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Friday, November 20, 2009, 3:26 PM
Wesley J. Smith

We have become a culture that tells the elderly, people with disabilities, and others who need care and support that they are “burdens.” Indeed, in my recent debate in Edinburgh with Dr. Libby Wilson, my opponent explicitly supported legalizing assisted suicide so that the ill and disabled could give their families the “gift” of not being a burden.

This is why I think that the assisted suicide/euthanasia agenda is a culture-changing issue that will–if it succeeds–radically and adversely transform the way we interrelate as members of society and as family members. And when you read about murder/suicides motivated by the “burden” fear, it really raises the alarm. From the story:

An elderly husband killed his poorly wife then committed suicide because he feared she would outlive him and become a ‘burden’ on their family. When Eileen Martin, 76, developed dementia, her husband of more than 50 years, Kenneth, cared for her at their home. But when he developed cancer he vowed not to leave his sick wife behind for the family to care for. Kenneth Martin and his wife Eileen. He hanged himself after killing her He warned his children: ‘I won’t leave you with the burden of your mother. When it’s my time to go, it’ll be her time to go.’

The message that it is worse to be a burden than dead is being broadcast and received–and stories like this tragedy, I believe, are a direct consequence. It’s a very scary time to be old, disabled, or needing care.


Friday, November 20, 2009, 2:24 PM
Wesley J. Smith

Apparently somebody hacked into climate change researchers’ e-mails and published the exchanges.  From the story:

Hundreds of private emails and documents allegedly exchanged between some of the world’s leading climate scientists over the past 13 years have been stolen by hackers and leaked online, it emerged today. The computer files were apparently accessed earlier this week from servers at the UK’s University of East Anglia’s Climate Research Unit, a world-renowned centre focused on the study of natural and anthropogenic climate change…So far the veracity of the emails has not been confirmed and the scientists involved have declined to comment on the story, which broke on a blog called The Air Vent.

You know, there is just too much of this kind of thing going on.  Hacking private computers and then publishing the material thereby obtained is inexcusable behavior– it is theft and invasion of privacy. Moreover, everyone knows that the people who stole this material would not have posted it on the Internet if the e-mails wholly supported the scientists’ research and integrity–raising the specter of bushels worth of cherry picking.

Such crimes are profoundly anti democratic in that they stifle free discourse, and indeed, chill engagement by citizens in controversial issues. The time has come for all sides on this and other issues to disclaim such conduct categorically–not just when its one’s own side that is burned. Otherwise, we should apologize to Richard Nixon for holding him to account for Watergate, and acknowledge that there remain few limits in public advocacy and the pursuit of ideological agendas.


Friday, November 20, 2009, 1:23 PM
Wesley J. Smith

The more we use human body parts in medicine and products, the more stories like this are likely to take place:

Peruvian police said on Thursday they had broken up a gang that allegedly killed dozens of people and sold their fat to buyers who used it to make cosmetics. Four Peruvians were arrested on suspicion of kidnapping, murder and trafficking in human fat. The group stored the fat it collected in used soda and water bottles, which police showed reporters. “We have people detained who have declared and stated how they murdered people with the aim being to extract their fat in rudimentary labs and sell it,” said Police Commander Angel Toldeo.

Having your life taken so your fat can be used in cosmetics?  Good grief.

This too is biological colonialism.  Such vicious criminality is not a reason to halt ethical work that makes good use of human cells and body parts–such as adult stem cell research or transplant medicine.  But I do think we should ponder seriously the unintended side effects of viewing the human body as a larderhouse, particularly in areas far afield of medicine such as in cosmetics–as in the company bragging about using fetal skin biproducts reported about a few weeks ago here at SHS.


Friday, November 20, 2009, 11:07 AM
Wesley J. Smith

Global warming has apparently stalled, and the usual media suspects are getting restless. First, there was the heresy from the BBC, and now a major German news magazine is showing some sign of coming out the reverie. From the story in Der Spiegel:

Climatologists use their computer models to draw temperature curves that continue well into the future. They predict that the average global temperature will increase by about three degrees Celsius (5.4 degrees Fahrenheit) by the end of the century, unless humanity manages to drastically reduce greenhouse gas emissions. However, no one really knows what exactly the world climate will look like in the not-so-distant future, that is, in 2015, 2030 or 2050.

This is because it is not just human influence but natural factors that affect the Earth’s climate. For instance, currents in the world’s oceans are subject to certain cycles, as is solar activity. Major volcanic eruptions can also curb rising temperatures in the medium term. The eruption of Mount Pinatubo in June 1991, for example, caused world temperatures to drop by an average of 0.5 degrees Celsius, thereby prolonging a cooler climate phase that had begun in the late 1980s. But the Mount Pinatubo eruption happened too long ago to be related to the current slowdown in  global warming. So what is behind this more recent phenomenon?

Did you get that? The long term models tell us that we’re in a crisis!!!!, its just the short term ones, uh, seem to be off. Please. If the short term models have gotten it so wrong, there is no reason for us to change the entire economies of the world in reliance on computer projections that will be even more subject to error due to the vicissitudes of the sun, currents, volcanoes, etc.

But “the scientists” refuse to revamp their game to reflect a more moderate and reasonable approach:

Despite their current findings, scientists agree that temperatures will continue to rise in the long term. The big question is: When will it start getting warmer again?

If the deep waters of the Pacific are, in fact, the most important factor holding up global warming, climate change will remain at a standstill until the middle of the next decade, says Latif. But if the cooling trend is the result of reduced solar activity, things could start getting warmer again much sooner. Based on past experience, solar activity will likely increase again in the next few years...The Hadley Center group expects warming to resume in the coming years. “That resumption could come as a bit of a jolt,” says Hadley climatologist Adam Scaife, explaining that natural cyclical warming would then be augmented by the warming effect caused by anthropogenic greenhouse gas emissions.

How about adding a third dimension to the discussion–that is, whether it will occur.  Until that is understood to be as legitimate an area of scientific research in this field as the UN-favored end-of-the-world approach, climate change will continue to be more ideology than science.

Still, I am hopeful that reason may be starting to prevail.  Wouldn’t it be delightful if in the next few years Al Gore became the new Charlie Brown, all alone on the pitcher’s mound in a pouring rainstorm asking where everybody went.


Friday, November 20, 2009, 12:26 AM
Wesley J. Smith

Here are a few more of the photos I took during my recent sojourn to the British Isle.

A view from Edinburgh Castle over the city to the extinct volcano just outside of town:

I was taken with the color coordination between the (rare) blue sky of Edinburgh and the gray statue on top of an Edinburgh building:

This shot of a statue in front of the British Library is my favorite of the trip:

I have shot the dome over the inner court of the British Museum before, but this is the the most successful yet.

Gosh, I love photography! For those interested, I have posted some more on my Facebook page.


Thursday, November 19, 2009, 4:31 PM
Wesley J. Smith

I don’t remember a more vivid case of tricky legislating than the attempt to shove Obamacare down the collective throat.  And here’s the latest example. The Senate version of Obamacare is actually an unrelated House Bill that has already passed the Lower Chamber.  From the Bill:

To amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes…AMENDMENT IN THE NATURE OF A SUBSTITUTE intended to be proposed by Mr. REID (for himself, Mr. BAUCUS, Mr. DODD, and Mr. HARKIN) Viz: Strike all after the enacting clause and insert the following [2076 pages]

Why do this?  By gutting the passed bill and substituting the Obamacare plan, it could avoid the necessity for a conference committee.  If the bill passed, it would go back to the House, and if it passed without amendment, there would be no need for a conference committee. It’s a vehicle to allow a fast track to passage.


Thursday, November 19, 2009, 4:03 PM
Wesley J. Smith

Major changes in the new Senate Obamacare bill from its House counterpart, in the sections involving assisted suicide.  (The bill is actually a gutted and already passed bill from the House–HR 3590–a trick that may be designed to get around the necessity of a conference committee.  More on that in the next post.)  Recall that the House Bill prevented the promotion of assisted suicide in the end of life counseling.  It’s missing altogether from HR 3590. This is the only reference to assisted suicide in the bill, starting at page 364:

SEC. 1553. PROHIBITION AGAINST DISCRIMINATION ON ASSISTED SUICIDE.

(a) IN GENERAL.—The Federal Government, and any State or local government or health care provider that receives Federal financial assistance under this Act (or under an amendment made by this Act) or any health plan created under this Act (or under an amendment made by this Act), may not subject an individual or institutional health care entity to discrimination on the basis that the entity does not provide any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.

That’s it. In other words, it is a conscience clause protecting medical professionals who don’t commit assisted suicide. There is no prohibition on promoting it or having it paid for under the plan.

Why need a conscience clause?  Get this clause under the section 1323 of the bill creating the public option (p. 183), beginning at page 186:

(F) PROTECTING ACCESS TO END OF LIFE CARE.—A community health insurance option offered under this section shall be prohibited from limiting access to end of life care.

If assisted suicide, or even euthanasia, are legally considered forms of “end of life care” in a particular state–as it is now in Oregon, Washington, and Montana–it seems to me that the area’s community health insurance option would be required to provide “access” to it under this clause. How else can the provision be read? And because it would have been passed later in time, this clause could be construed to subsume existing federal law that prevents federal funds from being used in assisted suicide.

None of this is by accident. The next question becomes: Why might that be?  Ideology plays a part, certainly.  But considering all of the emphasis on cost control in the Obamacare debate, this has to also be about money.  Can you think of any “medical treatment” for seriously ill or disabled people than assisted suicide/euthanasia?  The cost of the drugs to kill are only about $100.  Think of the millions that could be saved if expensive treatments never have to be rendered because patients have made themselves dead.


Thursday, November 19, 2009, 1:30 PM
Wesley J. Smith

I have a long piece out in this month’s First Things on the conscience clause issue.  I believe that the Culture of Death brooks no dissent and we are witnessing the beginning of requirements for health care professionals to either participate in medical procedures that end human life–or be complicit in them by requiring them to refer–the current abortion law in Victoria, Australia.  The piece is too long to present fully here, but here are a few exerpts

First, I set up the problem.  From the article:

Over the past fifty years, the purposes and practices of medicine have changed radically. Where medical ethics was once life-affirming, today’s treatments and medical procedures increasingly involve the legal taking of human life. The litany is familiar: More than one million pregnancies are extinguished each year in the United States, thousands late-term. Physician-assisted suicide is legal in Oregon, Washington, and, as this is written, Montana via a court ruling (currently on appeal to the state supreme court). One day, doctors may be authorized to kill patients with active euthanasia, as they do already in the Netherlands, Belgium, and Luxembourg.

The trend toward accepting the termination of some human lives as a normal part of medicine is accelerating. For example, ten or twenty years from now, the physician’s tools may include embryonic stem cells or products obtained from cloned embryos and fetuses gestated for that purpose, making physicians who provide such treatments complicit in the life destruction required to obtain the modalities. Medical and bioethics journals energetically advocate a redefinition of death to include a diagnosis of persistent vegetative state so that these living patients—redefined as dead—may be used for organ harvesting and medical ­experimentation. More radical bioethicists and mental-health professionals even suggest that patients suffering from BIID (body-integrity identity disorder), a terrible compulsion to become an amputee, should be treated by having healthy limbs removed, just as transsexuals today receive surgical sexual reassignment.

I acknowledge the comity that currently exists in the USA, where no doctor is forced to perform an abortion or participate in assisted suicide. But the times, they are a’changing. I quote articles, a court decision, medical professional ethics decisions, etc., pointing toward forced participation by health care workers in life-terminating medical procedures.  I then turn to what I think conscience clauses should look like:

If Hippocratic medicine is to be salvaged, the rights of medical conscience need to be expanded and made explicit. With the understanding that there may be nuances in specific circumstances not discussed here, I suggest that the following general principles apply in crafting such ­protections:

  • Conscience clauses should be legally binding.
  • The rights of conscience should apply to medical facilities such as hospitals and nursing homes as well as to individuals.
  • Except in rare and compelling circumstances in which a patient’s life is at stake, no medical professional should be compelled to perform or participate in procedures or treatments that take human life.
  • The rights of conscience should apply most strongly in elective procedures, that is, medical treatments not required to extend the life of, or prevent serious harm to, the patient.
  • It should be the procedure that is objectionable, not the patient. In this way, for example, physicians could not refuse to treat a lung-cancer patient because the patient smoked or to maintain the life of a patient in a vegetative state because the physician believed that people with profound impairments do not have a life worth living.
  • No medical professional should ever be forced to participate in a medical procedure intended primarily to facilitate the patient’s lifestyle preferences or desires (in contrast to maintaining life or treating a disease or injury).
  • To avoid conflicts and respect patient autonomy, patients should be advised, whenever feasible, in advance of a professional’s or facility’s conscientious objection to performing or participating in legal medical procedures or treatments.
  • The rights of conscience should be limited to bona fide medical facilities such as hospitals, skilled nursing centers, and hospices and to licensed medical professionals such as physicians, nurses, and pharmacists.

Then, I conclude:

It is a sad day when medical professionals and facilities have to be protected legally from coerced participation in life-terminating medical procedures. But there is no denying the direction in which the scientific and moral currents are flowing. With ethical views in society and medicine growing increasingly polyglot, with the sanctity of human life increasingly under a cloud in the medical context, and given the establishment’s marked hostility toward medical professionals who adhere to the traditional Hippocratic maxims, conscience clauses may be the only shelter protecting traditional morality in medicine.

I believe that medical conscience is going to be one of the most intense and bitter bioethical issues of the next ten years. The time to prepare to wage the debate is now.


Thursday, November 19, 2009, 11:08 AM
Wesley J. Smith

The Senate version of Obamacare will tax elective cosmetic surgery. From the story:

The bill levies a 5 percent tax on elective cosmetic surgery. The provision raises $5 billion and was needed to make the numbers work, according to a Democratic Senate aide. The Finance Committee considered the tax but dismissed it, in part because it was a public relations battle that senators were not willing to wage.

Actually, if I believed that taxing services and products with low/negative social utility was proper, I would enthusiastically support this tax.  Cosmetic surgery sucks tremendous amounts of medical resources out of our strained medical sector for (usually) frivolous purposes–and just as harmfully, promotes a very destructive and unrealistic standard of beauty, leading to much pain and destructive behavior. But I don’t, so I oppose the tax.


Thursday, November 19, 2009, 12:28 AM
Wesley J. Smith

Each fall the CBC asks me to predict what will happen in the coming year in bioethics/biotechnology. To say the least, I have a mixed record.  I was more worried about 2009 than turned out to be warranted by events especially about assisted suicide which moved the ball not at all in the USA.  (The UK was a different story altogether.).  The stem cell predicting the demise of the Bush ESCR funding policy was a gimme, but Obama stepped over the line of expectation–and destroyed a good and uncontroversial policy–by revoking Bush’s 2007 order requiring non embryonic pluripotent stem cell research to be federally funded. That’s when I really knew–I already had suspected–that Obama was not a great compromiser, much less a committed uniter–he is an ideologue.

In any event, here are a few more matters I got right, wrong, and missed altogether.  From my column, “2009–A Not so Dark Year After All:”

Miscellaneous

I made several predictions in other bioethical fields, and proved pretty prescient, but not infallible.

Abortion. I predicted that the Freedom of Choice Act (FOCA) – which would erase all state laws limiting abortion – would not pass. Not only did the bill not pass, no efforts were made to move the bill. However, I was wrong that federal funding for abortion would be permitted by the end of the year. That remains a goal of the Administration and the leaders of Congress, but as of now, it remains an unrealized goal.

Conscience Clauses. A great bioethical battle is coming over whether medical professionals who do not wish to be complicit in life-ending activities – such as abortion or assisted suicide – will be driven out of health care. I predicted that the “Bush Conscience Clause” protecting such dissenting health care workers would be overturned by the Obama Administration. I was certainly right that the effort would be made. Indeed, the effort was one of Obama’s first official acts. But bureaucracy being what it is, as of this writing, the revocation has not been published in the Federal Register. Meanwhile, a Ninth Circuit Court of Appeals ruled in a contraception case that a Washington regulation requiring all legal prescriptions to be filled did not violate the right to freedom of religion. If this case sticks, not only would Washington pharmacists with a religious objection to contraception be required to dispense birth control, but also to provide lethal prescriptions for use in assisted suicide…

Futile Care. Alas, I was right that Texas would not rescind its law legalizing medical futility in 2009. I was wrong that a major lawsuit in the field would make big news. Other than a temporarily stalled attempt to legalize futile care in Idaho, the field was generally quiet in 2009.

Biological Colonialism. I worried that despite legal attempts to restrict the exploitation of the world’s destitute for their body parts, biological colonialism (such as buying organs), would increase in 2009. While there were no reliable studies published about this, it is clear that at the very least, the problem remained undiminished.

Missing the Story of the Year

My greatest failure – and it’s a whopper – was missing the entire brouhaha over Obamacare. I expected health care reform to be introduced. But I never anticipated it would bloat to a 2000-page bill or that Congressional leaders would try and push the behemoth through with such scant opportunity for democratic debate. And because I missed the ruthlessness of Obamacare’s pushers, I also failed to predict the commitment and resiliency of the resistance. In other words, I wrote not a word about what turned out to be the biggest story in bioethics of the year. Why I still have this predictor gig is beyond me.

I am a bit chagrined about not seeing the approach of the big debate over Obamacare. Perhaps I thought he would learn from Hillarycare and not try to do a complete makeover.  No such wisdom.

Jennifer Lahl tells me I am still the in-house prophet, so next month, I’ll sacrifice a bull and examine its intestines to tell you what 2010 will look like.  Hey, if it was good enough for the Romans…

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