Do Prisoners Have the Right to Starve Themselves to Death?

The bioethicist Art Caplan has argued against a court order requiring prison authorities to force feed a prisoner named William Coleman, who is on a hunger strike. It is against his autonomy, Caplan opines. From his column:

Recently, he took a turn for the worse. Prison officials, fearing for his life, sought and received a court order giving them the right to force-feed Coleman by giving food and water intravenously. They are wrong. Competent prisoners should not be fed medically against their will.Feeding Coleman or any other prisoner will require a doctor, nurse or other medically-trained prison worker to use restraints while inserting needles carrying artificial nutrition into the body. Feeding of this sort, as the U.S. Supreme Court recognized in the 1990 case of Nancy Cruzan, a young woman in a permanent coma whose relatives wished to discontinue her feeding tube, constitutes medical treatment. And that makes force-feeding any competent adult against their will unethical.

I think Caplan is looking at this from the wrong end of the telescope. First, this isn't a case of a sick or disabled person refusing medical treatment in the usual sense. The harm being ameliorated is self-caused. Would Caplan similarly claim that if a prisoner hanged himself and left a note that authorities were not to revive him, that the direction should be followed? Indeed, would he argue that about anyone who attempts suicide? I would hope not, and it seems to me the only difference is that Coleman's self destruction is occurring in slow motion, while other forms are generally quicker. Second, Coleman is a prisoner and has hence lost significant autonomy rights. Third, prison authorities have the duty to protect the health and safety of those in their charge--including against self harm. That is surely why the court granted the authorities' request for the court order. Finally, prison officials also have the duty maintain good order. Imagine the potentially disrupting impact that could arise were prisoners able to kill themselves by self starvation.

Caplan has anticipated some of these arguments, and in response claims that even if Coleman dies, his act would be protest, not suicide:

Some would argue that refusing food and water is an act of suicide and prisons do not have to accept suicides on the part of inmates. But a hunger-strike is not a suicide attempt. It is an act of protest. Coleman himself says he does not want to die, but he is willing to in order to draw attention to what he believes is his unjust conviction. Risking death is a means to an end. The end may be horrific, but even prisoners have the right to refuse medical care to make their point.

No they don't. Prisoners are not free. They don't have full first amendment rights of protest. Indeed, had Coleman decided to immolate himself as a form of protest--as Buddhist monks did during the Vietnam War--rather than go on a hunger strike, should that also be permitted?

Sometimes Caplan is right--as in his good thinking about the ethics of organ transplantation. But sometimes his pugilistic political liberalism leads him terribly astray. In my view, this is one of those times.

Washington Medical Association Brochure Against I-1000 and Assisted Suicide

The Washington State Medical Association has come out against legalizing assisted suicide and passing I 1000. From its brochure:

This fall Washington voters must decide whether to support or oppose Initiative 1000. It may help to know that the Washington State Medical Association strongly opposes Initiative 1000. Doctors oppose I-1000 because our training and experience in the practice of medicine directs us to heal and comfort,
not to cause death.

The WSMA believes physician assisted suicide is fundamentally incompatible with the role of physicians as healers. Patients put their trust in physicians and that bond of trust would be irrevokably harmed by the provisions of this dangerous initiative.

Indeed. Add in futile care theory and there would be a perfect storm of mistrust created with the most vulnerable patients perceived to be pushed toward death--one way or the other.

Martin Sheen Ad Against Washington's I-1000

Martin Sheen--known to be a left handed hitter politically--has a radio ad out against the assisted suicide legalization initiative, I-1000. This is important because despite the broad and diverse coalition against legalizing assisted suicide that cuts diagonally across the nation's usual political and cultural divides, the media continue their myopic ways by reporting that conservative pro lifers are the primary opponents to assisted suicide.

Here is what Sheen said his reasons were for agreeing to participate in the No on I-1000 campaign:

"I try to work when I'm not on the screen to help improve conditions for the most vulnerable people in our country--low wage workers, immigrants, the disabled and the poor," Sheen said. "We have a health care system where the more money you have, the better medical care you receive. Initiative 1000 is a dangerous idea--because so many people do not have the money necessary to get the care they need. When I heard about Initiative 1000, I wanted to help stop it before it harms people who are at risk."

No lie. Recall that Oregon has offered to pay for the assisted suicides of poor people after refusing to fund their chemotherapy.

To hear the ad, follow this link and then click on the audio file.

Arnold Schwarzenegger is Disgracefully in the Tank With Big Biotech

Arnold Schwarzenegger, who alas is my governor, was elected to produce fiscal responsibility in California. Well, that didn't work out: This year alone, we are about $17 billion in the hole and counting.

That aside, Schwarzenneger first violated his fiscal responsibility raison d' etre for running for governor by supporting California's going $6 billion deeper into debt--at a time when our streets weren't being repaired and our hospitals were cracking under fiscal burdens--to pay the private sector and their university business partners to conduct human cloning and ESCR. This was back when he was really popular. Before his support, Proposition 71 was under 50% in the polls. Afterwards, it soared to victory.

This year, when the CIRM paid $270 million this year to buy the most expensive buildings that the most expensive of the world's architects could design, Arnold cheered.

And now, when the California Legislature actually passes a bill with huge bipartisan support to hold the California Institute of Regenerative Medicine to its campaign promises to share the benefits of its grants with the people of CA, Arnold vetoes the bill! From the story:

Gov. Arnold Schwarzenegger vetoed SB 1565, aimed at making stem cell therapies and diagnostics funded by California's multibillion-dollar stem cell research agency affordable and accessible.

The bill also would have made it easier for the California Institute for Regenerative Medicine to fund research beyond politically charged embryonic stem cells. In vetoing the bill Saturday, Schwarzenegger said SB 1565 would have undermined "the express intent of Proposition 71," which California voters approved in 2004, setting up a $3 billion agency with state bonds.

But the field has changed dramatically. Cloning is not working and IPSCs are! Good GRIEF (a term to which I seem increasingly resorting to avoid using stronger language)!

Arnold is so in the tank with the Establishment types that control the CIRM that it is sickening. Plus, the CIRM is being mismanaged to the point that the Little Hoover Commission is having to investigate. From the story:

Despite Schwarzenegger's veto, another key provision of the bill will become reality. California's Milton Marks, or "Little Hoover," Commission on California State Government Organization and Economy last week said it would examine CIRM and ICOC, with an eye to determining what, if any, conflicts of interest are posed by the current governance of the state stem-cell agency.

Little Hoover's first hearings on CIRM will be held Nov. 20 with another likely Jan. 22, Stuart Drown, the commission's executive director, told California Stem Cell Report, a blog focused on public policy related to the stem cell agency. Drown also told the Report the commission may go beyond governance issues: "The commission has been asked to look at governance and transparency, but may look at other issues as well, including a discussion on ways to insure the most effective use of bond money."

Across the breath and scope of the USA, way beyond the issues we address here at SHS, we see corruption, incompetence by "the experts," and abject failure after failure to lead. The CIRM and Governor Schwarzenegger are abject cases in point.

Swamps Now Have "Rights" in Ecuador. Literally

The picture above, if it were taken in Ecuador, would be the image of a rights-bearing entity, with constitutional rights co-equal with those of "people" and "persons." Yes, as expected, the people of Ecuador have passed their new constitution, which as I wrote in an earlier SHS post contains the following provision:

Persons and people have the fundamental rights guaranteed in this Constitution and in the international human rights instruments. Nature is subject to those rights given by this Constitution and Law.

The only way to read that provision is that nature and all aspects thereof--rocks, dirt, pond scum, mosquitoes, lizards, trees--is and are co-equal with humans since "nature rights" are the same as those of people, a provision that is now the supreme law of Ecuador. Good GRIEF! John Adams, Thomas Jefferson, James Madison, Abraham Lincoln, Martin Luther King--with all the greats who believed so fervently in promoting human welfare and freedom through constitutions are spinning like centrifuges in their graves.

Let's consider briefly what this might mean: Swamps, which are part of nature, now have rights in Ecuador, potentially meaning that if a poor Ecuadoran wants to drain one on his property--can property be owned anymore since people can't be owned?--he could theoretically be stopped by the government for violating the rights of the swamp, its constituent parts, and its denizens, the mosquitoes, snakes, pond scum, rats, spiders, water, and fish. And if the government fails to protect the rights of the swamp, the constitution explicitly allows non Ecuadorians to come in to the country and bring lawsuits and otherwise pressure the government to protect the swamp's rights.

The leader of Ecuador, Rafael Correa, is a hard Leftist who is extremely close to the equally or more hard Left wing head of Venezuela, Hugo Chavez. So this is what the emerging radical Left that is gaining power in various places around the world, is producing--and fast; the personalization of nature, which will redound to the terrible detriment of people, particularly the poor.

Some might say that Ecuador is a small country with little influence internationally. But the anti-human exceptionalism Left is on the march elsewhere too. Remember, the Socialists and Greens in Spain are about to make apes co-equal members of the moral community with humans by passing the Great Ape Project. Switzerland has also lost its mind, with a constitutional provision requiring that the dignity of plants and animals be protected, that has begun a process that had already declared the intrinsic dignity of individual plants, which could mark the emergence of plant rights in Europe. The European Court of Human Rights will decide whether a chimpanzee is a person.

The consequences that will befall suffering humanity as this bitterly anti-human exceptionalism agenda picks up more steam are profound. Our self definition and self perception will change radically. Our ability to exploit natural resources and thrive will be handcuffed. This could really harm the poor and destitute, the very people the Left beats its collective breast about and whose needs and interests it claims to champion. Indeed, the total consequences of granting rights to nature are so profound and potentially unlimited, that for the moment they are probably beyond our comprehension.

I am beside myself, squared: First, because this is happening. Second, because so few people seem to think it is important.

The New Slavery: Chinese Style

Standing up for human exceptionalism means fighting slavery and other forms of naked human exploitation. In this regard, Peter Hitchens, the UK writer, has a very disturbing piece out about how the Chinese are exploiting the poorest in Africa in what can charitably be called a new colonialism, and perhaps more realistically, a new slavery. From the story:

These poor, hopeless, angry people exist by grubbing for scraps of cobalt and copper ore in the filth and dust of abandoned copper mines in Congo, sinking perilous 80ft shafts by hand, washing their finds in cholera-infected streams full of human filth, then pushing enormous two-hundredweight loads uphill on ancient bicycles to the nearby town of Likasi where middlemen buy them to sell on, mainly to Chinese businessmen hungry for these vital metals.

To see them, as they plod miserably past, is to be reminded of pictures of unemployed miners in Thirties Britain, stumbling home in the drizzle with sacks of coal scraps gleaned from spoil heaps. Except that here the unsparing heat makes the labour five times as hard, and the conditions of work and life are worse by far than any known in England since the 18th Century. Many perish as their primitive mines collapse on them, or are horribly injured without hope of medical treatment.

Many are little more than children. On a good day they may earn $3, which just supports a meagre existence in diseased, malarial slums. We had been earlier to this awful pit, which looked like a penal colony in an ancient slave empire. Defeated, bowed figures toiled endlessly in dozens of hand-dug pits. Their faces, when visible, were blank and without hope.

Who is doing this to these people?

I can give you no better explanation in miniature of the wicked thing that I believe is now happening in Africa. Out of desperation, much of the continent is selling itself into a new era of corruption and virtual slavery as China seeks to buy up all the metals, minerals and oil she can lay her hands on: copper for electric and telephone cables, cobalt for mobile phones and jet engines--the basic raw materials of modern life. It is crude rapacity, but to Africans and many of their leaders it is better than the alternative, which is slow starvation.

It is my view...that China's cynical new version of imperialism in Africa is a wicked enterprise. China offers both rulers and the ruled in Africa the simple, squalid advantages of shameless exploitation.

Where are the protests in the streets? Where are the screams for international justice? Oh. This isn't Bush's fault. Never mind.

Persuasive academics advised me before I set off on this journey that China's scramble for Africa had much to be said for it. They pointed out China needs African markets for its goods, and has an interest in real economic advance in that broken continent. For once, they argued, a foreign intervention in Africa might work precisely because it is so cynical and self-interested. They said Western aid, with all its conditions, did little to create real advances in Africa, laughing as they declared: 'The only country that ever got rich through donations is the Vatican.

It's a long and disturbing article. The utter corruption and brute force that that is loose in the world on so many fronts, with China--the human organ merchants so often, it seems, in the lead--is taking my breath away.

Adult Stem Cells Effectively Treat Liver Disease

In a human trial using patients' own bone marrow adult stem cells, alcohol-caused cirrhosis of the liver has been treated and the patients improved. From the story:

All patients tolerated the procedure well and over 12 weeks of follow-up there were significant decreases in serum bilirubin. A significant reduction in levels of alanine transaminase and aspartate transaminase was seen 1 week after the transfusion and showed improvement through the study period.

Seven of the patients showed an improvement in Child-Pugh scores, and on imaging at 12 weeks, three patients showed a complete resolution of ascites and two had a significant reduction.

"This is an area of medicine where there is tremendous progress day by day," concluded Dr. Habib. "We hope that stem cell therapy will help many patients with liver disease."

Oh hum: Another day, another adult stem cell success.

Court: Suicide Assisters Can Inherit

This is definitely bad policy, but it was probably the right decision by the court: A Wisconsin Court of Appeals ruled that a relatives who may have assisted a suicide can still inherit from his estate. From the story:

The wife and daughter of a Wisconsin man who committed suicide can inherit his estate even if they assisted him in the act, an appeals court ruled Thursday.

A Wisconsin law prevents anyone who "intentionally kills" another from inheriting from the person but the District 4 Court of Appeals said that does not extend to those who assist in suicide. "A person who assists another in voluntarily and intentionally taking his or her own life is plainly not depriving the other of life," Judge Margaret Vergeront wrote for a unanimous three-judge panel. "We do not agree that 'killer' is commonly understood to mean the person who provides the means that enable another to kill himself or herself."

Wisconsin Right to Life, which opposes assisted suicide, immediately blasted the ruling, saying it gives a financial incentive for people to help relatives die prematurely...

The two admitted they drove him home from the hospital on a one-day pass the day he committed suicide but they denied assisting. The other children alleged the two knew he wanted to commit suicide, drove him to a cabin on the property, helped him inside, gave him a loaded shotgun and left. For the purposes of deciding the dispute, the court assumed those facts were true but still ruled in their favor. "Providing Edward with a loaded shotgun did not deprive him of his life: he deprived himself of life by shooting himself with the shotgun," Vergeront wrote.

Wisconsin Right to Life, good people who I know very well, are absolutely correct. The problems with permitting those who assist suicide to inherent from the dead person are so obvious that I need not belabor them here.

But it isn't up to the court to decide proper policy. It is up to the court to apply the law. And given the facts of this case, and the wording of the law, at least as described in the story, I think the court is probably right that these people did not actively kill the decedent.

That said, the legislature should immediately and forthrightly close this loophole in civil law.

Genetically Altering Pigs to Find Cure for Cystic Fibrosis

This is an example of how animal research can lead to tremendous alleviation of human suffering. Pigs are being genetically altered to have CF and cloned for use in research. From the story:

Cystic fibrosis (CF) is triggered when a person inherits two copies of a faulty gene carried by about one in 25 of the population. The disorder causes widespread damage to internal organs, especially the lungs and gut, by clogging them with thick, sticky mucus.

Now a team at the University of Missouri has developed a pig which appears to closely mimic the disease. The striking similarities suggest that the pigs will help improve understanding and may also speed discovery of new treatments.

Animal rights activists would say that the pigs lives are as important and valuable as all those people with cystic fibrosis, and hence, this kind of research should not be done. They are wrong.

Lead Into Gold: IPSCs Pass Another Hurdle

IPSCs were first created in humans only about 10 1/2 months ago. Yet, hurdles to their full use in regenerative medicine fall at a rate not seen with ESCR or, for sure, therapeutic cloning. And now another one. From the story:

Scientists are reporting today that they have overcome a major obstacle to using a promising alternative to embryonic stem cells, bolstering the prospects for bypassing the political and ethical tempest that has embroiled hopes for a new generation of medical treatments.

The researchers said they found a safe way to coax adult cells to regress into an embryonic state, alleviating what had been the most worrisome uncertainty about developing the cells into potential cures. "We have removed a major roadblock for translating this into a clinical setting," said Konrad Hochedlinger, a Harvard University stem cell researcher whose research was published online today by the journal Science. "I think it's an important advance."

So what was the big breakthrough?

Scientists last year shook up the scientific and political landscape by discovering how to manipulate the genes of adult cells to revert them into the equivalent of embryonic cells--entities dubbed "induced pluripotent stem" or "iPS" cells -- which could then be transformed into any type of cell in the body. Subsequent work has found that the cells can alleviate symptoms of Parkinson's disease and sickle cell anemia in mice.

But the first iPS cells were created by ferrying four genes into the DNA of adult cells using retroviruses, which can cause cancer in animals. There was also concern because the viruses integrated their genes into the cells' DNA in the course of transforming them. In the new work, Hochedlinger and his colleagues used a different type of virus, known as an adenovirus, which does not integrate its genes into a cell's DNA and therefore is believed to be harmless, to ferry the same four transformative genes into the DNA of mouse skin and liver cells.

"The adenovirus will infect the cells but then will clear themselves from the cells. After a few cell divisions there are no traces of the virus in the cell," he said. "You can't tell the virus was ever there."

This does not resolve the problem with all pluripotent cells, e.g., they cause teratomas--a different tumor issue than the cancer fear with IPSCs that seems to have been overcome. But boy, is this field moving fast.

Succinct Wisdom Against Court Imposed Assisted Suicide Legalization

As I reported here at SHS, Compassion and Choices (formerly the Hemlock Society)--the leaders of which are all so supportive of respecting the political process about assisted suicide in Oregon--at the same time are attempting to trash the right of Montana to outlaw assisted suicide via its political processes by seeking a court decree that the law in the Big Sky State is unconstitutional--a tack that has failed previously in Florida and Alaska.

I haven't seen all the briefs, but I do have one from the State of Montana, and it makes a cogent point about the debate beyond the court case. The brief notes that promoters of assisted suicide are long on emotion and ideology in their pursuit of state-sanction facilitated suicide, but short on facts. From its Reply Brief (no link, but can supply):

Plaintiffs continue to deal in undefined abstractions like "how one will cross the threshold to death" instead of explaining in detail why physicians must intend to cause a patient's death in order to relieve suffering or promote dignity at the end of life. (Pls.' Reply at 3.) Plaintiffs' basic failure to move past these platitudes and into attractable definition of "aid in dying" confirms the true breadth of their claim: a dying process altogether "free from government control," ending in a patient dead and a physician immune from prosecution. (Pls.' Reply at L) There is no precedent for such a right.

Indeed. Rarely has the entire agenda been so accurately and succinctly stated.

And with that wide-as-the-ocean-objective, how can any such "right" be limited to those who are diagnosed with a terminal illness (who may, in the end, not die of their disease if allowed to run its course). It won't be. For once the right to have medical killings facilitated is defined merely as a medical treatment, the next cases will be filed claiming that the restrictions on lethal treatment to alleviate suffering cannot be limited to the dying any more than any other form of palliation. If assisted suicide ever becomes widely accepted in this country, bet on it.

Sarah Palin Psychosis: Shoot and Eat a Moose--Support Killing Jews?

Sarah Palin psychosis continues undiminished: Now, Democratic Representative Alcee Hastings told a Jewish audience that Sarah Palin is probably a threat to Jews and blacks--because she hunts. From the story:

"If Sarah Palin isn't enough of a reason for you to get over whatever your problem is with Barack Obama, then you damn well had better pay attention," Rep. Alcee Hastings of Florida said at a panel about the shared agenda of Jewish and African-American Democrats Wednesday. Hastings, who is African-American, was explaining what he intended to tell his Jewish constituents about the presidential race. "Anybody toting guns and stripping moose don't care too much about what they do with Jews and blacks. So, you just think this through," Hastings added as the room erupted in laughter and applause.

Very funny. To think, this man was once a judge.

Hastings' incendiary and outrageous demagoguery--he essentially accused Palin of anti-Semitism and racism, after all--is worrying because of what it might portend for the balance of the campaign. Still, I am sure PETA would agree with Hastings since it once asserted that eating meat made one the moral equivalent of an SS guard at Auschwitz in the infamous Holocaust on Your Plate Campaign, and that animal husbandry was the moral equivalent of lynching in its odious Animal Liberation Project.

Ecuador to Vote Sunday on Granting Rights to "Nature"!

A radical environmental group called the Community Environmental Legal Defense Fund is the brainchild behind a constitutional proposal, to be voted on Sunday, that would grant rights to "nature." From the proposal:

Persons and people have the fundamental rights guaranteed in this Constitution and in the international human rights instruments. Nature is subject to those rights given by this Constitution and Law

The purpose of this is to permit ideologues to sue and for nature, or aspects thereof, to have standing as litigants in court:

Every person, people, community or nationality, will be able to demand the recognitions of rights for nature before the public organisms.* The application and interpretation of these rights will follow the related principles established in the Constitution. [The word "organisms" means government bodies and courts.]

Do we need any further proof of the game that is afoot around the world to turn nature and animals into the moral equals of people--of course with only people having any obligations. In essence, this is the worship of nature transformed into an established religion.

To show you how far this kind of thinking is spreading--and how radical the MSM has become--the LA Times , in effect, praised the measure by refusing to take a position on giving rights to trees!

It sounds like a stunt by the San Francisco City Council. But Ecuador is engaged in nothing less than an effort to redefine the relationship between human beings and the natural world...

No other country has gone as far as Ecuador in proposing to give trees their day in court, but it certainly is not alone in its recalibration of natural rights...Ecuador is codifying this shift in sensibility. In some ways, this makes sense for a country whose cultural identity is almost indistinguishable from its regional geography--the Galapagos, the Amazon, the Sierra. How this new area of constitutional law will work, however, is another question. We aren't ready to endorse such a step at home, or even abroad. But it's intriguing. We'll be watching Ecuador's example.

If this passes, I will write further. But for now, let us be clear: This isn't promoting a human duty to treat the environmental correctly--a matter the Times editorialists are too woolly headed to understand. By granting nature equal rights, human needs and welfare will have to be sacrificed! Those most hurt will be the poor looking to develop their countries! This radical deconstruction of the importance of being human should concern everyone who believes in human prosperity and the importance of the concept of distinctly human rights.

And don't say, "It can't happen here," or I'll scream!

SF Chronicle Opposes Proposition 2

The SF Chronicle's editorial page hews distinctly left--with Secondhand Smokette providing an alternate view on the op/ed page. That is why I was struck by the paper coming out against Proposition 2, the HSUS sponsored initiative to ban caging egg chickens. And the editorial board seems to have done its homework. From the editorial:

We heard from the advocates of both sides, and perhaps the most persuasive testimony against the measure came from Steve Mahrt, a Petaluma farmer who specializes in organic, cage-free eggs. Mahrt suggested the rigid language of Proposition 2 would make cage-free operations such as his "uncompetitive" with farmers from other states who could house their hens in greater density. He also suggested that his quarter-century of experience in the egg business - all cage-free - convinced him that the birds were healthier, and happier, in environments where they were packed closer together than would be allowed under Proposition 2.

My biggest concern is the cost to consumers. I was at the store Monday and bought eggs labeled as cage free--at a cost of $2.00 per dozen higher than unlabeled eggs, which presumably came from caged chickens. The editorial also tackles this issue:

Also, as Mahrt noted, cage-free eggs are considerable more expensive than the mass-production variety--but he made a good case that it is more labor intensive and difficult to raise egg-laying hens outside cages. Proponents of Proposition 2 have suggested that the additional cost would amount to only about a penny an egg.

The one cent more line was pushed here too by a HSUS representative, and I am sorry, I don't buy it. The prices at the store demonstrate that it is false.

The editorial also opines that initiatives are not the way to go in passing animal welfare laws such as Proposition 2, and I agree. This was written by a special interest group that I believe seeks the ultimate end of all domesticated animals, although it doesn't overtly push that animal rights party line. Yet, I have never seen HSUS admit that any use of animals is necessary for human prosperity or welfare. Thus, rather than pass a law written by one side, I would prefer to see legislative proposals in this field in which HSUS's voice is heard, but so too are industry voices and those of consumers. As the editorial noted:

The case against battery cages is neither as simple nor as overwhelming as supporters would want you to believe. This is an issue that cries out for balance between the call for concern for the conditions of animals and the interests of those who produce one of the staples of our food supply. The ballot box is not the place to regulate this aspect of California agriculture. Voters should reject Proposition 2.

I don't tend to follow newspaper editorials when deciding how to vote. But this one may be an exception.

(The Chronicle published an alternative view on the op/ed page today by Bill Niman, the founder of Niman Ranch, a raiser of humane meat, that focused solely on the humane aspects of the argument. Here is the link. I wonder of Niman knows that animal rights activists would like to drive him out of business?)

PETA a Joke: Wants Ice Cream Made From Human Milk

I can't tell you all how often I ignore PETA's ridiculous antics. They are addicted to publicity--any publicity--to promote their zealotry and I am loath to lend any hand in that enterprise. But sometimes a story comes along that so succinctly illustrates the group's idiocy that it is impossible to resist: PETA wants Ben and Jerry's to make ice cream from human milk. From the story:

"PETA's request comes in the wake of news reports that a Swiss restaurant owner will begin purchasing breast milk from nursing mothers and substituting breast milk for 75 percent of the cow's milk in the food he serves," the statement says.PETA officials say a move to human breast milk would lessen the suffering of dairy cows and their babies on factory farms and benefit human health.

Women as so many dairy cows: If a right wing group suggested something like this the sisterhood would explode. More to the point, PETA knows the proposal is beyond stupid. How many millions of gallons of ice cream does Ben and Jerry's sell a year? That requires millions of cows putting out more milk each day than women do. You also need to pasteurize the milk, etc. etc. etc.

The restaurant aspect of the story is just another indication that the Swiss are losing their minds, what with their biggest brains promoting plant rights and all. But PETA's leaders will latch onto anything--no matter how inane--to anthropomorphize animals and get the group into the klieg lights. But then, the group rakes in millions each year from people who dig into their own pockets "for the animals." So, apparently its leaders have found that stupid sells.

Guilty as Charged for Murdering Daughter With Cerebral Palsy: But Would She Have Received Slap on Wrist if "Compassion" Was Defense?

I reported a little while ago about Joanne Hill, who murdered her daughter with cerebral palsy. Now, she has been found guilty. From the story:

A mother who drowned her disabled daughter in a bath after drinking wine was convicted of murder yesterday and sentenced to life in prison.

Joanne Hill, 32, from Connah's Quay, Flintshire, north Wales, admitted killing four-year-old Naomi by drowning her in November last year. She had denied murder but pleaded guilty to manslaughter on the grounds of diminished responsibility. However, the jury at Chester crown court, which had heard Hill was embarrassed about her daughter's mild cerebral palsy, rejected this plea and found her guilty of murder after deliberating for an hour-and-a-half. She will not be eligible for parole for at least 15 years.

Her estranged husband, Simon Hill, 38, told a press conference he would never be able to come to terms with what had happened. His daughter "lived life to the full and was an inspiration", he said.

Judge Elgan Edwards told Hill: "There can be no excuse for what you did."

The judge said: "You killed your own daughter because you could not cope with her disability. You had other pressures upon you, a disintegrating marriage, and you decided to kill your own daughter by drowning her."

Good. Killing children should be beyond excuse.

However, I can't help but think that Ms. Hill's lawyer chose the wrong defense strategy. Recall Robert Latimer, the Canadian who murdered his daughter Traci because she had cerebral palsy--an act supported by his wife after the fact and applauded widely in Canada. Latimer's defense was he was doing it for Traci, as a compassionate and loving act. He got off with a several years in prison, and the jury didn't even want him to serve that much time.

So, this is apparently the moral of the story: Murder your daughter because you are embarrassed that she has cerebral palsy; go to jail for life. But murder your daughter because she has cerebral palsy and excuse it as a loving act to put her out of her misery; do very little time and get good poll ratings. It isn't the act, it's the feelings of pity that can be generated among the populace that really counts. Such are the times in which we live.

Lack of Physician Empathy: Another Cause of Popular Distrust in Medicine

In a recent previous post, we discussed the reasons why many patients no longer trust the medical system. A disturbing study that found too little empathy from doctors toward their cancer patients could also be a contributing cause. From the story:

U.S. researchers who assessed interactions between a small group of people with lung cancer and their doctors found physicians provided little emotional support even when patients seemed to be searching for it.

When patients made comments on topics like the personal impact of cancer, their diagnosis and treatment and struggles with the health care system, doctors responded with words of empathy only 10 percent of the time, the researchers said.

This was a small study -- appointments between doctors and 10 patients at a Veterans Affairs hospital in Houston were audio taped and analyzed for whether the physicians provided empathy for the plight of these people with a deadly illness.

But Dr. Diane Morse of the University of Rochester Medical Center in Rochester, New York said the findings reinforce other research showing doctors fall short in the simple act of acknowledging the emotional difficulties of their patients' predicament.

In their defense, doctors are under tremendous financial pressure from managed care economics to push the patients through their offices assembly line style. And as the story discussed, the study was small. But clearly, the milk of human kindness should be a crucial part of medicine and despite the pressures they are under, doctors will have to do a better job.

Big Bailout Will Sink National Health Insurance

With the national financial artery severed due to moronic mortgage mismanagers--even I knew these no interest, no down payment mortgages would result in foreclosures, so why didn't the big salaried?--it seems to me that any chance for a fully funded national health insurance is quickly fading. We are just too broke.

At the same time, with insurance companies increasingly cherry picking and raising premiums through the roof, a pure market system won't work either. Thus, it seems to me we should begin to focus on ways to make private health insurance--subsidized and regulated some by the government, a la the Medicare Drug Plan--more accessible and affordable. Here are a few suggestions:
1. Eliminate state-by-state markets and permit national coverage to facilitate greater spreading of the risk.
2. Create 10 national private plans akin to the Medicare Drug Plan, an approach which I like, to allow freedom of choice, but also set floors of coverage.
3. Have the government guarantee catastrophic care, which should help keep the pressure off of premiums.
4. Permit high deductibles and copays to discourage over utilization.
5. Encourage health savings accounts and permit tax deductions (or perhaps credits) for the price of premiums.
6. Permit people to buy into Medicare at age 60.
7. The basic plan will have to only cover the basics; limited mental health, no dental, no elective abortions, only partial prescription payments. If people want those kinds of elective coverages or greater protection, they should pay for it themselves.
8. Increase the uses of physicians assistants, certified nurse practitioners, and properly licensed midwives--under the direction of a physician--for primary care and obstetrician services.
9. Encourage price competition in both the funder and service provider sectors. This should include increasing the doctor pool to allow the law of supply and demand to click in.
10. Sorry, but to qualify for coverage, someone will have to be a citizen or legal resident.

Of course, that is pie in the sky, since we are so divided politically and culturally from each other that those fights will probably prevent any solution--whether nationalized or primarily privatized--from taking hold. Plus, for even a partially government funded program to work, we will have to triage government and ruthlessly cut in other areas. So, I am not holding my breath.

But the status quo will not hold. So, unless we want a total collapse, we'd better learn to work together and reacquire the ability to compromise.

And as for fighting global warming--if it exists--fuhgataboutit.

New Diagnostic Techniques to Reduce Forty Percent PVS Misdiagnosis

The Times of London reports that scientists hope to be able to reduce the 40% misdiagnosis of PVS. From the story:

Ten years ago, Kate went into a deep coma and was on a ventilator for several weeks. She had suffered severe brain inflammation after contracting a viral infection. When she came out of the coma, she opened her eyes and could breathe naturally, but she was unresponsive to speech and visual stimuli, and appeared to lack all conscious awareness. She was still in this condition four months after falling ill, and was later diagnosed to be in a persistent vegetative state, or PVS: in other words, persistently unaware. But the diagnosis was wrong.

Although Kate could not speak, or hear properly, or make any kind of signal, or take in sustenance except through a tube into the stomach, she was sometimes aware of herself and her surroundings. She had a raging thirst that was not alleviated by the ward staff. She was racked with pain. Sometimes she'd cry out, but the ward staff thought it was just a reflex action. Kate suffered so much pain and despair that she tried to take her own life by holding her breath.

Then a Cambridge neuroscientist called Dr Adrian Owen put her in a special kind of scanner and performed an unprecedented experiment. It revealed evidence of fluctuating levels of brain activation when she was presented with pictures of her parents. From that point, she started her long journey back into the world.

It's always "just a reflex." When families or nurses report signs of cognizance, it is often, "They are only seeing what they want to see."

But that may change:

The team is now experimenting with drawing parallels between scanners and EEG machines, which measure brainwaves. It is possible that EEG "markers" can be created that are identical to crucial brain locations found only by scanning techniques. The plan is to be able to make functional brain tests at the patient’s bedside that preclude the high cost and massive bulk involved in Pet and MRI scans. This should lead to "tailor-made" rehabilitation based on highly refined external observations in combination with precise interior knowledge of an impaired brain.

The story also discusses the problem of putting the disabled person out of our misery:

"Imagine the case of this family who, after several years, want to finally grieve and get their lives back. Mr K has a new partner, their son plans to go to Australia, and their daughter has moved to Scotland. Their hospital visits have dwindled to once every three months. They've made their decision to apply for withdrawal of feeding and allow Mrs K to die. What if a scan now finds a trace of minimal awareness? The withdrawal will obviously be halted, there will be new feelings of guilt to be dealt with, and the family's life is back on hold.

Decisions about patients' deaths should not be made on the basis of family impact. Besides, in the US at least, conscious patients are dehydrated all the time.

I strongly believe that it should not matter whether a patient is in a PVS or not in the sense of their right to life, and care, and moral worth. Barring an advance directive in writing, their food and water should not be removed on the decision of others based on quality of life judgments. But using these tests to determine the extent of the brain insult can lead to better treatment and improved conditions. The question will be raised, of course about the price tag. But are we really willing to abandon these patients because we don't think their lives are worth living?

Fraud Pays: Hwang Gets Patent for Nonexistant Cloned Embryonic Stem Cells

Sometimes I am just amazed. Hwang Woo suk is a charlatan. Readers of SHS and others will recall that, a few years ago, he created an international media sensation by claiming to have created the first cloned embryos from which he obtained patient specific, tailor made, embryonic stem cells. He was lying. An investigation showed he had faked the research.

But now, the Australian government is going to give Hwang a patent on cloned embryonic stem cells! From the story:

Australian patent authorities will likely grant a patent to disgraced Korean stem cell researcher Hwang Woo-suk for a cloned human embryonic stem cell. "Once the registration process is over, Dr. Hwang can collect royalties on the proceeds from the sales of new medicine developed with his technology. His technology will equal the patent on the cloned sheep Dolly," the foundation said.

Well, I guess he can patent the technique--which didn't work--but there are no cloned stem cells to patent. Ridiculous.

On the plus side, Hwang's patent could serve to further impede the development of human cloning, since he might begin demanding payments from anybody who tries. Indeed, that is a major factor that impeded the development of embryonic stem cell research.

The Tide Turns: James Thomson to Pursue Non Embryonic Stem Cell Research

I can't think of any more vivid example of the dramatic change in the scientific and political paradigms regarding stem cell research than James Thomson, the discoverer of human ESCs--moving away from embryonic stem cell field and into IPSCs. From the story:

With their field riding a wave of discovery and change, researchers, financiers and policy-makers from around the world will arrive today for the 2008 World Stem Cell Summit in Madison, the city where James Thomson started a scientific revolution almost a decade ago. If any need confirmation of the rapidly changing landscape, it should come with this announcement planned for the summit: The two Madison companies co-founded by Thomson have merged and shifted their focus to products involving non-embryonic stem cells.

We know why, of course. Cloning hasn't exactly panned out, besides which it would be far more contentious, dangerous for women due to egg procurement, complicated, and expensive. But IPSCs have really changed the paradigm:

Ever since the reprogramming breakthrough, researchers have published a stream of papers using the new technique to rescue mice with sickle cell anemia and to create human cell lines from people with a host of different diseases. The cell lines hold the promise of allowing scientists to gain a new window into the disease process and a powerful new tool for testing drugs. Longer term, the new technology may allow doctors to use patients' own cells to treat genetic and other ailments.

I have always admired Thomson. I didn't agree with him on the ethical issues, but he never pretended embryonic stem cells didn't come from embryos. He never pretended that somatic cell nuclear transfer didn't create an embryo (KC Star and Kit Wagar, hello!), and he never denied that there weren't serious moral concerns with the entire embryonic field of research.

May he live long and prosper and may the IPSCs and other ethical means of regenerative medicine succeed beyond all of our wildest dreams.

Have Microphone: Will Talk..And Talk...And Talk

I was honored to appear on Friday the 19th of September before the Connecticut Council on Developmental Disabilities, as part of its series on "Life Threatening Public Policy." My presentation is a bit lengthy--more than an hour--during which I focus on human exceptionalism, human equality, universal human rights, bioethics, personhood theory, infanticide, the odious promotion of harvesting organs from the people with profound cognitive disabilities, futile care theory, and the duty to die.

If what I had to say is of interest, hit this link and listen in to the whole program, including comments about the series and introductory remarks. Thanks to all, particularly Ed Preneta of the CTCDD for hosting me (and for the beer), and to Dan Caley of the Rhode Island Developmental Disabilities Council for posting the presentation on-line. And special thanks to Jo Massarelli of the Social Role Valorization Implementation Project for making my several appearances last week in New England possible, and most especially for her and her colleagues' concerted and selfless commitment to protecting the most weak and vulnerable among us.

Confusion: FDA to Treat Genetically Engineered Animals as Drugs

The FDA has decided to regulate genetic engineering of animals. And it looks to be confusing. From the story:

The agency has premised the rules on an unusual reading of the federal Food, Drug and Cosmetic Act, saying that the inserted DNA used to modify an animal can be regulated as a "new animal drug" under the 1938 law from which the agency draws much of its regulatory clout. Under this interpretation, the same gene inserted into two different animals of the same species on separate occasions creates two different entities to regulate, because DNA integrates itself into the genome pretty much at random. However, the offspring of genetically modified animals will be, in regulatory terms, the same thing as their parents...

The new regulations are unlikely to have an impact on most bench scientists. The agency says genetically engineered laboratory animals are a "principal" case where it would exercise its discretion not to regulate. "In general we are not interested in having an application from every postdoc and grad student making a knockout mouse for this that or the other thing," said Rudenko. The agency says it will also take what some would see as a light touch in not requiring foods from genetically engineered animals to be labelled as such unless the engineering was specifically designed to change their nutritional values, or if it did so by chance.

Not surprisingly, the industry is cheering and consumer groups are not amused:

The biotechnology industry, which has long urged the agency to issue such rules, praised the draft. Barbara Glenn, the managing director for animal biotechnology at the Biotechnology Industry Organization in Washington DC, says that about a dozen of her group's 1,200 member companies are currently developing genetically engineered animals. "The guidance is going to ensure that we can reach the very compelling benefits of genetic engineering of animals," she says. "It simply allows industry to move forward."

Consumer groups, by contrast, were highly critical. They said that the guidance was far too vague, leaving consumers to trust that FDA will conduct adequate assessments of animals' environmental and safety impacts.

It sounds to me as if Congress should revisit the law and grant the FDA more specific authority based on current science. But considering the Congress we have, they might make it worse instead of better.

Of course animal rights activists would prefer we receive no benefit from these genetically modified animals. But then, they don't want us to benefit from the use of animals at all.

Pushing the Duty to Die in the UK

I am concluding a very successful trip to MA and CT, giving a series of speeches to advocates for, and defenders of, people with developmental and cognitive disabilities, in which I have warned against utilitarian bioethics and its explicit and implicit push toward the so-called "duty to die." This view is even more pronounced in the United Kingdom, where one of the most prominent ethicists is a woman named Baronness Warnock. As reported by the Telegraph, Warnock has recently called on dementia patients to kill themselves to spare society the burden of their care. From the story:

Elderly people suffering from dementia should consider ending their lives because they are a burden on the NHS and their families, according to the influential medical ethics expert Baroness Warnock.

The veteran Government adviser said pensioners in mental decline are "wasting people's lives" because of the care they require and should be allowed to opt for euthanasia even if they are not in pain. She insisted there was "nothing wrong" with people being helped to die for the sake of their loved ones or society.

Warnock's views could just as easily apply to those with developmental disabilities or those who have suffered serious brain injuries. And don't think that her views are materially different than some--although certainly not all--bioethicists here in the USA. She's just more blunt and candid.

Barach Obama Apparently Doesn't Know the Difference Between a Fetus and an Infant

Barach Obama has been accused of opposing the Infant Born Alive Protection Act, which requires hospitals and doctors to treat the survivors of attempted abortion. He denies this despite having refused repeatedly to vote for the Illinois versions.

This 2001 transcript, pp.86-87, is telling. Expressing a hyper-legalism to avoid grappling with the issue, Obama argued against the legislation, stating:

The second reason that it would probably be found unconstitutional is that this essentially says that a doctor is required to provide treatment for a previable child or fetus, however way you want to describe it. Viability is the line that has been drawn by the Supreme Court to determine whether or not an abortion can or cannot take place. And if we place the burden on the doctor, that says you have to keep alive even a previable child as long as possible and give them as much medical attention--as is necessary to try to keep the child alive, then we're probably crossing the line in terms of unconstitutionality.

"A previable child or fetus, however way you want to describe it"? Once the child is delivered, he or she is an infant, not a fetus. And the requirement that a living baby be treated once delivered, has nothing to do with abortion or the woman's right to the same. So, it seems to me that the only way to read Obama's statement is that he doesn't believe that abortion survivors should have to be treated as fully human beings.

And how's this for leadership? After making his statement, after asserting that the bill is unconstitutional, Obama said:

I think that we will probably end up in court once again, as we often do on this issue. And as a consequence, I'll be voting Present.

The courage to lead!

HT: Yuval Levin

Scientists to Study Near Death Experiences

I am not sure this kind of thing can be studied scientifically since the reports of such experiences are so ad hoc. In any event, scientists are going to try and find out if out of body experiences reported by people who have had full cardiac arrest can be validated: From the story:

People who report seeing bright lights or tunnels as they leave their bodies in near-death experiences are having their claims treated seriously in a hospital study.

Doctors in hospitals in Britain and the US will study 1,500 heart attack patients to see if people with no heartbeat or brain activity can have "out of body" experiences. Some people report being able to soar out of their bodies and look down on themselves and medical staff.

The study at 25 UK and US hospitals will include doctors placing images on shelves that are only visible from the ceiling to test the theory. Dr Sam Parnia, an intensive care doctor who is heading the study, said: "If you can demonstrate that consciousness continues after the brain switches off, it allows for the possibility that the consciousness is a separate entity.

That would certainly challenge materialistic thinking, wouldn't it? However, I believe such studies have been tried before; no dice. Perhaps this one will be different, but I wouldn't hold my breath.