Let's Take a Poll About ESCR and Cloning

The last several years have been quite eventful in the field of biotechnology. President Bush was castigated for modest restrictions on federal funding of human ESCR and his policy is on the brink of being overturned. Several countries outlawed all human cloning. Some, like the UK moved full speed ahead into human SCNT. Hwang Wu-suk claimed to have created cloned human embryos, only later to have been proved a charlatan. California passed Proposition 71 which will pour $3 billion over 10 years into cloning and ESCR.

So, where will all of this lead? Take this poll and tell us what you think. (Feel free to explain your vote in the comments section.)

Which of the following outcomes do you believe will MOST likely result from embryonic stem cell research and human cloning?
	Cures for most degenerative diseases.
	Answers to lingering questions about human embryo development
	Very little. Most advances will be in adult/umbilical cord blood stem cells.
	To scientists gestating cloned fetuses for use in medical experiments and organ procurement.
	To reproductive cloning.
	To genetic engineering to eradicate disease.
	To genetic engineering to "enhance" progeny.
Free polls from Pollhost.com

Protect "The Dignified Cycle of Natural Life and Death"

L.A. Daily News columnist Bridget Johnson has written a splendid column pointing out some of the many flaws with legalizing assisted suicide. Here is a sampling:

Invariably, when society decides that some life is less valuable, less worth caring for, than other life, the results can be disastrous. Some "merciful" laws have descended into involuntary euthanasia as well, resting on the argument of keeping those humans around who would have an acceptable "quality of life." After the Netherlands legalized euthanasia in 2000 for 12-year-olds and up, the Groningen Protocol was established to ensure doctors wouldn't be prosecuted for killing infants they deemed not fit to live.

"My observations in the Netherlands persuade me that legalization of assisted suicide and euthanasia are not the answer to the problems of the seriously or terminally ill," wrote Dr. Herbert Hendin, executive director of the American Suicide Foundation, in Psychiatric Times.

"The Netherlands has moved from assisted suicide to euthanasia, from euthanasia for the terminally ill to euthanasia for the chronically ill, from euthanasia for physical illness to euthanasia for psychological distress and from voluntary euthanasia to involuntary euthanasia (called `termination of the patient without explicit request')."

"Assisted suicide" is just semantics for a doctor prescribing the means to die versus the doctor administering the means to die. Regardless of the name, regardless of the method, the profession designated to care for the weakest crosses the line into doing harm.

As we remember friends who passed with grace, courage and unshakable dignity, let's also remember this week to remind our legislators of their duty to protect the inherently dignified cycle of natural life and death

Johnson nails it: Being overdosed is so often called "death with dignity" by advocates and their media parrots, you would think that dying naturally is undignified. The only indignity is acting as if anyone has a life not worth living or protecting.

NYT: "Aged, Frail and Denied Care by Insurers"

This New York Times story about the poor treatment received by the elderly at the hands of long term health care insurers is important. From the story:

Tens of thousands of elderly Americans have received life-prolonging care as a result of their long-term-care policies. With more than eight million customers, such insurance is one of the many products that companies are pitching to older Americans reaching retirement.

Yet thousands of policyholders say they have received only excuses about why insurers will not pay. Interviews by The New York Times and confidential depositions indicate that some long-term-care insurers have developed procedures that make it difficult--if not impossible--for policyholders to get paid.

Such stories vividly demonstrate two things: First the context in which assisted suicide would be practiced is dysfunctional and would lead to people being pushed out of the lifeboat. Second, despite running many stories of this kind, the editorial writers of most mainstream newspapers ignore these very matters when they tout "choice" in support of assisted suicide.

This is what I call "euthanasia world." Media will rail against HMOs and the number of uninsured. Then when the topic turns to assisted suicide, suddenly every doctor is Marcus Welby, MD (for the young among you or those from outside the country, Welby was a television doctor who never charged his patients and who made house calls during which he solved all of their medical problems). And every family is the Waltons (for the young and those from outside the country, the Waltons was an idealized family first made famous in a book and then in a television series. Everyone took care of and loved each other selflessly during the Depression.)

SHS Hits 15,000 Monthly Visitors

In less than a year when I began keeping track, visitors to Secondhand Smoke have increased from 10,000 to the just hit 15,000-plus visitors each month. I am most pleased. Granted, it isn't a Little Green Footballs or a Daily Kos, but I am happy.

The issues with which we grapple here are among the most important the world faces. I deeply appreciative everyone who takes the time to stop by here and who ponder the issues of human exceptionalism, intrinsic human worth, bioethics, assisted suicide, animal liberation, slavery, and the other matters covered here. And I wish to reeiterate a point I have made before about how impressed I almost always am by the thoughtfulness of the commenters here--and the courtesy with which people debate--an attribute too often lacking in the cybersphere. I will keep striving to find stories of interest and to find ways to make the site fresh and worthy of your important time. Thanks again to all.

Ian Wilmut Predicts Ethical Stem Cells Achieved Before Cloning

Ian Wilmut, who supervised the team that cloned Dolly the sheep, is sad that human cloning hasn't worked so far. But something else he said was unexpected and is interesting news: He believes that cell reprogramming--that is, reverting a cell from a differentiated state (e.g, blood, skin, bone, etc.) to an embryonic stem cell state will occur before it cloning can be accomplished in humans. Leaving aside for the moment whether embryonic stem cells actually offer the "best hope," about which the jury is still out, if Wilmut is prophetic and a way is found to obtain pluripotent stem cells ethically and without treating human life like a crop--President Bush should receive the credit. His funding restrictions kept the moral value of nascent human life on the table. It caused scientists to search diligently for "alternative" methods," such as reprogramming and ANT. Had Bush gone along with the tide, I believe the federal government would be funding SCNT cloning by now and the importance of nascent human life would have long been swept away.

Human Cloning: Have Your Say

The Scientist is having an on-line discussion about human cloning. Below are the questions The Scientist poses:

Is the nuclear transfer challenge one of understanding or technique? It would seem that the scientific community presumes successful stem cell cloning is a matter of resources and technical skill. Put enough technicians on a problem and eventually it will be overcome. This isn't the way we normally perceive scientific challenges and there seem to be too many gaps in our understanding to proceed this way. How might we approach the situation as a scientific, rather than a technical, challenge and who has ideas for new approaches?

Is it time to reevaluate the ethics of stem cell cloning? The ethical quandaries about reproductive cloning have evolved from discussions that took groups like the Raelians seriously. Nevertheless, the idea that cloning for reproductive purposes might at some point be possible warrants discussion, and the debate about the status of an embryo is not something to take lightly. Moreover, the rights of egg donors need to be considered. What are the most pressing ethical concerns about proceeding with a nuclear transfer research program and who has novel ideas on how to address them?

Does stem cell cloning need new terminology? The terminology for stem cell cloning has become so obtuse that it strains public understanding and may also obscure the best scientific approaches. The avoidance or attenuation of the word cloning has left us with names that describe a technique, not the study of a phenomena that includes such fascinating biological puzzles as nuclear programming, development, and pluripotency. Is there a better name for this type of research program?

It seems to me that the people who hang out here at Secondhand Smoke would have much to contribute to such a discussion. If you want to participate, just click here and weigh in. And please, be sure to stay polite.

Prominent New Opponent of California Assisted Suicide (A.B 374)

This is good news indeed: Dr. Catherine Campisi, former director of the California Department of Rehabilitation has joined the effort against legalizing assisted suicide in California. From the press release:

"Assisted suicide is a direct threat to anyone that is viewed as a significant cost liability to public or private healthcare providers," stated Dr. Campisi."We cannot assume that such a high pressure, profit motivated industry will always take the high road. It seems there are almost daily accounts of health care providers cutting costs to the detriment of patients.

"Looking at the psychological impacts, assisted suicide has far more potential to do harm than good to thousands of Californians facing serious illness or disability that may be defined as terminal. While it is understandable that people in such situations may greatly fear loss of autonomy or being a burden emotionally or financially on their family, assisted suicide is not the solution since it poses such great risks to vulnerable people. Increasing access and information to quality counseling, hospice, and palliative care, for those with an illness defined as terminal, are far sounder public policy options than the legalization of assisted suicide"

Opponents of assisted suicide are as diverse as the American people. Thank you Dr. Campisi.

Adult Stem Cells Help Save Lives of Liver Patients

If this were not about adult stem cells, it would be a much bigger story. But get this: Liver cancer patients whose liver was too far gone to have surgery, were able to have sufficient liver generated with the help of their own adult stem cells, to the point that they regenerated sufficient liver to sustain surgery. Six of the eight patients treated are still alive two years later.

This is superb news. Not that you are likely to read much about it in the American media.

California "Elder Suicide Rates Sound Alarm"

Well, what do you know: Two reporters have connected a few dots about the assisted suicide issue. In this story, byline John Simerman and Cassandra Braun of the Contra Costa Times, note that while California is debating assisted suicide, we have a brewing elder suicide crisis on our hands. From the story:

Beneath a simmering debate on a proposal to legalize assisted suicide in California for some terminally ill patients lies a muffled truth: Seniors-- and particularly older white men--kill themselves at a higher rate than any other age group.

The theories vary, but not the phenomenon. It runs across the country and through Contra Costa County, where every three weeks another senior ends his or her life. Older men swing the balance. They make up 5 percent of the county population but 16 percent of confirmed suicides, county health data show.

Experts suggest the disparity may be even greater. Suicides, among the elderly in particular, are widely underreported, often mistaken as natural, accidental or unexplained -- an overdose of medication, for instance. Some experts have predicted that a decline in elderly suicides during several decades could soon reverse itself as the baby boomers surge into retirement amid a shortage of mental health services tailored to the aging population.

"One of the predictions, certainly, is that this increasingly large cohort, as it reaches older adulthood, will tax the system, leaving more people in distress without enough geriatricians and mental health professionals," said John McIntosh, associate dean of psychology at Indiana University and author of "Suicide and the Older Adult."

"If, on top of what's already the highest risk group, you put gas on the fire, the expectation is it's going to be astronomical."

Assisted suicide is more fuel for the flame, because when legalized the state is telling its citizens that suicide is an acceptable answer to the problems of human suffering and difficulty. (Oregon has also declared an elder suicide crisis.) And mark my words, once people accept the premise of assisted suicide, advocates will begin agitating for expanding the license to include the elderly and others--and using the same arguments we hear today for the terminally ill. It has already happened in the Netherlands where elderly are euthanized and a former Minister of Health advocated suicide pills for the elderly who are tired of life.

The Devil is in the Details

The Eureka Journal reported that the California Association of Physicians Groups supports the assisted suicide legalization bill A.B. 374. As I noted here at the time, that organization is a lobbying group representing the business and political interests of group physician practices, that is, it is a group for HMO doctors. One would think this would be a relevant part of the story since one big issue in the assisted suicide debate is that the "medical treatment" of killing could become a splendid method of cost cutting in a managed care/HMO health care economy given that these are often the most expensive patient for which to care.

Unfortunately, the Eureka Journal--probably merely writing off of a press release--omits that part of the story. Indeed, their description makes it sound as if the CAPG represents non profit professional associations, rather than the business entities. From the story:

The California Association of Physician Groups, which represents thousands of doctors in more than 150 organized medical organizations, is one of the largest of its kind in the nation.

Also note that the Journal didn't get a response of opponents of the bill to the endorsement. Had they done so, they wouldn't have missed the core of the story.

Post Script: I wrote a letter to the editor about this that will apparently be published. That's nice.

Mendacious Feinstein/Hatch S. 812

I can disagree with people about political, social, and moral issues and still respect them. But when they resort to the kind of deceptions that permeate S. 812, the Feinstein/Hatch bill to legalize human cloning and pay women to procure eggs for use in research--which pretends to ban human cloning and egg selling--it really makes me see red. So, I have detailed the Feinstein/Hatch deceptions in this piece in the Daily Standard.

I write:

How can a bill to legalize human cloning be instead called a ban? Through the time-tested method of disingenuous legislating--the bogus definition. Here's a rarely discussed truth: Key words and terms in legislation mean only what a bill's authors say they mean, rather than their actual definitions. If a dung beetle was defined in legislation as a butterfly, for the purposes of that bill, the dung beetle would be a butterfly. Which is essentially what S. 812 does. It defines the term "human cloning" inaccurately and unscientifically so that Feinstein and Hatch can pretend their bill will outlaw human cloning.

Read the rest to see the whole sad saga. Is it any wonder the American people are so distrustful of politicians and their government?

We Have a Social Duty to be Reasonably Altruistic

This is an awful story: A man needs a bone marrow transplant to save his life, and the only suitable donor is his sister. But she won't do it. Now, he will almost surely die.

The law can't force anyone to be altruistic, of course. It would be wrong to take her bone marrow by force. But doesn't she have a social duty? This isn't like asking for a kidney, which anybody would be justified to refuse. It is bone marrow. Extraction isn't fun, of course, but it is an extremely low risk procedure and a life is literally at stake. A stranger would have a moral obligation to help, it seems to me. We owe each other that much. So much more, a sister.

It strikes me that unless there was an overriding health issue that compelled the sister to refuse to save her brother's life, she should be shunned socially. What say y'all?

Organ Hysteria

I think that the hue and cry against non heart beating cadaver donor protocols--what I have called "heart death"-- is misguided. And it reflects a misconception about the concept of "brain death," a popular term for death by neurological criteria--which does not mean that every brain cell is dead, but that the brain and each constituent part has ceased to function as a brain. What is even more ironic, is that some pro life advocates oppose brain death as not really being dead because the patient's heart is still beating.

This statement from a story on this issue in LifeSite is wrong factually:

"The person is not dead yet," said Jerry A. Menikoff, an associate professor of law, ethics and medicine at the University of Kansas. "They are going to be dead, but we should be honest and say that we're starting to remove the organs a few minutes before they meet the legal definition of death."

No, irreversible cardio/pulmonary arrest is dead, and in these cases the arrest is irreversible because there will be no CPR. When writing Culture of Death, I inquired of many neurologists as to whether patients would have any awareness after such a time. The answer from pro life and non pro life doctors alike was unanimous: No.

Death by neurological criteria, is the other method of declaring death. In other words, there are two methods of declaring death, with heart death being the tried and true one from time immemorial.

Some of these "heart death" protocols permit organ procurement as short as 2 minutes after cardiac arrest. I think this is too short, not based on the patient having any awareness--which I was again told unanimously was not possible--but based on giving the benefit of the doubt to caution and the lack of tests about whether such reverses are irreversible after such a short time.

I think a few people believe there should be no organ transplants because they don't think it can be done ethically. They don't believe in brain death--which is an arguable position. But they also don't believe in heart death along these protocols. That's fine. But we should not let these well meaning advocates panic us. The real danger, in my view, to ethical organ procurement comes not from heart death donor protocols, or from brain death procurements, but rather from shoddy following of ethical rules and from advocacy among many bioethicists to expand the donor pool to people who are not really dead.

Let's chill out there and keep our priorities straight.

New Jersey Legislation to Require HIV Testing of All Mothers, Babies

Legislation soon to be introduced in New Jersey would require HIV testing for all mothers and babies. Good. AIDS has been treated as a political disease rather than an urgent matter of public health for far too long.

Back in 2001, I wrote "Privacy that Kills" in the Weekly Standard about the difficulties that New York Assemblywoman Nettie Meyersohn, a feminist Democrat, had in getting the "Baby AIDS" bill passed, requiring all newborns to be tested. The link is for subscribers only, but here is a sampling of what I wrote:

The fight over Mayersohn's "Baby AIDS" bill was a real donnybrook. Movement feminists, gay activists, ACLU types, some physicians, and legislative colleagues unleashed a near-hysterical hue and cry. Mayersohn became a pariah, turned on angrily by former political allies and friends. "After I introduced the legislation, all hell broke loose," Mayersohn recalls. "On World AIDS Day, I had about 50 activists at my apartment building demonstrating at mid-night, going on the intercom demanding to meet...

Even more astounding to Mayersohn was the illogic of her opponents' arguments and their skewed priorities: "I was visited by the Gay Men's Health Crisis and they asked me to withdraw the legislation. I said to them, 'Your community has been so devastated by the disease; so many young lives have been lost. Why wouldn't you support this?' And they said, 'Privacy is our main concern.'"

"Then I met with the feminists. I asked them to support my bill. I said, 'This is a woman's bill.' Their response knocked my socks off. They said, 'Well, Nettie, think of the potential for domestic violence the bill will be generating if a guy finds out [his partner's] infected. This is a domestic violence issue.'" "I said, 'The real violence is getting infected!' ...

Slowly, though, the tide turned away from political correctness and toward protecting the lives of new-borns exposed to HIV. After a three-year struggle, Mayersohn's legislation passed in June 1996. New York became the first state to require that all newborn infants be tested for HIV and to disclose the results of the testing to the mothers.

Today, the law is working well and saving lives. According to the New York Department of Health, prior to the "Baby AIDS" law about 59 percent of infants with HIV went home from the hospital unidentified to their mothers as having tested positive. By the time of a study published on November 3, 1997, a magnificent 98.8 percent of HIV-exposed infants were being identified and receiving follow-up care.

It worked in New York: It will work in New Jersey, too. The legislature should pass the bill.

HMO Docs Support Assisted Suicide

This is one medical endorsement that I welcome for assisted suicide because it reflects an important truth about the whole movement: It is about money and "treating" the most expensive patients with a lethal overdose. Talk about cost containment!

Lest you doubt it, the California Association of Physicians Groups, self-described as "the nation's largest professional association representing physician groups practicing in the managed care model," that is HMOs, have endorsed assisted suicide. How fitting. And how ironic that left-leaning Assemblywoman Patty Berg and Assemblyman Lloyd Levine would embrace an endorsement by an HMO group--when the Left usually hates HMOs.

Here is the press release about this political faux pas from the California Disability Alliance.

More Feinstein/Hatch Deception in S. 812

I have read the bill several times now. Funny thing: Even though the title of the bill is "The Human Cloning Ban and Stem Cell Protection Act of 2007," the bill never even mentions stem cell research except in the title. The bill legalizes human cloning and paying women to procure eggs for use in cloning. It is not at all about stem cell research. It is thus a thoroughly dishonest piece of legislating. No wonder people are losing faith in honest governance.

Democrats Remained Divided Over Assisted Suicide

A major reason that assisted suicide has not moved beyond Oregon in this country is that the Democratic Party remains divided about the issue--despite some of its more left leaning members seeking to transform the issue into a Democratic Agenda item. Proof is in the inability of Democrats Patty Berg and Lloyd Levine to pass A.B. 651 last year in the California Legislature--both houses of which are dominated by Democrats.

Further proof of this can be found in the vote breakdown by party in Vermont, which just defeated assisted suicide:

Democrats: 55 Yes --- 36 No
Republicans: 2 Yes --- 45 No
Other: 6 Yes --- 1 No

Total: 63 Yes --- 82 No

Good for the no-voting Democrats who have not forgotten that the party is supposed to be about protecting the most vulnerable of society's members.

Feinstein and Hatch: Mendacious or Merely Ignorant?

I just went to Senators Orin Hatch and Dianne Feinstein's Web sites to read their press releases on the introduction of S. 812, a bill that would legalize human cloning and authorize researchers to pay women to undergo egg procurement. Here, in part, is what both releases state:

The Human Cloning Ban and Stem Cell Protection Act of 2007 would allow stem cell research--known as somatic cell nuclear transplantation--to proceed under strict oversight from the federal government. However, the bill would draw a distinct line between this promising research and human reproductive cloning, which it bans outright.

Where does one begin? Somatic Cell Nuclear Transfer is not embryonic stem cell research. Rather SCNT is a method of creating mammalian life "asexually," that is, it creates a cloned embryo. One potential use for an embryo created through SCNT is embryonic stem cell research, but it is certainly not the only use. Indeed, proving that SCNT is not the same thing as stem cell research, as I wrote about yesterday, the bill would outlaw the implantion of the "product of SCNT" into a uterus. The perceived necessity to ban implantation proves my point that the "product of SCNT" are not stem cells: They are embryos. Stem cells could be implanted into billions of women for hundreds of years and not one pregnancy would result. But implant the "product of SCNT", and a pregnancy could well result.

And here's another bit of mendacity from both releases, which states that the bill would only:

Allow this stem cell research only to take place on unfertilized eggs.

But the bill itself refers to the "product of SCNT" as an "unfertilized blastocyst." A blastocyst is the name given an embryo at about the one week stage of development. It is not an unfertilized egg, which is a single cell, an oocyte, also known as a gamete.

Either Dianne Feinstein and Orin Hatch do not know what they are legislating about or they don't care about honestly communicating with their constituents about what they are legislating about. Either way, it does not speak well of Senators Dianne Feinstein and Orin Hatch.

New Brave New Bioethics Podcast

In this edition of Brave New Bioethics, I examine the abdication of the American Academy of Hospice and Palliative Medicine, which has switched its position on legalizing assisted suicide to "studied neutrality." I explain how and why this abandons dying patients and abdicates its responsibility as a professional medical organization. You can also read all about it here.

Great News: Vermont Euthanizes Assisted Suicide

The Vermont House of Representatives just voted down the bill to legalize assisted suicide. The vote was 83-62. This is a real victory. Behind the scenes, it looked bleak for awhile. But here is a verite: The more people learn about assisted suicide, the less they tend to support it.

Hawaii and Vermont are down (for now): California yet to go.

Feinstein/Hatch Would Permit Egg Buying for Cloning

I just found another area of dishonesty in S. 812, the bill that should be called "The Human Cloning Authorization Act." Section 2(e) is entitled Voluntary Donation of Oocytes, meaning eggs. Indeed, Section II(e)(2) states:

Prohibition on Purchase or Sale--No human oocyte or unfertilized blastocyst [meaning cloned embryo] may be acquired, received, or otherwise transferred for valuable consideration if the transfer affects interstate commerce.

Sounds good. Ah, but what the good senators take away with one hand, they give with the other. Section 2(C)(ii) restricts the meaning of "valuable consideration," to wit:

The term "valuable consideration" does not include payments...to compensate a donor of one or more human oocytes for the time or inconvenience associated with such donation.

So, the eggs themselves could not be purchased, but the woman egg donor could be offered plenty of money as to compensate her for the discomfort, inconvenience and time she spends in being super-ovulated to produce the eggs that cannot be purchased. Can we say, distinction without a difference?

I plan to write a more detailed analysis of S. 812 soon.

Human Cloning Legalization Bill Introduced by Senators Feinstein and Hatch

Once again it is "pull the wool over their eyes" time in the United States Senate. My senator, Diane Feinstein (D-CA), and Utah's Orin Hatch (R-UT) have introduced the dishonestly named "Human Cloning Ban and Stem Cell Research Protection Act of 2007" (S. 812).

Is it any wonder that the American people have such little respect for the legislative process? The bill purports to outlaw human cloning. Instead, it would explicitly legalize human somatic cell nuclear transfer--which is the actual act of cloning, a.k.a., asexual reproduction. So how do the senators justify calling their cloning legalization bill a cloning "ban?" Why, through the tried and true method, of course: They simply Redefine the term cloning into a scientifically inaccurate political term.

Here is how "human cloning" is defined in S. 812:

The term `human cloning' means implanting or attempting to implant the product of nuclear transplantation into a uterus or the functional equivalent of a uterus.

But implantation is no more an act of cloning then is the implanting of an embryo created via IVF an act of fertilization. This bill is beyond disingenuous: It is dishonest.

Undermining Hospice

Euthanasia is antithetical to the philosophy of hospice care, which honors the intrinsic equal dignity of all people and promises to care for people to the end of their natural lives. One method by which this philosophy is carried out is suicide prevention. If a hospice patient becomes suicidal, the threat to life is treated just as seriously as suicide threats from people who are not dying.

But assisted suicide philosophy is contrary, claiming that killing oneself for purposes of alleviating suffering is the "ultimate civil right," creating a dichotomy that is sometimes framed as "hemlock versus hospice." This story from New Zealand about a proposal to create euthanasia "havens" is an example of the philosophical conflict. Note that the euthanasia advocate frames mercy killing as an alternative to hospice. At least that is honest: Hospice and euthanasia are mutually exclusive concepts.

Bobby Schindler Discusses the Death of His Sister

Bobby Schindler is one of the finest, most decent people I have ever met. Over the years I have known him, I watched as he emerged, somewhat dazed, from a wholly private life as a high school teacher to becoming one of the most sought after activists worldwide standing up unequivocally for the equality and sanctity of human life, with a special concern for discrimination against people with disabilities.

Today, he has weighed in on the death of his sister, Terri Schiavo, two years ago. He believes--and I agree--that the facts of the Schiavo controversy have been so distorted and spun, and the supporters of the Schindlers have been so demonized--that there are few who remember what actually happened and what the fight was really all about. (For example, we are told that only religious conservatives supported laws to try and save Terri's life. Yet, the federal "Terri's Bill," received unanimous consent in the United States Senate, and about 40% Democratic support in the House of Representatives.)

In any event, I will let Bobby speak for himself at this link.

Reprieve for Baby Emilio

Ah, the power of good lawyers and public scrutiny. After going to court, attorney Jerri Ward, attorney for Baby Emilio's mother, just informed me that the Children's Hospital of Austin has agreed not to remove life support until April 10. And good for the people at the hospital for being flexible enough to continue to try and work these matters out. But note this quote from a committee member:"This care is medically inappropriate," said committee member Michael Regier. "The aggressive care that this infant is receiving is causing suffering, harm to the infant and without clinical benefit, and that should be discontinued."

Note that Mr. Regier is essentially claiming that continuing to live is not a clinical benefit. That turns the ultimate purpose of medicine on its head.

The Texas Futile Care law must go.

"Little Emilio:" Another Texas Futile Care Case

Should a hospital ethics committee be empowered to decide in secret to withdraw wanted life-sustaining treatment? This is the heart of what I call Futile Care Theory, a.k.a, medical futility, which is being quietly pushed into official policy throughout the country by the mainstream bioethics movement.

Texas has been ground zero for the futile care movement. In the late 90s, a group of Houston hospitals agreed to implement futile care theory and honor each other's futile care determinations. Under the protocols that were established, once a patient was voted by an ethics committee to no longer qualify to have their life maintained, the patient/family only had 3 days to find a new hospital to provide the care.

An attempt was made in the Texas Legislature to prevent this imposition of duty-to-die values. All that could be obtained was an extension from the 3 day limit to 10 days. Then Governor George W. Bush foolishly signed the bill, which he should have vetoed so that Futile Care Theory could be attacked in the courts.

Be that as it may, Texas hospitals are now seeking to move the agenda forward by actually depriving people of wanted care. The Andrea Clarke case was reported about extensively here at Secondhand Smoke. Now, there is a new case out of the Children's Hospital of Austin, in which an ethics committee is striving to remove "Little Emilio" from treatment. Little Emilio has been diagnosed, according to Ward, with Leigh's disease, which requires breathing and vitamin therapy. People with Leigh's disease have a limited life expectancy, generally 6 or 7 years, but can live longer. Little Emilio is 16 months old.

Attorneys Jerri Ward (who frequents SHS) and Joshua Carden have filed a request for a temporary restraining order to prevent the removal of life sustaining treatment. I will look further into this and report more when I know more.

Kill the Polar Bear Cub!

I have long believed that many animal liberationists don't love animals. They just hate people. Evidence of this is to be found in this story about a polar bear cub that was saved from dying in the wild and brought to the Berlin Zoo. Rather than have the cub live in captivity, liberationists are insisting that the bear cub be destroyed. From the story:

"Feeding by hand is not species-appropriate but a gross violation of animal protection laws," animal rights activist Frank Albrecht was quoted as saying by the mass-circulation Bild daily, which has featured regular photo spreads tracking fuzzy Knut's frolicking. "The zoo must kill the bear," he added.

This is the thing: Animal liberationists are not animal welfarists. They don't desire to improve the human use and care of animals, but rather, they want to utterly eliminate virtually all human/animal interactions. If they had their way, there would be no saved bear cubs, no seeing -eye dogs, no cattle, no domestic cats, in the end, only animals in the wild with people kept at bay.

This would cause tremendous harm to humans, of course. But so what? Animal liberation, whether implicitly or explicitly, is anti-human.

Steyn on Wilberforce

Mark Steyn does not generally write about matters of concern here at Secondhand Smoke, but today he focused on the legacy of William Wilberforce, the great British abolitionist. I truly believe in the power of committed individuals to improve the human condition. Wilberforce proved the point. Indeed, he was one of the first in modern times to do so. Here is the heart of Steyn's fine column:

As [Wilberforce biographer, Eric] Metaxas puts it, "Slavery was as accepted as birth and marriage and death, was so woven into the tapestry of human history that you could barely see its threads, much less pull them out. Everywhere on the globe, for 5,000 years, the idea of human civilization without slavery was unimaginable...What Wilberforce vanquished was something even worse than slavery,'' says Metaxas, "something that was much more fundamental and can hardly be seen from where we stand today: He vanquished the very mind-set that made slavery acceptable and allowed it to survive and thrive for millennia. He destroyed an entire way of seeing the world, one that had held sway from the beginning of history, and he replaced it with another way of seeing the world."

...But the life of William Wilberforce and the bicentennial of his extraordinary achievement remind us that great men don't shirk things because the focus-group numbers look unpromising. What we think of as "the Victorian era" was, in large part, an invention of Wilberforce that he succeeded in selling to his compatriots. We children of the 20th century mock our 19th century forebears as uptight prudes, moralists and do-gooders. If they were, it's because of Wilberforce. His legacy includes the very notion of a "social conscience": In the 1790s a good man could stroll past an 11-year-old prostitute on a London street without feeling a twinge of disgust or outrage; he accepted her as merely a feature of the landscape, like an ugly hill. By the 1890s, there were still child prostitutes, but there were also charities and improvement societies and orphanages.

Of course, Wilberforce stood for the intrinsic value of all human life. So did another of my heroes, William Lloyd Garrison. So did Susan B. Anthony. So did Gandhi. So did Martin Luther King. So did all the truly greats of the modern era. Which raises an important question: Why are assertions for the intrinsic moral worth of human life so controversial today?

UK Government Vows to Crush Slavery

We need to see more of this kind of anti-slavery action all around the world. From the story in the Telegraph: Last night, Mr Reid said: "In 1807 the slave trade was rightly abolished in this country. We now face a modern version of this despicable trade in the vile crime of human trafficking, which is destroying the lives of innocent people across the world. This plan will focus on prevention and enforcement, while ensuring that victims are successfully identified and given the support they need to overcome their ordeal."

Slavery is a profound violation of human rights and a despicable affront to human exceptionalism. It needs to be crushed. Three cheers to Tony Blaire's government for giving the issue such a high profile.

Some Nader Wisdom

I have been reading The Seventeen Traditions, Ralph Nader's autobiographical reflection on his parents, siblings, and upbringing. I know Ralph's family pretty well. His sisters are as formidable as he is and his nieces and nephew are just as impressive, and so I find the read doubly fascinating.

I bring this up because I just came to a part of the book in which Ralph briefly describes the end of his mother's life. In an era in which too many elderly people are made to feel as if they are somehow "burdens," the Nader family's response to Mrs. Nader's final illness is illuminating. Ralph doesn't go into details, and I won't either. But I know some of them. Let us just say that the the entire family--grandchildren included--devoted themselves utterly to ensuring that the wonderful woman Ralph sometimes calls "the originator" was always comfortable and received the best medical care. Here is how Ralph describes this difficult time in the family's life:

My mother had always been one of the most self-reliant and independent people I'd ever known, but by the time she was nearing her one hundredth birthday, she finally needed help getting around. My sister Claire was there to care for her, and she treated the responsibility as if it were a privilege to extend her hands to embrace our mother's needs. Claire rejected the bureaucratic term, "caregiver." To her it was a much simpler matter. "She is my mother," she would say. "And I am her daughter. We respond to each other's needs."

As the weeks passed, and mother needed more assistance, not once did Rose Nader ever suggest that she was a burden on her children. She had cared for us all during our infancy, childhood, and adulthood. Of course we would be there for her at the very end of her life. She viewed her life as a state of oneness with her children and grandchildren. And oneness cannot be a burden on itself.

"Oneness cannot be a burden on itself:" In this one sentence, I think, Ralph identified the key to the secret of life.

California HealthCare Foundation's Important Report on End-of-Life Care

The California HealthCare Foundation has issued an important report revealing that minorities receive much less effective end-of-life and palliative care than do whites. This study is important in its own right, but let us contemplate what it means in the context of A.B. 374, the bill that would legalize assisted suicide in California. (It's a long report, which can be linked here.) Here is just a sampling of the Foundation's troubling findings:

- Ethnically diverse populations are significantly less likely to use hospice care than whites. In 2004, for example, of those who died while receiving hospice services, only 4% were Asian American, 6% were African American, and 15% were Latino, contrasted with 74% who were white.
- While the majority of Californians die in hospitals and nursing homes, few of the state's hospitals--and even fewer skilled nursing facilities--offer organized palliative care services, according to the report. (Palliative care is the term for providing care for symptom relief and improved quality of life, rather than care aimed at a cure. Palliative care can be provided simultaneously with curative treatment.) Regarding other palliative care issues, the report found:
- The under treatment of pain is prevalent among the elderly, poor, and racial and ethnic minorities.
- Recent legislation requiring palliative care training for physicians in order to renew their medical licenses did not address cultural sensitivity even though many may lack those skills.

The relevance to this report to the advisability of legalizing assisted suicide is self evident. But don't expect the media to connect the dots since for most reporters "choice" and the fact that some opponents of assisted suicide are religious conservatives is the story line on this issue. It will thus be up to opponents of A.B. 374 to get Democrat legislators who represent minority districts to come to grips with the importance of this report, and understand how the context of unequal deliveryof care makes legalized assisted suicide acutely dangerous to their constituents.

HT: Ross S. Heckmann

Organ Donor Cards to Overrule Advance Directives?

Bioethicists Art Caplan and Michael A. Devita have written an important column warning against plans that are afoot to increase the organ supply, but which if enacted, would instead be more likely to undermine the already thin crust of trust the people have in the organ procurement system.

Apparently, a proposal is being crafted that would alter the terms of the Uniform Anatomical Gift Act, a "model law" which states often follow in crafting their respective public policies. The proposal would give priority to the signing of organ donor cards. Caplan and Divita explain what this could mean: Their proposal, which is under consideration by states, is that organ donation consent (on a driver's license, for instance) be allowed to override a person's living will, advance directive or even physician orders. The proposed language in the revision states, "measures necessary to ensure the medical suitability of an organ for transplantation or therapy may not be withheld or withdrawn from the prospective donor." What this means is that if you say you are willing to donate your organs, your advance directive, living will and physician's orders are in trouble. In other words, if these recommendations become law and you sign an organ donation card, preserving your organs could become the primary consideration in determining your medical care--which could either prevent you from receiving treatment you might want, or be forced to accept interventions you would not want.

This is nuts. If people ever come to feel that their organs might be seen as more important than their own medical welfare, they will rip up their organ donation cards en masse. Good for Caplan and Devita for bringing this important matter to public light.

Time to Change Dumb "Medical" Marijuna Federal Policy

A federal court has ruled against finding a constitutional right to take medical marijuna. That is the right decision. But I think the Feds have missed an important bet on this issue. When the Controlled Substances Act was enacted, marijuana was explicitly defined as having no legitimate medical use. When states passed their medical marijuana laws, the Supreme Court ruled that such state statutes did not prevent the Feds from enforcing federal law in this regard. This too, was the right decision as a matter of law.

But it is now clear that at least for some maladies, marijuana provides effective palliation. So, why is it still identified in the law as a drug with no legitimate medical use? If this status were changed, then a rational policy could be adopted that would eliminate the two, opposite-ended problems with medical marijuana as it is currently dispensed. First, the status of marijuana should be changed to that of say, morphine, permitting it to be prescribed for conditions that it palliates. (This would also permit medical testing to identify those.) At the same time, the ability to prescribe and dispense through a pharmacy would obviate the need for marijuana clubs. It would also do away with the "letter" system where a doctor merely writes a note to a patient recommending marijuna. This system is too loose to prevent improper prescribing.

I think one of the Bush Administration's biggest mistakes in the areas about which I engage has been its failure to push for a better medical marijuana policy. This would have been true "compassionate conservatism." At the same time, now that the Dems are in charge of Congress, why aren't they making this a policy priority?

Disabled Chinese Woman Asks for Euthanasia

This story reveals an awful lot about the current state of Chinese society. A paralyzed woman wants euthanasia because she wants to die before her parents. Here's why: "I must die before my parents; otherwise I will live a miserable life after their pass-away -- dirty, stinking, and sick. The thought of such a life and death is unbearable."

Considering that China sells organs of executed prisoners, may kill Falun Gong and then sell their organs, and has other very serious human rights problems, it is not unreasonable for one of its citizens to be so afraid. The proper response, of course, is to assure her that she will receive proper care--and do it--not acede to her request to be killed, a point noted in an editorial on Eastbay.com: "I deeply understand the pain that illness has brought to this 28 year-old woman. I also respect her right to express her innermost feelings. But this is merely sympathy, an involuntary sympathy. If we really have NPC representatives or CPPCC committee members making a proposal on euthanasia in China today, this is clearly an inopportune abuse of rights."

French Euthanasia Conviction: Trouble on the Horizon

A French doctor was convicted of euthanizing a cancer patient. Good. According to the BBC report, she was given a suspended sentence, after stating that she decided to resort to a lethal injection after Druais had told her that she did not want to die "in filth" the French news agency AFP reported. But proper medical care does not permit dying to die "in filth." Didn't the good doctor assure her patient of this?

Such taps on the wrist are not good. There should be some real consequences for acts of this kind, even if based on a motive to alleviate suffering. Suicidal patients should have their concerns addressed. They should be assured that their pain will be alleviated and that they are not burdens. They should not be killed.

Worse, French politicians are beginning to speak about legalizing euthanasia. Now, there may be some confusion about what that means. In Europe, removing unwanted life support is sometimes called euthanasia--as in a recent Italian controversy. But this ignorant quote from the conservative candidate for President reveals the extent to which the people and leaders of France need to be educated about end of life care. From the story: Nicolas Sarkozy, the candidate for the ruling conservative party, suggested he might favor a law permitting euthanasia, saying recently: "Faced with suffering, we can't just sit there doing nothing."

Well, of course not! Hospice and other forms of palliative interventions--when properly provided--alleviate tremendous suffering. Even in cases such as AIDS. I remember interviewing one of the doctors at St. Christopher's Hospice in London. Out of 1700 AIDS patients they cared for (by that time, which was several years ago), only 2 had asked for suicide and they changed their minds when proper interventions were applied.

If the media spent half as much time highlighting the tremendous opportunities to alleviate suffering through ethical medical means rather than repeatedly highlighting killing as an acceptable answer to the problem of human suffering, it would be better for all of humanity.

"Christian" Eugenics

Dr. Albert Mohler, a national Christian leader, advocated in his blog a few weeks ago for what can only be described as the eugenic manipulation of fetuses--if and when it becomes possible--to prevent the babies from being homosexual. The blog entry is only now being reported in the mainstream press, and as you would expect, it looks as if it might become a firestorm.

Rather than rely on media reporting, let's analyze what Mohler actually wrote. To his credit, Mohler acknowledged the intrinsic equal worth of gay children: The biblical basis for establishing the dignity of all persons--the fact that all humans are made in God's image--reminds us that this means all persons, including those who may be marked by a predisposition toward homosexuality. For the sake of clarity, we must insist at all times that all persons--whether identified as heterosexual, homosexual, lesbian, transsexual, transgendered, bisexual, or whatever--are equally made in the image of God.

And he warns against eugenic abortion: Thus, we will gladly contend for the right to life of all persons, born and unborn, whatever their sexual orientation. We must fight against the idea of aborting fetuses or human embryos identified as homosexual in orientation.

But having also warned against the drive to create "designer" babies as if children are a matter of mere manufacture, Mohler undercuts his own intrinsic worth argument by claiming that it would be appropriate and "Christian" to redesign fetuses found with biological factors that would create a propensity to being homosexual: If a biological basis is found, and if a prenatal test is then developed, and if a successful treatment to reverse the sexual orientation to heterosexual is ever developed, we would support its use as we should unapologetically support the use of any appropriate means to avoid sexual temptation and the inevitable effects of sin.

How is this in any less eugenics than, say, redesigning a baby with normal intelligence to be an Einstein, redesigning a child who will be diminutive, to be tall, or redesigning a baby with normal hearing to be deaf? Once we accept that children can be remade to suit parental desires for their children--which is a different matter than, say, correcting a heart defect--we have bought into Brave New World.

Misplaced Suicide Priorities

Apparently there has been a backlash against advertising with "suicide" themes. From the Seattle Post Intelligencer story: Washington Mutual has stopped running a spot that showed actors playing bankers poised atop a building as if about to jump. These ads are clearly not pro-suicide, but are oriented toward humor.

It seems to me that not only is this overly sensitive, but it misses the real pro-suicide content of the public discourse. There have been many stories published in mainstream media that give a positive spin choosing suicide. Indeed, Jack Kevorkian became such a media hero that Time invited him as an honored guest to its 75th anniversary gala. Assisted suicide advocacy explicitly states that suicide is acceptable in some circumstances. And yet, not only is there no backlash, but there is much editorial support for the idea.
Oregon has such a terrible problem with elder-suicide that the state is looking for ways to reduce the toll. The Dutch are very worried about a youth suicide epidemic. And the leaders of these pro-assisted suicide sovereignties somehow miss the profound irony: This is the same state that says suicide in some cases is now a sacred right. Such mixed messages in the law do far more harm than humorous ads.

Finally, a brief story: A few months ago I received an e-mail from a suicidal person. I wrote back asking for contact information. He gave me his phone number and permission to have someone call him. I tried to find a suicide prevention center in his area code. There were none. I had to find an adjoining county to get the man help.

This really alarmed me. When I was a young lawyer in Los Angeles, suicide prevention education was everywhere. I received training. There were ubiquitous ads almost begging suicidal people to call suicide prevention hotlines. Maybe it's me, but I don't see such emphasis any more. Is it possible we are becoming less "anti-suicide?" I say yes.

Pearls Before Swine Takes on Stem Cell Research

I love the comic strip Pearls Before Swine. In the last few days, it has poked fun at the embryonic stem cell/cloning debate. For a good laugh, check these out: Rat gets bored; the pitter patter of little feet, why cloning is bad, and bad news for Goat.

Letting Computers Decide Who Lives and Who Dies?

According to an article in the New Scientist, A simple formula can predict how people would want to be treated in dire medical situations as accurately as their loved ones can, say researchers. According to a study, surrogate decision makers were only 68% right when trying to predict what their loved one would want under hypothetical circumstances. But the computer program did better, getting it right about 78% of the time.

The formula is based on people, asked to imagine themselves in comas, wanting care if they have a 1% chance of recovering awareness. But using such a formula would be a case of garbage in, garbage out. Diagnoses of persistent vegetative state are notoriously inaccurate. Indeed, there are unexpected awakenings, of confusion between a "locked in state" (unable to communicate) and a persistent unconscious state (actually unaware).

More importantly, using such a computer model would not treat the patient as an individual. Even if the computer could predict in 78 out of 100 cases, that would still leave 22 people whose wishes would be violated.

Everyone should create an advance directive. Absent that, patients and society are much better served giving the benefit of doubt to life over death when we do not know what the patient would want. My friend Bobby Schindler had it right, when he told the New Scientist: "I believe it would be extremely irresponsible to allow machines to make decisions involving life and death," says Bobby Schindler, brother of Terri Schiavo. Schiavo was in a persistent vegetative state for 15 years until she died in 2005 after doctors removed her feeding tube. Her case sparked huge debate in the US. "If a person becomes incapacitated, is not dying, and can assimilate food and water via a feeding tube, then I believe that we are morally obligated to care for the person and provide them this basic care--regardless of a computer attempting to 'predict' what that person's wishes might be," Schindler adds. "Essentially, you would be allowing a machine to determine what is ethical, what is right and wrong, which no machine is able to do."

Animal Liberationist Thugs Harass Wachovia Employees

This is tertiary targeting, and it is now a felony thanks to the Animal Enterprise Terrorism Act. Thugs from the Animal Liberation Front are targeting employees of Wachovia, Corporation--a financial company--vandalizing their property and otherwise terrorizing them. Why is ALF targeting employees of a financial company? Wachovia owns stock in GlaxoSmithKline, which does business with Huntingdon Life Sciences, that the terrorists want to drive out of business for conducting animal research. Such is the fanaticism that is bred by animal rights/liberation when its primary leadership--Gary Francione excepted--generally refrain from the kind of vigorous criticism against violence and intimidation in the name of the animals that might influence their co-believers to remain peaceful and within the law. Indeed, PETA ludicrously extols these types of actions by likening them to the Underground Railroad's liberating slaves. Let us just hope that some fanatic doesn't decide to become John Brown.

More Media Stem Cell Ignorance on Display

The Star Ledger ("the voice of New Jersey") has an ESCR story out, byline Kitta MacPherson, which is, as usual, biased in the direction of promoting ESCR. A study has been published in Nature reporting that human embryonic stem cells in mice effectively treated Sandhoff disease, a malady similar to Tay Sachs and other such neurological disorders. Much more is made of the story than is warranted, as I will explain below. However, I think the bias comes from ignorance rather than the reporter's intent. A general staff reporter will naturally rely on the scientists for the facts--which in these highly politicized days will not always result in accurate reporting.

MacPherson got the usual spin. Check this out from the story: "Everybody is always saying to us, 'Well, you guys studying the human embryonic stem cells, you haven't benefited anyone yet,'" said Evan Snyder, a neuroscientist who has published breakthrough papers on both embryonic and adult stem cells. "Well, this is it." Except, it isn't. The study was done in rodents, not people. Surely, a neuroscientist (and a staff journalist, for that matter), knows that a mouse made better is not the same thing as a human made better. Indeed, what works in animal models does not always work in humans.

But note this part of the story. The scientists used both adult and embryonic stem cells in their experiments, with interesting results: The international team, headed by Snyder, a physician-scientist at the Burnham Institute in California, also compared the effectiveness of embryonic stem cells versus the "adult" variety and found them to be equally effective. In other words, in mice adult stem cells were just as therapeutic as embryonic! That should have been the headline and the story's emphasis. Moreover, if this is so, why use ESCs in human trials, as these scientists want to do, given their propensity to cause tumors and their ethical contentiousness?

Chalk up another hyped story of a purported embryonic stem cell success that is less then advertised, and which actually boosts the argument in favor of adult stem cell research.

"Death by Indifference"

This story is a warning: Six developmentally disabled people have died in the UK, apparently, due to medical neglect, according to "Death by Indifference," a report published by MENCAP, a Mental Disability Charity. From the Telegraph story: Dr Roger Banks, the vice-president of the Royal College of Psychiatrists, who is supporting Mencap, welcomed the Health Department's response [agreeing to an investigation]. "People with disabilities are not valued in society and its systems," he said. Most health professionals were not malevolent, he added, but in a cash-strapped, time-scarce NHS, where there was a move away from treating people as individuals and towards treating them as groups, people with learning disabilities were regarded as second class citizens. He also highlighted problems around the issue of consent. Today's report says doctors and nurses sometimes wrongly believe someone is refusing treatment if they recoil from an injection or pull out tubes because they are frightened.

Let us ponder: It is easy to view the matter as a problem with socialized medicine. But I think it goes far deeper. It seems to me that this kind of horror results from the constant chipping away at the intrinsic value of human life by the utilitarian view that some of us have greater worth than others of us. And it is the acceptance of this concept that threatens the lives and well being of the weakest among us.

This is the context in which we are told that assisted suicide should be a "choice," while at the same time patients who make the "wrong" decision--to live--can be overruled by doctors and ethics committee refusing wanted life-sustaining treatment under Futile Care Theory. This is the milieu in which we are looking for ways to dramatically increase the pool of transplantable organs and even, ease the standards under which we engage in human subject medical research. This is the environment in which human cloners seek a bounteous supply of human eggs for their research, as some among our intelligentsia seek to normalize eugenic infanticide.

The warning signs are everywhere that we are in danger of going badly akilter. If health care, the most altruistic of professions, succumbs to the utilitarian impulse, imagine what will happen in the rest of society. Either all of us matter, or in the end, none of us do.

Science is Not Science When it is Politics

I am growing increasingly concerned about suppression of heterodox views in science. This story in the Telegraph, I think, demonstrates the point. It is about the stifling of scientists who are skeptical about the conventional view about the existence of global warming and its causes.

I don't want to get into the global warming issue. What concerns me is the stifling of opposing views--which is a corruption of science. From the story: Scientists who questioned mankind's impact on climate change have received death threats and claim to have been shunned by the scientific community. They say the debate on global warming has been "hijacked" by a powerful alliance of politicians, scientists and environmentalists who have stifled all questioning about the true environmental impact of carbon dioxide emissions... "Western governments have pumped billions of dollars into careers and institutes and they feel threatened," said the professor. "I can tolerate being called a sceptic because all scientists should be sceptics, but then they started calling us deniers, with all the connotations of the Holocaust. That is an obscenity. It has got really nasty and personal."...

"Richard Lindzen, the professor of Atmospheric Science at Massachusetts Institute of Technology...recently claimed: "Scientists who dissent from the alarmism have seen their funds disappear, their work derided, and themselves labelled as industry stooges."

I have seen the same suppression in the human cloning issue. Scientists who have an ethical objection are threatened with firing if they express them publicly. They are informed that their careers will be in tatters if they support an "anti-science" view. They will not be invited to symposia or asked to write book chapters. If they don't have tenure, they are toast. If they do, they are shunned to the sidelines.

The media are quick to jump on the Bush Administration for suppressing views with which it disagrees, a matter about which I have no opinion. But with rare exceptions, such as the story in the Telegraph, they are silent about the bullying when it comes from the other direction. Indeed, I have tried to interest media in this story only to be met by barely stifled yawns.

Abdication of Professional Responsibility to Lead

I wrote a post a few days ago criticizing the decision by the board of directors of the American Academy of Hospice and Palliative Medicine to assume a position of "studied neutrality" on the crucial moral issue of physician-assisted suicide. It is simply a disgrace that the professional academy of hospice and palliative doctors is now on record as taking no position on what may be the most important issue facing the care of their dying patients. More, it is a cowardly abdication of the professional responsibility to lead.

I write more in this article in the Weekly Standard. Here is my conclusion: The AAHPM properly urges that "medical practitioners carefully scrutinize the sources of fear and suffering leading to the request" for assisted suicide "with the goal of addressing these sources without hastening death," along with practice guidelines for accomplishing these important goals. But this promotion of good medical practice rings hollow given the association's explicit neutrality on assisted suicide, which in effect grants member doctors permission to help kill their patients without threatening their good standing with the association.

Such terminal nonjudgmentalism is a profound abandonment of the organization's professed goal of promoting proper hospice care--a philosophy that unequivocally opposes assisted suicide. Perhaps more egregiously, it abandons patients--whose lives depend on ethical doctors acting energetically to relieve suffering while abiding by the Hippocratic Oath's sacred duty to "neither give a deadly drug to anybody who asked for it, nor . . . make a suggestion to this effect."

Let us hope that the membership of the AAHPM follows the lead of the members of the British Medical Association, who, when their leaders also assumed a neutral stance on assisted suicide, reversed the decision the first chance they had. Hospice doctors: It is up to you.

Oregon Issues Ninth Meaningless Assisted Suicide Report

The Oregon Department of Human Services has issued its ninth, virtually meaningless report on assisted suicide. I say virtually meaningless because it's statistical analysis depends almost entirely on death doctor self-reporting. Little noted in the media, which regurgitates these statistics as if they were empirically valid, there is no independent oversight by the state over assisted suicide, the DHS does not even have the power or budget to investigate potential abuses, and indeed, as the news release that accompanied the statistical report acknowledged, "The role of the DHS is that of a steward of data about the use of the law. This is a law, not a DHS program, and our only legal role is to report accurate aggregate data about the use of the law. It is critical that we have accurate data so that informed ethical, legal, and medical decisions can be made."

So there you have it. DHS bureaucrats are merely stewards of data, not overseers. The DHS merely compiles statistics and only spot checks the accuracy of the data they receive. Not only that, but after the annual reports are published, the DHS destroys the data from which it was compiled, which prevents outside researchers from even verifying the DHS's analysis. Thus, there is no way to know whether these reports are accurate, or instead, whether they are more a matter of garbage in-garbage out.

For a cogent critique of the many failings of "oversite" system in Oregon, see "The Oregon Experience," a fact sheet compiled by theInternational Task Force on Euthanasia and Assisted Suicide.

Embryonic Stem Cell Breakthrough

In mice, Israeli scientists have apparently created a "miniature heart" using embryonic stem cells. If the story is right, the stem cells were morphed into the building blocks of heart cells, after which the scientists "found a way of persuading the different types of cell which form the heart to grow and work together. The result was a tiny piece of heart muscle--less than one centimetre square--but threaded with minute blood vessels and closely resembling the complex tissue of the human heart. While stem cells have been coaxed into heart tissue before, this is the first time scientists have succeeded in creating tissue that contains all the vital cells." This has yet to be done in human tissues and the issue of tissue rejection would still have to be contended with. But if this anecdotal report is verified, it is a major scientific achievement. (Remember, the ESCR/cloning debate is not a scientific controversy. It is a dispute over ethics.)

A similar achievement has been made with umbilical cord blood stem cells to make a miniature liver.

Mark Pickup's Blog, Humanlife Matters is Running Again

Humanlife Matters, Mark Pickup's blog, is back after experiencing technical difficulties. Today, Mark riffs on how the culture of death is really discrmination against the weakest and most vulnerable among us.

Zurich Hospital Forbids Assisted Suicide on Premises

This is the proper response to the legalization of assisted suicide: complete non participation by medical professionals at every level of care. Zurich University Hospital does not permit assisted suicides on premises. That is the honorable approach.

If A.B. 374 passes in California, hospitals like that in Zurich could do the same thing. But the California equivalent of a Zurich University Nursing Home, or Zurich Hospice could not. As written, most in patient or residential health facilities in CA would be forced to be complicit in assisted suicide by allowing them to occur on premises.

Ethical Guidelines to Protect Robots From Abuse

This is so ridiculous. Ethical guidelines are being drafted to protect humans from robot abuse and robots from human abuse. First, robots are inanimate objects. I don't care how sophisticated or "intelligent" they become, they could no more be abused than my vacuum cleaner or the Dell computer on which I am writing this post. Sophisticated processing of information is not the same thing as becoming a "being." Even the most sophisticated robots will always be inanimate.

The story also contains this point: Other bodies are also thinking about the robotic future. Last year a UK government study predicted that in the next 50 years robots could demand the same rights as human beings. If robots could really become so elevated that they would "demand rights," there is a simple solution: Don't construct them! We have choices in this regard. Because we can do something--highly doubtful in this matter--that doesn't mean we should to it.

Why don't these people tackle real problems?

Amendment 2 Kills Life Sciences Building Project in MO

Missouri's universities will not have a life sciences building project funded due to the potential that the buildings would be used to conduct human cloning and embryonic stem cell research. While the media rails against cloning opponents, the real fault lies with the authors of Amendment 2. Not satisfied to just create a constitutional right to engage in human cloning research in Missouri, the authors also put in a non-discrimination clause, requiring that funding for any kind of stem cell research would also require funding of the embryonic variety.

Opponents felt that a law permitting the buildings to be built and limiting them to ethical stem cell research would be declared unconstitutional due to Amendment 2. They were right. So the whole project went down in flames.

The Problem of Media Ignorance in Embryonic Stem Cell Debate

I often describe the blatant biased reporting about the ESCR debate. But much of the problem isn't bias--it is ignorance. Say a general beat reporter is directed by his or her editor to do a stem cell story. He or she calls scientists--who may or may not mislead the reporter--and then writes a story that is often erroneous--not from bias, but because the reporter doesn't understand what he or she is writing about. This story in the Philadelphia Inquirer, byline Marie McCullough, seems to be a case in point.

The story is purportedly about deriving ES cells without creating embryos. Hence, McCullough writes: Now, University of Pennsylvania researchers have stretched the definition [of an embryo] even further. In studies with mice, they created embryos using genetic material from only one parent--either a mother or a father. "In humans, this could provide a therapeutic route for both genders," said senior author K. John McLaughlin, a researcher at the University of Pennsylvania's New Bolton Center. "Members of either sex can use this technique to produce compatible stem cells, much like you might donate blood for your own use."

For most people, the concept of a human "embryo" is straightforward: After a man's sperm fertilizes a woman's egg, it grows into a ball of cells that implants and develops in a woman's uterus. But as animal cloning has shown, embryos can be created by replacing the nuclear DNA of an egg with the DNA of a body cell--say, a skin cell. No sperm needed."

Uh, this is hardly news. It is called somatic cell nuclear transfer, a.k.a. cloning. And cloning does create an embryo. McCullough writes, no doubt because this is what she was told, that cloned embryos are "dead-ended," and could not develop beyond the early embryo stage. But this isn't at all clear. Cloned embryos certainly are not dead ended in animals. Remember Dolly?

McCullough then discusses what is known as parthenogenesis, a process which stimulates an egg to divide to the point where stem cells might be obtainable. She writes, "the human parthenogenetic embryos soon die because parts of their genetic code are unreadable." But it isn't at all clear that these divided eggs ever rise to the status of an organism. If they are not organisms, they are not embryos.

Finally, she discusses "androgenesis," which I had not heard about before. The scientists also carried out the male version of parthenogenesis, called androgenesis. They removed the nuclear DNA from an egg and slipped in two sperm nuclei from a mouse. Two sperm nuclei were needed because, just as in humans, each sperm carries half the necessary genetic material.

This appears more akin to cloning than parthenogenesis. In any event, it would not create "tailor made" embryonic stem cells since the genetic makeup of the entities would not be identical to either sperm donor.

Most of this would seem to be way too impractical for therapeutic purposes.

Prisoners Are Not Crops Ripe for the Harvest

Yes, we have a shortage of transplantable organs. But that does not in the least excuse this legislation in South Carolina to give reduced sentences to prisoners in return for agreeing to be an organ or bone marrow donor. No, I am not joking.

There is a terrible history in this country of using prisoners in unethical human medical experimentation. This proposal is right out of that playbook. I don't care if they are murderers, rapists, or former executives of Enron, prisoners have intrinsic value as human beings--which if that concept is to mean anything, has to prevent them from being reduced to the moral equivalent of a string bean crop. And don't talk to me about "choice." The potential for coercion in prison self evident. (The story is unclear whether the organ donations could be live or would be restricted to cadavers. If "live," it is an absolute outrage.)

China may treat prisoners as sources of organs. We should never get into that gutter. This is not to say that a prisoner should never be able to be an organ donor, but the donation would have to be freely given and without a hint of coercion or "time off for good donations."

Scientists Using Fish and Insects to Boost Security--PETA Will be Outraged

Scientists are using bluegill fish to screen water for toxins and are developing methods by which bees and cockroaches will help with airline security. As I often say, never under estimate the imagination and abilities of scientists.

Just don't tell PETA. It thinks fish should not be kept in tanks. It has also protested cruelty to cockroaches, and has called the brood of insects, "children."

75 Reasons to be Encouraged About Non Embryonic Stem Cell Research

There is so much going on in the fields of adult/umbilical cord blood stem cell research, that I can't possibly post it all here at Secondhand Smoke, much less read it all. Happily, these advances are collected by the inestimable Richard Doerflinger, and published on a periodic basis by Do No Harm. Here is the most recent report, "75 New Reasons to Reconsider the Alleged Need for Stem Cell Research that Destroys Human Embryos." Hey, Richard: You gotta come up with pithier titles!

75 Reasons covers the depth and breadth of recent advances, including links to the studies or stories about them. If you are interested in details about how things are going in this field, check it out. Research in non embryonic stem cell research is moving forward at a splendid pace.

Christa Lilly has Relapsed Into Seeming Unconsciousness

Christa Lilly, the Colorado woman diagnosed with persistent vegetative state who woke up and began talking, has relapsed into an unresponsive state. Her mother promises to care for her no matter what. Good. Lilly's moral worth and intrinsic value as a human being--a sister of all humanity--does not depend on her ability to interact. Would that more of us could find it within ourselves to love the most helpless among us unconditionally rather than set marginalizing parameters which, in effect, throw them out of the moral community.

The brain is a fascinating organ, which we don't understand. Add the UK case in which a purportedly unconscious woman has been found through brain scans to be interactive, and it becomes clear that we should treat the seemingly unconscious as we would conscious people. Whatever we do, when visiting an unconscious person, assume they can hear every word we say.

Assisted Suicide and Elder Abuse Crisis in California

It is incredible that anyone would seriously contemplate legalizing assisted suicide in California, given the elder abuse statistics. In 2003, the California Attorney General’s Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) and Crime and Violence Prevention Center (CVPC) issued a 50-page booklet, entitled A Citizen’s Guide to Preventing and Reporting Elder Abuse. Check out these shameful numbers:

- There are approximately 225,000 cases of elder abuse in California each year.
- Two-thirds (2/3) of abusers are family members.
- For every case of elder abuse reported, five cases go unreported.
- Elder abuse in California is "of crisis proportion," and "the problem threatens to grow worse as the ‘graying’ of the Baby Boom generation results in unprecedented demographic shifts."
- Elder abuse victims are often unwilling to get help because they fear retaliation from their abusers.
- Many victims remain silent to protect abusive family members from legal action and/or prosecution.
- Isolation is "an insidious tool" of abuse used by many family members or caregivers.

But don't expect the media or assisted suicide boosters in the California Legislature to care. When it comes to the issue of assisted suicide, real world context in which lethal prescriptions would be issued doesn't matter. All that counts is belief in "choice."

HT: Kathi Hamlon

ANOTHER PVS "Wakeup" Call

This wonderful story demonstrates that being diagnosed PVS does not mean necessarily that one will never wake up, and indeed, that one will not again become interactive. Christa Lilly woke up after 6 years in a diagnosed unconscious condition, and is now telling her story on television!

Imagine, if Lilly's family had decided to dehydrate her to death instead of caring for her. Bioethicists and the media would merely written her off as another "death with dignity." Instead, she is alive, kicking, and talking to the media.

Will we gain any wisdom from this "miracle?" Nope.

Vegetarian Activists Wrong: Atkins Diet Safe

For years, PETA and vegan front groups like Physicians Committee for Responsible Medicine (PCRM), have assailed the Atkins diet on the basis of health--when the true cause for their loathing is that it is very high in protein--e.g. meat. No lie has been too low for these vegan fanatics to go. For example, when Robert Atkins, the diet's creator, died from a head injury sustained in a fall, somehow the PRCM obtained copies of his medical records and published excerpts indicating that he was obese at the time of his death. Not true. When admitted to the hospital, Atkins was not obese, weighing 196 pounds and being six feet tall. During his coma, water retention caused weight gain, which was then used as a smear on the Atkins diet. Vegan activists had also falsely attributed Atkins' previous heart problems to his diet, when, in fact, it was caused by an infection.

Now, a study conducted at Stanford hs been published that rebuts the claim that the Atkins diet is unsafe. From the story in the San Francisco Chronicle: A yearlong, head-to-head study of four widely used diets found that overweight women who followed the very low-carbohydrate Atkins diet had no adverse health effects and lost slightly more weight than women on the other three...The latest findings add to a growing body of evidence that the very low-carbohydrate, high-protein Atkins diet does not cause the harmful heart and artery effects long feared by many researchers.

Women who followed the Atkins plan had a significant drop in triglycerides, one of the unhealthful blood fats linked to a higher risk of heart disease. Their blood pressure also dropped the most of the four groups, a finding that the researchers think may relate to their slightly greater weight loss. Those in the Atkins group also experienced the largest increase in high-density lipoprotein (HDL), a protective type of cholesterol.

I went on Atkins when I turned 50 and lost 40 pounds in 7 months. My cholesterol levels plummeted. I regained some of the weight, but only after I went off the diet. (Frankly, I began to feel like ground beef was coming out of my ears.) I have a friend who came close to needing insulin from adult onset diabetes, but was spared having to take it after he went on Atkins and the problem abated.

This is not a brief for Atkins. The point is that the PCRM, PETA, and others who assailed the diet based on health were being typically disingenuous in their advocacy against Atkins. Their sole gripe against the diet and its creator is that it promotes the eating of meat. Concerns about dieters' health is nothing but a smoke screen.