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Human Exceptionalism

Life and dignity with Wesley J. Smith.

Advance Planning Yes, Bureaucracy No



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I was flattered to be mentioned in the New York Times today by Brendan Nyhan in a piece about paying doctors to engage in end-of-life conversations with patients, and how these talks are not “death panels.” From, “Can We Have a Fact-Based Conversation About End-of-Life Planning:”

Support for covering voluntary end-of-life planning is actually remarkably strong across the political spectrum. In addition to the American Medical Association panel’s recommendation, both private insurers and states such as Colorado and Oregon are now offering coverage for these consultations.

Even critics of President Obama’s health care plan such as National Review’s Wesley J. Smith and Senator Johnny Isakson, Republican of Georgia, are in favor of advance planning.

I am not sure why the word “even” is in there. Surely one can adamantly oppose Obamacare–as I do, primarily because it opened the door to centralized bureaucratic control–and believe that doctors should discuss these matters with patients: Walking and chewing gum at the same time.

But to say that one is “for conversations” isn’t enough. The circumstances in which the talks occur matter too. So, to be clear, these are my positions:

- Doctors should discuss these matters whether they are paid or not. It is part of the job of physician.

- The conversations should be an ongoing dialogue, not a one off.  Some worry that paying for the talks will dictate when the discussions occur. I don’t think the talks pay enough for that, but it is a reasonable concern.

- The talks should not be designed to convince people to refuse treatment based on costs. The doctor should not represent “society” in these discussions. That would be a conflict of interest.

- We should not bureaucratize these conversations ancillary to paying for them. Thus, I wrote against a Senate bill that would have dictated the hoops through which doctors and patients had to jump to make the conversations compensable–and even established a federal advisory board, appointed by the president and the leaders of Congress. Good grief.

- These discussions should be with doctors if they are to be paid by insurance or government, and not with special interest groups. In this regard, I have warned that the assisted suicide advocacy organization Compassion and Choices–which bragged about being behind the failed Obamacare proposal to pay doctors or specialist organizations–wants to become the Planned Parenthood of death. That can’t be allowed.

- Talk isn’t enough. Everyone should sign an advance directive appointing a surrogate in the event of incapacity. Stating that you don’t want to be pushed out of the lifeboat makes it harder to push you out of the lifeboat.

- Rather than pay doctors to have these discussions, better to raise physician compensation generally with the understanding that the “talks” are expected as part of the compensation package. Think of the saved paperwork!

End-of-life conversations are controversial because people know that technocratic types hope to cut costs by restricting access to care to the most expensive patients, particularly those deemed to have a low quality of life–which is why the “death panel” warning resonated so deeply.

But silence is the wrong strategy. Discussing these issues openly make a death panel outcome more difficult to impose.

Invisible World Suicide Prevention Day



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Today is World Suicide Prevention Day! 

Did you know that? I’ll bet you didn’t.  From the International Association of Suicide Prevention Website:

Efforts to prevent suicide have been celebrated on World Suicide Prevention Day – September 10th – each year since 2003. In 2014, the theme of World Suicide Prevention Day is ‘Suicide Prevention: One World Connected.’ The theme reflects the fact that connections are important at several levels if we are to combat suicide.

And yet, suicide prevention organizations refuse to grapple with and/or oppose suicide promotion by the euthanasia movement. Time.  After time. After time.

Indeed, I searched the IASP site: There is basically nothing opposing suicide promotion by assisted suicide advocates, or much at all on the issue.

The media is, except for a few minor stories, silent. Again. And if it wasn’t for Robin Williams, I’ll bet there would be even less coverage–as I have documented in past years.

That’s too bad. Suicide takes a terrible toll. From the World Health Organization:

Over 800,000 people die due to suicide every year and there are many more who attempt suicide. Hence, many millions of people are affected or experience suicide bereavement every year. Suicide occurs throughout the lifespan and was the second leading cause of death among 15-29 year olds globally in 2012.

Notice the difference between the attention given to suicide prevention–very little–and suicide facilitation–cheers and clapping. Pushing suicide almost always garners headlines, even TV shows showing real suicides as “taking control.”  Popular shows and movies also push the pro-suicide meme.

Prevention, mostly the sound of crickets.

That is because we are increasingly a pro-suicide culture. Saying it’s okay for people with cancer but not for a mother whose child died doesn’t work.

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Sex Selection Abortion Ban Racist?



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One would think that liberals–so opposed to real (and imagined) discrimination–would oppose abortion based on sexism. Nope.

San Francisco–where else?–could go on record opposing protecting female (mostly) fetuses from being aborted because they are the wrong gender. From the San Francisco Examiner story:

San Francisco would become the first jurisdiction in the country to go on record opposing sex-selective abortion bans if a resolution stating they perpetuate racial stereotypes, being introduced by Supervisor David Chiu today, is adopted by the Board of Supervisors.

Sex-selective abortion bans prohibit terminating a pregnancy on the basis of sex, and doctors who perform such abortions can face fines, jail time or lawsuits. The bans “encourage racial profiling of women by some medical providers,” according to Chiu’s resolution, and can lead to women being denied services.

“Lawmakers across the country have successfully advocated for sex-selective abortion bans by perpetuating false and harmful racial stereotypes that such laws are necessary to stop an influx of Asian immigrants from spreading this practice, and that Asian American communities do not value the lives of women,” states the resolution, which Chiu will announce at City Hall today.

I wonder if pro abortion types would oppose banning eugenic gay-selection abortion if a test could detect the sexual orientation of a gestating fetus.

Close call, but in a culture of death, abortion trumps all. 

We Shouldn’t Have to Pay Doctors to Talk



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I oppose Futile Care Theory–aka medical futility–because it authorizes the unilateral withholding of wanted efficacious treatment.

What is efficacious? A proper understanding would be treatment that accomplished its purpose. Hence, a ventilator facilitates respiration and helps keep the patient alive. 

Futile care is when–in the above example–the wanted ventilator is removed because it is working–not because it isn’t–based on the perceived quality of the patient’s life.

This is sometimes called “qualitative futility.” In other words, in qualitative futility the patient is being declared futile, which is why the efficacious treatment is withdrawn. That’s why it presents such an acute danger to ethical medical practice. 

But there is also something known as physiological futility, that is, a situation when the intervention objectively does not provide efficacious benefit. To use an extreme example, no doctor should perform an appendectomy for an ear ache. 

From this story in the LA Times, it appears that some Alzheimer’s medications don’t work at the end stages of the disease. From the story:

Alzheimer’s disease drugs, which are virtually ineffective in patients with severe dementia, were the questionable medications most commonly given to nursing home patients with advanced disease.

Prescriptions for Alzheimer’s drugs such as donepezil (better known by its commercial name, Aricept), rivastigmine (Exelon), and memantine (Namenda) are commonly initiated for patients in the early stages of the disease and may slow the rate at which they become unable to care for themselves.

There’s little evidence they improve memory or mental performance in people in late stages of the disease, however.

Should doctors refuse such medication in end stage patients, even if wanted? It depends on the meaning of the term, “little evidence.”

But the bigger point is that it should never–or only very rarely–come to disputation. Most families will not want their loved ones to undergo greater discomfort for no or very minor efficacious gain. Ongoing dialogue is the best way to avoid such unfortunate outcomes and avoid futility disputes.

This is why I am worried that the varying plans to pay doctors for these communications–once a year or once every five years, whatever–miss the mark. If we bureaucratize these essential and ongoing dialogues, the doctor/patient/family relationship could easily become sclerotic.  

Better to raise doctor’s general pay in the understanding that their overall compensation includes end–of-life talks whenever they are needed and wherever they occur. 

We Are Bigoted Against the Old



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How often have we heard our elderly brothers and sisters say they don’t want to be “a burden.” Who made them think such a thing? We did!

A great column in the Daily Mail by Stephen Glover indicts the UK culture for its blatant ageism–a condemnation that applies equally to the USA. From, “Why Today’s Elderly are Old Age Pariahs:”

It can scarcely be disputed that people in their 70s, 80s and 90s are increasingly made to feel they are part of a burdensome minority which is more or less surplus to requirement. What is particularly disturbing is that the kind of prejudice expressed recently by Jeremy Paxman — who said Britain has too many elderly people, and that there should be a Dignitas [the Swiss suicide] clinic ‘on every street corner’ — is now widely shared, particularly by the agencies of the State.

It’s an interesting reflection that if Paxo had said he hated Africans, the disabled or even the young, there would have been an uproar. But the elderly are easy game, and he can be rude about them with impunity. He may have been joking, but it was in poor taste to say the least — particularly given that only a few weeks earlier the House of Lords had debated Lord Falconer’s Assisted Dying Bill, which raises the prospect of overbearing relatives putting pressure on the elderly to do away with themselves for fear of being a burden.

President Obama said the elderly should often take pain pills instead of receiving curative care.

Meanwhile, the death pushers at Compassion and Choices promote suicide by self-starvation for the elderly–and are treated as a respectable patients rights group by the media and medical intelligentsia.

Glover is absolutely right: We are bigoted against the old. Shame on us!

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Obama Will Never OK Over Counter Birth Control



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The Democrats took a non-issue–contraception–and turned it into cynical “war on women” demagoguery in 2012.

Similarly, Obamacarians used birth control pills as a bludgeon to undermine religious liberty with the contraception mandate, which they seek to impose on religious groups and business owners that see birth control as a sin,

But what would happen if birth control pills were available over-the-counter? Planned Parenthood supports that course, and now, in response to being accused falsely of trying to keep women from taking birth control pills, some Republicans think the time has come. From a Washington D.C. Examiner column by Byron York:

The most intense debate over the idea has taken place in Colorado, where Gardner unveiled a birth control TV commercial last week. “What’s the difference between me and Mark Udall on contraception?” Gardner asked in the ad. “I believe the pill ought to be available over the counter, round the clock, without a prescription — cheaper and easier, for you.” Udall, Gardner said, would “keep government bureaucrats between you and your healthcare plan,” resulting in “more politics, and more profits for drug companies.”

It seems to me that Republicans are responding to cynicism with cynicism. But that’s politics, I guess.

The question should not be based on politics, but safety. On that question, I have no opinion.

I do believe that over-the-counter birth control–if ever approved–should be behind the pharmacist’s counter for adults only to prevent minors from taking a powerful drug without parental knowledge. (I know, I am old fashioned that way.)

The Republicans are on to one thing from a political perspective: Over-the-counter birth control pills would no longer be covered by Obamacare. That, in turn, would prevent the present government from using contraception as a means to attack religious liberty, rally the secularists’ vote against “the theocracy,” and use the specter of unavailable birth control to scare single women to the polls.

And that is precisely why the Obama FDA will never approve over-the-counter birth control pills. The good politics–from the administration’s perspective–trump science and proper public policy.

Yes, I believe Obamacarians are that radical and the president that demagogic. 

ADF Court Filing Against Belgian Euthanasia



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The invaluable Alliance Defending Freedom has filed a complaint against the brutal Belgian euthanasia law as violating human rights. From the ADF announcement:

Alliance Defending Freedom filed an application with the European Court of Human Rights Wednesday on behalf of Tom Mortier, who is challenging Belgium’s laws that allow doctor-prescribed death. Mortier’s mother was put to death by a doctor for “untreatable depression” even though she was not terminally ill.

Mortier did not find out what had happened until he received a telephone call the day after her death.

The killer isn’t even a psychiatrist. He is an oncologist.

Such an atrocity should not be surprising. Belgian euthanasia is beyond “guidelines,” including the joint killings of elderly couples, psychiatric patients, and people with disabilities. And, let us not forget, it allows assisted suicide for children.

ADF makes the following human rights argument:

As the ADF application explains, “The institutions of the Council of Europe have shown consistent opposition to the legalization of assisted suicide and euthanasia…. [T]he only positive duty on a State is the positive duty to protect life.”

The application argues that Belgium’s law, which now allows children to kill themselves as well, has gone too far: “the balance has shifted unacceptably in favour of personal autonomy at the expense of the important public interest and a State’s obligation under Article 2 (the right to life).”

I wish ADF–with which I have warm relations–nothing but the best in this effort. I will keep readers of HE updated as events transpire.

AARP Exclude Suicide Pushers From Expo



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I rarely say these words, but good for the AARP.

The suicide pushers at Final Exit Network want to have a booth at AARP’s Expos to push their poison. But the oldster lobby said no and now FEN is crying in its hemlock. From the UT San Diego story:

In case you’re cloudy about Final Exit Network, it’s a national organization (related to the former Hemlock Society) that, in the words of local right-to-die activist Faye Girsh, “provides information and support to its members who are considering a peaceful, hastened death.” ’

In March, Final Exit Network applied for a booth at a spring expo in Boston. AARP responded that it had not established guidelines for right-to-die groups but hoped to do so this year. In June, responding to a Final Exit request for booth space at the San Diego convention, AARP wrote: “

After further consideration, we are unable to approve right-to-die societies and other like organizations as exhibitors.”

I repeat: Good for the AAPR.

FEN is a fanatical and destructive group of suicide pushers:

  • It teaches people how to commit suicide with helium;
  • It has gone around family to help suicides;
  • “Counselors” sanitize the sites of FEN-involved suicides in which the are ”witnesses.” It is a crime to disturb a death scene.
  • It helped facilitate suicide of a mentally ill woman in Arizona, for which two members were guilty of felonies.
  • It works in places like Oregon–also where physician- assisted suicide is legal for the terminally ill, since it has no such ideological limitations.

If AARP ever let’s such groups near its members–or Compassion and Choices that teach seniors how to commit suicide by self-starvation–it will invite oppobrium.  

 

Sex Selection Abortion Home Gender Test?



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So there I am, standing in line at my local pharmacy to fill a prescription and get a flu shot. I look to my right, and what do I see? The IntelliGender Gender Prediction Test.

Considering that sex selection abortion is becoming more of a problem in the West, I pick up the package and read. From the promotional material:

A fun pre-birth experience for moms who can’t wait to know! You may use our gender prediction test weeks before your sonogram. A simple baby gender prediction test you can take at home

gender prediction test clock

As early as 10 weeks into your pregnancy (8 weeks post- conception)! Most women find out the sex of their baby at their 20-week sonogram as long as Baby chooses to cooperate. IntelliGender bridges the curiosity gap between conception and sonogram…

“Fun?” “Curiosity gap?” Or something more utilitarian and eugenic?

Abortions are far easier at 10 weeks than 20, and “informed” by an early home test, the abortionist need never be told that the reason for the termination is that the fetus is a girl (usually).

The company would rightly say that it is not responsible for what women do with the results, and they do put in a caveat that the test could be wrong. And then, there is this little missive:

IntelliGender does not recommend test users to make any financial, emotional or family planning decisions based on the test results. This includes painting a nursery!

Ah, don’t paint the nursery!

Whew. Ok. That eases my mind. 

I’m Revising/Updating Culture of Death



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Culture of Death: The Assault on Medical Ethics in America may be my most successful and impactful book. And, after nearly 14 years, it is still selling.

But COD, like its author, is getting a bit long in the tooth. That is why I am very pleased that Encounter Books has agreed to publish an updated and revised version, probably late next year.

Think about the stories and controversies in bioethics that have roiled the country–and challenged our collective morality–since the book came out:

- The Terri Schiavo dehydration;

- The growing euthanasia horrors in Belgium, the Netherlands, and Switzerland;

- Obamacare and the specter of death panels;

- The mainstream bioethics movement’s conniption fit over the conservative President’s Council on Bioethics;

- The worsening of the exploitation of the body parts and functions of the poor and destitute, a  phenomenon I call biological colonialism;

- Continued advocacy for “after birth abortion.

- The Jahi McMath brain death controversy.

The list goes on and on.

I have been rereading COD for the first time in several years and find that my problem isn’t going to be what to include, but exclude–and deciding what original material has to go. I could write another book-length critique on the continuing challenges to Hippocratic values in medicine and healthcare public policy.

I have already decided on one change: The chapter on animal rights will go since the work I did for COD on that issue led directly to my writing A Rat is a Pig is a Dog is a Boy.

Well, back to the old writing salt mines. But then, that is precisely where I like to be!

How to Avoid Death Panels



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With all the controversy about paying doctors to hold end of life conversations arising again, I thought I would weigh in on how people can best avoid being subjected to death panel scrutiny.

The answer? Talk about it with physician, family, and friends. And write an advance directive! From, “How to Avoid Death Panels:”

The best defense against having your life’s worth judged by a death panel isn’t hiding in a hole of denial but having “the conversation”—or better stated, conversations—about what you would and would not want at the end of your life, should you become incapable of making your own medical choices. 

These are not simple discussions. There is a lot to consider and a lot at stake. Do you want CPR if you have a cardiac arrest? What about antibiotics if, say, you catch pneumonia? Then there are potential questions of feeding tubes or kidney dialysis.

But you say: How do I know whether I would want or refuse these things until I know what my overall condition will be when these issues arise?

That is why a one-off “conversation” isn’t enough. Rather, you and your doctor, family, and trusted friends should engage in a continuing dialogue.

Not only that—talk alone isn’t enough. Your best chance of avoiding sentencing by death panel is to put your medical preferences in writing in an advance directive, most particularly one that names a trusted loved one or friend to be your legally appointed surrogate to make these choices if you become incompetent.

I tell two true stories–one about my late uncle–demonstrating how talking and writing about what was and was not wanted ensured that Alzheimer’s patients’ wishes were honored.

Following my prescription won’t guarantee that a death panel might not one day turn thumbs down on your continued care. But it sure will make it harded to push you out of the life boat if you made it very clear you don’t want to be pushed. 

Memorial to German Euthanasia Victims



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It wasn’t “the Nazis” that caused the mass euthanasia deaths of disabled infants and adults. It was the eugenics ideology of the era that denied human exceptionalism.

We are heading in the same direction–although certainly not mass murder of the kind that happened in Germany circa 1939-1945.

But we too have accepted the idea that there is such a thing as an unlivable life. Indeed, in the Netherlands, babies born with serious or terminal disabilities are killed in their cribs by doctors.

In Belgium and the Netherlands, people with serious mental illnesses are euthanized–to widespread applause.

All of this reminds me of the words of Nuremberg Medical Investigator Leo Alexander, published in 1949 in the New England Journal of Medicine:

Whatever proportions these crimes finally assumed, it became evident to all who investigated them that they had started from small beginnings. The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as life not worthy to be lived.

This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans. But it is important to realize that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude toward the nonrehabilitable sick…

The killing center is the reductio ad absurdum of all health planning based only on rational principles and economy and not on humane compassion and divine law. To be sure, American physicians are still far from the point of thinking of killing centers, but they have arrived at a danger point in thinking, at which likelihood of full rehabilitation is considered a factor that should determine the amount of time, effort and cost to be devoted to a particular type of patient on the part of the social body upon which this decision rests.

At this point Americans should remember that the enormity of a euthanasia movement is present in their own midst.

Do you want to know what keeps me up at night? I don’t think that today’s NEJM would publish Alexander. I think it has embraced the very mindset against which he warned.

Waddya Know: A Blastocyst IS an Embryo!



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How often have I heard scientists and political hacks lie by claiming that an embryo isn’t an embryo until it is implanted in a uterus. Before that, they have often said, it is just a “ball of cells,” a “pre-embryo,” or just a “blastocyst.”

By lying about the nature of the embryo, pro embryonic stem cell research advocates hoped to manipulate society into supporting their research agendas.

These arguments were always–and remain–false. When you get down to it, we are all just big balls of cells,  so that’s a meaningless term. An embryo, unlike say a tumor, is an organism, in other words, a human embryo is a nascent, developing human being.

Nor is there such a thing biologically as a pre-embryo–as Princeton biologist Lee Silver admitted. That is a political term invented to skew ethical debates and decisions to permit the manipulation of human life.

As for the blastocyst, the term describes an embryo’s stage of development, not a different thing than an embryo. Thus, the, “It’s not an embryo, it’s a blastocyst,” is also junk biology.

In this regard, consider the following scientific finding that identified a gene that may cause the first cell differentiation. From the PhysOrg story:

The blastocyst is an embryonic structure present at early stages of the development of mammals, before implantation in the lining of the mother’s uterus. It is composed of between 64 and 100 cells that surround a central cavity. Before the embryo reaches this stage all its cells are equivalent and totipotent, meaning that each cell is capable of giving rise to all embryonic and extraembryonic cell types.

But the formation of the blastocyst implies the first distinction between cell types.

Did you get that? “Before THE EMBRYO reaches this stage of development…”

I write this here so that the next time a researcher or activist claims that embryonic destructive research doesn’t destroy an embryo, you will know you are witnessing blatant mendacity that disrespects moral deliberation and democratic engagement.

This is biology: At no point in a human life are we not a human life–that started from the time you were a one-cell embryo and has continued uninterrupted until the moment you read these words. And that is true whether your genesis occurred in your mother’s fallopian tube or a Petri dish. 

Taking Pride in V-Word “Unrepentant Bigotry”



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I am on a rather lonely campaign to make the V-word–”vegetable”–as unacceptable as the N-word in describing human beings. I call it an “unrepentant bigotry.”

Why? Like the N-word, the V-word dehumanizes the human beings against whom it is wielded toward the end of lowering their perceived moral value, thereby allowing them to be treated as somehow less than human.  

Just like the N-word justified Jim Crow and slavery, the V-word makes respectable actions that would otherwise be deemed profound wrongs, as I have repeatedly reported. Examples: 

- We take away the food and water from such people causing them to die slowly over 10-14 days. Do that to an ISIS leader and it would be correctly deemed a human rights atrocity.

- Bioethicists and organ transplant professionals advocate killing profoundly disabled people for their organs.

- Some even urge that our unconscious or minimally conscious brothers and sisters be used in medical experimentation, perhaps in place of animals.

I bring this up again because of a rather astonishing reaction in the Huffington Post to my blog entry here, “Joan Rivers Will Never be a Carrot.” James Peron claims that my arguing in favor of respectful language to describe those with profound cognitive disabilities–coupled with my Discovery Institute affiliation–means that I don’t really care about such people, but rather, that I am engaged in some kind of “creationist” plot to impose religion on society. (The DI is not a religious or creationist think tank, but never mind.)

I don’t want to get too deep into the weeds, but a few points must be made. First, Peron writes as if I take marching orders from my DI overlords. From, “Controlling Language Controls the Euthanasia Debate:”

Discovery Institute even goes as far as calling it “the v word.” I presume they think people in vegetative states find the term offensive.

I want to make it clear: “The Discovery Institute” did not write this: I did, for this blog. It was later reposted at a DI site as some of my work is with my permission, with a note stating where it first appeared.

I am a senior fellow at the DI. That is a no strings attached affiliation. My work is supported by the wonderful folk in Seattle, but not controlled by them. In other words, I am not an employee.

Next, Peron states the obvious:

Discovery Institute may not realize “persistent vegetative state” and “permanent vegetative state” are terms used by physicians, not insults thrown around carelessly.

Duh, really? In fact, I believe that PVS is the only diagnosis that contains a pejorative. 

But even if one disagrees with that point, to say, “Charlie is IN a PVS,” is not the same thing as saying,”Charlie IS a vegetable.”

The former describes a medical condition. The latter denigrates the human being in the same way and for the same purposes as the N-word.  

Thus, we say someone has cancer. We don’t say he is a tumor! 

Moreover, the V-word is not exclusively used to describe people who are persistently unconscious. (Peron may be ignorant of the fact that about half of PVS diagnoses prove to be incorrect.)​ It is also used to denigrate those who are aware, sometimes less commonly, those with developmental disabilities, occasionally even, those with serious physical disabilities.

Then, as so commonly happens among two-dimensional thinkers who attack my work from the Left, Peron proceeds to prove my point:

The term “vegetative state” has to go, because the Religious Right fears it will cause people to consider whether people in that condition, who have lost cognitive abilities, are still human in any meaningful sense of the word…

They don’t think any of us should have the right to end our life, or have it ended for us, when we reach the stage where meaningful life is impossible.

Isn’t that exactly what I was saying? The point of the V-word is to dehumanize. But one can advocate legalizing euthanasia without throwing around pejoratives at those deemed killable. 

Peron repeatedly tries to reduce this discussion to religion. But disability rights groups like Not Dead Yet–decidedly on the secular Left–also strongly object to using the V-word to describe those who are profoundly cognitively disabled. And disability rights activists were on the front lines trying to save Terri Schiavo from a long, cruel dehydration death. So much for the theocracy.

In conclusion, consider this: We use far more respectful language about dead people than we do those with severe cognitive disabilities. Those who have died are called the “late John Smith” as a way of continuing the decedent’s (another respectful term) connection to us and respecting the human lives they once led.  

Sure, there are disrespectful slang terms for the dead, like “stiff.” But you would never see a news report refer to the dead person as “the stiff,” nor would an expert use the term in media quotes.

Peron also claims that those who are unconscious aren’t offended by the V-word. (How would he know?) But I can tell you, I hear from family members of such people all the time, and they are offended to hear their loved one called a V-wordAnd hurt.

The point of the V-word is to exclude. My purpose is to help improve our language toward the end that we understand that such people are not “them.” They are still “us.”

Joan Rivers Will Never be a Carrot



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Whatever the future holds for Joan Rivers, who may have experienced brain damage during surgery, she will always be an exceptional human being deserving of equal rights and perceived moral value.

To put it another way, contrary to some stories describing her potential health outcome, she will never be a carrot. Carrots are vegetables, human beings never are.

We need to stop using the V-word to describe our brothers and sisters with profound cognitive disabilities. That word is just as bigoted as the N-word for people of sub Saharan African descent, the K word for Jews, or the C-word for women. From my piece, “That Unrepentant Bigotry:”

Many of our brothers and sisters remain the victims of a pervasive but nearly invisible bigotry—and indeed subjected continually to profoundly demeaning and hateful characterizations—mostly without social protest, cultural opprobrium, or even notice by the usual enforcers of cultural comity.  Indeed, the “hate speakers” may even be applauded or their denigration either not noticed or ignored, perhaps because the denigrators are often themselves unaware that they have engaged in hurtful rhetoric.

Ironically, this still-discriminated-against group is also our most diverse. Its membership comes in all races, ages, nationalities, genders, sexual orientations, and any other human identifier one can conjure.  In fact, if not already within this scorned cadre, any one of us could become a member at any time, and all of us have—or had—loved ones who could be so identified.

So, who are these despised unfortunates?  People with profound cognitive disabilities and catastrophically debilitating diseases, against whom it remains respectable to employ profoundly demeaning descriptives both in public discourse, public policy advocacy, and private conversation.

I am often amazed that in a time when a football team is pressured from the highest levels of political leadership and ubiquitously in the media to change its name because it is offensive to Native Americans, that so many have no compunction whatsoever using the hurtful and inaccurate V-word epithet to characterize the most defenseless among us.

Yet, it is just as demeaning to the intrinsic human dignity as racial and sexist slurs. We need some serious consciousness raising. 

 

Insuring End-of-Life Talk Not Death Panels



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Sarah Palin started the idea that paying doctors to discuss end-of-life care with patients were death panels. She soon corrected herself to properly note that health care rationing boards under Obamacare would be the death panels. Ever since, even those who support rationing call them death panels. 

But to the subject at hand: I have never understood why paying doctors to hold these conversations was a big deal–either way. It seems to me that such discussions are a basic part of the physician’s job, whether they get paid separately for it or not. 

In any event, Obamacare doesn’t cover such conversations, and currently neither does Medicare. But insurance companies are beginning to. From the NYT story:

We are seeing more insurers who are reimbursing for these important conversations,” said Susan Pisano, a spokeswoman for America’s Health Insurance Plans, a trade association. The industry, which usually uses Medicare billing codes, had created its own code under a system that allows that if Medicare does not have one, and more insurance companies are using it or covering the discussions in other ways.

This year, for example, Blue Cross Blue Shield of Michigan began paying an average of $35 per conversation, face to face or by phone, conducted by doctors, nurses, social workers and others. And Cambia Health Solutions, which covers 2.2 million patients in Idaho, Oregon, Utah and Washington, started a program including end-of-life conversations and training in conducting them.

What? Evil insurance companies did something of which the New York Times approves? Snow in August!

Snark aside: Let’s think about this. Will $35 really make the difference between a doctor doing and not doing her duty to the patient? I don’t think so.

Moreover, it isn’t as if these talks are one-offs: Rather, such matters should be the subject of a continuing dialog: A patient is diagnosed with a serious illness. Doctor and patient discuss what should or should not be done. Patient’s condition improves or worsens. Often, that will spark another conversation–and then another.

Now, if insurers want to pay for this, fine with me. If Medicare pays for it, fine too--depending on the details.

For example, I opposed legislation to have Medicare cover such conversations, not because I oppose the talks, but because the authors larded the bill with tons red tape–complete with a Care Planning Advisory Board.  Good grief.

And, of course, we wouldn’t want the conversation to become a push toward no treatment to save money. Well, most of us wouldn’t.

For some reason, the Times made this relatively minor matter a front page story. It doesn’t warrant that kind of coverage. It isn’t really that big a deal.   

Evil Humans Infect Monkeys with Ebola!



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Animal researchers love to sadistically torture animals, liberationists tell us. Animal research is useless. It does no good.

Use computer programs or cell lines–or people. Anything else is pointless cruelty.

This animal rights argument is strong on emotion and devoid of rationality. Case in point: The desperate attempt to find a treatment for Ebola, devastating Africa and threatening the world. From the Star Phoenix story:

Canadian scientists have rescued from death monkeys that were infected with a lethal dose of Ebola, in the latest study of an experimental drug that has been used on a handful of Ebola victims in West Africa. The antibody based compound known as ZMapp rescued 100 per cent of 18 Ebola-infected rhesus macaques, even when the drug was administered up to five days after infection with the virus.

All treated monkeys recovered fully and show no side-effects, said Dr. Gary Kobinger, chief of special pathogens at Canada’s National Microbiology Laboratory in Winnipeg. Three Ebola-infected macaques that didn’t receive ZMapp died.

Did you get that? They intentionally infected the monkeys and watched them die!

Cruel? No, a grim good.

This technique is how research must be done–if it is to be effective and not descend to Mengele-style immorality by risking humans in basic research.

If it doesn’t work, it won’t be tried on people. If it is dangerous, it won’t be tried on people. That is why the Nuremberg Code states that animal research is a necessary protection of human rights.

We don’t know whether this particular experiment will work. But note: Scientists were able to identify the SARS virus using this precise method, the crucial first step toward diagnosis and cures.

So, which should be infected first in the search for a cure or vaccine? People or monkeys? Monkeys or people? 

It shouldn’t be a tough question to answer. Those who choose people are part of the war on humans.

What is the Best Word for Transhumanism?



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Apparently members of the materialist religious denomination of futurists, often known as transhumanists, are having a bit of a tussle. No, it isn’t an argument over how many non souls can fit into a computer server array, but about nomenclature. From the Slate story:

These are all terms thrown around trying to describe a future in which mind uploading, indefinite lifespans, artificial intelligence, and bionic augmentation may (and I think will) help us to become far more than just human. They are words you hear in a MIT robotics laboratory, or on a launch site of SpaceX, or on Reddit’s Futurology channel.

This word war is a clash of intellectual ideals. It goes something like this: The singularity people (many at Singularity University) don’t like the term transhumanism. Transhumanists don’t like posthumanism. Posthumanists don’t like cyborgism. And cyborgism advocates don’t like the life extension tag. If you arrange the groups in any order, the same enmity occurs. All sides are wary of others, fearing they might lose ground in bringing the future closer in precisely their way.

I’ll settle this. I know the perfect word to describe the goals and aspirations of this rather sad and desperate movement: Fiction.

Embryonic Stem Cell Hype Encore



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I predicted in 2013 that the company which bought Geron would restart its embryonic stem cell product human trial. Indeed, it is.

I could also have predicted the media would hype it to the moon. And so the San Francisco Chronicle has in big headlines on the front page. From, “Stem Cell Industry’s ‘Huge Development’ in Bay Area:”

Almost three years after a Bay Area company shut down the world’s first clinical trial of a therapy using embryonic stem cells, another local company is reviving the therapy.The treatment drew international attention in 2010, when Geron in Menlo Park began testing it in patients with severe spinal cord injuries. But it scrapped the project a year later because of a lack of funds – a move seen as a major blow to the nascent field. The therapy was then sold to Asterias Biotherapeutics, also in Menlo Park. On Wednesday, Asterias said it had gained regulatory permission to test whether the treatment, which is derived from human embryonic stem cells, helps heal patients with a different kind of spinal cord injury…

“It’s a huge development for the field,” said Kevin Whittlesey, science officer at the agency. “We’re starting to realize the potential touted so highly when embryonic stem cell research was in its infancy.”

Let’s deconstruct this. First, the prominence of the story seeks to help California’s boondoggle stem cell agency keep its door open

The trial was also described as a victory by the state’s taxpayer-funded stem cell agency. Created by voters a decade ago, the California Institute for Regenerative Medicine is authorized to spend $3 billion on stem cell research, and its future rests on the results, including any potential therapies, that those scientists and companies develop. A $14.3 million grant will cover half the costs of Asterias’ trial, the company said.

Secondly, the original Geron study may not have worked all that well:

With some tweaks, Asterias is picking up where Geron left off. Geron treated severe injuries in the thoracic region of the spinal cord, which runs along the back. Asterias is targeting injuries that originate in the neck, citing an outside study that suggests injuries in this area are easier to treat. It will also amp up the doses used to inject patients.

Finally, if this is such a big deal, why do the media constantly ignore far more advanced human trials for spinal cord injury using ethical stem cells? For example this very exciting peer reviewed study of paralyzed subjects treated with olfactory stem cells:

Of the 13 patients assessed by functional studies, 1 paraplegic patient (patient 9) can ambulate with 2 crutches and knee braces with no physical assistance and 10 other patients can ambulate with walkers with or without braces with physical assistance.

One tetraplegic patient (patient 13) ambulates with a walker, without knee braces or physical assistance.

Did you get that? Tetraplegia means paralyzed from the neck down! In this study, one totally paralyzed subject now uses a walker without assistance. Why isn’t that worth a front page story?

Let me answer my own question: Because when it comes to cultural deconstruction, it isn’t the treatment that matters so much as the source of the treatment. Adult stem cells just don’t shatter any moral boundaries.

Canadian Cowardly Head Doc’s Hand-Wringing OK for Assisted Suicide



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This is how the culture of death advances. A clueless, or cowardly–or both–authority figure says he or she is against assisted suicide except as a very last resort when everything else has been tried.

Never mind that medicalized killing has never been so limited anywhere assisted suicide/euthanasia is legal. Never. Ever. Nowhere.

Not Oregon. Not Washington. Not the Netherlands. Not Belgium. Not anywhere on planet earth.

But saying that it is OK, if limited to a very last resort when everything that can be conjured by the minds of medical science has failed allows a surrender with seeming principle.

That’s the kind of abjection now pushed by the head of the Canadian Medical Association, Dr. Chris Simpson. From the Canada.com story:

Doctor-hastened death would only be appropriate after all other reasonable choices have been exhausted, says the head of the country’s largest doctors’ group. Dr. Chris Simpson, newly installed president of the Canadian Medical Association, made the comments in advance of a landmark Supreme Court of Canada hearing expected to add fuel to the emotional end-of-life debate gaining urgency across Canada.

Simpson said there are enough doctors in Canada willing to perform doctor-hastened death, if the federal ban outlawing euthanasia were lifted.

But doctors first need safeguards to protect the vulnerable and a strategy to urgently shore up palliative care “so that this is not seen as a first, or second or even third choice, but a choice that’s appropriate for people after all other reasonable options are exhausted,” he said.

I have zero respect for this argument. Zero. Better to advocate for outright legalization than engage in this cowardly charade.

The “last resort” justification is a hiding place for those without sufficient guts or principle–either to admit they are for assisted suicide or who don’t have the bone marrow–I am tempted to use a cruder image–to stand against it and be accused of lacking compassion.

Reading the balance of the article, it seems that Simpson comes in the former category.

More proof of my thesis:

Simpson, who will be appearing before the Supreme Court, said that the CMA will be neither “pro nor con” and that as long as euthanasia and doctor-assisted death remain illegal “we’ll be advising our members not to participate in it.”

Should the legal landscape change, “Our new policy will be to allow physicians to follow their conscience” within the confines of the law.

How can a medical association be NEUTRAL about legalizing doctor prescribed death?

Moeover, that statement completely belies the “last resort” pretense. No principles!

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