Saturday, August 30, 2008

Time to Defend Human Exceptionalism in the Professional Journals!

Many of the chances we see in society today, were gestated decades ago in professional journals and law review articles, which from what I have seen, tend to be pretty uniformly pushing society in one direction. Example: Today pulling feeding tubes from cognitively disabled patients is routine. I doubt this would have happened--because it was once unthinkable, but for the many professional journal articles written in the 1980s that promoted the policy.

Case in point, a 2007 article in the Tulsa Law Review (no link, have copy) promoting Futile Care Theory: As readers of SHS know, I believe that medical futility is part of an overarching attempt to shift society's fundamental value away from being focused primarily on individual worth, to a more collectivist approach of the kind warned against so vividly in the old sci-fi flick, Logan's Run. Be that as it may, I think it is very dangerous because it turns over determining when a life is worth living from patients and families to doctors and bioethicists.

The author makes this point chillingly explicit:

Physicians, because of their expertise and thorough education, are best able to determine when a patient is no longer benefiting from life-sustaining measures. A survey shows that ninety percent of patients feel that doctors are accurate decision-makers as to end-of-life care. n332 After a physician makes a judgment, an ethics committee further examines the futility determination. Because a concrete, and agreed upon definition for the term "futile" appears to be unattainable, physicians should be the primary, if not sole, judges, and decide when continued treatment is unnecessary, unethical, and no longer serves any purpose. Their judgments and decisions should be recognized and respected as legitimate, thoughtful, and final.
Nothing new here, of course. I bring it up because a judge might one day rely on this article (among others) in determining that medical futility is constitutional. Indeed, that is why it was written.

Articles published in intellectual and professional journals that receive little or no public discussion, are very important as they become the intellectual ammunition (if you will) for the guns that seek to destroy human exceptionalism, particularly in the courts. Thus, as I have occasionally remarked about here, we see journal articles pushing assisted suicide, a radical constitutional right to conduct scientific research, for animal moral and legal equality, etc. etc., all of which are written in the hope that they will one day influence courts or policy makers to go along. And if there is a dearth of material on the other side--which seems to be the case--that influence can be greatly magnified.

And I worry that those with the expertise and ability to counter these arguments in the intellectual spheres tend not to man the ramparts defending the sanctity and equality of human life. Perhaps this is based on the blithe assumption that "It can't happen here." But anyone who thinks that today is just not paying attention. Indeed, given that a Swiss ethics panel has promoted what could be called plant rights, things are becoming so extreme that you can't even engage in parody because they catch up to you.

Law students, doctors, lawyers, Ph.D.s and others who wish to maintain a society based on human exceptionalism need to be just as active in the "learned journals" as are those who support policies that would destroy it. And believe me, they are active. Are we?

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Friday, August 29, 2008

Sarah Palin's Real Claim to Fame:

She's made SHS!

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Thursday, August 28, 2008

Lincoln, King, Garrison, Douglas, Stanton, and So Many Others are Smiling Tonight


This is not a political endorsement: But it is a celebration of the culmination and success of an earlier fight on behalf of human exceptionalism--Abolitionism and racial equality.

Abraham Lincoln who grew into abolitionism during his presidency, is smiling tonight as the first African-American in history accepts his party's nomination to be its candidate for President of the United States. So is the great William Lloyd Garrison, who not only stood for abolition, but full equal moral worth between blacks and whites--and men and women--at a time when only a very few did either.

Ditto the great Frederick Douglas, who escaped slavery and became a clarion beacon for equality.

And Elizabeth Cady Stanton, who before she was a feminist, cut her teeth in the abolitionist movement.

Also, Booker T. Washington, whose great granddaughter I met a few weeks ago--living history--who at a time of vicious Jim Crow oppression, led the country toward a better time.

And of course, Martin Luther King, who on this day 45 years ago, gave us a dream we could all embrace.

It took hundreds of years and hundreds of thousands of deaths to get here. But perhaps the time has come when those incredible words can at last be spoken without reservation: "Free at last, free at last, thank God Almighty, we are free at last!"


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What Passes for Animal Rights Credibility:Pretending a Child Has Cancer Due to Eating Hotdogs.



The animal rights movement's strongest claim promoting vegetarianism is ethical, as in "If it has a face, don't eat it." But that isn't good enough. Too often they go into odious comparisons between the worst human evils and barbecuing a steak (PETA's infamous Holocaust on Your Plate Campaign), or engage in outright distortion and propagandist manipulation. Case in point, pretending a child eating a hot dog has colon cancer. From the story:

A new TV commercial shows kids eating hot dogs in a school cafeteria and one little boy's haunting lament: "I was dumbfounded when the doctor told me I have late-stage colon cancer." It's a startling revelation in an ad that vilifies one of America's most beloved, if maligned, foods, while stoking fears about a dreaded disease.

But the boy doesn't have cancer. Neither do two other kids in the ad who claim to be afflicted. The commercial's pro-vegetarian sponsors say it's a dramatization that highlights research linking processed meats, including hot dogs, with higher odds of getting colon cancer. But that connection is based on studies of adults, not children, and the increased risk is slight, even if you ate a hot dog a day
Without reading the whole story, I thought this will be the Physicians Committee for Responsible Medicine, a PETA creature, as mendacious a group as you will find. Yup:

Dr. Neal Barnard, president of the Physicians Committee for Responsible Medicine, called the ad "a way to raise appropriate concern about a deadly concern." Barnard also heads The Cancer Project, an offshoot of his anti-meat advocacy group.
Never believe anything the PCRM or the Cancer Project say. Less than 5% of the committee are physicians. They are quacks in this field, their assertions products of their ideology rather than objective science. If in doubt about what they claim, turn to a credible source.

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The Harsh Values of Health Care Rationing

The Oregonian is trying to defend the Oregon Medicaid rationing scheme and its offer to pay for the assisted suicides of patients for whom it denied life-extending chemotherapy. The idea behind the Oregon scheme was to expand coverage to people who were not the poorest of the poor, but at the cost of restricting treatment to certain patients. Politics came into the system early as late stage AIDS patients--who would have been opted out in the early iteration of the plan--were opted in because of the political clout of their community. But some cancer patients don't have such clout, so they are out of luck.

From the editorial:

The money Oregon can spend on health care is limited. Currently, 576,000 Oregonians have no health insurance coverage whatsoever. Many are people formerly on the Oregon Health Plan whom the state can no longer cover because of the ever-rising cost of medical care. Some of these Oregonians will develop cancer but, unlike those still on the state's health plan, they will not have coverage for even a first round of chemotherapy, or for potentially curative surgery.

The reality is that if we pay for marginally effective, expensive, second-line treatments for one person, we would be denying access to well-established, first-line treatments for others
So socialized health care, leads to rationing, which leads to patient groups vying against each other for coverage.

And get this crass reaction of the Oregonian toward Medicaid telling patients "we won't pay for you to live but we will to kill you:"
Weighing the cost of end-of-life treatment against the voter-approved Death with Dignity Act was never a part of those discussions. No treatment has ever been denied because death would be more "cost effective." The very idea is both abhorrent and a blatant distortion of the facts.

The Oregon Health Plan is charged with prioritizing services that reflect the values of Oregonians, who have made it clear--twice--through their ballots that physician aid in dying is an option they want at the end of life. But the fact that it is covered by the health plan has no bearing on the decision in this or any other case.

It's deeply regrettable that insensitive wording in a letter caused a patient distress
That's it? It is "regrettable" that the patients were caused "distress?" What compassion!

Moreover, the editorial is factually wrong. The threat of the state or HMOs paying for killing but not for caring has been repeatedly raised by opponents of assisted suicide. Indeed, reflecting my Naderite roots, I began warning about this potential as soon as I entered the fray about the issue in 1993. We were called alarmists by the likes of the Oregonian, of course. But we were clearly right.

Which raises another point: The Oregonian--which once opposed PAS--has predictably fallen in line to march to the logic of the culture of death. Once its values are accepted by a society, every time an abuse comes to light it is shrugged off or justified--just like the Oregonian did about this travesty.

If this keeps up, in thirty years Oregon will be precisely where the Netherlands is today, if not sooner.

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Wednesday, August 27, 2008

The Manuscript is Turned In!


Finally. It was several years in the making, but I have just electronically turned in my manuscript of the animal rights book to the publisher. It came in at between 90,000 and 100,000 words, not surprising given that "short-winded" is not exactly my strong suit.

I can't tell you what a relief it is to be done. Much work remains, of course. Editing can be a cruel and painful process. But most of it now is in the hands of the publisher.

I am going to take a week off, except for SHS, rest, and paint the bedroom. And then I will get back to the lecture circuit, writing articles, and return to recording Brave New Bioethics podcasts, which I sorely neglected in the press of the looming book deadline.

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"Stunning" Adult Stem Cell Success


When the MSM declares an adult stem cell success "stunning," as the Washington Post headline does, you know it is a new day. In mice, scientists were able to transform adult cells into stem cells--from within the body! From the story:

Scientists have transformed one type of fully developed adult cell directly into another inside a living animal, a startling advance that could lead to cures for a plethora of illnesses and sidestep the political and ethical quagmires that have plagued embryonic stem cell research.

Through a series of painstaking experiments involving mice, the Harvard biologists pinpointed three crucial molecular switches that, when flipped, completely convert a common cell in the pancreas into the more precious insulin-producing ones that diabetics need to survive.

The feat, published online today by the journal Nature, raises the tantalizing prospect that patients suffering from not only diabetes but also heart disease, strokes and many other ailments could eventually have some of their cells reprogrammed to cure their afflictions without the need for drugs, transplants or other therapies.
There is a long way to go before this can be used in humans, if ever. But my, how the world has changed from less than a year ago. ESCR has lost its political potency as an issue. The newest and most hopeful areas of advancement are coming from morally uncontentious areas of biotechnology. The drive to push human cloning has been staggered by IPSCs.

Perhaps we will be able to have everything that scientists wanted from ESCRs, without the moral baggage. And you know what: I believe that some people would be extremely unhappy about that because they saw this field of scientific inquiry as a way not only to improve health care, but also to change the culture in a less sanctity of life direction. Looks now like that might not happen.

And for our friends in the animal rights movement: One more proof of the efficacy of using animals in research.

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SHS Funnies

The transhumanist psychologist's last words, uttered moments before he suddenly realized that he had been chasing the literally impossible dream:


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New Federal Regulation Favoring "Conscience?"

The Department of Health and Human Services has a proposed regulation up for public comment that would apparently provide protection for doctors who do not wish to perform abortions. From the story:

The proposed rule, which applies to institutions receiving government money, would require as many as 584,000 employers ranging from major hospitals to doctors' offices and nursing homes to certify in writing that they are complying with several federal laws that protect the conscience rights of health care workers. Violations could lead to a loss of government funding and legal action to recoup federal money already paid.

Abortion foes called it a victory for the First Amendment, but abortion rights supporters said they feared the rule could stretch the definition of abortion to include birth control, and served notice that they intend to challenge the administration.
What about the birth control fear? Secretary Leavitt says no, it won't apply. As I quickly read this, this seems right, but I think there is some room for doubt. From page 34-35 of the Notice of Proposed Rule Making:

Section 88.4 Requirements and Prohibitions
(a) Entities to whom this subsection 88.4 (a) applies shall not:
(1) subject any institutional or individual health care entity to discrimination for refusing: (A) to undergo training in the performance of abortions, or to require, provide, refer for, or make arrangements for training in the performance of abortions; (B) to perform, refer for, or make other arrangements for, abortions; or (C) to refer for abortions;
(2) subject any institutional or individual health care entity to discrimination for attending or having attended a post-graduate physician training program, or any other program of training in the health professions, that does not or did not require attendees to perform induced abortions or require, provide, or refer for training in the performance of induced abortions, or make arrangements for the provision of such training.
It seems clear that the proposal would not protect a health care worker who refused to participate in providing barrier-type birth control methods. And it would also appear that the term "perform abortions" would not apply to birth control since the dispenser of birth control doesn't "perform" an abortion even if the method of birth control is an abortofacient. However, this analysis would also cover dispensing RU 486, which causes an abortion but which the health care provider does not perform. What about that? And if that form of abortion would be covered by the regulation, then why wouldn't abortofacient forms of birth control? This is particularly germane since, in my quick reading, I didn't see a definition of the term abortion (although that might exist in referenced laws, regulations, or court rulings). So, I think Leavitt is right, but I can see how it might be construed otherwise.

But this is where we are: When a culture is divided about what is right and what is wrong as ours is, and indeed, in which the very concepts seem to becoming relativized, we end up with such proposed regulations.

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Tuesday, August 26, 2008

SHS Political Funnies

This isn't presented as a political statement, but I love good political cartoons. This one from The Times of London is tops. Enjoy.

Science Helps Paralyzed People Walk


So much good is happening in science that has nothing to do with controversial areas such as human cloning--that lest we forget that most scientific research is not controversial--I feel duty-bound to bring it to the attention of SHSers. Case in wonderful point: An engineer, who is himself paralyzed, has invented an "exoskeleton" that permits paraplegics to walk. From the story:
HAIFA, Israel (Reuters)--paralyzed for the past 20 years, former Israeli paratrooper Radi Kaiof now walks down the street with a dim mechanical hum.

That is the sound of an electronic exoskeleton moving the 41-year-old's legs and propelling him forward--with a proud expression on his face--as passersby stare in surprise. "I never dreamed I would walk again. After I was wounded, I forgot what it's like," said Kaiof, who was injured while serving in the Israeli military in 1988. "Only when standing up can I feel how tall I really am and speak to people eye to eye, not from below."

The device, called ReWalk, is the brainchild of engineer Amit Goffer, founder of Argo Medical Technologies, a small Israeli high-tech company. Something of a mix between the exoskeleton of a crustacean and the suit worn by comic hero Iron Man, ReWalk helps paraplegics--people paralyzed below the waist--to stand, walk and climb stairs...

The ReWalk is now in clinical trials in Tel Aviv's Sheba Medical Centre and Goffer said it will soon be used in trials at the Moss Rehabilitation Research Institute in Pennsylvania
It's also healthy for people to be able to get up on their feet:
Kate Parkin, director of physical and occupational therapy at NYU Medical Centre, said it has the potential to improve a user's health in two ways.

"Physically, the body works differently when upright. You can challenge different muscles and allow full expansion of the lungs," Parkin said. "Psychologically, it lets people live at the upright level and make eye contact."

Iuly Treger, deputy director of Israel's Loewenstein Rehabilitation Centre, said: "It may be a burdensome device, but it will be very helpful and important for those who choose to use it."
So, let us never forget: Good ethics and good science are a powerful combination that offer a cornucopia of benefits to humankind.

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SHS Funnies

Another early transhumanist experiment goes awry.

Monday, August 25, 2008

NHS Meltdown: Doctors Withhold Information on Treatments from Patients


So now some UK doctors are withholding information from patients about possible cancer treatments due to NHS funding polices. From the story:

Cancer patients are being denied information about treatments that could help them live longer by their own doctors, a new survey has disclosed. A quarter of specialists in myeloma, a bone marrow cancer that claims 2,600 lives in the UK each year, admitted keeping their patients in the dark about possible therapies.

They believed it was better not to talk about certain treatments not yet approved by the health service's rationing watchdog to avoid raising false hope. Primary care trusts are generally reluctant to pay for drugs not already passed by the National Institute for Health and Clinical Excellence (Nice).
NICE is the Orwellian-named utilitarian bioethics "advisory" board that continues to push policies that promote utilitarianism at the expense of Hippocratic values.

This is what happens when rationing convinces doctors to assume a "dual mandate," that is to both treat patients and to adhere to funding policies. It destroys their ability to provide optimal care and it destroys trust of patients in their doctors.

The right thing to do is to tell the patient about the treatments. That is their job. If the NHS won't pay for it, the patient might be able to find out other means of obtaining the care. Keeping patients in ignorance is inexcusable.

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Animal Rights Leader Slams HSUS for Offering Reward to Catch Terrorists

I believe that the Humane Society of the United States (HSUS) is an animal rights group as committed to the agenda as PETA. But it is far more clever. Rather than engage in PETA-style antics, and rather than push the meme that animals are people too, intead, it implacably files lawsuits against animal industries, pushes voter initiatives like the one that put pregnant pigs in Florida's Constitution and Proposition 2 this year in California, and otherwise spends a fortune trying to make animal husbandry more difficult.

As a tactic, it is brilliant: If you keep chewing at the edges long enough, the entire pie will be consumed.

Some animal rightists hate this approach because, to them, it reeks of animal welfare advocacy that validates animal husbandry and increases public support for it by eliminating the worst practices. And so, radical animal rights leader Stephen Best has exploded in rage against HSUS. And what seems to have really set him off is HSUS's token reward offer of $2500 (from a non profit with more than $200 million in assets) for the capture and conviction of the terrorists who exploded an incendiary bomb on the porch of a Santa Cruz animal researcher. From Best's wildly ranting blog:

[W]hen three years ago HSUS seemed content to merely "applaud" the state for breaking into activists’ homes – armed and angry men breaking down their doors, stealing and destroying their possessions, separating them from their human and nonhuman families, and locking them away in federal prisons for years--now it seems that HSUS has taken its treachery and complicity one step further, by actually offering a $2,500 reward, in cooperation with the FBI and state and local law enforcement officials, to capture the person(s) who set off firebombs at the homes of two vivisector in Santa Cruz, California in August 2008.

As one bomb exploded when the researchers and their families were here and someone could have been injured of killed, these actions were clearly not the work of the ALF, which adheres to a strict nonviolent policy that targets the property of animal exploiters but never the exploiters themselves.
Best, being a complete wacko, suggests that the terrorist bomb was actually planted by the state. But his real point seems to be to money:
I encourage people to send HSUS a polemic not a check, and to donate their hard-earned money not to robotic raconteurs but rather to ardent activists who fight on the front lines of the emerging war over nature with substantial results. I'm talking, for instance, about small groups such as the Sea Shepherd Conservation Society; amazing activists like Anthony Marr or Gary Yourofsky, who foment revolutionary change on a shoestring budget; and stellar local animal rescue groups.
The head of the Sea Shepherd's, Paul Watson, has called human beings an AIDS virus afflicting the earth and Yourofsky has wished rape upon any woman who wears fur, while yearning for researchers to die slowly of cancer--in the "compassionate" name of animal rights.

It is tempting to think of this as a fight within the family. I applaud HSUS's opposition--albeit tepid, as I see it--to violence and terrorism. The animal rights movement as a whole would do itself a huge favor if it united in opposing terrorism and cooperated with law enforcement to purge the movement of these criminals. But with rare exceptions, mostly what we get is the sound of crickets chirping. Meanwhile, fanatics like Best reveal the depth of rage and misanthropic radicalism that is part--not the whole, but part--of the DNA of animal rights.

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Saturday, August 23, 2008

The Hard, Cold, Awful Reality of Euthanasia/Assisted Suicide


A story just published in the UK's Guardian is a diary account of the euthanasia death of Mieneke Weide-Boelkes, a woman with brain cancer, written by her son Marc Weide, who made it public. As such, and because it is so awful, it seemed to me that frank comment was warranted. I sent it off to First Things, and they put it up on the site.

But I want to reproduce my comments here, too. The story of Weide-Boelkes' euthanasia amply demonstrates the abandonment that assisted suicide/euthanasia consciousness generates in society, within medicine, and among families. And it proves clearly that the "protective guidelines" are utterly meaningless. It also demonstrates that once mercy killing is sanctioned, families become almost remote bystanders.

To cases: One of the supposed requirements of Dutch euthanasia is that there can be no other way to alleviate suffering other than killing the patient. Yet, in this actual case, the woman who would soon be dead wants to die for fear of going bald during life-extending chemotherapy: From the story:

The prognosis is she could live another year if she undergoes chemotherapy. But she won't. "I'm not going to go bald," she says. "I don't want people saying, 'How sad, that beautiful hair all gone.' Never."
Despite the ability to extend Weide-Boelkes' life, and the driving motives of worries that she will not be pretty (and hence not worthy of being loved?), and fears about losing the ability to engage in enjoyable activities as the reasons for wanting euthanasia, the doctor agrees to kill.

And here are two things so often seen in euthanasia/assisted suicide cases that are reported publicly: We have created a "choice" culture so pervasive that even in the face of impending killing families feel they are not entitled to resist their loved one's desire to be made dead. Second, the fear of the future from the patient--precisely what happens in Oregon with assisted suicide--is what most often leads to the killing, not the actual experience of unalleviable pain and suffering:
The doctor says euthanasia can take place next week. Another doctor first needs to verify, though, that Mum cannot be cured, that her wish to die has been consistent, and that her suffering is unbearable.

Martin is convinced of the first two conditions but not of the third. If Mum is too energetic to stay in bed, then how is her suffering unbearable? Mum puts her coffee down. "Well, I have to die anyway, don't I?" Then she asks us what we think.

I interrupt: "It should be your own decision. None of us is to say anything." But Mum struggles to say she wants to die. Eventually I say, "I think what she finds unbearable is not so much her pain and sickness, but the fear of it getting worse and of losing control." When Martin is finally satisfied that Mum wants to end it, he agrees to contact the second doctor. He leaves with an empathetic nod to us all.
None of us is to say anything! And yet he did! I couldn't believe my eyes: Weide, not his mother, found the words to justify the euthanasia. When she asked what the family thought, where were their kisses? Where were the assurances of always being there for her? Where were the phone calls to doctors to assure the patient her suffering could be alleviated through palliative care. Where were the efforts to obtain proper mental health interventions to help alleviate the woman's terror of the future? Instead, a terrified woman was left to sink or swim in the midst of an emotional crisis! I know we are not supposed to "judge" in these matters, but what an abdication of a son's responsibility to his mother--what I call terminal nonjudgmentalism in action.

On the day she dies, she vacuums the house!

I can hear she is hoisting the vacuum cleaner up to the attic. It is just after 6am. It is the start of an increasingly mad day, during which Mum hoovers the whole house and does six loads of washing (one of which consists of a single white shirt). She scrapes all the woodwork on the outside of the house clear of moss and cleans the windows.

After breakfast, I find Dad fuming after Mum has given him grief for not ironing fast enough. I ask him if it helps to see her as a mental patient instead of his wife. He grumbles. I think of what was said the night before, about Mum's relative physical fitness and her obsession with material objects and cleanliness. I feel an increasing tension as the day progresses and I still don't know whether it is going to be Mum's last.
Even the doctor pushes through hesitancy on the part of the patient.6.15pm:
The doctor arrives shortly after the scene with the toilets. Mum greets him, then disappears upstairs, saying, "Best let me potter for a bit." Nobody sees her for another 20 minutes.

"Does it happen at all that people pull out at the last minute?" I ask. "Yes," Martin says. "Quite often I go home again and a new appointment is made. But in many cases the patient passes away between visits."

When Mum comes back, listing things she has put in bags and boxes, Martin gently interrupts her: "Can I just ask you something? Is there still a lot you feel you need to do?"

"Yes," she says, "I mean no. I'm just nervous."

"I can always come back later if you are not ready," says the doctor.

Mum sits down and listens to the doctor. Then she takes a deep breath and says, "OK. I am ready." At 7pm, with my father, brother and me around her bed as well as Martin, who has given her the injection, Mum goes to sleep.
This is beyond awful. Euthanasia leads to the most profound abandonment of frightened and suffering people.

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Friday, August 22, 2008

Pluripotent Stem Cells From Wisdom Teeth?

Spending the money and scientific talent to perfect human cloning (SCNT) is becoming very hard to justify--if that is, all that is wanted are tailor made, patient specific stem cells for study of diseases and/or eventual therapeutic purposes. (Of course, therapeutic cloning is not the real goal, it is the pretext.) From the story:

Researchers at the government-backed National Institute of Advanced Industrial Science and Technology said they created stem cells of the type found in human embryos using the removed wisdom teeth of a 10-year-old girl.

"This is significant in two ways," team leader Hajime Ogushi told AFP. "One is that we can avoid the ethical issues of stem cells because wisdom teeth are destined to be thrown away anyway.

"Also, we used teeth that had been extracted three years ago and had been preserved in a freezer. That means that it's easy for us to stock this source of stem cells."
President Bush said he had confidence that scientists would be able to find ethical means of obtaining pluripotent stem cells. He was right.

UPDATE: Mea culpa. This appears to have been another IPSC experiment. The teeth do not appear to have had pluripotent cells within them without injection of genes. Good catch by Lydia.

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I Am Not a Chimp--And Neither Are You













As promised, I have a more extended piece up at the Weekly Standard Website demonstrating that the case for granting equal rights to chimpanzees with humans is not justified scientifically. First, I describe the ideological agenda behind the effort to reduce humans to the status of apes. From my column:

THERE IS A CONCERTED advocacy campaign underway across several disciplines aimed at knocking human beings off our pedestal of moral exceptionalism and redefining us as merely another animal in the forest. Toward this end, elements of the natural world are being personalized by public intellectuals, even as they seek to strip personhood from some people. The point of this ideological drive is to degrade our perceived self-worth so much that we will readily sacrifice human prosperity and welfare "to save the planet" or "for the animals," while undercutting the power of theistic religion in general, and Judeo-Christian moral teaching in particular, to influence public policies.
But what about our alleged close genetic relationship with chimpanzees?
[T]he purported 94-98 percent [genetic]similarity [between humans and chimps]--whichever it is--doesn't compare total genetic makeup, but only the DNA that "encodes proteins," that is, that stimulates the production of the building blocks of our physical bodies and functions...

[R]ecent studies have surprised scientists, showing that [non coding]junk DNA isn't really junk, but has a function. Research continues as to its exact purposes, but given the significant differences between human and chimp non-coding DNA, even if the purported 98 percent similarity of coding-DNA is true, it actually applies to only a small percentage of our total functional genetic makeup.
But what about the similarity between humans and chimps at the protein coding level? First, as Bill Hurlbut explains, even identical genes express differently across species, and hence, may produce different outcomes. Beyond that the "98%" identical meme masks tremendous biological differences, at least 40 million of which have been identified:
Forty million biological differences at the most fundamental biological level of life from whence our form and function spring is no mere crack in the pavement, as the likes of Goodall, Dawkins, and Singer would have us believe. No wonder geneticist Svante Paabo, a chimp consortium member based at Max Planck Institute for Evolutionary Anthropology, told Science, "I don't think there's any way to calculate a number [of similarities between chimps and humans]. In the end," he said, "it's a political and social and cultural thing about how we see our differences."
Which gets us back to what is really going on:
Ideology--not science--is the nub of the matter, reflecting a fervent desire among the "all we are is apes" crowd to destroy the cultural values explicitly upholding the highest moral worth of human beings. Society may choose to go the ape route, of course. But it is perfectly clear that the proposed radical changes in morality and law are not justified by current scientific understanding.
Out of necessity, the piece is a bit arcane, but I think it is important for those of us fighting off the assaults on human exceptionalism to know that the science supports our position, not that of the "all we are is apes" crowd.

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Thursday, August 21, 2008

Dogs Prove Human Exceptionalism

Everyone knows that dogs did not evolve, they were (and are still, technically) wolves that were intelligently designed by us.

The tight bond between humans and our best friends, and more particularly their exposure to our love and our genetic and behavioral manipulation has created special traits not often seen in the natural world. From the story:

Dogs are becoming more intelligent and are even learning morals from human contact, scientists claim. They say the fact that dogs' play rarely escalates into a fight shows the animals abide by social rules...

Dr Peter Pongracz from Eotvos Lorand University, Budapest, and colleagues have produced evidence dog barks contain information that people can understand. They found even people who have never owned a dog can recognise the emotional 'meaning' of barks produced in various situations, such as when playing, left alone and confronted by a stranger.

His team has now developed a computer program that can aggregate hundreds of barks recorded in various settings and boil them down to their basic acoustic ingredients. They found each of the different types of bark has distinct patterns of frequency, tonality and pulsing, and that an artificial neural network can use these features to correctly identify a bark it has never encountered before.

This is further evidence that barking conveys information about a dog's mental state, reports New Scientist magazine. They also discovered people can correctly identify aggregated barks as conveying happiness, loneliness or aggression.

'Even children from the age of six who have never had a dog recognise these patterns,' says Dr Pongracz.Dogs are not just able to 'speak' to us--they can also understand some aspects of human communication.
Still, we shouldn't make too much out of this:
Dr Alexandra Horowitz from Barnard College in New York prefers the term "theory of behaviour" to describe dogs' apparent insight. She said: 'I think there is a massive territory between a theory of mind and a theory of behaviour.' Her own recent study illustrates the point--when dogs play together, they use appropriate signals for grabbing attention or signalling the desire to play depending on their playmate's apparent level of attention, such as whether it is facing them or side-on.

That could be interpreted as mind reading, she admits, but a simpler explanation is that dogs are reading body language and reacting in stereotyped ways.
This much is clear: It took the exceptional species--us--to change what were only 10,000 years ago gray wolves and intentionally transform them into the multitudinous breeds of dogs that are not only noble--and at times delightfully goofy--but also protectors, wonderful companions, and the givers and receivers of tremendous love and joy.

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I- 1000 Propganda Clearly Untrue

Pro assisted suicide advocates are expert spin artists who specialize in ignoring the forest for the trees. But this bit of cow manure is so obviously false that if the media weren't generally totally in the tank, the campaign would become a laughing stock. From "The Oregon Experience" on the Yes on 1-000 Web site:

The poor, disabled or minority populations were not adversely impacted in any manner because all of the patients who chose the option had health care coverage.
Oh really? Better tell that to Oregon lung cancer patient Barbara Wagner, who was told by Oregon Medicaid that it would not pay for chemotherapy to extend her life, but would pay for her assisted suicide. The same thing happened to Randy Stroup when he wanted chemo for his recurrent prostate cancer.

If refusing to pay for treatment but paying for killing isn't an "adverse impact," then what is?

Here's another whopper:
Approximately 88% or more over the years were in hospice, and all of them were at the very end of their dying process.
First, the annual statistics published by the State of Oregon can't tell us that. Moreover, we know for a fact that the assertion is flat out false. As described in the Journal of the American Psychiatric Association, Michael Freeland received a lethal prescription nearly 2 years before he died a natural death--meaning that he clearly was not at the last stages of his disease.

And here's another abuse in that case: When Freeland became psychotic, his psychiatrist left the lethal prescription "safely at home" even as he recommended hospitalization and then court oversight over the ill man's affairs.

Assisted suicide in Oregon is rife with abuse. With the exceptions of the "no funds for care but will pay for killing" stories, the media just won't cover it.

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Wednesday, August 20, 2008

Embryonic Stem Cells Stimulate Immune Rejection in Mice

This shouldn't be a surprise because scientists have worried about it all along, but ES cells injected in mice clearly stimulated the kind of immune rejection seen with transplanted organs. From the Scientific American story:

The much-ballyhooed human embryonic stem cell apparently may share a problem with transplanted organs: a high probability of rejection.

Researchers at Stanford University School of Medicine found that mice mounted an immune response after being injected with human embryonic stem cells (hESCs). The result: all the transplanted stem cells--which hold the promise of maturing into several different types of tissue--were dead within a week.

Wu says that the fact that the hESCs could not survive in the mouse, coupled with previous work showing that the animals also reject mice ESCs, suggests that if human stem cells were transplanted to a patient, they would very likely provoke an immune response. The U.S. Food and Drug Administration, however, has not approved the injection of hESCs into patients because the raw cells have the potential to become cancerous...

The new study not only showed that these cells are not invisible to the immune system, but using a noninvasive molecular imaging technique, the scientists could see when exactly the cells were dying off. The finding means that people who may one day be treated using pools of stem cells taken from many lines could reject them, making the therapy useless.
This is a real problem for proponents of ESCR as a therapy that will make it difficult to permit human trials. Moreover, when added to the tumor problem, the very pronounced difficulties with ESCR should color our thinking about where we want to put public money in research--even without cosidering the ethical objections that have raised such a fuss for the last ten years. It seems clear to me that based on the emerging science alone, public funding should favor IPSCs--which will not have the immune response problem (but as pluripotent cells, still have tumor issues)--and adult/umbilical cord blood stem cells.

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Embryonic Stem Cell Success: Morphed into Blood


An interesting ESCR success was published in the journal Blood. ES cells were morphed into blood, offering the potential of greatly easing blood shortages and making transfusions safer for patients. From the story:

In the new study, researchers were able to make as many as 100 billion red blood cells--enough to fill two or three collection tubes--from a single plate of embryonic stem cells.

After allowing the stem cells to begin the earliest stages of embryonic development, the researchers prompted some of them to grow into red blood cells by exposing them to a variety of proteins. Up to 65% of the resulting cells matured to the point at which they shed their nucleus, which allows them to take on the distinctive doughnut shape of circulating red blood cells, said Dr. Robert Lanza, chief scientific officer at Advanced Cell Technology Inc. and the study's senior author.

The team, which also included researchers from the University of Illinois at Chicago and the Mayo Clinic in Rochester, Minn., produced blood of types A-positive, A-negative, B-positive, B-negative and O-positive. The method was 100 times more efficient than previous efforts, said Eric Bouhassira, a professor of stem cell biology and regenerative medicine at Albert Einstein College of Medicine in New York. But most of the cells had embryonic or fetal versions of globin, the compound in red blood cells that carries oxygen. Only a relative few appeared to contain the adult globin that would be needed by patients, he said.

"Whether they would be good enough for transfusion is very unclear," said Bouhassira, who wasn't involved in the study. Lanza said the research team was conducting more experiments to see whether the stem cells would produce more adult globin if given more time to mature in the lab.

Even with substantial improvements, the method faces another big hurdle. Roger Dodd, director of the American Red Cross' Holland Laboratory in Rockville, Md., said that producing blood in the lab could cost thousands of dollars per unit--far too expensive to replace the 14 million pints of red blood cells that are transfused every year. "It's a rather ambitious goal," Dodd said.
A few points:

This is from Advanced Cell Technology, along with others. With ACT, it is always wise to trust but verify, since the hype is often a bigger deal than the actual experiment. However, Blood is certainly a reputable journal.

Second, while the story says that adult stem cells are not as efficient in this process, it is interesting to note that the change to blood cells came from embryonic stem cells that were not then truly stem cells but had begun differentiation.

Third, I wonder if IPSCs would work as well.

Fourth, the cost factor could easily prevent this from ever going into clinical application even if the existing kinks are solved.

Fifth: I will bet the cells used were Bush approved, since ACT is bankrupt and thus, these researchers probably received an NIH grant.

Finally, if ESCR/blood ever became widely acceptable, would it have to be labeled so that those with ethical objections could refuse it?

UPDATE: Re Bush-approved lines, I checked with my sources. One of the ESC lines was indeed Bush-approved . Another line was one that Harvard had established privately, and two from lines created at ACT.

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Tuesday, August 19, 2008

A Coming McCain Change in ESCR Federal Funding?

The stem cell issue sure didn't turn out to be as potent--or as important--as people expected this time last year. With the IPSC breakthrough, President Bush's funding limitations ceased to be a cutting edge issue in the presidential campaign. That won't matter to Senator Obama, since smashing everything Bush is a Democratic driving force. But apparently some involved with the issue think that Senator McCain may be softening in his opposition to the current policy. From the story:

McCain's campaign did not respond to The Hill's questions or numerous attempts to obtain a comment for this article. In February, the campaign issued a statement to the Wisconsin State Journal standing behind his record but containing the language O'Steen quoted as evidence of McCain's flexibility on the issue.

"John McCain does support federal funding for embryonic stem cell research," the February statement says in part. "[H]e believes that recent scientific breakthroughs [IPSCs] may render this debate academic," according to the statement.
Oh, that is piquant isn't it? I noticed that he made the same kind of statement during the candidates' forum hosted by Pastor Rich Warren on Saturday.

The Bush policy--which has still resulted in at least $160 million in NIH funding for human ESCR--may survive after all. Stay tuned.

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Gay Twist on Medical Conscience Issue

This is a new angle on the right of patients to demand treatment and when doctors can say no. This time it involves a religious objection to providing artificial insemination for a lesbian.

The doctor believed it was immoral to help a homosexual get pregnant and refused to participate, but referred her to someone else for the services. The new doctor was not covered by health insurance. The woman in question sued the original doctor and the California Supreme Court ruled unanimously that anti discrimination laws trump religious objections. From the story:

The ruling, based on a state law prohibiting businesses from discriminating against customers because of their sexual orientation, comes three months after the court struck down California's ban on same-sex marriage. "This isn't just a win for me personally and for other lesbian women," said the plaintiff, Guadalupe Benitez. "Anyone could be the next target if doctors are allowed to pick and choose their patients based on religious views about other groups of people."

The ruling is the first in the nation to address doctors' religious objections to treating gay or lesbian patients and should make health care more accessible, said Benitez's lawyer, Jennifer Pizer, of the Lambda Legal Defense and Education Fund.

Lawyers for the clinic and two of its doctors said they were considering an appeal to the U.S. Supreme Court. One supporter of the physicians called the ruling a strike against religious freedom. "This court is allowing two lesbians to force these individuals to choose between being doctors in the state of California or being able to practice their faith," said attorney Brad Dacus of the conservative Pacific Justice Institute, which filed arguments backing the doctors...The law "furthers California's compelling interest in ensuring full and equal access to medical treatment irrespective of sexual orientation," said Justice Joyce Kennard.
So this seems to be the state of the situation in law and as I perceive the mainstream view within bioethics:

- Doctors refusing to sustain lives based on quality of life determinations, still to be determined in the courts, explicitly legal in Texas and perhaps in other states, generally although not unanimously, supported in bioethics.
- Doctors and pharmacists refusing to supply contraception services based on conscience, under concerted attack throughout the nation in legislatures and courts, bioethicists almost all against permitting conscience to control in this circumstance.
- Doctor refusing elective fertility treatment based on religious views, outlawed in California, a ruling I suspect will be recieved happily within mainstream bioethics.

None of this is consistent if the actual issue is the consciences of doctors and other medical professionals. But that isn't what is really going on. Rather, these and other bioethical issues, at least partially, serve as a canvas for broader cultural struggles that are roiling society.

Looked at it that way, and the consistency becomes clear. The ethics of medicine and health care come about as close as we get to expressing the general core values of a society. The current societal trend is to subsume actual or deemed to be religiously-based views to secular values and tolerance of individual choices in the public sphere--a trend moving swiftly into the ethics of medicine. But individual or professional values actually or perceived to be based primarily on secular or "rational" analyses, such as in medical futility, are more likely to be honored in the courts and among public intellectuals, and individual conscience of patients or professionals required to take a back seat.

How these play out as we go along will thus tell us a lot about where we are as a society and where we are going.

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Monday, August 18, 2008

SHS Poll: When Should Human Rights First Apply?

Killing for Organs: More on Attempt to Kill the Dead Donor Rule

Last week I posted two criticisms of the NEJM article advocating the dismantling of the dead donor rule (here and here) that requires death before the taking of vital organs. I got some backstage blowback that I painted with too broad a brush about the kind of support such proposals have within bioethics. I don't think I did that, given that the attempt to kill the dead donor rule is being mounted in the most Establishment medical and bioethics journals by some of the most respected thinkers in their fields, but there is no question that "killing for organs" is far from the unanimous view--for example Art Caplan's good work in this area--a point that I could perhaps have made more clear. (The URL for the NEJM article is also now available, which can be accessed here.)

Still, it seems to me that the issue is gaining traction, particularly within the field of organ transplant medicine, in part because the idea has been "in play" for some time. This was perhaps most vividly illustrated in a very disturbing article written by Robert M. Arnold and Stuart J. Youngner in the prestigious Kennedy Institute of Ethics Journal way back in June 1993, "The Dead Donor Rule: Should we Stretch It, Bend It, or Abandon It?" (no link). They claim in the piece that "the production of body parts will increasingly be linked to the intentional ending of some lives with the salvaging of others." And they give a hypothetical that would seem to be the product of a nightmare:

Machine dependent patients could give consent for organ removal before they are dead. For example, a ventilator-dependent ALS patient could request life support to be removed at 5:00 p.m., but that at 9:00 a.m. the same day he be taken to the operating room, put under general anesthesia, and his kidneys, liver, and pancreas removed. Bleeding vessels would be tied off or cauterized. The patient's heart would not be removed and would continue to beat throughout the surgery, perfusing the other organs with warm, oxygen-and nutrient rich blood until they were removed. The heart would stop, and the patient would be pronounced dead only after the ventilator was removed at 5:00 p.m, according to plan, and long before the patient could die from renal, hepatic, or pancreatic failure.
If "choice" becomes the issue in organ donation instead of being dead, how do we avoid ultimately sinking to that scenario? Indeed, the authors seem to support moving in that direction--while using the usual "on one hand, on the other" hedge that is a hallmark of bioethical discourse, writing:
Given the difficulties our society is likely to experience in trying to openly adjudicate these disparate views [pro and con dead donor], why not simply go along with the quieter strategy of policy creep. It seems to be getting us where we seem to want to go, albeit slowly. Besides, total candor is not always compatible with the moral compromises that inevitably accompany the formulation of public policy.

Calling a spade a spade has at least one advantage however. By framing our choice in stark rather than obfuscated terms, we may be able to choose our path more clearly and be less surprised where it takes us.
This is precisely how I see my role: I strive to bring these controversies out of the ivory tower and into the public square in ways that prevent the obfuscation that leads to stealth policy creep.

And on this issue, the stakes could not be more stark. We turn our heads away and let "the experts" sort it all out at society's peril.

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Sunday, August 17, 2008

Gwynith Paltrow Endorses Company that Uses The Skins of Animals: Predictably, the Fur Flies


Oh, oh. A-list movie star Gwyneth Paltrow has endorsed a clothing company that uses animal skin in some of its products, and predictably, the animal rights ideologues are coming unglued. From the story:

The Hollywood star has been signed up by Italian designer Tod's and is pictured draped in fox fur and wearing fur-lined boots feature in the company's latest advertising campaign.

Miss Paltrow, 35, who is married to the Coldplay singer and vegetarian Chris Martin has won praise for her impeccable green credentials and is a fan of holistic practices and yoga. The decision to endorse Tod's, a luxury goods company which also uses ostrich and snakeskin in its products, and describes itself as "refined, understated luxury, impeccable taste and enviable quality", has come as a shock to animal rights campaigners.

Mark Glover, director of Respect for Animals, said: "Gwyneth Paltrow should be ashamed. I can only assume that Paltrow either is ignorant of the facts or lacks human decency and compassion."

No, the people who are responsible for Darfur lack human decency and compassion. Those who block a solution politically should be ashamed

What one wears hardly rises to that level of importance. Assuming the clothing is not made of endangered species, I don't see the problem. We have been wearing animal skins as long as we have been human. Indeed, wearing fur or ostrich hide is no more immoral in my view than wearing leather shoes made from the cattle we eat as steak.

Besides, fur is green. It is all natural. There are no petroleum or synthetics involved in its manufacture. Negligible carbon footprint. It is biodegradable. Heck, fur fits right in to the new global paradigm!

I certainly respect those who disagree, and laud them for living out their ethics--which is an aspect of human exceptionalism since only we refrain from or take actions based on purely ethical concerns.

So leave the poor, I mean rich, woman alone and find something more worthy of complaining about than a big time movie star being overpaid to permit her name to be associated with a line of ludicrously priced prestige clothing.

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Will San Francisco Voters Protect Human Traffickers?

Usually my wife Debra J. Saunders--better known as Secondhand Smokette--and I plow different fields in our writing. But once in a while, our interests converge, as in a few weeks ago when she wrote a splendid column about animal rights violence directed against researchers in Santa Cruz, the issue of assisted suicide--which she first criticized before I was ever onto the issu