Handprints on a Wall

This is true compassion: The George Mark Children's House of San Leandro, California (SF Bay Area), is the first freestanding hospice and respite center for children in the country (as hard as that is to believe). This new approach to pediatric end-of-life care has expanded the approaches to cherishing and caring for dying children. From the story in the Tri Valley Herald:

Painted handprints cover the wall of a room as a reminder of the many children who have come here to die. Most of the rooms at George Mark Children's House, the country's first freestanding pediatric hospice dedicated to helping children and their families cope with untimely death, have murals. But this mural is special because the kids have done it themselves--imprints left to keep their memories forever alive, even though they had reached the end of their own lives. "It's a way for us to remember the child," said Teri Rose, a spokeswoman for George Mark...

One of the reasons George Mark has gained so much recognition while still in its early stages is because of its unique approach to hospice care.
Until now, most terminally ill children have had only two options when it comes to respite care, family therapy or grief support: staying at a hospital or at home.

But George Mark, which models its philosophy after similar facilities in England and Canada, takes end-of-life care to another level by offering a nurturing environment where the children can receive high-quality care while their families are able take a break from the nonstop responsibility of home care. Families are asked to pay what they can, but the rest is covered by private donors. "What we provide for families is that continuum of care that meets them in the middle of the hospital and the home," Hull said.

More of this, please.

Some Vegetarians Eating Meat Again

This story doesn't surprise me. Human beings are omnivores biologically. That means eating meat is natural for us--and healthy when consumed in moderation. This is why vegetarianism requires discipline. (In this regard, I recall a statement by a very well known animal liberationist, who shall remain nameless because the conversation was private. This person told me that pizza restaurants caused the person to salivate, stating, "That's how addicted to meat and cheese I am." I responded that the reaction wasn't an addiction, it was the body's normal response to natural food.)

In any event, apparently an increasing number of now former vegetarians are again eating meat if it is ethically raised, e.g. grass fed beef, uncaged chickens, no factory farming, etc. From the story in Food and Wine:

Former vegetarians are some of the most outspoken proponents of eating meat. "I was vegan for 16 years, and I truly believed I was doing the right thing for my health," says the actress and model Mariel Hemingway, who is the author of Healthy Living from the Inside Out. "But when I was vegan, I was super-weak. I love animals, and we should not support anything but ethical ranching, but when I eat meat, I feel more grounded. I have more energy."

Even chef Mollie Katzen, author of the vegetarian bible the Moosewood Cookbook, is experimenting with meat again. "For about 30 years I didn't eat meat at all, just a bite of fish every once in a while, and always some dairy," she says. "Lately, I've been eating a little meat. People say, 'Ha, ha, Mollie Katzen is eating steak.' But now that cleaner, naturally fed meat is available, it's a great option for anyone who's looking to complete his diet. Somehow, it got ascribed to me that I don't want people to eat meat. I've just wanted to supply possibilities that were low on the food chain."

I understand the drive to become a vegetarian--if it has a face, don't eat it--and I understand going back to meat. About 20 years ago, I went veggie, but promised myself that if my body told me to begin eating meat again, I would. At first I felt good, but after about a year, I began to crave chicken in a rich sauce. Then one day, I desperately wanted eggs. Acting on the craving, as if I were a starving man, I wolfed down 6 hard boiled eggs as soon as I could cook them. It was then I knew: My body needed and wanted meat. So, I went back to natural eating.

I respect people who control their appetites in furtherance of a moral principle or in obedience to religious dogma. Good for them. Such self control is an example of human exceptionalism in that we are the only species to refuse to act naturally based on belief. But eating meat is not immoral. It is natural. And it is good for us.

Killed For Organs?

One of the greatest fears among the general public about transplant medicine is that the sickest patients will not be viewed as people so much as organ farms, and indeed, that patients may be euthanized in order to gain access to their organs. Now, a San Francisco transplant surgeon is charged with doing just that. From the story:

A San Francisco transplant surgeon was charged Monday with prescribing overdoses of medication to speed up the death of a man at a San Luis Obispo hospital and harvest his organs.

Dr. Hootan Roozrokh, 33, prescribed excessive amounts of morphine and Ativan and injected the topical antiseptic Betadine into Ruben Navarro's stomach in February 2006, prosecutors in San Luis Obispo County said. Navarro, 26, who was severely disabled mentally and physically, had suffered respiratory and cardiac arrest and had been taken off life support, authorities said.

The intended donation would have been an example of a "non-heart beating cadaver donor protocol," under which life support is removed and if a patient goes into cardiac arrest, several minutes after death the organs are procured. However, if the patient doesn't die within thirty minutes or an hour of life support removal, then the patient is to be reconnected to treatment and removed permanently from eligibility for organ donation. From what I can tell, this may be why the overdose was administered--to get him dead within the time limit--since the patient in this case died eight hours after removal of life support.

One of the supposedly iron-clad protocols to ensure ethical treatment of the living patient is that the transplant team is to have no involvement with the patient's care prior to death. If Dr. Roozrrokh violated this fundamental and easy-to-understand rule--even if he didn't intend to hasten the patient's death--his license to practice medicine should be on the line.

Dr. Roozrokh denies all wrongdoing, but if this charge is true, he not only contributed to the death of a patient, but also will have caused tremendous harm to the people's trust in transplant medicine.

Scientists Create Schizophrenic Mice

Here's another reason why we need animal research: Scientists have created mice with schizophrenia, which they can then test and study as they seek to learn about the disease and find effective treatments. Sometimes you just need a living organism--some of which will need to be dissected and studied--to learn about the worst human ailments and potential treatments in preparation for potential human trials. In such cases it is either animals, us, or don't do the science. I choose animals.

Animal Rights Activists Try to Impede Testing Lab

Animal research is vital to human thriving. It is essential for advancing science and improving human (and animal) medical treatment and overall health. Yes, alternatives should be used when reasonably feasible, but at some point testing requires a living, breathing organism, and the only other choice is to use cognitively disabled human beings--which has been supported by Peter Singer among others.

Yet when a medical testing laboratory announced plans to build a $44 million lab in a town near Phoenix, the radicals, along with utterly misguided locals, organized to stop the project. From the story in the Christian Science Monitor:

Protesters of the plans decry the method that the US government requires for the development of medicines and other compounds such as antibacterial cleansers: that they be tested on animals before humans. Critics claim the method is outdated and that the toxins they introduce in animals cause them to react differently than humans. They also note that the US Department of Agriculture cited Covance for violations of the federal Animal Welfare Act in 2005.

But others point out that companies like Covance are following US regulations. "In this society, like all developed nations, any new compound, product, or medical device must be tested in a whole living system, and we do not test on humans first," says Frankie Trull, president of the Foundation for Biomedical Research, a group in Washington dedicated to fostering support for humane and responsible animal research. "The law and regulations are really quite proscriptive in what a company has to do."

Most test animals--some 95 percent--are rodents bred for that purpose, Ms. Trull says. But Covance also tests on some primates, as well as dogs.

So long as the protesters use legal means, I may disagree with their cause but will support utterly their right to derail this project through robust political persuasion. Indeed, have at it!

But if we see any of the violence, threats, and personal intimidation that have marked other attempts to close animal testing laboratories, the federal government should intervene under the authority of the Animal Enterprise Terrorism Act and punish the wrongdoers to the full extent of the law.

Preview of Coming Attractions: The Push to Permit Reproductive Cloning

The big secret that the media rarely address is that many bioethicists and bioscientists actually support reproductive cloning. Yes, yes, I know: Most scientific organizations, such as the NAS, and big-name bioethicists currently oppose permitting a cloned embryo to be implanted and gestated to birth. But this opposition isn't generally based on principled moral objections to cloning as a form of reproduction (replication). To the contrary: Many believe there is a fundamental right to reproduce by any means desired or necessary. Thus, objections among this camp are based on safety concerns. Currently, animal cloning is very inefficient, also leading to many miscarriages, birth defects, and the deaths of birth mothers.

Still, even now there are calls in some quarters to damn the safety concerns and go full speed ahead with permitting reproductive cloning. One such advocacy piece, "Let's Legalize Cloning," appeared in the July 18 New Scientist (no link available). Written by Glasgow Caledonian University bioethicist Hugh McLachlan, we are told that even safety should cause us little concern. He writes:

We know from animal cloning studies that the risks to the mother and the baby are likely to be very high, although they may diminish as the technique is perfected. Yet in other areas of reproduction (or life in general) safety alone is not seen as sufficient grounds to make something illegal. The risks should be explained to the prospective mother, and she should then have the right to decide for herself, as with any other medical procedure, whether to accept them.

The potential baby, of course, cannot give consent. There may be an increased risk of miscarriage or being born with a deformity, but for people born as a result of cloning, it is their only chance of life. Cloning is therefore not a risk but an opportunity. If you could only have been born as a clone, with the risks that entails, would you have wanted your life to have been prevented? I would say loudly: no.

The idea that cloning presents an "opportunity" for the nonexistent to become existent seems close to some religious doctrines about married couples having a duty to bring babies into the world. That point aside, non-existent beings have no right to come into existence, and if they don't, they will never know it, because there will never be a "they" to know that they don't exist.
Whew.

Moreover, notice the sheer indifference to the pain and suffering that would be caused, miscarriages, abortions, and human experimentation that would be involved in such an endeavor. To make cloning "safe" would require repeated creation of cloned embryos to study why gene expression is defective. It would require implantation and abortion to learn why some cloned fetuses develop with defects or in such a way as to endanger the birth mother. And it would require the surviving babies to be studied throughout their lives to determine whether they exhibit later resulting health or developmental difficulties. In other words, it would be to treat some people as experiments.

But when one's philosophy denies the intrinsic value of human life--and the primary impetus in "ethics" becomes anything goes to fulfill wants and desires--advocacy such as McLachlan's is entirely logical. This is why I don't view him as a fringe rider, but merely a candid harbinger of things to come.

ACT Misses Out on the $--For Now

Advanced Cell Technology is always on the lookout for opportunities to garner money, either from private investors (sometimes after hyped stories of its research "successes" somehow "make it" into the papers), or from government grants. ACT's most recent escapade involved its refuted contention that it created embryonic stem cells without destroying embryos. The story made headlines and generated tremendous controversy because company researchers had destroyed each embryo it researched upon--a matter that was covered extensively here at SHS.) In subsequent unpublished research, ACT now claims to have actually created ES cell lines without destroying embryos, which was also covered here at SHS.

ACT quickly applied for NIH money to do research on obtaining ES cell lines from early embryos, but has hit a different roadblock. The Dickey Amendment, passed by every Congress and signed by both Presidents Clinton and Bush since 1996, does not permit funding for research that "harms" embryos. This language was also used in Bush's recent executive order calling for the NIH to develop regulations for funding "alternatives" to conventional ESCR.
The question is thus, whether taking one cell from an 8-cell embryo harms it, even if it doesn't destroy it. (We know this can be done because the technique is used in pre-implantation genetic diagnosis and such embryos have been successfully implanted and gestated to birth.)

In any event, that question has put ACT's grant on hold. From the Washington Post story:

The legal standard of allowable harm to an embryo is spelled out in 1995 congressional language and is reiterated in Bush's June 2007 executive order. It bans federal funding of research that subjects an embryo to more than "minimal" risk, although greater risk is allowed if the research is anticipated to benefit the embryo.

For now, Lanza has suggested limiting his technique to embryos that are already due to be biopsied at a fertility clinic. The plucked cell could divide for a day, providing enough cells for both the genetic testing and to start a line of stem cells. That way the embryo would not be subjected to any new or additional risk.

My question is why is a delayed $240,000 grant to ACT such a big story?
Why do the media always seem to jump through ACT's press release hoops and continually quote people closely associated with the company despite their--the media--having been, shall we say, misled by the company's PR machine several times before? I'll say this for the company: ACT may or may not be a good biotech company, but it is a publicity hound par excellence.

Biotech Casualty

A gene therapy subject in an early human trial to treat arthritis has died, causing the experiment to be halted. Very sad. But such are the risks in human trials, which sometimes puts people in potential peril in the effort to get cutting edge medical treatments to clinical use. (There are, of course, cases in which known risks are not disclosed, as in the 1999 gene therapy death of Jesse Gelsinger, which is not part of the usual process.)

There has been so much hope placed in this biotechnological approach, but this isn't the first such death, and it may indicate that it will be a very long time before this potentially promising treatment modality is available--if ever.

This event should remind us that biotechnology seeks to harness the power of sheer biology. That can be risky, which is why people should be wary. We must take this one step at a time.

"Medical Marijuana" Political Follies

The House of Representatives has voted down an amendment that would have prohibited the DEA from enforcing federal drug laws against medical marijuana participants in states where cannabis as medicine is legal. And the bill only got two more votes than the last time the House considered it before the recent Democratic takeover. What a dumb approach, so typical of our gutless politicians!

The reason why marijuana can't be used as medicine under federal law is simple: The Controlled Substances Act states explicitly that marijuana has no medical uses. That is the law. It is wrong. And it chills efforts to study marijuana's potential medicinal uses--which definitely need to be studied.

So instead, we have the surrealistic state systems in which doctors write letters instead of prescriptions, and patients go to "pot clubs" instead of pharmacies to obtain their "medicine." This kind of chaotic distribution leads to crime, people getting pot for "stress," and etc. And it breeds disrespect for crucial distinctions between using drugs for medicinal and recreational purposes.

What needs to be done is change the federal law, conduct studies to determine what conditions for which marijuana has and does not have medicinal benefits, and allow formal prescriptions for cannabis distributed through pharmacies to treat those afflictions against which cannabis has a medicinal benefit. And not permit prescriptions for ailments in which it doesn't.

Unfortunately, the government doesn't have that kind of wisdom. And some supporters of medical marijuana aren't interested in that approach either, apparently, because their cause too often seems to be about legalizing pot, not helping people who are sick.

This leads to the nonsense we have now of at least three different approaches toward medical marijuana in the country: The federal government's strict prohibition, most states' strict prohibition, and some states' permissiveness with few effective regulatory controls. This ridiculousness has to change--and that starts with removing marijuana from the category of no medical benefits in the Controlled Substances Act--which should be done as a matter of integrity, in any event, because it clearly isn't true.

Can Human "Non Persons" be Molested?

Personhood theorists claim that one who becomes permanently unconscious has lost personhood. Some even claim that such people are "dead." In any event, personhood theorists hold that a permanently unconscious human being is of materially less moral value than persons (perhaps including animals), and hence, can be harvested for organs and used in medical experimentation in ways that would be wrong to do in persons.

I disagree adamantly with that. But this terrible story about the sentencing of a sexual predator of the profoundly disabled makes me wonder: If a patient who is non aware has lost much of their moral value due to their cognitive disability, can they truly be sexually molested? If so, is the crime just as wrong, or should it be deemed akin to violating a corpse--which under law is punished less severely as sexually assaulting a living person.

The creep got 45 years in a plea bargain, the least he deserved. True, some of his victims were conscious. But should that matter? No! And it didn't in this case, in which the prosecutors treated the violation of the unconscious just as seriously as that of the conscious. This is as it should be because the unconscious are--and should be so treated--as fully human persons possessing full human dignity, not as mere meat or quasi-cadavers.

Cosmetic Animal Testing May Be Coming to an End

Good news: Thanks to biotechnology, it may soon be possible to not use animals in testing cosmetics for skin irritation. From the story in New Scientist:

Stretched taut across the top of a vial, the thin cream-coloured material feels almost like rubber. Barely 1 centimetre in diameter, this is a sample of Episkin - a reconstructed human skin which has been approved for testing if cosmetics are likely to irritate the skin. It is the first complete replacement for animal testing...

Tessonneaud's team grows the skin layers on collagen, using skin cells called keratinocytes left-over from breast surgery (see Diagram). The team can test the safety of cosmetics by simply smothering the skin in the product. They can then check the proportion of cells that have been killed off by adding a yellow chemical called MTT which turns blue in the presence of living tissue. "To be validated we had to show that we could reproduce results as effectively as animal tests," says Patricia Pineau, scientific director at L'Oréal. Independent tests showed that in some cases Episkin was able to predict more accurately how a person would react to products than animal tests, she says.

Episkin improves on animal testing in other ways too. For example, it can be adapted to resemble older skin by exposing it to high concentrations of UV light. Adding melanocytes also results in skin that can tan, and by using donor cells from women of different ethnicities, the team has created a spectrum of skin colours which they are using to measure the efficiency of sunblock for different skin tones.

We have a solemn duty to treat animals humanely and not cause them gratuitous suffering. It is thus fully in keeping with human exceptionalism to replace animal testing with ethical alternatives whenever feasible and without substantially compromising human safety and well being.

Massachussetts Shortage of Primary Care Physicians

Massachusetts passed state-wide guaranteed health care last year, and it now has an insufficient number of primary care physicians. From the Wall Street Journal story:

On the day Ms. [Tamar] Lewis signed up, she said she called more than two dozen primary-care doctors approved by her insurer looking for a checkup. All of them turned her away.

Her experience stands to be common among the 550,000 people whom Massachusetts hopes to rescue from the ranks of the uninsured. They will be seeking care in a state with a "critical shortage" of primary-care physicians, according to a study by the Massachusetts Medical Society released yesterday, which found that 49% of internists aren't accepting new patients. Boston's top three teaching hospitals say that 95% of their 270 doctors in general practice have halted enrollment.

For those residents who can get an appointment with their primary-care doctor, the average wait is more than seven weeks, according to the medical society, a 57% leap from last year's survey.

The dearth of primary-care providers threatens to undermine the Massachusetts health-care initiative, which passed amid much fanfare last year. Newly insured patients are expected to avail themselves of primary care because the insurance covers it. And with the primary-care system already straining, some providers say they have no idea how they will accommodate an additional half-million patients seeking checkups and other routine care.

This is the same pattern we see in Canada. But I don't think that the shortage can be blamed primarily on state-wide care--although it might be a contributing factor--but on the general managed care system in which HMOs, government funders, and others control costs through capitation. Unfortunately, the key to make the managed care system work is the specialized generalist (internists, family care docs, etc.) and they are the least paid. Again from the story:

As it happens, primary-care doctors, including internists, family physicians, and pediatricians, are in short supply across the country.

Their numbers dropped 6% relative to the general population from 2001 to 2005, according to the Center for Studying Health System Change in Washington. The proportion of third-year internal medicine residents choosing to practice primary care fell to 20% in 2005, from 54% in 1998.

A principal reason: too little money for too much work. Median income for primary-care doctors was $162,000 in 2004, the lowest of any physician type, according to a study by the Medical Group Management Association in Englewood, Colo.

I seem to recall that the Clinton Administration wanted to pay medical schools not to train doctors based on an alleged oversupply. I don't know if the plan was ever adopted. Be that as it may, whatever form of expanded health care we decide upon as a nation, we need to graduate more PCPs and we need to pay them better if we want them to serve as gate keepers to specialized care. Enough is enough.

Interfering with Natural Selection

This charming story about Jessica the Hippo is a bit disturbing. Jessica was saved from death by human intervention--we are the only species that do this constantly for species other than our own. And the game warden's saving her life at the age of one day, represents our unique capacity to empathize with all life. (Yes, I have heard the occasional story about humans being saved by dolphins from sharks.) Not only did this interfere with the usual workings of natural selection, but rather than returning to the wild, she has been substantially domesticated. Indeed, she is now a pet.

Animal behavior can be profoundly impacted by their contacts with us--as Jessica demonstrates. This shows us our raw power to surmount nature--another unique attribute of human beings that make us so exceptional.

But with that power come solemn responsibilities. I am not sure that domesticating wild animals like hippos fulfills that responsibility properly. Jessica is happy, sure. But we have interfered with nature in a profound fashion. And we have changed her in ways that could affect her progeny.

Is this right? What say you?

South Africa Study Demonstrates Why We Need Mandatory HIV Testing for Infants

Seven years ago, I wrote about the courageous campaign of New York Assemblywoman Nettie Mayersohn (D-Queens), who bucked her usual political allies to force the first "Baby AIDS" legislation in the country, requiring all infants to be routinely tested for HIV. The hell she was put through for trying to save lives was unbelievable. From my Weekly Standard article (subscription required):

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. ...

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!' If I am in a bad marriage or abusive relationship, I can do something about it. I can get myself out. I can repair a broken jaw. But if someone infects me with HIV, that will mean the end of my life. So, the feminists turned on me. ...

But Meyherson persevered, and NY became the first state with mandatory testing. The law saved lives:

Today [circa 2000] 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.

Well, now more proof that instituting universal infant HIV testing would improve infected babies' chances for survival comes out of a study in South Africa. From the story:

A study of infants in Cape Town and Soweto in South Africa found that infants given immediate drug treatment had a 96 percent survival rate compared with 84 percent for children where treatment was deferred.

The study, sponsored by the U.S. National Institute of Allergy and Infectious Diseases (NIAID), was so successful that it was amended in 2007, ending enrollments for the deferred treatment group and evaluating those in the group for treatment...An estimated 2.3 million children are currently HIV infected, with around 600,000 new HIV infections in children each year. Without treatment half of all babies infected with HIV die before their second birthday.

"Children with HIV infection frequently show rapid disease progression within the first year of life due to their developing immune systems and susceptibility to other serious infections," said Dr Elias Zerhouni, director of the U.S. National Institute of Health, in a statement on the study at an IAS conference. "This is the first randomised clinical trial that shows that infants treated before 3 months of age will do better than infants who have their treatment delayed," Zerhouni said.

Implementing mandatory testing in poor countries would be difficult, but should be a priority for the billions in AIDS funding that is pouring into these at-risk nations. Developed countries like the USA have no excuse. There should be mandatory and routine HIV testing of all newborns. Now.

India's Shame: 30 Bags Found Stuffed with the Bodies of Female Babies and Fetuses

This is the price paid when we reject human exceptionalism and its necessary corollary, universal human equality--in this case between females and males. From the awful story in the Telegraph:

Thirty polythene bags stuffed with the remains of female foetuses and newly born babies have been found in a dry well near a private clinic in the east Indian state of Orissa, police said yesterday.

Police suspect that the remains were dumped in the well shortly after birth or abortion at the clinic in Nayagarh district, 55 miles southwest of the state capital, Bhubaneswar. The manager of the clinic has been arrested...

India's cultural pogrom against girls is reaching holocaust proportions:

Despite laws banning sex determination tests, the killing of female foetuses is still common in India, where the preference for sons runs deep. Infanticide is also practised in some areas. The government has said that around 10 million girls have been killed by their parents--either before or immediately after birth--during the last 20 years. (My emphasis.)

I know the government is trying to stop this slaughter--but clearly not hard enough. And cultures change slowly. But there is no excuse whatsoever for this kind of carnage. Clearly, a crackdown is in order. Otherwise, the definition of genocide will have to be expanded to include mass extermination based on sex.

Canada Moving Toward "Mixed" Health Care System?

I once favored Canadian-style health care for the USA, but no more. Having visited that wonderful country frequently and paid much attention to its politics and culture, I reluctantly concluded that full nationalized funding--even with doctors remaining in the private sector--does not work. (We recently discussed this issue here at SHS with regard to the UK's National Health Service.) I thus shifted my thinking to supporting a combination of private/public health care funding to provide close to universal coverage.

Apparently Canada is moving slowly in the same direction--although with a far more limited private sector than I think necessary--at least for now. From the story in the Washington Times:

For the first time, private health care clinics are proliferating throughout Canada and arguments for allowing private physicians to practice freely are being heard. "You are seeing the Medicare orthodoxy of the last 30 years being questioned in Canada," said Dr. David Gratzer, a registered physician in Canada and the U.S., and senior fellow at the Manhattan Institute, a nonprofit public-policy think tank. "Over the last two years, the health care system has dramatically changed to allow more private health care."

The Supreme Court of Canada, widely viewed as among the most liberal in the world, nearly two years ago allowed a man in Quebec to buy health care on his own--striking down 30 years of precedent and giving advocates for private health care a major victory. The case is known as the Chaoulli decision, after Dr. Jacques Chaoulli, who took action against the system after a patient was forced to wait nearly one year for a hip replacement.

Chief Justice Beverley McLachlin and Justice John Major wrote in the decision: "The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care."

Currently, only about 1% of Canadian health care is delivered by the private sector. But the times may be a changin':

[A]s a result of the Chaoulli decision, the health care debate turned in favor of private financing. The largest impact of the decision has been to change the consensus on whether or not the health care system is sustainable. "It has changed the consensus on whether it's even just," said Brett Skinner, director of pharmaceutical-policy research at the Fraser Institute, an independent research organization in Canada. "There's an evolutionary change that's under way that will be incremental, year over year — a slow expansion of private options, and the development of private insurance for those things," said Mr. Skinner.

But despite a groundswell for more privatization in Canada, it remains illegal under federal law to pay for health care that is deemed medically necessary by a provincial government.

These are important shifts that could remedy what ails Canada (long waits for surgery and testing, many without a primary care physician, etc.). I remember giving a speech in Canada in which I got a big laugh by stating, "When I am in the USA, everyone says they want a Canadian style health care system. Now, here in Canada, I am hearing everyone wants a USA-type system." That overstates the case, of course, but the future seems clearly to be moving in the direction of nationalized care through a combination of private/public funding both in Canada and the USA. The sooner we find the right mix--which will probably be different in both countries--the better for everyone.

Coming Cure for Alzheimer's?

Actually, perhaps an effective drug treatment that can prevent the plaque from destroying areas of the brain. From the story:

Biologists have developed a compound which has successfully prevented the disease killing brain cells, improving memory and learning ability that was already damaged.

The researchers at the University of St Andrews, working with scientists in the US, have developed man-made compounds capable of blocking a nerve cell interaction known to lead to the symptoms of the disease.

Of course, there is much work yet to do--including full human trials to test efficacy and safety--and hence years probably before the treatment would be widely available. But this story is only one of many exciting avenues of medical and biotechnological research ongoing that is not controversial. Too often this fact gets lost in the hype and controversy over stem cells.

Man With Tiny Brain Fully Functional

This is an interesting story that demonstrates the astonishing adaptability of the body. A man was found with a brain only about 25% the usual size, and yet he is fully functional and not mentally impaired. From the story in the New Scientist:

A man with an unusually tiny brain manages to live an entirely normal life despite his condition, which was caused by a fluid build-up in his skull. Scans of the 44-year-old man's brain showed that a huge fluid-filled chamber called a ventricle took up most of the room in his skull, leaving little more than a thin sheet of actual brain tissue (see image, right).

Scientists say that the finding could challenge many presumptions about the brain:

The findings reveal "the brain is very plastic and can adapt to some brain damage occurring in the pre- and postnatal period when treated appropriately," [Lionel Feuillet, a neurologist at the Mediterranean University in Marseille, France] says.

"What I find amazing to this day is how the brain can deal with something which you think should not be compatible with life," comments Max Muenke, a paediatric brain defect specialist at the National Human Genome Research Institute in Bethesda, Maryland, US. "If something happens very slowly over quite some time, maybe over decades, the different parts of the brain take up functions that would normally be done by the part that is pushed to the side," adds Muenke, who was not involved in the case.

What is that old saying, what we don't know could fill a book?

Murder/Suicides Not About "Choice"

Now with the Lake County (IL) Coroner supporting some murder/suicides of the elderly, it is worth looking at some of the professional literature on the subject. It isn't merely another "choice," but often is a result of spousal abuse and depression. This is from an abstract of a 2005 article in the American Journal of Geriatric Psychology (13:211-217, March 2005):

Homicide--suicide perpetrators displayed significantly more domestic violence or were caregivers for their wives, in contrast to suicide perpetrators, who had health problems and were receiving care from their spouses. Both groups of perpetrators had reported depressed mood, and there were no differences in sociodemographic factors.

Conclusions: Depression plays a significant role in both homicide--suicide and suicide, but the associated factors are different: we see caregiving strain in perpetrators of homicide-suicide, and living with physical health disorders as a care-recipient in men who commit suicide. Marital conflict is a significant factor in some spousal homicide-suicides. (My emphasis.)

The answer isn't a pat on the back (figuratively speaking) to murder-suicides, as Coroner Richard Keller has done. It is unequivocal opposition to suicide--not to mention murder--suicide prevention, and increased and improved care for the at-risk elderly.

HT: Alex Schadenberg.

Coroner Supports Murder/Suicide for Elderly Couples

Lake County, Illinois Coroner Richard Keller, is apparently a fan of elderly couples engaging in suicide pacts or murder/suicide. From the story:

"Murder-suicide of an elderly couple, is that such a bad way to go?" he wrote [in his blog]...

Weeks after the Stanleys' [a local murder/suicide] deaths, Keller--a licensed doctor elected coroner in 2004--told the Daily Herald some elderly and ill couples should have that option. He hopes laws and public opinion would allow people to end their lives less violently and with more dignity than by using a handgun, perhaps with prescription medication.

The attitude has developed during his time as coroner, he said, prompted by deaths he's investigated. "It's been on my mind for a while...as you delve into some of these cases and see how ill some of these people were," Keller explained.

Along similar lines, Keller said he'd support legislation allowing physician-assisted suicide. "As long as it's controlled in some manner and meets a certain criteria, I believe that that's an option that should be there," Keller said.

How about helping people live rather than abandon them to murder/suicide pacts or joint suicides? Moreover, Keller seems unconcerned that many murder/suicides are the result of coercion or abuse. Read Rita Marker's account in Deadly Compassion of the joint suicides of Anne Wicket's folks, which Wicket and Hemlock Society co-founder (with Wicket) Derek Humphry facilitated. It is absolutely chilling.)

Also notice that Keller is not at all speaking of limiting assisted suicides or murder/suicides to the terminally ill. And the throwaway line about these killings meeting "a certain criteria" is mere window dressing. We are watching nothing less than the emergence of a distinctly pro-suicide culture--and yet even though it is in the open now and plain as day, the media continue to pretend that we are talking about strict limits and state supervision. It's time they paid better attention!

An Embryonic Stem Cell Fade

They can't blame Bush for this one: A Singapore company that made a big splash when it announced it would soon be offering ES cell therapies to human patients--has backed off. From the story in Science July 2007: Vol. 317. no. 5836, p. 305 (no link):

In a sign that hopes for quick medical benefits from stem cells are fading, ES Cell International (ESI)--a company established with fanfare in Singapore 7 years ago--is halting work on human embryonic stem (hES) cell therapies. Investors lost interest because "the likelihood of having products in the clinic in the short term was vanishingly small," says Alan Colman, a stem cell pioneer who until last month was ESI's chief executive. ESI's setback may dampen investors' enthusiasm for stem cell therapies, says Robert Lanza, vice president for R&D at Advanced Cell Technology in Worcester, Massachusetts: "What the field badly needs is one or two success stories."
...

The company was attempting to turn hES cells into insulin-producing cells to treat diabetes and cardiac muscle cells to counter congestive heart failure. Both conditions represent major markets with unmet clinical needs, but making well-functioning insulin-producing cells "proved really difficult," Colman says. Both envisioned therapies would need at least a billion cells for each human dose. Producing such numbers at the required purity "becomes very expensive," Colman says, and meeting these challenges would have taken longer than investors have patience for.

There is much whistling past the graveyard in the story, as well. For example, a spokesman for Geron Corporation claims that the company expects to begin human trials for spinal cord injury in 2008. The only thing is, it said the same thing for the years 2005, 2006, and 2007. Time will tell.

Tell This to Michael Moore

A young UK woman named Laura Price, age 30, has died waiting for a vital brain scan from the NHS. From the story:

Laura Price...was found dead in her home just hours after she had been discharged from casualty. The evening before she died, Miss Price...had begged a junior A&E doctor for anti-seizure drugs but had been told they could only be prescribed by a neurologist.

Two days earlier she had visited a specialist at Charing Cross hospital and was told she would have to wait six weeks [emphasis mine] for a brain scan. She had felt "concerned and afraid" at having to wait that length of time for a test before being treated for a recurrence of childhood epilepsy, Westminster coroner's court heard.

She had not had a seizure for more than 10 years, but after a series of "strange episodes", including a numb face and flashing lights in her vision, she had visited her GP and was referred to the specialist.

I agree that the US system is badly in need of reform. But a socialized system like that in the UK ain't the answer.

Good News on the AIDS Front

New drug cocktail combinations are apparently helping AIDS patients live longer and with fewer symptoms, and indeed, return blood counts to normal levels. From the story:

AIDS drug cocktails may be able to restore the ravaged immune systems of some people infected with HIV, researchers reported on Wednesday. Immune cells known as CD4 T-cells returned to normal levels in an ideal group of patients, picked because they responded optimally to a combination of at least three AIDS drugs, the researchers reported in the Lancet medical journal...

The study involved 1,835 HIV-infected people drawn from a larger study involving more than 14,000 patients from across Europe, Israel and Argentina. "I think it's very encouraging that if people can respond to treatment well enough and can suppress the virus for long enough, we have sufficient evidence to say their CD4 counts can return to normal," Dr. Amanda Mocroft of Royal Free and University College Medical School in London, one of the researchers, said in a telephone interview.

There is still much work to do:

Mocroft said not all HIV patients respond as well to these drugs, and many, particularly in the hardest hit regions like sub-Saharan Africa, do not have access to them.

This is good news, indeed. With such medical advances and appropriate behavioral modifications by those infected with HIV and their partners, this disease can yet be beat.

More Animal Rights Threats of Violence

I am quoted in this story about the continuing threat among the most radical animal rights/liberationists to engage in violence in the name of saving the animals. From the story:

Radical animal rights activists will likely use "any means necessary" to stop what they consider the torture of animals, according to one of the movement's most prominent spokespeople. "Nothing else works, and these people are torturing animals to death, and they should be stopped," said Dr. Jerry Vlasak, a press officer with the North American Animal Liberation Press Office. "If they won't stop after using every other [peaceful means], they should be stopped using any means necessary."In what would represent a major departure from the movement's traditional ban on violence against individuals, Vlasak said Americans can expect to see more violence done against "animal abusers," including university scientists who participate in animal testing.

I pointed out to the reporter that the ideology of animal rights/liberation--which creates a human/animal moral equality--is what logically leads the most unhinged within the movement to the conclusion that violence is acceptable in support of the cause. I also noted that PETA, while not itself engaging in violent tactics, has so far refused to condemn the tactics of ALF and SHAC, which engage in threats of violence, intimidation, property destruction, and other assorted terrorizing activities such as sending videos of the target's children taken at school or in a store, and assorted nasty behaviors such as posting Social Security numbers and personal information on the internet to allow identity theft. The reporter quotes a different part of the WEB site that extols non violence. This is the section ("Ask Carla") to which I was referring:

Throughout history, some people have felt the need to break the law in order to fight injustice. The Underground Railroad and the French Resistance are both examples of people breaking the law in order to combat injustice. PETA is a legal activist organization, but we realize that other groups have different methods and we try not to condemn any efforts in behalf of animals in which no one is harmed.

"The ALF," which is simply the name adopted by people acting illegally in behalf of animal rights, breaks inanimate objects such as stereotaxic devices and decapitators in order to save lives. It burns empty buildings in which animals are tortured and killed. ALF "raids" have provided proof of horrific cruelty that would not have been discovered or believed otherwise. They have resulted in officials' filing of criminal charges against laboratories, the citing of experimenters for violations of the Animal Welfare Act, and, in some cases, the shutting down of abusive labs for good. Often ALF raids have been followed by widespread scientific condemnation of the practices occurring in the targeted labs. Anyone can be an activist. It does not take any special skills or superhuman abilities. You just need to care enough about animals to want to help them.

Boy, does Ask Carla understate the case. In addition, I would point out that the French Underground killed Nazis and collaborators. If, God forbid, someone hearkens to Vlasak's call for violence, will PETA finally object?

Thoughts on the Dog Fighting Scandal

The brutes--meaning the people--involved in the dog fighting scandal should be punished to the fullest extent of the law and they should be shunned socially. Not only is the "sport" beyond cruel, but it involves training dogs to fight for purposes and in ways never seen in nature. Horrible.

The criminals engaged in this enterprise have not only besmirched the intrinsic worth of the animals involved, they have profoundly assaulted human exceptionalism by violating one of its major tenets: Our solemn duty to never treat animals cruelly or cause them harm for a gratuitous or frivolous reason.

I am also fascinated, as ever, by our reactions to the depiction of the fights that are running like looped tapes on the ever-voyeuristic cable news networks. Many seem more upset at seeing the dogs treated cruelly than they are by seeing people beaten or killed. I think that this reflects our greater empathy toward the innocent and the helpless. Thus, we react to cruelty against animals in much the same way that we do when children are abused.

We are the only species capable of that level of caring for those that are not "our own." So, this story is steeped in human exceptionalism: both in its violation and in our outraged reaction to those who would so undermine their--and our shared--humanity by treating animals in such a vicious and despicable manner.

Postmodernism Comes to Death Itself

In postmodernism, facts don't matter as much as desired narratives, and now this view is being proposed as a way to define death itself--which would permit people to choose ahead of time when they were to be considered to have, as the Bard had it, shuffled off this mortal coil.

This is not a new idea and its most prominent advocate is probably the Georgetown University bioethicist Robert Veatch, who suggests that people decide for themselves when they will be considered dead for organ harvesting. From the story about all this in Reuters:

Most ordinary people, including most physicians, assume whether you're dead or alive is a science question," Veatch, a Georgetown University medical ethics professor who has lectured about death and dying for over three decades, told Reuters.

"In my view, it's a philosophical and religious issue and different people have different views on the matter," he said at a bioethics seminar at Georgetown's Kennedy School of Ethics. Thanks to medical progress, terminally ill patients or victims of severe accidents can be kept on life support far beyond the point where they would have died naturally.

Veatch asked if being permanently unconscious and dependent on feeding and hydration tubes is still really life. If not, then people taken off that support are not killed, he argued, but are "made dead" or they "become dead".

The traditional view is that death occurs when the heart and lungs stop. Since the 1970s, Western countries have defined it as the irreversible loss of the entire brain's functions.But the brain stem can keep basic functions going -- such as breathing -- even in a permanent vegetative or comatose state.

So since 1973 Veatch has been advocating a third definition saying that death sets in when the higher brain functions--the thinking and feeling that make us human--are lost.This means death comes when consciousness is permanently lost, he said: "If you've got the substratum in your brain for consciousness, you're alive. If that's gone, you're dead." Veatch suggests the law set a default definition, most likely whole brain death, and let individuals opt out and sign a statement saying they want to be declared deceased either by cardio-respiratory death or higher brain death.

Except that it would be a fiction, based on a narrative that would have the effect of transforming death from a biological event into a sociological one. Moreover, it could well lead to the confusing circumstance of one living, breathing person being declared dead, while the patient in the next bed with the same symptoms would still be considered alive. And once we get to decide when we are dead, why limit it to the profoundly disabled. There are plenty of people who suffer terrible tragedies who consider their lives over: Why not just make it official? Worst of all, if some dead people were actually living, we couldn't bury them--which I guess would create the need for someone to knock them on the head with a hammer or inject a drug to the "cadaver's" beating heart to actually get the job done so that organs could be harvested. Hey, Jack Kevorkian is looking for work!

Maybe we should just ask plumbers what to do. At least they tend to have common sense.

Brave New World Podcast: The War Against Unique Human Moral Worth

In this edition, I address some of the threats to human exceptionalism and a recent New York Times article that opened an unexpected new front in this ongoing conflict: Animal "ensoulment." Check it out here.

Subscription Now Available

I have been asked to add a subscription capability to the site, and so I have--I think. I am pretty techno-maladroit, so I would appreciate hearing whether I properly installed the function. Thanks to all who support Secondhand Smoke.

Anti-Humanism Gaining Traction

Here we go again. Newsweek reports--in surprisingly positive terms--on the movement to rid the earth of the vermin species--us:

Environmentalists have their own eschatology--a vision of a world not consumed by holy fire but returned to ecological balance by the removal of the most disruptive species in history. That, of course, would be us, the 6 billion furiously metabolizing and reproducing human beings polluting its surface. There's even a group trying to bring it about, the Voluntary Human Extinction Movement, whose Web site calls on people to stop having children altogether...And "four out of five" of the people he's told about it, he estimates, thought the idea sounded wonderful. Since we're headed inexorably toward an environmental crash anyway, why not get it over cleanly and allow the world to heal?

Over time, though, Weisman's attitude toward the rest of humanity softened, as he thought of some of the beautiful things human beings have accomplished, their architecture and poetry, and he eventually arrived at what he views as a compromise position: a worldwide, voluntary agreement to limit each human couple to one child. This, says Weisman--who is 60, and childless after the death of his only daughter--would stabilize the human population by the end of the century at about 1.6 billion, approximately where it was in 1900. And then, perhaps, more of the world could resemble Varosha, the beach resort in Cyprus in the no man's land between the Greek and Turkish zones, where, Weisman writes, thickets of hibiscus, oleander and passion lilac grow wild and houses disappear under magenta mounds of bougainvillea.

The anti-human movement--lets call it anti-humanism--is clearly gaining traction when an MSM outlet of the caliber of Newsweek reports positively about the "intriguing thought experiment" of doing away with all people. To me, respecting such notions--even if in a bemused manner--is a disturbing symptom of a view that evolves all too easily from the abandonment of human exceptionalism.

Besides, if all the people were gone and earth did return to an alleged paradise: What difference would it make? Only human beings give meaning to the beauty of nature. Only human beings appreciate the grandeur of fauna and flora. Only human beings have stepped sufficiently outside of nature to be able to look back at it as something worth protecting. Indeed, were we to disappear, the remaining denizens of the meaningless planet would just go on and on, suffering through the brutal and desperate tooth and claw struggle for survival utterly indifferent to the awesome beauty that our elimination would bequeath.

A Biologist Urges Wisdom in Human/Animal Chimera Creation

There was a good column in the July 16 Boston Globe by Vivek Ramashwamya, a biology student, urging restraint by scientists in the creation of human/animal chimeras. He writes:

If the creation of these new organisms bothers us as a society, we must ask ourselves why. We cannot merely dismiss human-animal chimeras as "unnatural," or else we would have just as easily dismissed recombinant DNA technology or any other scientific improvement upon nature. Nor can we merely accept that creating chimeras is ethical because of the potential medical advances; to do so begs the larger question of when ethical considerations should trump scientific inquiry... [P]olicymakers should use the following simple principle as a guide: one should treat a recipient of transferred humanity with the same level of respect as an organism with inborn humanity -- in other words, a human being. Even if an organism does not appear to be fully human in biological terms, it nonetheless deserves the moral value of a human being, as long as it possesses the qualities that our society has deemed worthy of human respect.

There is no societal consensus on what qualities merit such respect. But nearly everyone agrees that the capacities for language, consciousness, or rationality are probably among them. If a human-animal chimera (such as a monkey with a human-like brain) comes to possess any of these qualities, then it would be morally objectionable to create that organism. Meanwhile, certain chimeras, such as a mouse with human skin grafts or human muscle cells, pose no serious ethical risk.

That would be a good start. Scientists should agree to restrain themselves in making these transgenic and chimeric animals so as to give society the time to hash all of this out (with their input, to be sure). The goal should be to craft binding international regulations that would permit the areas of inquiry that pose "no serious ethical risk," in Ramashwamya's words, while also ensuring that scientists don't manufacture quasi-humans.

Don't hold your breath for "the scientists" to embrace this eminently reasonable approach. Too many leaders of the Science Establishment worship at the church of scientism. And scientism sees science as an end rather than a mean and disdains most restraint as an infringement on the fundamental (and some say, constitutional) right to engage in scientific research. Add to this mix public intellectuals--such as the transhumanist leader James Hughes (Citizen Cyborg)--who fervently yearn for the creation of such creatures as a way of knocking humans off of the pedestal of exceptionalism. But as Leon Kass wrote (I think), it would be a terribly cruelty to manufacture a human/animal chimera possessing sufficient levels of human reason to know that it was the artifact of an unethical and inexcusably selfish scientific experiment.

UK Moving Toward "Presumed Consent" to Organ "Donation?"

So much for "donating" organs. Britain's most senior doctor will recommend that when a person dies, that his organs be taken--unless he or she previously opted out--barring concerted objections from family.

Known as "soft presumed consent," such a plan could be disastrous and destroy the confidence people have in medicine--particularly in the UK in which the NHS is imploding and health care rationing is already encroaching on Hippocratic medical values. Here's why: If every patient were deemed by law a probably organ donor, the temptation--particularly given the increased influence of utilitarian bioethics--would be to view the sickest patients as so many organ systems whose primary worth would be to help other people. The fear among the people would be that the critically ill--particularly otherwise "healthy" people with significant cognitive impairments--would be treated (or non treated) in a way to benefit potential organ recipients rather than the patient him/herself. Paranoia would strike a beat/Into your life it would seep...

Will Saletan Hits a Home Run

I am a big fan of Slate's Will Saletan. He is a wonderful writer, he has a way of looking evenly at all sides of biotech issues, and even if I don't always (usually) agree with him, he is always well worth reading and pondering. Saletan scores in his newest column, about attending a "Progressive" bioethics conference. Please read the whole thing, but here are few choice tidbits:

Lately, "progressives" have taken to issuing talking points. Every time a peer-reviewed science journal reports some new way of deriving embryonic stem cells without having to kill embryos, I can count on receiving a "progressive bioethics" e-mail that warns me not to be distracted by such fantasies. Bioethics has become politics by another name.

Why are liberals playing this game? Because conservatives beat them to it. For the past several days, while eating lunch at my desk, I've been watching video of the liberals at a conference they held last year. I know, I need to get a life. But the video is kind of poignant. It shows a bunch of nerds commiserating about being beaten up by a gang of bullies. The bullies, according to the nerd movie, are Bush-appointed neoconservative bioethicists who do the bidding of the Christian right.

To fend off the bullies, the nerds have seized on stem cells. Some of them think embryonic stem-cell cures are just around the corner. Others know better but believe in the research anyway. What unites them is awareness that stem cells score very well in polls, much better than anything else on their agenda. Of 32 commentaries posted on the Web page of the "Progressive Bioethics Initiative," 26 focus on stem cells. Some don't even address ethics; they just lay out the polls. Stem cells are a chance for liberal bioethicists to beat the living daylights out of their opponents.

Good stuff. I have noticed too, that many on the Left are substantially reactive, which gives the "religious right" a lot of power: They get to decide what they believe and, because "the Left" reflexively take the opposite view, they get to decide what "progressives" believe, too.

Saletan then pronounces why he is a liberal, about which I have a bone to pick:

[W]hat makes me think I'm still a liberal? I guess it's a stubborn belief that liberalism isn't whatever dogmas currently possess this or that lefty camp. Liberalism is an admission of uncertainty. It's open to self-correction and to the complexity and unpredictability of life. Many ethicists and other self-described liberals don't fit or accept that definition. But I do.

No, that is a relativist. People need to be open-minded, sure. Open to persuasion and new ideas, absolutely. But not uncertain about critical truths. Indeed, liberals of my era were not at all uncertain. They were for civil rights unequivocally. They were against Vietnam, unequivocally. They believed that it was the duty of government and society to protect the weak and vulnerable, unequivocally.

What went wrong with liberalism, in my view--or better stated, one of the many things that went wrong--was that it lost its certainty about the intrinsic value of human life. So today, true liberals are called neo-cons. Go figure.

Kass v. Pinker at the Intellectual OK Corral

This exchange between Leon Kass and Stephen Pinker in Commentary is superb, and I must say, Kass wins the exchange hands down. (Full disclosure: I am an enthusiastic Kassophile. I consider him to be, perhaps, our most wise and profound public intellectual.)

The exchange was sparked by an article Kass wrote previously about scientism and its threat to meaning and morality. (Here's the link.) Pinker takes polemic exception to almost all of what Kass had to say, and receives from Kass at least as good as he gives.

Both letters are quite long and so I can only reproduce a highly abridged version of them here, focusing on one narrow point of disagreement. Let's start with Pinker:

Mr. Kass believes he is doing the world a service by arguing that modern biology--and the larger enterprise of science and secular reason of which it is a part--poses a grave threat to meaning and morality. One may question whether the sowing of such fear is wise. Progress in our understanding ourselves as part of the natural world is intellectually exhilarating, conducive to human flourishing, and probably unstoppable. Rather than insisting that morality is a fragile Judeo-Christian antiquity that must be sheltered from the blossoming of knowledge, one could show, as philosophers have done for millennia, that it has a robust foundation that is of a piece with that knowledge. Morality is rooted in the interchangeability of perspectives: the fact that an intelligent social agent, in dealing with other such agents, has no grounds for privileging his interests over theirs. Growing from an innate kernel of empathy, morality has been expanded by a cosmopolitan awareness that encourages people to imagine themselves in the shoes of people unlike themselves. No small part of this awareness is the modern biological sensibility that we are a single species, made of the same stuff arranged in the same way, and therefore with fundamentally similar feelings and interests.

To which points Kass responds:

Mr. Pinker is a careless reader and an even more careless thinker. I never said that modern biology poses a grave threat to meaning and morality. I said that scientism posed such a threat. I never said that progress in understanding human nature was not conducive to human flourishing or was anything but exhilarating, though I did say that scientism's faith in science's unqualified goodness was a moral prejudice that science itself cannot provide or confirm.

Indeed, nowhere is the silliness of Mr. Pinker's thinking more evident than in what he says about morality. How comforting to learn that morality is rooted in the fact that, thanks to our ability to see other persons' perspectives, no intelligent social agent has any grounds for privileging his own interests over theirs. How wonderful to learn that this cosmopolitan moral truth is supported by the discovery that we all share human DNA. Do the descendants of Darwin know nothing of competition and the survival of the fittest? Does their naturalistic morality really teach that it is immoral to "privilege" feeding my own children first? Or does not morality begin, rather, with the need to control nature, precisely in opposition to the excesses of naturally given self-love and love of one's own and (starting with toilet training) the unruliness of natural desires that embarrass rational self-command? Even leaving aside greed, cruelty, and natural lust, what about amour-propre--that natural form of comparative self-love found only among human animals and, famously, among scientists--that insists on recognition from and superiority to one's fellows?

These are among the most important issues we face engaged by two of the most prominent and capable protagonists in the struggle. For those interested in these matters, it is worth the time to read Kass's original article, all of Pinker's reply and Kass's rejoinder--as well as the other published letters-to-the-editor and Kass's replies.

The Tall and the Short of It: Ah, Those Exceptional Humans

This is a great picture published in the UK's Daily Mail memorializing a meeting between the world's tallest and shortest men. It's a hoot. And it got me to thinking about the wonderful diversity of our species.

Bao Xishun is 7 ft. 9 in., while Pingping is 2 ft. 4 in. Because we generally don't measure moral value by stature (at least, not any more), I doubt whether anyone would dispute that both Misters Xixhun and Pingping are equally human beings possessed of equal moral worth. Would that all humans--regardless of their "attributes or capacities" were so perceived.

Treatment for Depression Reduces Suicide Attempts

This story is quite pertinent to the trend among some in society to dismiss suicide prevention as paternalistic, and to promote assisted suicide for even the mentally ill. Treatment for depression reduces suicide attempts:

The study, in the American Journal of Psychiatry, involved an analysis of 70,368 depressed patients prescribed an antidepressant drug by a primary care physician, 7297 prescribed an antidepressant by a psychiatrist, and 54,123 treated with psychotherapy.

Medical claims were reviewed to assess the occurrence of suicide attempts 90 days before and 180 days after beginning treatment. In all three groups, the rate of suicide attempts was highest in the pre-treatment period, followed by the 30-day period after starting treatment. Beyond 30 days, the likelihood of suicide attempts continued to fall.

The investigators found that teenagers and young adults had the highest suicide attempt rates, but the trends related to treatment were the same as in other age groups.

Promoting "rational suicide" and facilitation for some won't help in treating these despairing people. It would be like society telling teenagers that they, maybe, probably shouldn't smoke, but if they--choose cigarettes with a filter.

Assisted Suicide Eviction

Can you blame them? The housing association where the Swiss assisted suicide organization Dignitas maintains a death apartment, has evicted the group because other residents are sick of the suicide parade.

It is a familiar sight for the residents of Zurich's Getrud Strasse number 84. Three or four times a week, during office hours, an ambulance pulls up in front of the unassuming dirty grey housing block. A body is carried out of the building in a charcoal-coloured sack. Often the tenants meet it propped up vertically in the lift on the way down, or in the narrow corridor, before it is placed in the vehicle and driven away.

What a surrealistic scene--perhaps even more than Kevorkian helping extinguish people in his rusty van.

Yet as awful as that depiction is, the reaction of one of the tenents is, to me, even more disturbing:

Gloria Sonny, 55, who has lived in the building for six years - or, as she calls it, "under the same roof as death"--headed a petition calling for Dignitas to go. "I'm not against assisted suicide," she said, "but this is a place where people live. It's the wrong place to help people die. I don't see why I should pay with the quality of my life because Switzerland deals with the topic in a more liberal way than other countries."

She said the building smelt of death and that she suffered nightmares that she would be forced into one of the "death flats" against her will and made to drink a fatal cocktail.

How twisted we have become: Sure, go ahead and help kill them, just don't make me have to look. For someone my age, who remembers society's once unequivocal support for suicide prevention rather than facilitation, this whole story is almost unimaginable. But the times they are a changing, as Dylan had it, and not necessarily for the better. Unless we reject the terminal nonjudmentalism--illustrated so vividly by Ms. Sonny--that is increasingly permeating society, one day cities might begin issuing zoning permits for euthanasia clinics--think E.G. Robinson going "home" in Soylent Green. After all, it isn't the killing that is wrong: It is the poor aesthetics.