and attending physicians or hospital staff and Andrea Clark's insurer regarding matters of coverage. The family is entitled to know if the insurer is placing pressure on the hospital based on its assessments regarding length of stay or any other measure impacting the insurer's willingness to pay.

...

On behalf of the family, I am putting you on notice that the family intends to file pleadings with the appropriate court in order to restrain you from withdrawing life-sustaining treatments. There are numerous questions of fact that should not be solely determined by you with regard to Andrea's treatment. There are fact issues with regard to whether or not the physicians and the hospital have acted with reasonable care in deciding that life-sustaining treatment should be withdrawn. Should you act to withdraw life-sustaining treatment prior to review by an appropriate Court, the family intends file complaints with the appropriate regulatory and licensure entities and to take any available legal action permitted under the law and in equity.

It is the family's opinion that the attending physician and ethics committee have overreached in this case. It should not be your decision as to whether or not Andrea's life is worth living. The family demands that life-sustaining treatments be continued in light of the fact that the family intends to take this matter up with the Court. [My emphasis.]

Should you have any questions, please contact me. Thank you for your immediate attention to this matter.

Very truly yours,

Jerri Lynn Ward"

Games Being Played by St. Luke’s?



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Andrea Clark's sister was assured (she says) by St. Luke's that Andrea would be maintained through Tuesday. But Jerri Ward, the attorney for the family, just e-mailed me: "I have not been able to get St. Luke's to agree on the record that care will be continued after the weekend. It probably will, but that's not been conveyed to me either in writing or orally."

I will continue to update as more information comes in.

Medical Futility Like Pornography: It’s Whatever We Say It Is



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Andrea Clark's becoming the "unwanted patient" began with Houston hospitals creating a collaborative policy on medical futility back in the 1990s. That led to the Texas law which sought (impotently, in my view) to limit the damage that can be caused by medical futility.

Here is a very telling part of the article describing the policy in the August 21, 1996, Journal of the American Medical Association (JAMA), page 571 ("A Multi-institutional Collaborative Policy on Medical Futility"). After noting that it is difficult to define medical futility or cases in which continued life-sustaining treatment would be "inappropriate," the authors, write:

"We concluded that we need to treat futility as courts treat pornography, acknowledging that while it cannot be defined, we certainly know it when we see it. This approach to value laden, context dependent judgment has recently been eloquently defended."

In other words, it is what we say it is. Sweet.

Andrea Clark’s Sister Wants You to Know



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I heard from Lanore Dixon, Andrea Clark's sister. Here is what I was told. She asked me to pass it on:

"St. Luke's has agreed not to pull Andrea's life support at least until Tuesday. On Tuesday, a committee of doctors from St. Luke's will meet to discuss how to proceed with Andrea's case. Andrea's new doctor--a doctor who shares our values about the sacredness of life--will take over her care on Tuesday and will fight for her right to live. Let us all hope and pray that the committee meeting on Tuesday is chaired by doctors who have a reverence for life and not a former abortionist like the St. Luke's ethics committee chair."

Apparently the Illinois facility was a nursing home and was not equipped to provide Andrea with proper care. So St. Luke's appropriately stopped the transfer.

The Unwanted Patient



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The deal to permit Andrea Clark to receive treatment in Illinois is off. The hospital there wasn't a hospital, it was a nursing home, and so St. Luke's cancelled the transfer. I am told, but don't know, that this was because of a miscommunication about the seriousness of her illness.

But this is the bottom line: A catastrophically ill woman and her family want her life sustained and no hospital in the country appears willing to permit her have this care. Such is the place that the bioethics movement has taken the country.

P.S. I have been spelling Andrea's last name incorrectly. It is Clark. No e at the end.

Euthanasia in the Netherlands--Going Up



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The numbers of euthanasia deaths in the Netherlands continue to increase, and those are just those reported. Several studies have shown that about half of all euthanasia deaths in the Netherlands are not reported, even though it is legal there for doctors to euthanize patients who ask for it. Not reporting violates the law, but of course, we are talking the Netherlands here, so nothing is ever done about it.

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