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 sym