Schiavo: Hope versus Despair

I am not writing much about the Terri Schiavo case any more. Partly, this is because most people's views about her death are now set in ten feet of concrete, and nothing I say or write will change it. And partly it is because there is so much about which to be concerned, that there just isn't the time.

But that isn't to say that the one year anniversary of her death by dehydration should be ignored. Today's NRO has an interesting analysis by Father Robert J. Johansen that is worth reading. Father Johansen's conclusion:

"It is clear now that the battle to protect the lives of people like Terri is best won at the very outset — by amassing the best scientific and medical evidence to support the position that even lives that seem profoundly limited are nonetheless worthwhile and human. Ultimately, this is a battle for people's hearts and minds: Once people understand that there is hope in life, even when that life is limited or entails suffering, they will be unwilling to embrace death as a solution to problems. In the end, the struggle to protect the lives of people like Terri Schiavo is a battle of hope against despair."

And lest cynics believe that only religious people opposed Terri's dehydration, remember that the disability rights movement was deeply involved in trying to save her life. Jesse Jackson and Ralph Nader both stood with the Schindlers. There were no dissenting votes in the United States Senate to the federal law that tried to save Terri's life, and about 45% of the Democratic House Caucus voted for the bill.

A Good Juxtaposition of Columns

I have a column in today's Seattle Times against assisted suicide that urges readers to consider the context in which assisted suicide would be carried out. (It is a rewritten version of a piece that first appeared a few months ago in the Orange County Register.)

I bring this up because the Times, perhaps inadvertently, juxtaposed my piece with another column about the collapse of primary care in medicine. The author, a medical professor, worries that "our health care system is unraveling," that it is "like a house riddled with termites." This is a good one, two punch. So often, euthanasia and assisted suicide are discussed in a vacuum, in which every patient receives optimal care, every doctor is Marcus Welby, and there is no such thing as family dysfunction, life insurance, inheritance, or other issues. Even in an ideal system, assisted suicide would be wrong. But the way things are in our country right now, it would be catastrophic for the most weak and vulnerable among us.

Hands Off Our Ovaries!

I know, I don't have ovaries. But women do, and their eggs are becoming valuable commodities for biotechnological research. Obtaining eggs, however can be an onerous, even dangerous process. Indeed, two women have died in the UK donating eggs in the last year. And if cloning takes off, millions of eggs could be needed, potentially endangering the lives and health of women, particularly poor women who could be paid a pittance to go through egg harvesting, which could leave them sterile, with ovaries the size of a grapefruit, or even, dead.

That is why pro choice and pro life feminists are joining together to demand a moratorium on obtaining human eggs for use in biotechnological research. (The moratorium would not impact fertility treatments.) Their rallying cry: Hands Off Our Ovaries!

This is a very worthwhile endeavor and protecting women's health has brought together women who disagree about other issues, such as abortion. The WEB site of Hands Off Our Ovaries is to be found here.

U.S. Not Falling Behind in Stem Cell Research After All

This is hot: The promoters of human cloning and ESCR constantly bemoan the alleged "fact" that the USA is falling behind in stem cell research because of President Bush's funding policies. Now, we know that is pure bunk. The Scientist, no less, has published statistics about the number of peer reviewed articles published about stem cells.

The USA is way ahead: "US-based scientists have by far authored the most stem cell articles, some 13,663 in 2000-2004--42% of total articles. Germany [which outlaws all human cloning and ESCR] came in second with 10.2% of the total, followed by Japan, the UK, France, Italy, Canada, The Netherlands, Spain, and Sweden."

Of course, the magazine tries to spin the findings to make the USA appear to be lagging. It does so by measuring the number of articles per million citizens, which permits Israel to be named as the leading country because it has such a small population. Under this spun way of measuring, the USA comes in 6th, but note that we are still ahead of the UK, which explicitly permits human cloning for biomedical research and has a generally anything goes approach to biotechnology.

This is the bottom line: United States researchers are responsible for almost half of all the stem cell articles published in the world between 2000 and 2004! And number two is the country with perhaps the most restrictive laws in the world about cloning and embryonic stem cell research.

"Mass Euthanasia" Wasn't

This story about a Japanese surgeon who is accused of "mass euthanasia" is misleading. The doctor is accused of removing respirators from dying patients with family consent. That is not euthanasia, at least as we use that term in the West, which refers to killing by some artificial means, e.g., overdose of drugs, bullet to the head, etc.

The law in Japan regarding the removal of life support is different than here. But this does not appear to be a case of mercy killing as occurs routinely in the Netherlands.

Infanticide in the Netherlands Compared to Infanticide in Germany

In this piece in the Daily Standard, I compare German infant euthanasia during World War II--which has been self evidently condemned as a crime against humanity--with infant euthansia in the Netherlands, which the Dutch insist is not a crime againt humanity. The Dutch are wrong.

Washington Post Calls Adult Stem Cell Success, Embryonic

It appears that the testes may provide cells that can be transformed into pluripotent stem cells that could be used to treat degenerative diseases in men, who would be able to have their own, er, delicate tissues harvested and then used as life saving medicine. But the headline writer for the Washington Post and Rick Weiss the reporter, repeatedly called these adult stem cells, embryonic stem cells (as did scientists). Talk about spin. A pluripotent cell is not a synonym for embryonic. Indeed, embryos have nothing to do with this potential breakthrough: If this proves successful, no embryos will be created or destroyed.

Brief Reflection on Mexico

I just returned from a very rewarding and interesting, if short, trip to Mexico (Mexicali). I spoke to an overflow crowd at a medical school, and was gratified by the response and the clear idealism of the soon-to-be doctors. I appeared on Mexican television where the interviewer asked better questions than usually is the case on American media. I did a newspaper interview to a reporter very interested in the hospice concept. And, I gave two speeches to a very receptive crowd who attended a symposium sponsored by a coalition of pro-life/pro-family groups called Congreso Internacional Vida y Familia. The people were wonderful. I made good friends. I had a wonderful time.

I learned that the socialist party is promoting euthanasia and that its candidate is first in polling to succeed President Vicente Fox. If true, that is bad news for the non elite in Mexico. I learned that there is no hospice movement in Mexico to speak of, which I made a point of urging my listeners to begin to rectify. I learned that Mexico voted to ban all human cloning in the United Nations only after the government succumbed to a strong grass roots political campaign to achieve that laudable end. People were very interested and engaged in the bioethical issues of the day.

Which illustrates a point worth remembering: The issues addressed at Secondhand Smoke are international. Every society is grappling with them in their own unique ways. There is much to do to maintain a culture that values the weak and vulnerable as much as the strong and rich. And, there is much to learn from other cultures who bring their own unique perspectives to the fray.

Netherlands Continues to Erupt Over Nazi Comparison

The brouhaha between the Prime Minister of the Netherlands and Italy's Parliamentary Affairs Minister, Carlo Giovanardi, continues to boil. Giovanardi, readers of Secondhand Smoke will recall, recently compared Dutch infant euthanasia to German infant euthanasia during WWII. That got Jan Peter Balkenende, the Dutch PM boiling, and the dispute has not cooled down yet. But Balkenende should instead reflect on the moral cliff off of which the Netherlands has jumped. While I believe Giovarnardi was not wise to use the Nazi analogy, and it certainly isn't exact (the Dutch aren't Nazis nor do their human rights violations compare with crimes of the Third Reich), there is a certain level of legitimate comparison that can be made.

Barring the unforeseen, I will have a detailed analysis about this matter published early next week. Stay tuned.

The Eugenicist Temptation

I reviewed a new book on the Eugenics Movement in the current National Review, and gave it a substantial rave. Better For All The World is great history. Sadly, the author understands the problem of the resurgence of eugenics thinking in bioethics and among some futurists, but the answer to this very real problem generally eludes him. But understanding the problem is half the solution, which makes Better a worthwhile read.

Haleigh Poutre: Mistakes Were Made

A panel investigating the near dehydration of 12-year-old Haleigh Poutre, the little girl beaten nearly to death and left with serious brain injuries, have concluded that mistakes were made leading to the court ordering her removed from all life support. To say the least. But how can we expect otherwise when bioethicists and doctors now measure the quality of a patient's life based on cognitive criteria and judges are often all too willing to see such people as being better off dead?

A classic example of this was the Ron Comeau case, which was the first "food and fluids case about which I ever wrote all the way back in 1994. Post Script: Comeau eventually died in a nursing home of pneumonia. But because he wasn't dehydrated, he was able to reconnect with his family from which he had been estranged.

North Korea May Kill Disabled Newborns

New York Times columnist Nicholas Kristof wrote a few years ago when he visited North Korea, that there were no disabled people in the capital, Pyongyang. He was told that they were all being cared for in the country. Kristof, didn't believe it, writing, "The darker explanation is that North Korea systematically exiles mentally retarded and disabled people from the capital, so as not to mar its beauty.'

When I read that column, the hairs stood up on my arm. I felt like yelling, "They haven't been moved you idiot, they have been killed!" I wrote a letter to the editor suggesting that possibility, which was not published.

But I never forgot that column. Now, it looks like I was right. A defector claims that disabled babies are killed in hospitals or homes soon after their births, a practice that is encouraged by the state.

Dutch doctors kill disabled babies too. But, it's "different" with them because they are motivated by compassion rather than eugenics. So even though the result is a killed baby, the Dutch tell us we have no right to be upset.

China Finds Willing Buyers for Organs

This is ugly: The Chinese sell the organs of executed prisoners and find willing buyers in Japan and elsewhere. China is also beginning to move toward accepting euthanasia, and we all know about the human rights impact of their "one child" population control policy. China's harsh utilitarian ethics and values should not be permitted to lead the world. It is up to the United States to assert and promote a better way, one that understands and promotes the intrinsic equal moral equality of every human individual.

Read the Beliefs of an Animal Rights Fanatic in his Own Words

Jerry Vlasik has justified murder in the name of animal liberation before a senate subcommittee. Here,he goes almost as far when interviewed by an animal liberationists publication. Some key quotes:

"Killing an animal abuser, who is not an innocent bystander, is morally defensible, and if they had the power to do so, animals would do it."

'All animal abusers should be politely asked to stop killing animals in their work and explain to them the scientific fraud in animal experimentation, as I was. If they refuse, they should be told to stop immediately, or suffer the consequences. If they still refuse, then they should be stopped by whatever means necessary."

Admittedly, Vlasik is more radical than most animal liberationist leaders. But he represents a sizeable minority. Note also his seeming desire for there to be a radical reduction in the human population, demonstrating a loose tie-in with the ideology of deep ecology that views humans as vermin on the living planet.

What is the Fallout of Hwang Cloning Scandal?

Robert P. George and Eric Cohen have written a good piece in today's NRO about the domestic fallout from the Hwang cloning scandal. Their most important point is that "the scientists" are not merely objective observers as the media (and they) often pretend, but are instead involved in an explicitly political campaign to persuade society to accept human research cloning.

Scientists have every right to participate in politics, of course. But the rub comes when they pretend that a subjective political or moral opinion is instead, a statement of objective science. Worse, as I hope to detail in a future extended article, sometimes they resort to the propaganda techniques of lying or telling half truths, while still pretending that their assertions are merely scientific observations. This is corrosive to science itself.

In any event, check out the piece. It's worthy of your consideration.

A Few Thoughts on My Excellent Adventure in the UK

I spent a very interesting and enjoyable week in London, speaking, meeting people involved in the issues about which I engage, doing a little BBC and other media, and generally enjoying the town. A few thoughts: The UK is a wonderful country but it seems to be heading down a bad utilitarian road when it comes to health care. Part of this, I think, has to do with the resource crisis in the National Health Service, and part with a changing belief system that we see throughout the West.

The assisted suicide bill is just a small part of it. Of equal concern are the draft regulations published to govern the Mental Capacity Act passed last year. Alas, most of the problems that opponents of that bill predicted appear to be coming true. Specifically, the draft regulations would lock Futile Care Theory (medical futility) into concrete law.

The draft regulations require absolute fealty to the pre-stated desires of an incapacitated patient who signed an advance directive requiring termination of treatment. But if the advance directive instructed that care be given, according to the terms of the draft rules, they would not have to be followed. Rather, patient and family desires would be merely one factor in determining whether the continued treatment are in the "best interests" of the patient. More alarmingly, this analysis would not be restricted to medical issues, or even quality of life judgments, but could also include issues such as the desire to be a good citizen, altruism, and the like. Talk about opening the door to a duty to die!

On the positive side, I met with some leading disability rights activists who are beginning to understand the threat that these policies pose to disabled and dependent people. Hopefully, if the disability rights community engages these issues with the energy and commitment we have seen from their colleagues here in the States, they can have a very salutary effect.

I hope to write more about these matters as time allows. In the meantime: Cheers!

Finally a European Official Criticizes the Dutch

Carlo Giovanardi, an Italian government official, is in hot water for likening the pending legalization of infanticide in the Netherlands to what happened during World War II in Germany, when doctors murdered hundreds of thousands disabled infants and adults. I am not a big fan of raising the Nazi specter, partly because nothing we are talking about today matches that mother of all death cultures in scope or magnitude, and partly because, ironically, bringing up the Nazis allows people deserving of strong criticism to deflect the reproach. Thus, Giovanardi says that killing disabled babies is what the Nazis did, and the Dutch merely retort (correctly) that they are not Nazis, allowing his deserved and righteous criticism falls on happily deaf ears.

Not that there isn't a rough analogy: German doctors were hanged at Nuremberg for having committed infanticide, an act some Dutch doctors do today with near impunity, and which will soon be formally legalized. The apologists for the Dutch claim that their infanticide and the German euthanasia program were different: The former, they claim, is based in compassion and patient welfare, the latter was steeped in bigotry.

Well, a killed baby is a killed baby, but even beyond that point, the Dutch defense doesn't exactly hold water: The German euthanasia program was considered a "healing treatment," and seen as a compassionate act that was best for the killed infant as well as the family and society. Moreover, it was driven by doctors and not by "the Nazis."

It's too involved to go into here, but it is an important issue worth revisiting in this age of creeping medical utilitarianism. I hope to write at greater length about this matter soon.

For now, let us say good for Signore Giovanardi. It is about time someone important in Europe began calling the Dutch on the carpet for their infanticide program.

Don't Learn Wrong Lesson About Animal Testing

There is an awful story here in the UK about 6 human subjects who were catastrophically injured during a test of a new drug being developed to treat leukemia. One may be in a coma for up to a year.

Many questions have been raised about whether the experimenters followed necessary safety protocols, and etc.. There have also been conflicting reports in the media here about whether there were adverse affects noted in some animals during that stage of the research, with the company firmly claiming that to the contrary, there were no red flags raised. It will take time to sort that out, but we do know that the human trials went forward resulting in a tragedy reminiscent of a gene therapy experiment out of the University of Pennsylvania that went terribly wrong a few years ago in which one young man died.

This story from the Times warns that animal models are not precise predictors of how humans will react to drugs. This is true, of course. But we shouldn't learn the wrong lesson. I have no doubt that animal liberationists will declare that the case (assuming that animals did not react adversely to the drugs) proves animal testing to be useless for the development of human medicines--an oft made charge. In fact, the reverse is true. Adverse animal testing have often warned of dangers before use was tried in humans, thereby saving lives. Indeed, in the U of P case, monkeys had died from the experimental therapy, but the medical experiment in humans proceeded anyway and the human subject was not warned before agreeing to submit to the experiment. This led to a lawsuit and confidential settlement in which, no doubt, much money changed hands. (Confidential settlements of this sort deprive the public of much needed transparency. See Ralph Nader's and my book, No Contest: Corporate Lawyers and the Perversion of Justice in America.)

Animal testing is not the be all and end all of medical research, but it remains a crucial component--which is why it is legally mandated in law and was made an essential part of the Nuremberg Code.

Really Nice Review of Consumer's Guide to a Brave New World

This writer gets it. He takes on transhumanism and offers some kind words for Consumer's Guide. Hat tip David Prentice.

Good News on Baby MB

The Court ruled in favor of the parents in the Baby MB case. Good. This is one of those "benefit of the doubt" cases, in which the benefit should go to life and respecting the desires of the child's parents. Doctors and bioethicists, however well intentioned, should not be able to substitute their values for those of patient or, as in this case, family. This is not to say that a parent's desire to receive (or reject)treatment on behalf of their child should never be overruled. But it seems to me that unless the parental choice rises to the level of abuse (such as refusing normal life saving surgery or insisting, say, demanding repeated amputations for a baby dying of gangrene), the values of doctors or bioethicists should not rule.

Dueling Schiavo Books to be Released

Both the Schindler family and Michael Schiavo have books coming out about the Terri Schiavo case. To me, the core legal problems faced by the Schindlers were the failure of the original trial lawyer to create an adequate trial record and the refusal of Judge Greer to truly apply a clear and convincing evidence standard to determining that Terri would want to be dehdyrated. As for the media: Its abiding refusal to report the many reasons why Michael should not have been permitted to remain guardian is a case study in bias and journalistic malpractice.

UK Report: Baby MB Case to be Decided Today

As I write this post, the Baby MB case decision is about to be announced. If the Court rules that doctors are permitted to unilaterally refuse life support, it will be a huge step forward for the medical futility movement, that persumes to permit bioethicists and doctors to, in effect, declare that some lives are not worth living. If the parents prevail, it will reaffirm the important principle that in these difficult cases, family decision making about "quality of life" and whether to continue treatment belong ultimately to patients and families.

Meanwhile, I spoke last night to interested parties at the Parliament on euthanasia and attended a very substantive debate on the same topic on Monday night. I was very impressed with the quality and substance of the debate and was quite pleased that the opponents of euthanasia carried the question from the audience.

UK Embroiled in NHS Financial Problems

Here in the UK, the NHS is all the news. It is bleeding red ink. Money problems are apparently leading toward health care rationing. The BBC had a big story about elderly people being denied coverage for care that might have been due under the rules of the Service. And yet the assisted suicide legalization bill continues to be promoted by its backers. It is as if one hand does not know what the other hand is doing. More to come...

Ian Wilmut May Lose Science Prize

I have been hearing from some folk that my post on Wilmut taking false credit as the cloner of Dolly is much ado about nothing. It was his lab, this thinking goes, so who cares who actually came up with the concept and did the actual work?

Well, apparently some scientists do. Wilmut received a presitious science award from a German science foundation and was given a substantial money prize for successfully cloning Dolly. Apparently, the award did not also include Keith Campbell, who Wilmut now says did most of the actual cloning work. Wilmut's admission has led the prize awarders to consider rescinding the honor and demanding their money back.

I think this Wilmut contretemps is a symptomatic of a more abiding problem with the politicization of science in general and of a certain loosening of standards about who should receive credit for advances the science community itself.

Fighting for Credit for Dolly

Apparently several people are now claiming credit for Dolly now that Ian Wilmut admits he didn't actually do the cloning.

Heading for the UK

I will be in the UK for the next week speaking and meeting people about the euthanasia threat over there and sundry other bioethical issues. Probably won't get to Blog much. But you never know.

I am interested in comments on the Hippocratic Oath controversy. Please feel free to weigh in.

Thanks to all who visit Secondhand Smoke.

Bradford Short's Short History of the Hippocratic Oath

Bradford Short is an Anglophile, with a capital A. He knows his English history. He has jumped to my defense on the Hippocratic Oath issue. It is too long to post here, but this link will take you to his Blog entry at The Fact Is. Thanks for covering my back, Bradford.

A Physician's Response re Hiopocratic Oath

This longish thoughtful response to my column on the Hippocratic Oath is worth posting on its own. This physician believes the Oath is a "living document," that must change with the times. Well, doctors sure don't swear by Apollo anymore, but I think this idea of a living Oath means that it can be deconstructed, which is precisely what is happening. In any event, here is the letter and my brief further response will follow:

"The oath is much more like a secret handshake than it is like the constitution of the United States. We look to it with reverence in that it reminds us that our duty to our patients is a sacred one. But it is not really possible to take it literally, unless you cherry pick. The oath forbids surgery and abortion. It enjoins us to teach our art to the sons of other practitioners (at no charge. Whatever you think of these strictures, you have to agree that they form no part of modern medical practice. Furthermore, the maxim "first do no harm" has a nice ring, but is not nearly as applicable to medicine today as the equally ancient and revered "you can't make an omelet without breaking a few eggs". We do a lot of harm with our surgery and chemotherapy. We do much more good, of course. The notion of avoiding all harm takes the life out of any possible risk/benefit approach to treatment.

I think that it is more realistic to view medical ethics as common law than as a compendium of defined, easily stated principles. We mostly learn it at the bedside, from our peers. Usually the lessons are dministered in medical school and residency by teachers and residents who are actually engaged in treating patients. It is absorbed through the skin, not memorized. Remarkably, most doctors end up with pretty much the same notions of what constitutes medical right and wrong. But the rules are not written in stone, and can be changed by societal pressures - not necessarily for the better. The notion that any form of euthanasia is unacceptable is still held by most of my colleagues, I think. It could change - it has, in some places. The idea that a doctor's loyalty is to his patient before anything (no good stewards of society's resources)is still almost universal among the people that I deal with.

The canon of medical ethics is a living "document" in exactly the way that the American constitution is not. The Hippocratic Oath is not our constitution."

It seems to me that the Oath should be neither akin to a secret handshake or a viewed as a constitution. But it should be embraced as establishing principles that all doctors are honor-bound to follow, summarized as "always put your patient first" (with a few examples given). As to the surgery issue, my understanding is that the doctors practicing under the Hippocratic tradition used different techniques and thus foreswore surgery (imagine what surgery would mean then before anesthesia and an understanding of microbiology), but I was interested to note that Hippocratic physicians were to refer patients wanting surger to a different type of doctor qualified to perform it.

Viewing it as a "living document" grants a license to undermine it and even change its meaning 180 degrees. Moreover, from what I can tell, the current versions of the Oath are destroying it by turning it more into pabulum than core principles.

Bill Gates Could Have Paid the Whole Cost of Prop. 71

Bill Gates gave $400,000 to fund the campaign for Proposition 71. In other words, he was willing to pay chump change--for him--to help persuade the people of California--already tens of billions in debt--to dig even deeper into our empty pockets to chase after the rainbow of therapeutic cloning research.

This story says he's worth over $50 billion. Well, good for him. But if he thinks cloning is so darned important, he can afford to pay for it--all of it--himself.

More on Column on the Hippocratic Oath

The Christian bioethicist Nigel Cameron published a book on this matter some years ago, called The New Medicine: Life and Death After After Hippocrates. For those interested, here is the Amazon link.

More Cloning Lies: Ian Wilmut Did Not Clone Dolly

This is unbelievable: Ian Wilmut has admitted that he did not clone Dolly the sheep. The more we learn about the cloning agenda, the less honesty there appears to have been in the field from the very start.

Wilmut has acknowledged in a court case that he did not develop the technology that led to Dolly's birth and claims he appeared as the lead author on the paper only because of a prior agreement with his colleague, Dr Keith Campbell. (This is similar to Gerald Schatten appearing on Woo-suk Hwang's fraudulent paper as a senior author despite not having done the actual work, for which he was criticized by his university.) Wilmut has been rewarded for this deception by becoming the head of the Institute for Regenerative Medicine at the University of Edinburgh

Science, as an objective field and dispassionate purveyor of facts, is in deep trouble. The science community had better wake up or they will find that their field has come to be viewed by a cynical public as just another special interest group.

The International Task Force on the California Assisted Suicide Bill

The International Task Force on Euthanasia and Assisted Suicide is an invaluable resource for anyone interested in the ongoing debates around the world to legalize mercy killing. I am honored to be an attorney and consultant for the organization. Indeed, Rita Marker and Kathy Hamlon of the Task Force are responsible for my getting involved in these issues.

The Task Force has analyzed California's bill. Here is the result.

Continuing Reactions to Deconstructing the Hippocratic Oath

The e-mail has been pouring in on my article in today's NRO on the deconstruction of the Hippocratic Oath. They are so interesting and varied, I thought I'd share some of them with the readers of Secondhand Smoke. I intend to keep posting some of the newer communications as I receive them.

A medical school professor writes that idealistic med. students embrace the Oath!

"Thank you! I have felt like a lone voice in the wilderness. For six years, I taught medical ethics at the University of Kentucky, the only practicing MD in the course. The first day of each year, I would hand my students a copy of the original Hippocratic Oath, and tell them that all they needed to know about medical ethics was contained therein; everything else was fluff and details. The students actually loved it. They loved the noble vision of the virtuous professional that the oath projects. No student every complained about my teaching of bright lines that must not be crossed, and respect for human life. Young physicians will embrace the good, if someone will only present it to them."

One wag suggests outsourcing executions to the Netherlands:

"Your article gave me a great idea. Wasn't there some problem with a state which insisted that capital punishment be carried out in the presence of a qualified anesthesiologist, versus the Hippocratic pretensions of anesthesiologists that they weren't going into the execution business? [That would be California.] Hey, let's outsource. There should be plenty of Dutch anesthesiologists we can hire."

Here's one correspondent that believes the LLU "steward resources" clause is about triage. I disagree:

"The decline of civilization can always be intriguing subject matter. We need to hold high individual dignity, as the Pope has recently said. My struggle with your article is the lack of resource measurement you allowed LLU in their triage. Shall a doctor stay with the first soldier he sees? Shall he risk the life or the mission of other soldiers as he focuses on the first soldier he touches?

LLU knows more than any other institution the excesses that can be expensed in the search for the best care. They gained world renown using a chimp's heart to further the life of an infant. Noble effort but recognized as not worthy of future development.

A few years ago, I adopted that exact clause in my practice mission statement. Otherwise, we would be denying affordable treatment to the masses, while waiting for a few wealthy patrons to garnish enough resources for the best treatments. Two extreme examples, the intense battle scene and the dull dental office both must utilize the triage principal. Acting as a good steward of the resources of society and of the talents granted me."

This writer laments the loss of traditional Hippocrtic values at a famous Catholic medical school:

"My school, "Catholic" Georgetown, changed our oath within 15 months of Roe. No other profession has (had ) such an innate trust by the public that allows them to share their most private behavoirs and allows such intimate exams on their first meeting with a physician with perfect confidence and trust. Mothers turn their children's care over to them. Patients allow themselves to be rendered unconscious and helpless knowing that a surgeon is going to cut them. Until HMOs, they knew doctors would do what was best for them and not their pocketbooks. Our profession went downhill when we became killers for hire. Then patients knew we would use our skills for violence for monetary gain."

This from Bradford Short, who takes me to task for not better rebutting Dr. Nuland: Bradford is a pal and he blogs at The Thing Is (www.thefactis.org/thethingis), and has a series of articles on these issues in Issues in Law and Medicine:

"First, Nuland is wrong on the history. The Oath has been an important ethical cannon (and respected for its content) in America and Britain for at least 450 years. Recent historiography on the subject has shown that prominent English physicians translated the Oath, with its strong prohibitions on all euthanasia and nearly all abortion, repeatedly throughout the 16th century and that 17th century English physicians known for being respected ethicists, like the physician/political theorist John Locke, opposed most abortion and condemned suicide and euthanasia just as the Oath told them to."

From a medical student:

"...I am a graduating medical student at the University of Pennsylvania, and am sad to say that here, too, we are encouraged to recite a watery-swill rendition of the classic oath. I have long been of the opinion that this is totally ridiculous and that the current versions of the oath border on lacking any real meaning and are an insult to the profession, to our patients, and to the rich and honorable tradition of Western medicine; as such it has, for some time, been my intention to recite the historic oath (albeit in English, not Ancient Greek). I'm encouraged to see that I am not alone in these sentiments, and I hope that your article receives the wide audience it, and its message, deserves."

From a non fan, although I am not exactly certain what his point is:

"You must have a really big problem with the Confederate flag. Once upon a time, it was a symbol of slavery. Some say its message is different today. I gather you don't."

This anecdote shows what can happen when doctors and patients have sex:

"A few years ago I asked a friend, a prominent spine surgeon in his mid-50s, if he had taken the Hippocratic Oath when he became a physician. He said he had not. (Oh, and he is currently divorcing his wife and just bought a $25K engagement ring for a former patient.)"

I have also heard from readers who believe that giving children vaccines violates the Oath, which I don't agree with at all, and others offering praise or condemnation. I think the reaction demonstrates the continuing importance of the Oath and people's emotional attachment to its "do no harm" precepts.

"Do No Harm" Being Undone

A while ago, I posted several entries at Secondhand Smoke about the ongoing deconstruction of the Hippocratic Oath. As I promised, I have written a longer article analyzing what it all may mean. It is in today's National Review Online.

I am getting a lot of response already. I will post some of the comments in a later post.

Now China Promoting Euthanasia

So the country of forced abortions, femaile infanticide, and selling of executed prisoners' organs wants to get into the euthanasia game. How appropriate.

With NHS in Financial Hole, Legalizing Assisted Suicide Would Be Utter Folly

This story reveals that Britain's National Health Service, the socialized funder of medical care in the UK, is running deeply in the red. Some hospital wards are closing, surgeries may be delayed, and cost cutting is the order of the day.

I have always worried that money would become a big part of assisted suicide here in the USA if it ever took hold, what with HMO's making profits from cutting costs, which too often means, cutting levels of care. Considering that the drugs for an assisted suicide would cost less than $100, and that those most likely to want to be overdosed would mostly be the most expensive to care for, the economic forces of gravity are obvious.

I have believed, perhaps naively, that the financial pressures pushing toward a system permitting euthanasia in a more nationalized system would be less acute, and certainly less direct. No more. Consider the possibilities of the NHS rationing and delaying care due to deficits, and the fact that assisted suicide, if legalized, would never be rationed. Indeed, it could become the "treatment" of choice for overstressed doctors working in a badly under funded health care system.

Paul McCartney's Animal Rights Advocacy Would Impede a Cancer Cure

Sir Paul McCartney is a fantastic musician and composer. As someone who grew up in the era of The Beatles, I can only smile when I watch him perform. But he is dead wrong in his attempts to impeded necessary animal testing in medical research. Here, he writes to Arizona's governor urging her to block the building of an animal testing facility.

First, animal testing of new drugs and medical substances is required by law. Second, if the extremists prevail and we do stop medical testing with animals, medical research will be badly stunted. Third, McCartney works against his own purposes. He supports cancer research, in memory of the cancer death of his beloved Linda, but then supports groups like PETA that would impede cancer research by prohibiting animal testing. It's kind of like giving with one hand and taking it away with the other.

Euthanasia Advocates Continue to Obfuscate

Sigh. The UK is in the midst of a renewed effort to legalize assisted suicide. Toward this end, one of the pro assisted suicide groups has published a poll showing that 2/3 of UK doctors have provided strong pain control knowing it could hasten death.

Well good for them. That is like saying that 3/4 of doctors had performed surgery on patients knowing that the surgery could hasten their deaths. This is because any medical procedure may cause death as an unintended side effect.

The euthanasia ideologues claim that their poll shows that there is no difference between euthanasia and pain control treatment. Bunk. Euthanasia kills. Pain control palliates. Euthanasia results in death almost every time, and it is considered shocking if the poisoned patient does not die. Pain control usually does not result in death, and indeed, may even lengthen life because a dying patient does not have to expend energy experiencing severe pain.

But count on the media to swallow this bilge whole. Unfortunately, it seems that critical thinking is not a strong suit of most contemporary journalists.

UK Continues To Slide Into Anti-Hippocratic Medicine

What is happening to the UK? Here is another in a series of recent medical futility cases that takes Futile Care Theory another step closer to a "duty to die."

A baby known publicly only as MB, has a degenerative disease called spinal muscular atrophy. The illness, which does not affect cognition, leads to total paralysis and eventually, death.

MB's doctors want to take the baby off his respirator so he will die now. His parents want to love and care for him at home. The doctors insist MB should die now because his life is unbearable. But how do they know? True, none of us would want to become totally paralyzed. But who are doctors to say that MB does not and cannot have a life worth living?

Their arrogance brings to mind a good friend of mine, the late Mark O'Brien, and how angry he would be about this case. Mark was totally paralyzed from polio. He lived his life in an iron lung from the age of 6 to his death at nearly 50. Yes, his life was often very difficult. But it was definitely worth living, and he would blister anyone who said it wasn't. He became a poet, a published author, and a wonderful biographical documentary was made about him called Breathing Lessons.

Mark knew what it was like to be written off by doctors. But he knew that the lives of disabled people are not the doctors' or the bioethicists' to denigrate.

What kind of hubris does it take for doctors to presume they have the right to decide that a baby should die rather than the parents be allowed to care for their child until he dies? If the Lords rule against life in this case, the people of the UK will be less free.

An Age of Arrogance

Editorialist Paul Greenberg has written a compelling critique of a society that prefers dehydrating the profoundly cognitively impaired rather than nurse and care for them. Key quote: "What arrogance to decree that, because we deem another's life not worth living, it must be ended. But that is the spirit, or spiritlessness, of the age."

This is definitely worth reading, which you can do by pressing your left mouse button here.

Kansas City Star Biased Cloning Reporting Continues

The KC Star is one of the most biased newspapers in the country when it comes to the cloning debate. I was given the courtesy of writing an op/ed piece on the issue last week, it is true, for which I am grateful. But the news reportage continues to misstate the science of what is sometimes called therapeutic cloning.

Here is the usual depiction in a story, byline, Kevin Murphy:

"That procedure takes the nucleus from an ordinary cell, such as a skin cell, and inserts it into an unfertilized egg that has had its nucleus removed. The cell is stimulated and begins to divide. The process produces early stem cells, which have the potential to grow into all the tissues of the body. Scientists hope to learn how to coax those cells into becoming heart muscle to treat heart attack victims, insulin-producing cells to treat diabetes, and nerve cells to treat spinal injuries."

1. The "cell does not begin to divide." It transforms into an embryo, which divides along the same manner as an embryo made via fertilization.
2. The process does not produce "early stem cells." This is a wholly unscientific term that is being used for political purposes, with the full cooperation of the Star.
3. The embryo is not just stem cells. It is an organism. To get the embryonic stem cells, the embryo is destroyed.
4. This has yet to be accomplished in the laboratory, as far as we know.

That's a lot of inaccuracy in just a few sentences. Pulitzer is turning over in his grave.

Haleigh Poutre Purportedly Eating Eggs

If doctors and bioethicists had gotten their way, little Haleigh Poutre would have been dehydrated to death via removal of feeding tube. But now, according to this story, she may be eating eggs. How unsurprising that the national media has generally ignored the case: It would demonstrate vividly the danger of writing off the cognitively devastated and "honoring" their "right to die" via intentional dehydration.

Another point made by Haleigh's natural mother in the story is worth pondering. (I have seen the same tactic applied in the Martin, Wendland, and Schiavo cases.) The patient is hidden behind closed doors to "protect privacy." But this seems a tactic to hide their humanity. For example, in the Wendland case the hospital kept insisting that he was as good as unconscious. Then, a local television station was able to obtain a video of him taking out and removing pegs upon request. The response of Lodi Memorial Hospital to this clear busting of their disingenuous PR campaign: Seek a gag order.

Selling Infanticide (Again)

The essence of euthanasia consciousness has never been about "choice," but about deciding that certain lives are not worth living. And, it leads inevitably to justifying infanticide since killing to end suffering has been redefined from bad to good. If that is your basic view, then in the end, what does "choice" have to do with it?

A lot of us have warned that assisted suicide puts us on the road that leads to eugenic infanticide, which has been practiced for at least 15 years rather openly in the Netherlands. Such arguments used to be dismissed as alarmist and paranoid. Now that the Netherlands is on the fast track to formally legalizing infanticide and our worries can no longer be derided as mere paranoia, we see a new approach: Infanticide itself is being sold as a right and proper policy.

Articles that promote infanticide as compassionate and proper have appeared here in the USA in the New England Journal of Medicine, the Los Angeles Times, and the New York Times. This is the latest example of news stories as infanticide propaganda in the London Times, where, not coincidentally, a big fight is brewing to legalize assisted suicide. (I will be traveling to the UK next week to speak to and rally the anti-euthanasia forces.)

Note that the article doesn't even bother to see what could have been done to alleviate the suffering of infants given as examples of proper infanticides. Opponents of infanticide are not given a chance to seriously rebut assertions or perhaps, to show examples of Dutch infanticides that were clearly based on bias against the disabled. Note also that the number of infanticides each year was misstated to be 15, which is actually the published figure for one hospital. According to the Lancet, the annual number is closer to 100, about 8% of all infants who die each year in the Netherlands.

The unattributed quote from American "conservatives" taken from the Weekly Standard in opposition to infant euthanasia, comparing it to the Nazis is mine--and unsurprisingly, it does not come close to fairly representing my argument against infanticide in general, or describe the points I was making in that article in particular. Also note that there is only one quote given from a Dutch opponent and it is merely a general condemnation.

Make no mistake: Infanticide is part of the euthanasia agenda. Toward this end, much effort is being made internationally to normalize the killing of very sick, dying, and disabled babies. Should that succeed, the categories of killable babies would expand just as Dutch adult euthanasia has spread to the point that even depressed people can be assisted in suicide.

As I have indeed written, if this effort succeeds, we will owe the German doctors hanged at Nuremberg for murdering disabled babies an apology. But that is just one small point made in a far larger argument against infanticide. Too bad the media reporters who seem so star struck by the killing agenda almost never bother to really explore the other side.

Shac Terrorists Convicted

This is a good start.

Kansas City Star Allows Me To Argue: SCNT IS Human Cloning

Regular readers of Secondhand Smoke know that I am absolutely fuming about the propaganda effort by cloning boosters to redefine terms and obfuscate basic science. I will be writing much about this in coming months.

Whether SCNT is human cloning is one of the threshold issues in the upcoming Missouri initiative to create a constitutional right to engage in research cloning in that state. I have been especially frustrated by the media's seeming kowtowing to whatever term or definition the pro cloning side wants used.

One of the big offenders, in my view, has been the Kansas City Star. The editorial board of the Star courteously agreed to meet me about this matter while I was recently in Kansas to give a speech. We had a productive exchange and the editorial board editor agreed to publish an op/ed piece on the issue of whether SCNT is human cloning. It appeared today. Thank you, KC Star.

Spinal Cord Patient Slowly Regaining Feeling After Adult Stem Cell Treatment

An Iowa television station is following the story of Amy Foels, who was paralyzed in an auto accident. Last year, she went to Portugal and received an adult stem cell treatment from Dr. Carlos Lima, who pioneered a regenerative therapy that uses the patient's own olfactory stem cells.

Amy has had slow but real progress. She can feel when someone touches her knees and can move some muscles formerly paralyzed.

This remains annecdotal. But it is my understanding that Dr. Lima's work will appear this year in a peer reviewed journal and that other places will be offering the therapy as human trials advance.

Let us all wish Amy and all of Dr. Lima's patients well. A lot of hope is riding on their progress.