Tuesday, July 31, 2007

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.

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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.

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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.

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Monday, July 30, 2007

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.

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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.

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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.

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Sunday, July 29, 2007

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.

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Friday, July 27, 2007

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.

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"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.

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Thursday, July 26, 2007

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.

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Wednesday, July 25, 2007

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.

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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.

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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?

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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.

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Monday, July 23, 2007

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.

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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.

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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.

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Saturday, July 21, 2007

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?

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Friday, July 20, 2007

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.

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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!

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Thursday, July 19, 2007

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.

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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.

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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.

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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?

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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.

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Tuesday, July 17, 2007

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.

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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.

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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.

Monday, July 16, 2007

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.

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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.

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Sunday, July 15, 2007

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...

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Saturday, July 14, 2007

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.

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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.

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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.

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Friday, July 13, 2007

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.

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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.

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Thursday, July 12, 2007

New Task Force UPDATE Now Available


The International Task Force on Euthanasia and Assisted Suicide is an invaluable educational resource in the fight against euthanasia. The Task Force publishes the highly informative Update, an essential tool to keeping up to date on the fast-moving euthanasia issue.

The current edition is now out. One of the most interesting articles exposes how Oregon has recently begun to severely truncate the information it releases in its annual (increasingly useless) annual report. Here is an excerpt:

Adding insult to the injury of questionable data in previous assisted-suicide reports, the Oregon Department of Human Services (ODHS) issued its latest "Ninth Annual Report on Oregon's Death with Dignity Act" in an abridged format so short that it prompted one Oregon doctors' group to call it "amazingly brief and incomplete."...Data missing in this report included the number of lethal prescriptions written by individual doctors, a statistic included in some previous reports. Also missing were explanations as to why statistic totals for previous years were changed in the 2006 tables (see chart)--making the questionable data even more suspect. Furthermore, doctors were present for only 15 of the 46 PAS deaths, so the exact circumstances of most deaths were not directly observed by reporting doctors. ["Ninth Annual Report on Oregon's Death with Dignity Act."]
The Update is not about polemics, but rather, the dissemination of accurate information (citations included). This is a good approach: The more people learn about euthanasia the less they tend to support it. Check it out.

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Should Organ "Donors" Be Put at Front of Organ Transplant Line?


I received an e-mail from David Undis, the executive director of LifeSharers, alerting me to a column he wrote promoting the creation of an organ transplant priority list that would put those who signed donor cards at the front of the organ transplantation line. Thus, Undis writes:

[R]egistered organ donors who need transplants are treated no better than people who have declined to donate their organs when they die. As a result, every year, thousands of registered organ donors die waiting for transplants when the organs that could have saved their lives are given to nondonors. LifeSharers is an organization that seeks to rectify the situation by giving preference to organ donors. Not only would this make the system fairer, but the effect of moving donors to the front of the line would be to increase the number of donated organs available for everyone.

At first blush this sounds fair. But is it? After all, there are plenty people whose organs are donated who have not signed donor cards, while there are also certainly people who signed donor cards whose organs are not donated due to family objections or for other reasons. More importantly, creating a VIP system for organ transplantation that would explicitly circumvent the organ triage system that matches the first available organs with the sickest people, could cause tremendous turmoil in that it would allow a less sick person who signed a donor card to cut in front of a more seriously ill person who had not signed a donor card.

Here's another aspect of Lifesharer's that I find disturbing:
LifeSharers members agree to donate their organs when they die. They also agree to offer them first to other members, if any member needs them, before offering them to others. This is done through directed donation, which is legal under federal law and in all 50 states. There is no age limit, and parents can enroll their minor children. LifeSharers has more than 9,200 members and has doubled its membership in the last year.
That might be fine for live donations, but I am not sure it is right for cadaver donations.

While the idea of LifeSharers is certainly well-meaning, and I applaud Undis' commitment to increasing the donor pool, in the end, I don't think that its approach is wise. First, I don't think most people would really respond to the carrot of being placed on the priority list, until that is, they became ill and needed an organ transplant. So it wouldn't really serve the purposes for which it is intended because most members would be recipients and not donors. Second, it sets up a private barter system that interferes with the triage process. If the idea took off, it seems to me that the entire organ distribution system could be well on the way to collapse. Moreover, there would soon be other categories of do-gooders (which I mean literally and not as a pejorative) who could also claim that they deserve special consideration for organ transplantation.

There is no doubt that we need more organ donations--although with greater auto safety standards and motorcycle/bicycle helmet laws, it is likely that the number of people with catastrophic head injuries--the prime organ donors--will continue to decline. No, rather than turn organ procurement into a quid pro quo system, I think it best to increase public confidence in the system by maintaining rigorous ethical parameters for organ transplants, setting national standards to which every transplant center and hospital must adhere, and educate, educate, educate.

Thanks to Dave Undis for alerting me to LifeSavers and for his commitment to saving human lives.

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Wednesday, July 11, 2007

Bobby Schindler Makes a Point


Bobby Schindler, Terri Schiavo's brother, has commented on a phenomenon I have also noticed: The propensity of the media to continually distinguish Terri's case from other examples when purportedly unconscious people awaken, or dehydrations are stopped because the patient is found to be much more aware--as in the Haleigh Poutre and Ron Comeau cases. He writes about it in "Please Don't Confuse This Story with Terri Schiavo." Here are a few excerpts:

One can't help but wonder if perhaps the mainstream media is feeling a growing sense of uneasiness regarding Terri's death. In the two years since my sister died I have witnessed an increasing determination on their part to convince the public that she was "hopeless" and in a persistent vegetative state (PVS) regardless of any and all evidence to the contrary.

I believe this is happening because of the increasing number of questions now being raised as to the veracity of the PVS diagnosis, which was the litmus test used to kill Terri--a litmus test which is still being used to justify the killing of others who are said to be in this condition. Just last month researchers found that over 40% of the people diagnosed as being in a PVS are, in fact, misdiagnosed. This new study confirmed an already existing British study regarding the high rate of PVS misdiagnoses...There have also been a growing number of persons diagnosed as being in "vegetative" conditions, predicted by doctors to never to regain consciousness, who have unexplainably awakened.

He gives several examples of this ubiquitous media approach, and writes:

One has to wonder why the media goes to such extravagant lengths to distance Terri's case from anything and everything that might connect her to a positive development or outcome. Perhaps it is because they realize just how culpable they are in her death. Rather than report the facts of her case, the media championed the cause of the so-called "right to die" movement. They wrote Terri off as "hopeless" from the beginning and never bothered to examine the reality of her situation. By trumpeting the decision of the judge who sentenced her to die, handling with kid gloves the "husband" who sought to kill her and giving a platform to euthanasia advocates, the media abdicated all responsibility to present the truth to the American public.

True, true, and true.

But what about Terri's famous autopsy that confirmed she was PVS? Uh, it didn't:
And let's not forget the autopsy which did NOT prove that Terri was PVS. The fact of matter is that the media--incredibly--continues to distort the autopsy with the public believing, all the while, that it confirmed Terri was in PVS. Dr. Thogmartin, who performed Terri's autopsy clearly stated, on at least three separate occasions, that he was unable to conclude whether Terri was in a PVS because it is a clinical diagnosis (person must be alive) and cannot be confirmed by autopsy. Even more significant was the statement of Dr. Thogmartin's colleague, neuropathologist Dr. Stephen Nelson, who said he could not rule out that Terri may even have been in a minimally conscious state (MCS) which is a higher level of consciousness than PVS.
Of course, it didn't matter to the Schindlers whether their beloved Terri was conscious or unconscious. They simply wanted to love and care for her for the rest of her days. Too bad the media is so intent on convincing everyone that her family was wrong.

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Umbilical Cord Blood Saves Leukemia Patient

The Seattle Times has a hopeful story about a patient who couldn't find a compatible bone marrow donor, being effectively treated for leukemia by umbilical cord blood stem cells. UCB stem cells are much easier to match than bone marrow, but for adults there has always been a problem:

But adults are bigger [than children who have benefited from UCB stem cell treatments], and they need far more stem cells than children to quickly replace those killed off by the procedure. That includes white cells to protect against infections and disease. As a result, adults are vulnerable to potentially fatal infections for about 25 days after such a transplant, while the cells reproduce and build a new immune system.

But never underestimate the creativity of scientists:

Now, Dr. Colleen Delaney, a Hutchinson Center oncologist and researcher, thinks she may have found a way around the problem. Before transplant, the cord-blood stem cells are placed in a special culture that stimulates them to reproduce quickly. The technique draws on the research of Dr. Irwin Bernstein, a Hutchinson Center pioneer in learning how stem cells develop. Delaney has expanded the number of blood stem cells 150-fold in just 17 days. That reduces to 15 days the amount of time a patient is most vulnerable to infection. Scientists at other institutions have tried similar technology but increased the cells only fourfold. "This can open up a whole new donor pool for people who can't find donors," Delaney said.

This is still early experimentation. But there is a lot of hope out there.

HT: Deborah Kelly

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Hint of Things to Come? Post Implantation Embryonic Stem Cells Discovered in Mice


I do not believe for a second that in the long term, embryonic stem cell research will be limited to early pre-implantation embryos destroyed in Petri dishes. Indeed, as I have repeatedly noted, New Jersey has already legalized human cloned fetal farming, only requiring that cloned fetuses be destroyed before the moment after birth. (This can't be done yet, technologically.) Along this line, companies like Advanced Cell Technology have already conducted cloned fetal farming experiments in cows.

And here is another hint of things to come: Scientists have found pluripotent ES cells in post implantation mouse embryos. From Nature:

New cell lines from mouse epiblast share defining features with human embryonic stem cells. Mouse and human embryonic stem (ES) cells use different signalling pathways to maintain their pluripotent status. Now, a new kind of pluripotent ES cell is described. This cell type is derived from mouse embryos after they implant in the wall of the uterus, and shares many defining features with human ES cells, including signalling responses that control differentiation to somatic fates.
Of course, this does not mean necessarily that scientists will want to study the same ES cells in humans--assuming they exist. But given the arguments given by Big Biotech and its boosters in favor of ESCR/human cloning, e.g., they are not really human because they will never be born, not persons, CURES!, etc, etc., what reason would there be for them not to proceed with such research, particularly if artificial wombs are created to permit out-of-body gestation? After all, in ESCR/human cloning, the watch word is "anything goes."

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Tuesday, July 10, 2007

Should Cloned Animal Products be Labeled?


This story makes the Naderite in me itch: The actual cloner of Dolly the sheep, Keith Campbell--Ian Wilmut supervised rather than doing the hands on work--is advocating that farmers raise cloned animals rather than those created sexually, as a way of bringing stronger and better animal products to market. Not sure how wise that would be, given the serious unproductively of mammalian cloning, what with many failures, miscarriages, birth defects, and early animal deaths. Moreover, farmers don't need biotechnologists to breed the next generation of animals: They can put female and male together at the right time and let nature take its course, use artificial insemination, or IVF--although embryo selection is also a tool of modern animal husbandry.

But that is not my real concern. Here is the part that galls. The would-be animal cloners oppose labeling. In other words, they don't want consumers to be told they are eating cloned meat. From the story:

Professor Campbell, director of animal bioscience at Nottingham University, said cloning is a useful extension of existing selective breeding, which includes artificial insemination and embryo transfer.

"It is just another technique that we can add to accelerate genetic improvements to farm animal species," he added. "Cloning allows us to multiply elite animals. "We have achieved the ability to clone a whole variety of animals and animal species. In farm animals, we have got cattle, sheep, goats, pigs and horses.

"In my opinion the ability to integrate cloning into the food production line should be allowed to farmers nowadays." He said there is 'no conceivable risk' in eating food produced from the off-spring of clones, suggesting the only barrier to the technology is public perception.

The U.S. Food & Drug Administration is expected to give approval for the technology, without a requirement for labeling, later this year. Dr Simon Best, chairman of the Bioindustry Association, believes labeling is unnecessary saying: "I don't think there is a scientific reason for doing it." He said: "There is a whole load of things that the public could want to know, but you end up with information overload.

By information overload, read, "People might not want to buy the product." We saw the same fight over Monsanto's litigation strategy that sought to legally prevent sellers from labeling their milk as coming from cows not given bouvine growth hormone (rBST)--as related in Ralph Nader's and my No Contest. That attempt failed miserably because people wanted to know. Indeed, just the other day, I bought milk at my local Safeway and noticed that the cap disclosed, "Not from cows given rBST. "

I am not saying that the FDA or other agencies should mandate labeling. But there should not be an attempt--as formerly by Monsanto--to prevent labeling. Consumers care about these matters and if a brand of beef or pork comes from non-cloned animals--the company should have every right to so inform consumers.

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Monday, July 09, 2007

Eugenics: Never Forget


There is a historical exhibit about eugenics at the North Carolina Museum of History in Raleigh. From the column by Rick Martinez, in The News and Observer, it seems the curators did a fine job. Here are few excerpts from Martinez's reaction:

EUGENICS WAS SOLD AS THE SCIENCE of improving the human race through the procreation of people thought to have humanity's best traits, while decreasing the birth rate of those saddled with the worst. It was a field embraced by wealthy and progressive leaders in North Carolina, including the editors of this newspaper. As proof of public support, a 1935 state sterilization manual cited an N&O editorial that read in part, "We cannot make a better world if we deliberately give our substance to subsidizing the production of the least worthy stock among men."

The characteristics of the least worthy were explicit. In North Carolina they included promiscuity, alcoholism, criminality, drug addiction, extreme nervousness and being a pauper.

Martinez is also aware that there is a potentially even more pernicious new eugenics loose in the land:

In May 2007, Andrew J. Imparato and Anne C. Sommers of the American Association of People With Disabilities marked the Buck decision's 80th anniversary by warning that intellectual underpinnings of eugenics still survive, particularly with regard to the disabled. They back up their claim with chilling facts and quotes.

From noted Princeton University bio-ethicist Peter Singer: "It does not seem quite wise to increase any further draining of limited resources by increasing the number of children with impairments."

From in vitro fertilization pioneer Robert Edwards: "Soon it will be a sin for parents to have a child that carries the heavy burden of genetic disease. We are entering a world where we have to consider the quality of our children."
Martinez writes that he was unaware of much of this before going to the exhibit, having assumed it was another form of racism. He sure gets it now. Eugenics is evil precisely because it rejects human exceptionalism and the intrinsic value of each and every one of us. Whether a laissez faire eugenics as pushed by some new eugenicists, or a eugenics imposed by the state (and the former would eventually lead to directly to the latter), eugenics is fundamentally wrong and a profound threat to the weak and vulnerable. We should never forget. Thanks to Rick Martinez for his good column.

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Tom Marzen, RIP

I received a sad e-mail today that Tom Marzen, Chief Counsel for the National Center for the Medically Dependent and Disabled, has died of lung cancer. Tom was a tireless advocate for the equal humanity and human rights of people with serious cognitive or developmental disabilities. By the time I first became aware of these issues, Tom was already deeply immersed, striving to prevent dehydrations and protect disabled babies against the imposition of futile care treatment removals, as in the Baby Terry case. He also wrote numerous amicus briefs and articles in defense of the intrinsic value of human life, as this one about the Robert Wendland case. Tom never tired and never allowed setbacks to discourage him from seeking to protect the weak and vulnerable. He will be missed.

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Australian "Kevorkian" Running for Office


Philip Nitschke, the "Down Under Kevorkian," is running for political office (again). Apparently, like his American soul cousin, he can't get enough publicity. Let's see what his plank would be: Oh, yes: Suicide pills available for sale in super markets; assisted suicide for troubled teens, plastic bags as a medical benefit. Perhaps he should call his movement the "Peaceful Pill Party."

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Saturday, July 07, 2007

Organ Harvesting Lawsuit: Potential Serious Breach of Organ Procurement Rules


Doctors and a San Luis Obispo hospital are being accused in a lawsuit of mistreating Reuben Navarro, a disabled dying patient toward the end that he would die sooner rather than later and that his organs could then be be procured. (Click here for PDF of Complaint.) Based on what has either been admitted or determined, there certainly appear to be some serious irregularities in this case, the facts about which definitely need to be investigated fully. These include denied allegations that the transplant surgeon made the decision to remove a respirator--which as discussed below, would be a real no-no--that Reuben's mother was told a lie that the respirator "had" to be turned off after five days in order to pressure her into consenting to organ harvesting, the injection of twenty-times the usual amounts of morphine when the patient was taken off a respirator but didn't die, and perhaps worst of all, that when Reuben didn't die, he was neglected for 9 hours without life support being reattached.

We have to be careful not to jump to conclusions, since allegations made are not facts proven. But these charges are very serious, which, if true, could amount to criminal as well as civil wrongdoing.

I am posting about this case not to prejudge it but to discuss the often misunderstood organ procurement policy that is supposed to be followed when procuring organs from the bodies of dead patients who are not, to use the vernacular, brain dead. Known in the transplant profession as "non heart beating cadaver donors," patients who die from cardiac arrest can have their organs procured for transplantation under the terms of what is sometimes called the "Pittsburgh Protocol." Space does not permit a full detailed listing of every step in this process, but here are the key points:

1. The medical teams and organ procurement teams are to be kept strictly apart so that there is a wall of separation between medical decision-making for the patient, including whether and when to terminate life-sustaining treatment, and the decision to donate organs and organ procurement.
2. If consent to procure is given, the family says their goodbyes and the patient is wheeled into the operating theater at the agreed upon time. Life support is removed. Proper palliative measures are permitted to prevent distress. If the patient goes into cardiac arrest and the heart stops, the transplant team waits to ensure that the arrest is irreversible. This time can range from 2 minutes (too short in my view) to five minutes (better).
3. If the patient does not experience cardiac arrest in 30 minutes (as in this case), life support is supposed to be reattached, and the patient returned to the care of his treating team. The patient is never again to be a candidate for organ procurement.
With these points in mind, we can see the serious nature of the lawsuit's allegations. On a broader scale, the time is long since nigh for national standards for organ procurement to be established with very clear and continuing training to ensure compliance. As it is, there is a hodge-podge, leading, perhaps, to confusion. If the people's confidence in transplant medicine--always thin--is to be maintained, this is a matter of great and growing urgency.

One last point: This case involves matters of such profound public import that no judge should permit the parties to enter into a "confidential settlement." Confidential settlements usually involve money changing hands in return for strict silence, which impedes the proper workings of the tort system, by for example, preventing unsafe products or serious abuses of law from becoming publicly known. For more on the wrongness of confidential settlements, see No Contest: Corporate Lawyers and the Perversion of Justice in America, which I coauthored some years ago with Ralph Nader.

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Friday, July 06, 2007

The Slippery Slope Slip-Sliding Away in Oregon

Here is an interesting--and predictable--turn of events: Two nurses are being investigated by law enforcement for engaging in assisted suicide, although the facts look more like a euthanasia. From the story:

Two Portland-area nurses gave [cancer patient Wendy Melcher] massive amounts of drugs intended to cause her death. The drugs were administered in what the nurses would later call an assisted-suicide plan directed by Melcher. The nurses have admitted to the Oregon State Board of Nursing that they administered doses of morphine and phenobarbital without informing Melcher's physician. Oregon's Death With Dignity Act--the only such law in the nation--allows assisted suicide but only with the assistance of a physician.
Another aspect of the law, apparently violated, was self-administration. But what is very notable is that this matter was previously investigated by the nurse licensing board in Oregon, which gave these apparent killers bare slaps on their wrists, and did not notify law enforcement! Again, from the story:

Among the issues authorities are expected to look into is how the state nursing board investigated the case and how it punished the nurses. The board, which oversees nurses in Oregon, was alerted to the case nearly two years ago, shortly after Melcher's Aug. 23, 2005, death. That death occurred four days after the nurses administered the drugs.

But the board took more than a year to complete its investigation, which found the nurses did, in fact, participate in a suicide plan.

The board did not report the nurses to criminal justice authorities for further investigation. The board did allow nurses Rebecca Cain and Diana Corson to keep their licenses and to continue practicing nursing, Cain with a two-year probationary period and Corson after a 30-day license suspension.

Not only are the actions of the nurses and reaction of the Board a pernicious assault on the integrity of the nursing profession, the alleged killings and subsequent lack of meaningful punishment are a direct challenge to the oft-repeated assertion that assisted suicide can be strictly controlled in Oregon. If the nurses did the deed--which appears likely given their admissions--and if they are not prosecuted now that it has all come to light; and if found guilty, they are not meaningfully punished, then toss all of the bromides about guidelines protecting against abuse into the trash.

Kudos to the Portland Tribune, a freely distributed, twice weekly alternative newspaper, for reporting this story. But I did a Google search and noted that there are no other stories out about this case. So, where is the Oregonian? Where are the other mainstream media outlets? Absent, apparently--which does not surprise. One of the major tools of media bias is to not report stories or facts that contradict the accepted story line, which in this case, is that Oregon's law is just hunky-dory.

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Dutch Medical Standards: Killing Patients OK in Euthanasia Land, but not Alternative Treatments


Get this story out of Euthanasia Land--a.k.a. the Netherlands: A physician has lost his medical license for attempting to treat his dying cancer patient with an alternative treatment. I am not for quackery, of course, and the physician may well deserve the harsh punishment. But this extreme sanction is being imposed by the same medical establishment that would have applauded had the doctor killed his patient in euthanasia instead of trying a questionable approach to keeping her alive. This is the same medical establishment that huffs and puffs at any government action, rare though they are, that would meaningfully punish doctors who break the country's euthanasia laws, and which, for example, winks at "termination without request or consent," the Dutch term for euthanizing patients who have not asked to be killed. This is the same medical establishment that has applauded infanticide and who are now urging that eugenic baby killing be legalized. Bottom line: In the Netherlands a doctor can kill patients, whether or not they ask to be killed, murder disabled and dying babies, and confidently expect the support of their medical peers. But engage in questionable treatments for a dying patient and lose the right to practice medicine. What a travesty.

HT: Bob Hiltner

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Thursday, July 05, 2007

"The Assisted Suicide Movement Sheds Its Fig Leaf"

Last week I posted here at SHS about an opinion column in the Hastings Center Report urging that assisted suicide be made available to some mentally ill people. I expound on that issue in greater length and detail in this piece published today in the Daily Standard. I conclude:

With the truth now clearly in view, the time has come to have real debate about the so-called right to die. This debate should not pretend that the practice will be limited and rare and it should fully address the societal implications of transforming assisted suicide into a mere medical treatment.

So, let's argue openly and frankly about the wisdom of permitting near death-on-demand as a method of ending serious and persistent suffering. Let's discuss whether "choice" and "individual autonomy" requires that we permit licensed and regulated euthanasia clinics to serve anyone who has made an irrevocable decision to die.

Indeed, let's argue whether or not society owes a duty of prevention to the self-destructive who are not acting on mere impulse. But finally, let's stop pretending that assisted suicide legalization would be just a tiny alteration in public policy restricted only to the terminally ill. That clearly isn't true.

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"In Defense of Human Exceptionalism"

I have a piece up today over at First Things about the latest attack on human exceptionalism--animal ensoulment--published, no less, in the science pages of the New York Times. I review some of the areas in which human exceptionalism is under assault and describe the NYT story. Here are a few central points:

How ironic that a report in the science pages of the New York Times would discuss souls respectfully, especially given that the existence or nonexistence of the soul isn't a matter that science can measure, test, or duplicate (as a believing scientist asserts at the end of Dean's piece). Nor is belief in the soul--whether uniquely human or present in all life--necessary to accepting what used to be considered the self-evident truth of human exceptionalism. But that's OK: Whatever it takes to knock us off the pedestal.

It should now be clear to everyone that very powerful forces have totally dedicated themselves for varying reasons to convincing us that we really aren't all that important. Those who think otherwise had better answer the call to defend the intellectual ramparts. Much is at stake. Demolishing our self-perception as a uniquely valuable species would have very grave consequences, given that human exceptionalism is both the philosophical underpinning for human rights and the basis of our unique self-imposed duties to each other, posterity, and the natural world.
I then quote philosopher Mortimer Adler about how rejecting our unique moral worth simply and merely for being human would justify the strong preying on the weak, and I conclude:
As Adler makes clear, "liberating" society's general embrace of human exceptionalism will not "save the planet" as some suppose, nor liberate man from the supposed oppression of superstitious faith. Rather, it would open the door wide to tyranny.
The more I think about this, the more important I believe the issue is. I hope y'all agree.

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Excellent Column Decrying Animal Rights Terrorism

And I don't just say that because it was written by my wife, nationally syndicated San Francisco Chronicle columnist, Debra J. Saunders. The problem of animal rights terrorism is real and of growing concern. So far, no one has been murdered--not for lack of advocacy for such an event by the likes of Jerry Vlasak (as noted by Debra). I worry that once that Rubicon is crossed, all restraint will evaporate. Here are a few key paragraphs from Debra's piece:

The threats of violence and intimidation work. Last year, UCLA researcher Dario Ringach sent an e-mail to Vlasak in which he proclaimed, "You win"--he would stop research with animals. Vlasak sent out a triumphant press release. Vlasak told the Daily Bruin that activists had tried to stop Rosenbaum's research by appealing to UCLA administrators, but had failed. "All reasonable attempts have failed, so we're going to take it to the next level," Vlasak told the student paper.

When abortion foes have harassed--even killed--abortion clinic workers, outrage rightly has followed. Oddly, when animal-rights activists threaten and harass people who are trying to cure diseases, the silence is deafening. When they've expanded their harassment to include people who work for targeted companies, and companies that will not pledge to not do business with targeted companies--as Chiron [a company targeted for bombing] refused to do--there is little outcry.

When animal-rights activists' vandalism cowed the New York Stock Exchange so that it pulled the planned listing of Life Sciences Research--a medical-research firm--in 2005, the New York Times didn't bother to report it.

Now, Vlasak says that animal-rights activists will move to the next level. Expect more firebombs, more harassment campaigns--and less research. Because there is no partisan angle to this story--no Democratic or Republican bogeyman--there is no outrage.

The threat of violence and the no-holds-barred harassment of medical researchers required the passage of the Animal Enterprise Terrorism Act--decried by whining animal rights fanatics as an infringement on free speech. But bombs are not speech. Receiving videos of your children at school--with the obvious implication that they could be targeted--is not speech.

Unfortunately, the only ones with any power to restrain the nutters are other animal rights believers. With the notable exception of Gary Francione, as Debra noted, the silence is deafening.

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NEJM Commentary Against Futile Care Theory


What a pleasant surprise: An opinion column in the New England Journal of Medicine opposes medical futility. Written by Harvard Medical School professor Robert D. Troug, M.D., it makes some very good points about the problem with even the best-intended futile care policies. Reacting to the Baby Emilio case in Texas, Dr. Troug writes:

Although the clinicians in Austin consistently denied that they were motivated by financial considerations, concern about excessive expense may be an ethically legitimate reason to refuse continued treatment to patients like Emilio. Health care is not an unlimited resource, and physicians have an ethical obligation to ensure that it is distributed fairly. Unfortunately, the United States has been reluctant to adopt a systematic approach to allocating resources across the health care spectrum. Although futility cases may seem like an obvious target for cost cutting, the evidence suggests otherwise. Even if life support were consistently denied to patients whose situations met common definitions of futility, the monetary savings would be trivial... Aside from considerations of suffering, dignity, and money, clinicians may justify their refusal to treat on the basis of their right to refuse to participate in medical interventions that they believe violate their moral integrity. The moral distress associated with providing futile care has been cited as an important source of burnout among critical care nurses. But though these concerns can sometimes be ethically legitimate, they are questionable in cases like that of Emilio. The claim that continued life support for Emilio was morally objectionable was nothing more than an assertion that the values of the clinicians were correct while those of Ms. Gonzales were wrong...

As a liberal society, we take pride in protecting the rights of minorities against the tyranny of the majority. Of all the unpopular values and preferences that we might respect, should not we favor those that have life-or-death consequences for the persons involved? Families live with the memories of the death of a loved one for years; certainly their religious, cultural, and personal preferences during that process should be honored, or at least tolerated, whenever possible.

The principal advantage of the Texas Advance Directives Act is that it provides a path for resolving intractable dilemmas in situations in which clinicians may feel compelled to do whatever patients and families demand. The law may therefore serve a useful purpose when patients are subjected to unwarranted pain and suffering or when clinicians have defensible claims that these demands compromise their moral integrity.

On the other hand, the Texas law's effectiveness as a mechanism for reaching closure in difficult cases is also what makes it most problematic. It relies on a due-process approach that is more illusory than real and that risks becoming a rubber-stamp mechanism for systematically overriding families' requests that seem unreasonable to the clinicians involved. During a 2-year period at Baylor Health Care System, for example, the ethics committee agreed with the clinical team's futility assessment in 43 of 47 cases. Although there may be cases in which the law should be used to trump the demands of patients and families, it is doubtful that the Gonzales case was one of them. Rather than jeopardize the respect we hold for diversity and minority viewpoints, I believe that in cases like that of Emilio Gonzales, we should seek to enhance our capacity to tolerate the choices of others, even when we believe they are wrong.
Excellently said. Futile Care Theory permits the imposition of a doctor's or hospital's moral values onto the lives and deaths of patients and families. If a case of continuing life-sustaining treatment is so egregious that it amounts to a form of abuse, then the issue should be decided in open court--not by an ethics committee made up of well-acquainted people who may share an institution's culture, meeting behind closed doors.

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Wednesday, July 04, 2007

Pre-implantation Genetic Diagnosis Reduces Live Birth Rate

Oops. Here we have been told that PGD, that is, removing one cell from an early embryo and testing to determine whether it is deemed worthy of implantation, does not harm embryos. Not so, perhaps. According to a study published in the New England Journal of Medicine:

Preimplantation genetic screening did not increase but instead significantly reduced the rates of ongoing pregnancies and live births after IVF in women of advanced maternal age. These results argue strongly against routinely performing preimplantation genetic screening as an adjunct to IVF in this group of women.
The study speculates on several potential causes:
Several mechanisms may be responsible for the failure of preimplantation genetic screening to improve the outcomes of IVF in women of advanced maternal age. It is possible that biopsy of a blastomere [cell] on day 3 of embryonic development hampers the potential of an embryo to successfully implant; however, the effect of biopsy alone on pregnancy rates has not been studied. Furthermore, the limitation in the number of chromosomes that can be analyzed with FISH could lead to the transfer of embryos labeled as normal that are in fact aneuploid for one or more chromosomes not tested. This problem may be overcome in the future by the use of new techniques, such as array comparative genomic hybridization, in which the complete ploidy status can be given for a blastomere after biopsy. Finally, many human embryos resulting from IVF may be mosaic, so that the chromosomal constitution revealed by analysis of the blastomere may not be representative of the entire embryo.
Interesting stuff. It appears that our attempts at hyper-control of progeny has a ways to go.

No word yet on whether this outcome impacts Advanced Cell Technology's assertion that it can obtain ES cells without harming embryos which uses the same PGD technique.

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Human/Chimp Biological Differences: Going Up

This just in from Science (no link available):

The fact that there is only a about a 1% difference between the genetic make-up of chimpanzees and human has been called "the most overly exposed factoid in modern science". First established in a paper in 1975, it was confirmed a couple of years ago by the Chimpanzee Sequencing and Analysis Consortium. However, a feature in the journal Science points out that this figure has enormous limitations. "For many, many years, the 1% difference served us well because it was under-appreciated how similar we were," says Pascal Gagneau, a zoologist at the University of California, San Diego. "Now it's totally clear that it's more a hindrance for understanding than a help."

The consortium pointed out that many stretches of DNA have been inserted or deleted in the genes. They account for an additional 3% difference. Entire genes are often reduplicated or lost, further distinguishing chimps from humans. Recent research shows that human and chimpanzee gene copy numbers differ by 6.4%.

Is it possible to propose a precise figure for the difference between the two species? Probably not, scientists feel. "I don't think there's any way to calculate a number," says Svante Pääbo, a member of the consortium working in Germany. "In the end, it's a political and social and cultural thing about how we see our differences." (My emphasis.)

Exactly: Many who fervently desire to knock human beings off of the pedestal of exceptionalism have grasped onto our genetic similarities as a way of justifying the reduction in human moral status. But the biology isn't cooperating, apparently: Chimps are chimps: Wonderful, smart animals to which we owe a duty of proper care. But they are not people. Our desire to make it otherwise--an act of exceptionalism since we are the only species capable of such a yearning--does not change that fact.

HT: Bioedge

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Tuesday, July 03, 2007

Embryonic Stem Cell Patent (Money) Fight


Patents. You don't hear too much about the issue in the ESCR debate, but patent some-would-say obstructionism, at least as much as those purportedly caused by President Bush's funding policy, have allegedly impeded ESCR.

Now, it appears that the iron grip of the Wisconsin Alumni Research Foundation, which owns the primary human ES cell patents, may be breaking. From the story:

The California-based Foundation for Taxpayer and Consumer Rights and others are challenging patents that cover discoveries by UW researcher Jamie Thomson, who was the first to grow and isolate human embryonic stem cells in 1998.

The Wisconsin Alumni Research Foundation, the university's research arm, holds the patents covering the cells and research techniques used by many American scientists. Critics say its license fees have stifled the young field.

The U.S. Patent and Trademark Office said in a preliminary decision in April that it was preparing to throw out the patents because Thomson's discoveries were obvious given previous research by other scientists.

Scientists fighting Bush is ho hum. Expected. A right of passage, if you will. But researchers going after each other? Follow the money.
Doug Melton, co-director of the Harvard Stem Cell Institute, said in a declaration released Monday that Thomson's achievements came from his access to money and materials, not groundbreaking science.

"He deserves recognition because he undertook the arduous and timely task of getting fresh and high quality human embryos to use as starting material in his work and sufficient funding for such research, not because he did anything that was inventive," Melton wrote.

Meeeow!

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When Is an a Human Embryo Not Really an Embryo?

When it is politically expedient to pretend that it isn't yet human life:

There is long discussion happening at a previous post (click here to check it out), that has evolved into a discussion, among other matters, of whether a one-week old human embryo, often called a blastocyst, is really an embryo. Also, whether there is such a thing as a pre-embryo, that is an entity created either through fertilization or SCNT that, somehow, is not yet a truly living human organism.

Due to length, I am starting a new thread about this here: A pre-embryo is a contraction for the term pre-implantation embryo--meaning it is an embryo that has not yet developed to the point that it has developed a placenta and attached to a uterus. The term does not mean that it is not actually yet an embryo, a form of non life that comes before the embryo comes into being.

Hence, Human Embryology and Teratology, an embryology textbook, in the name of scientific accuracy, places the term "pre-embryo" under the categorization, "Undesirable Term in Human Embryology," further asserting that "embryo" is the accurate and hence, "preferable term." They write further:

The term "pre-embryo" is not used here [in their book] for the following reasons: (1) it is ill-defined; (2) it is inaccurate...(3) it is unjustified because the accepted meaning of the world embryo includes all of the first 8 weeks; (4) it is equivocal because it may convey the erroneous idea that a new human organism is formed at only some considerable time after fertilization; and (5) it was introduced in 1986 "largely for public policy reasons." (My emphasis.)
Princeton biologist Lee Silver admits that the term pre-embryo is political. A pro-cloner and transhumanist, Silver wrote in his book Remaking Eden:
I'll let you in on a secret. The term pre-embryo has been embraced wholeheartedly...for reasons that are political, not scientific. [My emphasis.] The new term is used to provide the illusion that there is something profoundly different between what we nonmedical biologists still call a six-day old embryo [the blastocyst] and what we and everyone else call a sixteen-day old embryo [an embryo that has begun to develop differentiated tissues]. The term pre-embryo is useful in the political arena--where decisions are made about whether to allow early embryo (now called pre-embryo) experimentation--as well as in the confines of a doctor's office, where it can be used to allay moral concerns that might be expressed by IVF patients. "Don't worry," a doctor might say, "It's only pre-embryos that we're manipulating and freezing. They won't turn into real human embryos until after we've put them back in your body."
Redefining terms and blurring scientific distinctions to win a political debate is corrosive of science. Indeed, I am not alone in worrying that so-called advocates of "science," are devolving their beloved field into a mere special interest willing to use all of the spin, deception, obfuscation, and myth-making tools of the trade in order to obtain their desired political ends. And that's truly anti-science.

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Humans' "Greedy" Use of Solar Energy


Humans are now being denigrated as "greedy" for taking the "lion's share" of solar energy by converting more than our fair share of plant life to our own use. From the story:

HUMANS are just one of the millions of species on Earth, but we use up almost a quarter of the sun's energy captured by plants - the most of any species. The human dominance of this natural resource is affecting other species, reducing the amount of energy available to them by almost 10 per cent, scientists report. Researchers said the findings showed humans were using "a remarkable share" of the earth's plant productivity "to meet the needs and wants of one species".

Hmmm. What do you suppose is the real purpose of the study? Some might say to promote better environmental practices. But I don't think so. Rather, I see it as really being an attack against, and in ironic and unintended boost for, human exceptionalism.

First, the concern expressed by the authors of the report reflect our exceptionalism because we are the only species in the known history of the universe that would even care that we are "greedy" for allegedly consuming a disproportionate amount of the sun's energy than to which we are entitled by our population. All other species merely consume anything and everything that they can find--regardless of its impact on the environment or co-species. And it would be silly to call any of them greedy, which is the expression of a moral judgment. Animals are beyond and beneath such judgments: They are just engaged in the Darwinian struggle for survival.

Second, albeit impliedly, the argument being made seems to be that other species are entitled to an equal proportion of resources because they and we are morally equivalent. Thus it is our duty to ensure egalitarian distribution of the sun's energy and the earth's plant resources. If I am right, and if we act according to our purported obligation, the harm caused to human populations could be significant.

We can thus see that denying the hierarchy of moral worth with humans at the pinnacle has the distinct potential of causing us to harm ourselves and our posterity by intentionally reducing human prosperity and interfering with our own thriving. But choosing to harm ourselves to benefit other species is a uniquely human option and an ironic proof of our own exceptional status.

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Monday, July 02, 2007

Modern Day Slavery: Slaves Among Us

Patrick Bell, a graduate student at Seattle University and a valued staffer at the dreaded Discovery Institute, won third prize in the MPA/MPP You Tube "Change the World in One Minute" Public Policy Challenge. You see, the DI and people associated with it, care a great deal about universal human rights. One of my co-senior fellows at the DI (in human rights), John Miller, focuses quite a bit on the issue, and I touch on it too, considering slavery/trafficking to be a direct and pernicious assault on human exceptionalism and the intrinsic moral worth of human life.

Way to go, Patrick!

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The Joy of Blogging


One of the things that is most interesting about producing Secondhand Smoke is seeing which posts generate the most comments. Today, I posted an entry about the television program The 4400, that I thought would generate considerable interest. (I don't measure the interest of people in any post by the number of comments because I hear from people who tell me they like the site but don't express their opinions. Lurkers, of course, are always welcome here.) I also posted what I considered almost a throw away post about bias I perceive in the Kansas City Star and the hubris (again, as I see it) of the Stowers Institute with regard to SCNT research. I have written about that topic frequently here, and didn't expect much action. Wrong. The KC Star post took off with few comments (so far) on The 4400.

That's cool. It is fun to see what gets people riled or interested enough to take the time to engage.

Thanks very much to everyone who visits SHS regardless of your opinions or your level of participation in discussions.

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A Potential Way Around the Egg Dearth


A dearth in human eggs and the potential harm to women's health sometimes caused in obtaining them through current means, has both stymied human cloning research and moved biotechnology toward exploiting poor women for their eggs in their zeal to conduct human cloning research.

This important ethical issue may one day fade. Canadian scientists have apparently extracted immature eggs obtained from surgically removed ovarian tissue, matured them in a Petri dish, after which they were frozen, thawed, then used them in IVF fertilization. From the story:

The trial group comprised 20 women, whose average age was about 30, who had been diagnosed by ultrasound to have polycystic ovarian syndrome (PCOS), a fertility-threatening hormonal disorder that affects around 10 percent of all women of child-bearing years.

A total of 296 eggs were collected from the patients, of which 290 were immature, ESHRE said in a press release. They were then matured in the laboratory for 24-48 hours, and were frozen for several months and then thawed. Of these, 148 oocytes survived the thawing process and were fertilised by a technique called intra-cytoplasmic sperm injection.

Sixty-four embryos were then transferred to the women, who received multiple embryos in order to boost the chance of a successful pregnancy. Holzer said his team had progressively improved the success rate, noting that three of the pregnancies had been achieved in the past five patients.

But he cautioned against giving rise to false hopes. The research is still in its preliminary stages and had not yet been proven in cancer patients, the biggest potential beneficiaries.

There's more involved here than allowing women to have babies after removal of their ovaries. If the same technique could work with SCNT, it would be possible to obtain eggs ethically--as from cadavers or surgically removed ovaries. Another potential source that would cause howls of controversy would be aborted late term female fetuses.

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Transhumanism TV: "The 4400"


The USA Network has a great science fiction series called The 4400, which could just as easily be named Transhumanism TV. The plot is about "the 4400," people who were abducted by aliens or future human time travelers, and who are "returned" possessed of super-human "abilities." These are both good and evil, such as the ability to heal and to kill with one's mind--and everything in between.

The series initially dealt with society's reaction to these returnees. I like sci-fi, and enjoyed the show but didn't think of it as anything special. But a very clever and interesting plot turn has transformed the series into something that is not only fun, but deals in some of the deepest issues involving the human condition.

It turns out that the abilities that the returnees possess is caused by a substance in their blood called Promicin. And this is where the transhumanism comes in. (Here is one of the columns I wrote about transhumanism.) The head villain and strongest returnee allowed her blood to be filtered to create thousands of viles of Promicin, which the head rebel has now distributed free to the world in the hope of creating a new post-human era of history. However, there's a catch: Those who take Promicin have a 50/50 chance of dying. But if they live, they will have a super human ability. Meanwhile, the government is striving to quell the use of the drug, prevent the 4400 from using their abilities, and chase down the rebels.

Question: Do you take the drug? The characters who risk their lives in the series and take the drug do so because they are sad and unhappy. Just like transhumanists, they believe that if only they can grasp onto something special that is more than merely human, their lives will suddenly attain meaning. It is transcendence and purpose in a syringe--just like the transhumanists yearn to find it in uploading and genetic alterations. Indeed, the Promicin movement has become a new quasi religion--again just like transhumanism. Yet, even opponents of the 4400, those who think that it is all too dangerous and profoundly unwise, will quickly cast principle aside and make use the 4400's talents to benefit themselves--such as in the last episode in which the head of the law enforcement task force assigned to bringing all of this under control takes her father to a 4400 to be healed of Huntington's disease.

All very interesting and like the best science fiction, a reflective mirror on our times. Check it out.

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KANSAS CITY STAR: Where the Bias Never Stops

The KC Star is, in my view, the most biased newspaper in the country in its reporting on the ESCR/human cloning controversy. For example, when the political decision was made by promoters of human cloning research in MO to rename embryonic stem cells "early" stem cells, the paper made the shift without missing a beat. And it continually pimps the Stowers Institute line that unless Missouri whole-heartedly supports its desire to engage in human cloning research, why scientists will refuse to work for Stowers and the biotechnology industry will leave the state--never mind that most biotech is not controversial and doesn't involve cloning or embryonic stem cells.

Well, the paper has done it again in this whining editorial about how the "uncertainty" caused by continued resistance in MO to human cloning research is making life tough for Stowers. From the tale of woe:

Continued opposition in Missouri to a promising form of stem-cell research [BIAS ALERT: actually, human cloning] is causing medical researchers to view the state as unfriendly. Leading scientists who work with embryonic stem cells have declined offers to bring their work to a second Stowers facility, saying they can't risk the political uncertainty.

The news would be much worse if the institute had decided to establish a second campus in a state, such as California, that encourages cutting-edge medical research. Kansas City can ill afford to squander its best opportunity for scientific excellence. Jim and Virginia Stowers, fortunately, remain committed to Kansas City. The institute announced Thursday that it has acquired a large tract of land in Kansas City. Plans for the property will be firmed up when Missouri's political climate becomes more settled. The sooner that happens, the better. It's shameful that a facility with a humanitarian mission and superb scientific talent should continually be placed on the defensive.

Poor Stowers Institute. Here, Mr. Stowers buys his own constitutional amendment to the tune of $35 million, which pays for a thoroughly deceptive and dishonest campaign that, among other wrongs, misled the people by claiming to outlaw human cloning when it explicitly legalized it--all abetted by the in-the-tank Star--while threatening to take his Institute somewhere else if he didn't get his way. Yet, despite a 10-1 financial advantage, the blackmail, the media pimping, and the lies, Amendment A barely passed and the Star is upset that opponents don't just roll over and play dead. And note the new tantrum: Either MO citizens bend their necks to our will or we won't build the new facility. ("Stowers Puts Expansion Plans on Hold.")

Can you imagine if a tobacco or oil company executive acted with such hubris and sense of entitlement? The KC Star editors would be having conniptions. Well, that's democracy, Mr. Stowers and Star editorial board. There's plenty of non controversial work for the Institute to accomplish, a few of which are mentioned in the editorial. The price of insisting on one's own way through a deceptive campaign about morally contentious ethical issue is more contention. Live with it.

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Sunday, July 01, 2007

Book Argues "Liberal" Case Against Assisted Suicide


I haven't read Liberalism's Troubled Search for Equality yet, but it looks as if it takes a good approach. Here's the Amazon description:

In Liberalism's Troubled Search for Equality, Robert P. Jones presents a penetrating examination of physician-assisted suicide that exposes unresolved tensions deep within liberal political theory. Jones asks why egalitarian liberal philosophers--most notably, Ronald Dworkin and John Rawls--support legalized physician-assisted suicide in direct opposition to groups of disadvantaged citizens they theoretically champion. Jones argues that egalitarian liberals ought to oppose physician-assisted suicide--at least until we find the political will to ensure access to health care for all. More broadly, Jones challenges progressives to find the heart of the liberal tradition not in allegedly neutral appeals to "choice" but in a renewed commitment to equality and social justice that welcomes public religious voices as allies.
Ever since I got involved in the assisted suicide debate in 1992--in which I first debated Jack Kevorkian's attorney over California's Proposition 161 that would have legalized euthanasia--and more fully in the fall of 1993 when I committed myself to advocating about the issue, I have argued that legalizing assisted suicide is anything but liberal. Indeed, traditional liberalism of the kind on which I cut my political teeth--the liberalism of Martin Luther King, Robert Kennedy, Ralph Nader--should oppose assisted suicide in that this brand of liberalism looks at "us," rather than myopically at "me," and is dedicated to protecting vulnerable populations. The disability rights movement--which is overwhelmingly liberal politically--gets it and has become the most effective opponents of euthanasia in the country.

So, while I can't endorse the book because I have not read it, I applaud Jones for looking at the issue through the prism of political liberalism.

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