Last week, I broached the question of an attempted shift in the long-standing cultural balance in America between the paramountcy of the Judeo-Christian values of the sanctity of life and primacy of the individual will in pursuit of conventional moral standards, and the moral relativism of an evolving rationalist Enlightenment. It is, very broadly, the abrasion between positive faith and humanist reason, and although I saw no evidence that Senator Santorum saw the issues in exactly this historic context, I think he deserves credit for raising these different perspectives in what has otherwise seemed to me the most intellectually vapid U.S. presidential campaign I have observed. (And I have observed all of them starting with the relatively distinguished rematch in 1956 between Dwight D. Eisenhower and Adlai E. Stevenson, very different men but both of undoubted stature.)
These questions are regularly played out as what are called the life issues, and are not usually argued along partisan lines. The great majority of people of all political shadings will agree that personal and national self-defense justify recourse to force in the absence of other effective measures. The death penalty for heinous crimes is more hotly contested, especially as there are now constant revelations of deliberate prosecution suppression of exculpatory evidence all over the country, and all execution techniques, including lethal injection, have been shown to be potentially cruelly painful. Abortion is a proverbially divisive subject, and the depredations of the pro-abortionists are becoming steadily more aggressive: now partial-birth abortions, and even the first stirrings of the scandalous enormity of post-birth abortion. Assisted suicide and euthanasia are heating up, fueled by the burgeoning organ-transplant industry.
The notion of salvaging organs and other vital body parts from the deceased carries an almost John Donne sensation of triumph over death: Important parts of a dead person soldier on almost indefinitely. But “organ harvesting,” as it is called, has become an astonishing $20 billion annual industry. Commissioned salesmen of the industry, called “wranglers,” approach next of kin of the potential donors in the waiting rooms of the emergency rooms and intensive-care units, while the patients are still struggling, however unpromisingly, for life. The implicit presumption that has been disseminated, that these donations are invariably the removal of well-functioning body parts from unambiguously dead people in disinterested pursuit of the prolongation and promotion of life, is, unfortunately, largely a fraud.
Parallel to the medical advances that made such transplants increasingly possible came a convenient redefinition of medical death that facilitated the work of the wranglers. This partly promising but also macabre process really got into high gear when a team of doctors at Harvard Medical School in 1968 redefined death from the irretrievable cessation of the beating of the heart to a complicated idea of the permanent death of the brain, which was entrenched in the Uniform Definition of Death Act of 1981 (UDDA). This essentially replaced science with philosophy and imposed the following criteria for death: absolute unresponsiveness and lack of movement and spontaneous breathing (anything prompted by respirators doesn’t count as evidence of life); no reflexes in eyes, ears, or muscles; flat encephalography; and no change after 24 hours (though there were also warnings of the mimicry of death, especially by hypothermia and drug intoxication).
These Harvard standards that were adopted by the whole country were not based on any patients or experiments. Death has been redefined as a lack of “personhood” for no discernible reason except to facilitate the organ-transplant industry. Thus, those deemed under the UDDA to be dead include not only people whose hearts are beating, however slowly and faintly, but also those who continue to eliminate cellular wastes, maintain a sustainable body temperature, heal wounds, fight infections, suffer fevers, and have functioning organs and tissues; supposedly brain-dead pregnant women who continue to gestate a fetus; and supposedly brain-dead children who continue to mature sexually and grow normally.
Transplant surgeons earn an average of $400,000 per year and rich finders’ fees are paid to organ-source hospitals. Paradoxically, the only parties who do not benefit financially from this vast and swiftly growing industry are the donors and their families. The initial reason for this exclusion is understandable, as the idea of sick people or their families’ selling their organs, whether posthumously or not, is gruesome and degrading. But so is a good deal of what goes on legally now. The wranglers sell the concept of the death of a loved one as being mitigated by helping to save or enhance the life of someone else; the idea is good and the scientific achievement is impressive, but the pecuniary ambitions of the wranglers and everyone else in the profit chain are disconcerting.
Most patients diagnosed as brain-dead are practically indistinguishable from routinely anesthetized patients. In fact, the practice of anesthetizing organ donors deemed to be brain-dead, i.e., dead and lacking “personhood,” is steadily increasing because of growing concern that they may suffer pain during the profound operations, which often require the rending and opening of the sternum. “Beating-heart cadavers,” as they are called, may be declared dead though they are breathing spontaneously and are vulnerable to pain.
It all becomes impossibly complicated when pregnant women certified as brain-dead continue to gestate; a number, in many countries, have been successfully delivered of normal, viable children, albeit prematurely, but well within parameters for successful premature births, including one who gave birth 107 days after being pronounced dead, and nourished the child throughout. The brain-dead criterion has been watered down to a fuzzy and arbitrary notion of irreversibility. (The inevitability of physical death is irreversible for everyone.)
The transplantation of organs is a fundamentally positive phenomenon, but nothing is more defiant of death than giving birth. People who are really dead are not in need of being anesthetized, and, as Dick Teresi wrote on this subject in the May issue of Discover magazine, wheeling away the three-and-a-half-month-dead corpse of a woman who has just successfully given birth, to have her organs removed, gives new definition to the adage that “a woman’s work is never done.”
For moral reasons, independent of the vagaries of the organ-transplant industry, disability-rights groups have arisen, in an organization called “Second Thoughts” that contests the current practice. It is leading the no campaign in a November referendum proposition in Massachusetts arguing that because of coercion, false advocacy, and professional abuse, doctors counselling and assisting suicides should not enjoy an absolute immunity from prosecution that they are seeking (in lock step with American prosecutors, whose misfeasances are becoming more notorious each week).
As it now stands, doctors can issue lethal prescriptions with a practically unassailable presumption of good faith. Most states afford doctors who decline to treat the ill because of a presumption of futility “a safe harbor,” the customary American professional ambition for an absolute immunity from responsibility for their conduct, an ambition made more attainable in the case of doctors by the fortuitous reign of UDDA.
A recent Pittsburgh Medical Center study revealed a very disturbing likelihood that a living will or “Do not resuscitate” order will cause the withholding of a treatment a patient wants and to which he has a right. Doctors are far from the only problem, as dubiously motivated family members are also empowered to abuse the medical status quo.
Also now inching visibly forward on the hairy, cloven feet of the misnamed medical-ethics community — a well-paid advocacy group for whatever revenue-producing wheeze the pharmacological-medical complex currently seeks — is the horrifying outrage of post-birth abortion. This concept, just floated by two Australian doctors in the Journal of Medical Ethics, holds that since a baby’s illness, or the financial burden of having a child, or the sheer inconvenience to the mother of doing so, are acceptable reasons for aborting a fetus, they should also be for disposing of a born and viable child. If this sponsorship of capital murder by infanticide (logically extendable through all phases of a person’s dependency on others), is allowed any traction at all, civilization is doomed.
I am prepared to be cautiously optimistic on this point, but America, the West, and ultimately all mankind will have to define precisely and prayerfully when life begins, and when it begins to end, and what precautions are necessary to prevent and punish criminal homicide, no matter how swaddled in the self-righteous evasions of avaricious and desiccated doctors and lawyers who profit from it. Only elected legislators, the legitimate source of law, can do this. It must not be dumped again, as abortion tragically was in the United States, into the lap of a handful of disenthralled judges, lolling fecklessly in their appointive, unaccountable sinecures.
— Conrad Black is the author of Franklin Delano Roosevelt: Champion of Freedom, Richard M. Nixon: A Life in Full, and A Matter of Principle. He can be reached at cbletters@gmail.com.