Time to Defend Human Exceptionalism in the Professional Journals!
Many of the chances we see in society today, were gestated decades ago in professional journals and law review articles, which from what I have seen, tend to be pretty uniformly pushing society in one direction. Example: Today pulling feeding tubes from cognitively disabled patients is routine. I doubt this would have happened--because it was once unthinkable, but for the many professional journal articles written in the 1980s that promoted the policy.
Case in point, a 2007 article in the Tulsa Law Review (no link, have copy) promoting Futile Care Theory: As readers of SHS know, I believe that medical futility is part of an overarching attempt to shift society's fundamental value away from being focused primarily on individual worth, to a more collectivist approach of the kind warned against so vividly in the old sci-fi flick, Logan's Run. Be that as it may, I think it is very dangerous because it turns over determining when a life is worth living from patients and families to doctors and bioethicists.
The author makes this point chillingly explicit:
Physicians, because of their expertise and thorough education, are best able to determine when a patient is no longer benefiting from life-sustaining measures. A survey shows that ninety percent of patients feel that doctors are accurate decision-makers as to end-of-life care. n332 After a physician makes a judgment, an ethics committee further examines the futility determination. Because a concrete, and agreed upon definition for the term "futile" appears to be unattainable, physicians should be the primary, if not sole, judges, and decide when continued treatment is unnecessary, unethical, and no longer serves any purpose. Their judgments and decisions should be recognized and respected as legitimate, thoughtful, and final.Nothing new here, of course. I bring it up because a judge might one day rely on this article (among others) in determining that medical futility is constitutional. Indeed, that is why it was written.
Articles published in intellectual and professional journals that receive little or no public discussion, are very important as they become the intellectual ammunition (if you will) for the guns that seek to destroy human exceptionalism, particularly in the courts. Thus, as I have occasionally remarked about here, we see journal articles pushing assisted suicide, a radical constitutional right to conduct scientific research, for animal moral and legal equality, etc. etc., all of which are written in the hope that they will one day influence courts or policy makers to go along. And if there is a dearth of material on the other side--which seems to be the case--that influence can be greatly magnified.
And I worry that those with the expertise and ability to counter these arguments in the intellectual spheres tend not to man the ramparts defending the sanctity and equality of human life. Perhaps this is based on the blithe assumption that "It can't happen here." But anyone who thinks that today is just not paying attention. Indeed, given that a Swiss ethics panel has promoted what could be called plant rights, things are becoming so extreme that you can't even engage in parody because they catch up to you.Law students, doctors, lawyers, Ph.D.s and others who wish to maintain a society based on human exceptionalism need to be just as active in the "learned journals" as are those who support policies that would destroy it. And believe me, they are active. Are we?
posted by Wesley J. Smith @ 9:15 AM
9 Comments
9 Comments:
It is ironic that those pushing for doctors to "exercise their judgment" and kill patients are likely the same ones who think that doctors do not have the right to act in accordance with their judgment if it involves abortion, fertility care, or euthanasia when the doctor holds to the hippocratic oath.
I suspect that law students, lawyers, doctors, and Ph.D.s who would argue for human exceptionalism are themselves the exception in their fields. I know from my time in law school that those who argue against the commoditization of humans or for supporting tried and true institutions that have served to keep civil society civil, run the very real risk of being marginalized as "religious extremists". Using a non-religious argument is no cover against this charge and it should not be underestimated the pressure that professional students are under to conform to the culture of death
(under the label of tolerance).
Once out of school and in the workforce this pressure becomes even more intense as it can determine whether you get the job, promoted, etc. Without the proper "credentials" it is much harder to get your unpopular and intolerant articles in favor of human exceptionalism or any other topic published. If you do get them published, they can negatively effect your career options.
Only those who have already established themselves are willing to break ranks and it seems to me that the pool of students is becoming ideologically more conformist with every passing year thus lessening the chances that more professional will step up to the plate and join you in the fight.
The author of the article writes, "A survey shows that ninety percent of patients feel that doctors are accurate decision-makers as to end-of-life care." It would be interesting to see how the actual survey question was worded. As one who has designed a number of surveys and critically examined many more, I have come to learn two things:
- The way that you word a question goes a long way towards determining the answer you're likely to get; and
- Survey results sometimes don't prove what the authors say that they prove.
I believe that Jessie has brought out some very interesting tangents along the linear path that the legal definers have applied towards declassification of our human exceptionalism. And Makarios has applied an astute observance as to how such paths are built. I have no sense of shame in noting that the humankind are exceptional as we look at a chimp using a stick to pull termites out of a mound against a backdrop of the Space shuttle returning from the planting of another satellite. Why are some folks so anxious to feel shame that we are such a moralistic complicated species in comparison to other life forms?
I must also provide a personal journal on the points that Wesley brought up.
My dad was a diabetic who had a very mercurial fluctuation in sugar levels. It was hard to control his sugar levels. He had a heart attack and palliative care took over. They had a Dr that was a walking pill box take over his care. My dad was kept so comatose most of the time that he was incapable of recovery unless the drugs were cut back. One morning he questioned the Palliative care doctor as to why she was giving him a constant supply of drugs. She affirmed his and my suspicions as she stated , She "was there to teach my dad how to die and make the trip easier." Dad looked her straight in the eye and asked her, "how many times she made the trip herself to the afterlife." She had this emotionless face that answered "I suppose that was a poor choice of words." My 72 year old dad answered in his best slang "Yah ThinK!!!! And then stated, "You know something doctor, I am not afraid to die but I am not tired of living either."
I met with dad's family Doctor in a downstairs lobby. He is a straight shooter ,so I told him that dad was not getting recovery meds but drugs to knock him down. He then asked if we had placed dad in palliative care and noted that he didn't nor did he think dad should be there. We then went up to dad's room and he checked dad's charts. He became quite upset when he read the drug dosages.He told dad that he was getting enough drugs to put down a horse.
He told the nurse to tell her supervisors that he was taking over dad's case and the Palliative care doctors were to stay out of his room. Dad recovered enough to get four more years of life and we shared some great family times in his home and not beside his gravestone because Palliative care decided he was suffering to much by staying alive. Some of my best memories are of visiting dad in his home after almost losing him to a heart attack and palliative care drs.
Dr Ryan ,his family G.P. fought the fight that his Hippocratic Oath assigned to him. Our family will always be grateful. Dad was a very smart mind and the four years that he lasted after he should have died in Palliative care, were great moments for my own mind.
Donnie: Good for your family for protecting your dad.
As to your question of why people want to trod the path of human unexceptionalism: I think there are many reasons, but here are two that I really think are true. Humanism is now anti humanism in that there is a hypoer-romanticism afoot that projects innocence and Edenic attributes onto the natural world, ignoring its true tooth and claw nature. I think in this sense, it is almost a new earth religion. We will "save the planet" only when we realize we are not exceptional. Of course, only an exceptional species could either destroy or save the planet, but I digress. And only a species that understands it has unique dutes because of its exceptionalism would do so.
For others, it is a way to destroy theism, at least the branches that views humans as at the center of importance in this life. Theism is seen as oppressive of certain life styles and infringing on human freedoms. In this view, it has led to wars, stifled progress, created guilt, and kept us under the chains of ignorance There may not be a God but that means, to quote Nitsche, we are in charge.
The fox can kill the last rabbit and know no sense of the natural history of that rabbit nor its value to the natural world. We are exceptional because we know it is morally wrong to kill the last rabbit but common sense to cull individual rabbits so they don't eat the last orchid. For me the Living God planted a moral code in us to take our natural ability in Sciences, Math & understanding of our natural world to be His bean counters and protective force in nature. We have often strayed because of greed or ignorance but I think it is exceptional that we are the only animal that cares to try to balance & protect all animals and the planet. Destroying God will not make man a more moral being anymore then claiming we are as base as any other animal will supply a better sense of morals. Humanism will fail because it will destroy our exceptualism and supply us with anti-human values by increasing the values of other animals in my opinion. For me,I will honor God who gave Noah the absolute salvation of the animals that would enter the Ark, while God decided which humans were unfit to walk aboard. Wink.
One volunteer so far. Let's go for more.
This comment has been removed by the author.
What constitutes appropriate, compassionate end-of-life care (and who participates in this decision) has nothing to do with human exceptionalism. And to reflexively accede to the 'technological imperative' in all end-of-life situations does not necessarily make us more vituous care providers. Each case is different. This is not a slippery slope. Rather it's where we actually live.
But there is a real danger lurking in the implicit suggestion that in end of life situations, physicians should abdicate evidence-based medicine and simply provide care on demand like waiters in a medical restaurant. This position incorrectly assumes that these very vulnerable patients never die horribly extended, often painful, & terribly undignified deaths that often drains their life savings in the process. Many do-- needlessly. Their very real suffering is effectively ignored due to the ideological beliefs of the family and the passive health care system's failure to advocate for their critically ill patients.
I have yet to hear Wesley explain why end-of-life medical care deserves exceptional status (that is, families get to decide) while conventional medical treatments should be based on medical standards of care (doctors decide which treatments constitute reasonal options). Maybe this time?
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