[R]emind me again why pro-abortion activists want healthy five-month pregnant women to abort their healthy child in dirty, unsafe abortion clinics?
There are plenty of secular reasons to oppose elective abortion.
One of the main charges (read the comments on just about any blog, news story that even touches the subject) against pro-life advocates is that we are trying to force our religious views on everyone else. We’re accused of attempting to create a theocracy and compared to – or called – the “Taliban.”
First, for those of us who are human-centric, it is a fact that on this planet, humans are the only species having this conversation, which makes us special.
For atheists and agnostics who believe that this is our only life, doesn’t that give weight to the right not to be killed?
Finally, and most importantly, there’s the ethical viewpoint put forward by the Declaration of Independence. (Ignoring the “Creator,” and “created,” of course.) The Declaration clearly states that rights are endowed on the individual rather than bestowed by the government. that might does not make right. The proper function of government and society is to protect our inalienable rights to life, liberty and pursuit of happiness. Where might makes right to the point that the whoever has the biggest gun or can win the most votes, no one is truly safe.
Even if “We the People” decide who is human enough and who is not human enough to have the right not to be killed, there is no liberty and no pursuit of happiness.
Please let me know if you have other secular pro-life arguments.
In the Texas Senate, the filibuster is a method of allowing a minority viewpoint known. The minority Legislator is allowed to speak without time limits and without unwanted interruptions, as long as he or she follows the rules laid out beforehand.
Windy Wendy Davis began a filibuster. She knew the rules, and she broke them. Her fellow Democrat Senators engaged in stalling tactics, but it was the noise and chaos in the gallery that made the three minutes of difference that killed the Bill.
You can watch the Senate video at this page.The
Senators West, Whitmire,Watson, Ellis, Van de Putte, Zaffirini, and (of course) Senator Davis proved to all of us that they value the elective abortion of human beings above orderly government and Legislators.
I was, unfortunately, not shocked that Senator Leticia Van de Putte encouraged the gallery to disrupt the Senate. It also appears that she lied about the timing of her motion to adjourn. See the roll call vote beginning about 12:19/15:50. Note that she spoke and that the temporary President, Senator Duncan, responded after the roll call began. 12:31
I was surprised that the gallery wasn’t cleared much earlier, even though it might have meant that I would have had to leave. However, until the last hour, the outbreaks were intermittent and quickly calmed down.
My friends and I were very concerned about the reaction of those who so clearly showed no respect for the rest of us and who greatly outnumbered the State Troopers. Every seat was full, the pro-life crowd was greatly outnumbered and the halls were crammed with more people in orange. When the standing and shouting became constant, the Lt Governor signaled to the Troopers who began to remove people in an orderly manner.
More Troopers arrived, but they were constantly at risk of physical confrontation, with some of the Orange shirts resisting the request for them to file out. At one point, the Troopers were forced to lock the West doors of the Gallery and the Mob continued to push from the hall and fill the Rotunda.
I certainly didn’t want to be in the middle of a fight with these people and am grateful that the Troopers kept some semblance of order. I don’t believe that there was a way to clear the gallery earlier or with less disruption than we had and am proud of the State Troopers.
The Royal College of Obstetricians and Gynecologists published their white paper on “fetal awareness” in 2011. (Royal College of Obstetricians and Gynaecologists. Fetal Awareness – Review of Research and Recommendations for Practice. London: RCOG Press 2010 http://www.rcog.org.uk/files/rcog-corp/RCOGFetalAwarenessWPR0610.pdf Accessed June 24, 2013).
Here is a peer-reviewed, “editor’s choice” editorial outlining the flaws in that paper. “Fetal awareness and fetal pain: the Emperor’s new clothes” by Dr Martin Ward Platt, Newcastle Neonatal Service, of the Royal Victoria Infirmary http://fn.bmj.com/content/96/4/F236.long#ref-1 (Accessed June24, 2013).
The author, Dr. Platt, points out that the evidence for no fetal awareness until birth has no evidence in humans, only in animals. He further points out that it goes against our experience with sleep/wake cycles and what we know about the ability of the fetus to learn his mother’s voice and other learning, including long-term effects on brain anatomy and response to pain:
“So, what is the evidence that the human fetus lacks ‘awareness’? In a word, there is none. The only evidence, including the bit about the chemical environment, is in sheep and one or two other experimental animals. I have looked at the references in the report, and the references in the references, and when I finally got back to the primary literature I found no evidence for the contention that human fetuses lack awareness, or exist in some different conscious state, beyond the unwarranted extrapolation from sheep.
“In contradiction to the notion of the ‘unaware’ fetus, the everyday experience of pregnancy – the felt behaviours and responses of the unborn baby, especially to sound – as well as much primary research literature on the human fetus, contains strong evidence for an opposite view. There is an extensive literature, in humans, on fetal sleep and wakefulness, fetal motility, fetal memory, fetal hearing, fetal breathing and its control and fetal behaviour – and these are just examples that scratch the surface. None of this work is easily reconciled with the notion of a permanently unconscious human fetus. The third point in box 1 is simply not true.”
“. . . the precautionary principle of prevention and treatment of pain in case it is being experienced, which is an ethical rather than a scientific argument, nor does it affect the evidence in relation to the long term neurobiological effects of pain experiences in preterm babies.”
. . . “One notices statements in the report such as: “Interpretation of existing data indicates that cortical processing of pain perception, and therefore the ability of the fetus to feel pain, cannot occur before 24 weeks of gestation”. We could rewrite this as ‘in theory they can’t feel pain, therefore they don’t’. It is the substitution of wishful thinking for empirical enquiry. It reminds me of my days as a medical student when I was taught that once the periosteum was anaesthetised, bone marrow aspiration was painless because there were no nerve endings in the bone. As soon as I came to perform bone marrow aspiration I realised that, whether there were supposed to be nerve endings or not, the procedure caused deep bone pain. So: should we deny patients’ real experiences on entirely theoretical grounds, or accept them and look harder for the underlying cause? We now know that bone is richly innervated, but older techniques of bone histology were unable to demonstrate the fibres.”
BTW, Here’s the part of that (debunked by Dr Platt) 2011 RCOG paper that I found most interesting:
“One possible solution is to recognise that the newborn infant might be said to feel pain, whereas only the older infant can experience that they are in pain and explicitly share their condition with others as an acknowledged fact of being.”
Orange t-shirts admittedly outnumbered those of us in blue at the Texas State Capitol on Sunday, June 23. However, in the long run, what mattered in the passage of the House version of Senator Hegar’s Senate Bill 5, sponsored in the House by State Representative Jodi Laubenberg, is that Texas voters had sent a clear majority of pro-life Republicans to the House of Representatives.
If you’ve always wondered about the meaning of “chubbing,” look at the 6/23/13 record of the House video, available at the House website. Pro-abortion Democrat after Dem took the microphone to bring an amendment, with fellow pro-abortion Dems standing to ask questions and run out the clock.
You can also watch the effects of “POO,” or calling for “points of order” around 4:30 PM. House Democrats called for a review of the Rules, resulting in adjournment and restart after a delay of 2 hours.
As to those t-shirts, someone showed up with 1000 t-shirts to give away. Where did that money come from? Interestingly, the women who gave out the shirts also wore Planned Parenthood buttons and successfully instructed those in the shirts how to act in the Gallery. And the orange shirts obeyed immediately.
One theme the Dems repeat is that SB 5 is not the protection for women that the Republicans say it is. They claim that pro-life laws are not about human life and ethics, but rather, simply about winning Republican primaries. This is a great example of “projection” of one’s own motives and wishes onto another. While I believe that Jessica Farrar would abort everyone with spina bifida and that Thompson is convinced that the embarrassment of the trauma of rape and incest is cured by abortion, the ultimate reason for the long night of interruptions and delays is that the clock is running out on the Special Session. If the Dems manage to delay long enough, SB 5 will not pass in the House. Even when it passes, the time used up in the House decreases the time that will have to be wasted in blocking it by filibuster in the Senate.
In the long run, the Democrat members in the Texas Legislature have repeatedly called for unfettered and unregulated elective abortion on demand.They claim that abortion is better for women and families than spending money on babies and children, that allowing babies to be born will ruin women’s lives, that it’s better to abort children with “fetal anomalies” and “birth defects” even when the “defective” human could live and make his or her own way through life. Senfronia Thompson even brought out a coat hanger to shake at the House and claimed that the cure for the “embarrassment” of the trauma of rape and incest is abortion, even after 20 weeks. Every one of the Dems seemed to have no understanding that the facility improvements will not be required for 15 months.
SB5 was passed finally in the House this morning. It will now have to go back to the Senate. There may not be time enough for reconciliation with the Senate version because of delays caused by both the House Republicans and House Dems. I hope that the protections in the Bill become law to protect the women who make the choice to abort their children and to protect the lives of fetuses at 20 weeks and greater.
Edited 7/11/13 for grammar and spelling errors – BBN
#TxProlife and all Texas voters who would stop (or at least limit) the abortions of our little brothers and sisters are asked to join us in a prayerful, peaceful stand in favor of no abortions after 20 weeks, higher standards for abortion facilities and a requirement that the doctors who perform abortions maintain hospital privileges within 30 miles of the facility.
(seriously: doctors should have local hospital privileges, don’t you think?)
Please consider joining us at the Capitol when the House debates these Bills on Sunday. Wear blue, so we can show our numbers.
If you can’t attend, please pray for us and call your Representative’s office to ask for a “yes” vote on SB5 and HB60. Our best chance is to pass the Senate Bill, so the law will go through faster and with less chance of stalling. If the Senate has to agree with a different Bill, there may not be time.
Pray for a peaceful stand for life and courageous Legislators who will defend the Texans of tomorrow!
I won’t be able to follow this page very well during the meeting at the House, but should be able to keep up with those of you who contact me on Twitter, at bnuckols.
“We agree that some treatments do stop achieving the intended goal of that specific treatment, such as dialysis no longer filtering uric acid from the blood. When a treatment or therapy is in fact medically futile, no physician would ever continue that, and a properly informed patient or his surrogate would not want to continue futile or harmful treatment, and nothing in current law or in any of Texas Right to Life’s past or present proposals would require the continuation of such medically futile treatment. Physicians would not continue medically futile treatment anyway.”
“Conflicts arise when the futility judgments are transferred from the efficacy of a medical treatment to a value judgment on the futility of the patient’s life.”
- don’t have the right to be notified of DNR’s placed on their charts,
- have no protection against the removal of artificial nutrition and hydration,
- don’t have the right to medical records before the medical ethics committee meets,
- don’t have the right to be accompanied in the medical committee meeting, and
- don’t have an additional 7 days to prepare for the medical ethics committee and an additional 14 days to find another doctor willing to accept responsibility for the medical treatment of the patient.
Like many of you, I feel betrayed after our years of support and defense of the BSA. Worse, the BSA is betraying the boys who will be misled by their own whims and impulses and by peer pressure and predators.
A child cannot legally consent to any sort of sex during the years he is eligible for the Scouts and he cannot truly know his sexual orientation. But he can be influenced and abused by the normalization of immorality.
Will the BSA now confirm other behaviors that once were considered contrary to “God and my Country?”
If they can kill you, why not lie a little, too?
And so much for “peer review:” Rush to publish: The Cloning article I wrote about last week was “accepted” 3 days after submission, 12 days to publishing in the journal.
That big story from Cell really, really wanted cloning humans to be true.
The first problem was an image duplication. Figure 2F, which shows a cloned stem-cell colony “with typical morphology”, is reproduced in the top left of Figure 6D where it is labelled as “hESO-7” — an embryonic stem-cell line derived not from cloning but from in vitro fertilization (IVF). Mitalipov says that the duplication was intentional but that the labelling was reversed. The top left panel in 6D should have been labelled hESO-NT1, indicating a cloned colony, as in Figure 2F. The top right figure should have been hESO-7.
He says that label reversal also explains another set of duplicated images — the top right figure in 6D and the top right figure in Supplementary Figure S5. With the labels reversed, the identical images are both representing the hESO-7 cell line. “Then everything falls into place,” Mitalipov says.
Even so, the decision to use the same image to illustrate two different properties, once to show typical morphology (2F) and once as a basis for comparison of cell markers between embryonic stem cells from normal IVF embryos and cloned embryos (6D), is “not ideal,” says Martin Pera, a stem-cell expert at the University of Melbourne, Australia. “It’s considered bad form, unless you have a reason to do it.”
The 83rd Legislature of the State of Texas still has a couple of weeks to go, and it ain’t over ’till both the House and Senate are sine die, but it appears that SB 303 did die over the weekend.
Representative Susan King, who broke her leg last Sunday, just the day before the marathon meeting of the House Public Health Committee, has done an incredible job of working with Senator (Dr.) Bob Duell in their attempt to reform our State’s Advance Directive Act through SB 303.
The Committee Substitute which Representative King presented in the Committee had all of the benefits I wrote about last week, as well as a revision to prohibit a doctor from writing a DNR order against the wishes off a competent patient.
(Talk about unintended consequences: current law is silent on “DNRs,” so it’s apparently legal for a doctor to order that resuscitation not be performed on a competent patient without any discussion with the patient, much less obtain consent! I have sincere doubts that any doctor would do so, but there have been allegations. Even though the ones who claim to have knowledge – and who have not produced one iota of proof – are the same disingenuous cynical scaremongers (I’ll call them “CS2”) I’ve mentioned before, this reform would be a good. And should be accepted on its face.)
Because of the egregious misrepresentations of the CS2, Committee Chair Lois Kolkhorst declined to allow SB303 out of the Committee as it was written. Rep. King tried one more time, with a bare bones CS1 containing the protection against DNRs for competent patients and the prohibition against withdrawal of Artificial Hydration and Nutrition, except when it would harm the patient or hasten his death.
So, for the next two years, when you hear the CS2 complain about Texas “death panels” or read a plea for funds to fight “secret DNRs” and withdrawal of food and water in Texas hospitals, remember the CS2 who killed pro-life reform in the 83rd Legislature.
If we can still believe scientific journals, Cell reports in the June 6, 2013 issue indicate that scientists have succeeded in cloning human embryos.
The term used for cloning by the group is “reprogramming” fibroblasts using somatic cell nuclear transplantation. However, there’s no longer an attempt by the authors or members of the scientific press to create a new “unfertilized blastocyst” or pre-embryo: the embryos are called embryos, morula, and blastocysts.In recognition that these are not quite the same as embryonic stem cells derived from embryos produced by direct fertilization, the stem cells derived from the cloned blastocysts are designated as “Nuclear Transfer Embryonic Stem Cells” or NT-ESC.
Tachibana’s group obtained well over a 100 oocytes from women who underwent ovarian stimulation and transvaginal retrieval.
The growth of four embryos to the blastocyst stage resulted in NT-ESC, after differentiation into a blastocyst with a trophoblast (precursor of the placenta) and the inner cell mass (the part that will develops into the actual body of the human). These embryos were destroyed to harvest the ICM.
The report details years of research to find the optimum technique for cloning human embryos. It was found that the mitotic stage of the oocytes, MII, is critical. The researchers further developed a protocol utilizing caffeine and electrical stimulation to induce activation of the fused nucleus from the skin cell and donor oocyte. In addition, the authors found that “higher quality oocytes,” those more likely to form viable embryos, resulted when the ovarian stimulation yielded fewer than ten oocytes. If larger numbers of oocytes were produced due to the ovarian stimulation, somatic cell nuclear transfer was less likely. In fact, the first four clones that developed far enough to produce NT-ESC came from one woman who donated eight oocytes in one cycle, resulting in the production of five cloned embryos.
There are several ethical problems which surround this research.
First, as strongly noted by the Center for Bioethics and Culture, the ovarian stimulation risks abuse of women who might be placed at risk due to the hormones administered to induce ovulation. As noted in the paper,
“In the context of generating patient-specific pluripotent stem cells, reproducible results with various patient-derived somatic cells and with different egg donors are a necessity.”
Although the donation is called voluntary and anonymous, the women were compensated for their “time, effort, discomfort, and inconvenience associated with the donation process.” I can’t help but wonder about how long the anonymity will last for the one woman whose oocytes yielded those first four successful clones and NT-ESCs or for the two women whose oocytes yielded the clones confirming the reproducibility of their method, in the second stage of the research. Or how much pressure they will face to continue to donate “voluntarily.”
The lack of concern for the women involved is revealed in this interview with the authors at The Scientist,
““I was worried that we might need a couple of thousand eggs to make all these optimizations, to find that winning combination. But it actually took just 128 [eggs], which is a surprisingly low number to make 6 [hESC] lines.””
6 NT-ESC lines were derived from 128 harvested oocytes, for a yield of 4.6% In later stages, the success rate was still 2 NT-ESC lines from 7 embryos and 15 oocytes, or 13% of oocytes.
The primary objection is that 100% of the human embryos were created in harm’s way and must be destroyed to harvest the NT-ESCs.
These embryos are delayed human twins, artificially induced. Although the first cell of these embryos began in the lab, as the result of highly technical and involved procedures, they are human embryos and near-identical twins of the somatic cell nucleus. There is indirect acknowledgement that the embryos are twins of the donor of the fibroblasts by the reporting that tests of the chromosomes of the cloned embryos show that the DNA matches that of the donor of the fibroblasts, a patient with Leigh’s syndrome.
The sources of fibroblast nuclei raise other ethical dilemmas. The first research was carried out using female fetal fibroblasts. Later research involved creating human embryos with Leigh’s syndrome. Leigh’s syndrome results from a genetic defect of the mitochondria, the cell “power plant,” which is inherited from the mother and only found in the cell cytoplasm, not the nucleus. Reports are already ignoring the fact that the donor’s twins were produced with the express intention of destroying them for their inner cell mass. At least one is predicting that this is a technique which can be used to create future children for mothers who have the abnormal mitochondria.
The report, Tachibana et al., “Human Embryonic Stem Cells Derived by Somatic Cell Nuclear Transfer,” Cell (2013),http://dx.doi.org/10.1016/j.cell.2013.05.006, is available on-line and in PDF (as of today).
Last night, an emergency meeting ot the 83rd Texas Legislature’s Public Health Committee addressed Senate Bill 303, by Senator Duell in a 12 hour long meeting. Representative Susan King, who authored the Companion Bill in the House and sponsored SB303 in this meeting, appeared only one day after a fracture of her tibia. This woman is a hero!
I also want to thank Chair Lois Kolkhorst for ensuring that the meeting was held so that SB303 – and all the people who are so passionate about patients rights and good medicine in Texas could be heard.
It was wonderful to see all the people who volunteer so much of their time to influence Texas law – even when they disagreed with me. What a pleasure to meet new friends, including a gentleman whose name I can’t recall (will fix this later) and Jacqueline Harvey, Ph.D.
Here’s an excerpt from Dr. Harvey’s testimony,
While opponents say that S.B.303 grants power to providers to remove care patients in irreversible conditions, I’d remind them again that one cannot extend to providers power which they already legally possess. Opponents claim that S.B. 303 adds this broad definition, when in fact; this broad definition was established in TADA and is current Texas Law. What S.B. 303 does is add protections to prohibit discrimination against persons with disabilities by ensuring that care may be removed only when harmful (i.e. treatment would fail, hasten patient death, exacerbate another medical condition or cause unnecessary pain). These conditions are standard medical ethics a la “do no harm.”
I’ll write more after I get a chance to review the video of the hearing. There’s some sort of glitch at the Legislature Audio and Video page. (Might have something to do with 12 hours of recordings, ending after 2 AM)
Life After Life: A Novel, by Kate Atkinson is based on the premise that the protagonist, Ursula Todd, lives her life over and over and over and over. The suggests that the reason might be so that she can do it until she gets it right. Ursula never seems to get it right.
The book illustrates the main reason I don’t believe in multiple universes or reincarnation. The Creator seems to have set up an orderly universe, with predictable consequences – you know, those laws of physics like, an object in motion tends to stay in motion, conservation of mass and energy in a closed system, and that for action there’s and equal and opposite reaction. He has also instilled unconditional love as our highest value. None of which is consistent with forcing us to go through life – or death – over and over until we get it right.
The best part of the book is that most of the story takes place in London during World War II. Ursula was born, each time she was born, in 1910, so she was a teen during the War to End All Wars and a young woman working for the British Government during the Battle of Britain and the Blitz. We Americans are blissfully ignorant of the nightly (“save one”) bombing of London for 10 weeks in September and October, 1940, followed by bombing of that city and others by the Germans the attempt to instill terror in the British and to literally destroy Britain. I am in awe of the people who lived through those nights and of the Air Raid Wardens who served them.
The author pretty much lost my respect for her insight because of a scene in which Ursula is raped. I’m not sure the act could physically be completed the way it’s described, but there’s no way that rape is that nonchalant, non-violent and silent. Perhaps it would have been more plausible if she had induced a fugue state in Ursula. Ms. Atkinson does a much better job with the miserable timeline during which Ursula marries an abusive husband.
There is an interesting detour as Ursula sort of falls into the outer ring of Adolph Hitler’s inner circle.
I only finished the book because of the Battle of Britain stories and a hope of making some sense out of the author’s concept. Or maybe I just wanted a happy ending?
“Father Tad” is the Director of Education at the National Catholic Bioethics Center. The Texas Catholic Conference published his commentary on “DNR’s” on May 10, 2013.
These judgments are tricky to make, because the specifics of each case differ, and those specifics change with time and disease progression. DNR’s should be put in place only when the circumstances warrant it, that is to say, on a case-by-case, patient-specific basis. In other words, when CPR/resuscitation can reasonably be determined to no longer offer a hope of benefit to the patient or if it entails an excessive burden to him, at that time a DNR can be put into place.
Some of the possible burdens that may need to be considered in deciding whether to pursue resuscitative interventions for a patient would include some of the following: the risk of rib or other bone fractures, puncture of the lungs by a broken bone (or from the trauma of lung compression and decompression), bleeding in the center of the chest, cerebral dysfunction or permanent brain damage, the small risk (about 3 or 4 percent) that the patient might end up entering a vegetative state, and subsequent complications if the patient ends up staying on a ventilator for an extended period following the resuscitation.
During resuscitative efforts, elderly patients are more likely to experience complications or to have ribs break during CPR. Younger patients, on the other hand, tend to show a greater resilience and are often better able to tolerate CPR. Patients suffering from advanced cancer are also known to fare poorly following resuscitative efforts.
In terms of overall statistics, when a patient codes in the hospital and all resuscitative measures are taken, patients frequently do not end up leaving the hospital, especially when they are elderly or have other co-accompanying conditions. Based on data from the National Registry of Cardiopulmonary Resuscitation (NRCPR), studies have determined that patients who undergo cardiac arrest in the hospital have an overall survival to discharge rate of about 17 percent. The rate drops even lower (to around 13 percent) for cancer patients. In other words, the benefits are oftentimes few and short-lived, while the burdens tend to be high. There are, of course, exceptions — while many patients do not experience significant benefits from resuscitative measures, a small percentage do.
So when death is imminent, and disease states are very advanced (perhaps with multiple organ failure), and assuming other spiritual matters, such as last sacraments, have been addressed, a DNR order may not raise any moral problems. The key consideration in making the judgment will be to determine whether the benefits of resuscitation outweigh the burdens. So when death is imminent, and disease states are very advanced (perhaps with multiple organ failure), and assuming other spiritual matters, such as last sacraments, have been addressed, a DNR order may not raise any moral problems. The key consideration in making the judgment will be to determine whether the benefits of resuscitation outweigh the burdens.
DNR orders can be misused, of course, if they are broadly construed as calling on medical professionals to abandon or otherwise discontinue all care of a patient. Even as patients may be declining and dying of serious underlying illnesses, we must continue to care for them, support and comfort them, and use the various ordinary means that they may have been relying on, such as heart and blood pressure medications, diuretics, insulin, etc.
We should always seek to do what is ethically “ordinary” or “proportionate” in providing care for our loved ones, though we are never obligated to choose anything that would be heroic, disproportionate or unduly burdensome when it comes to CPR or other resuscitative measures.
An opponent of SB 303 and I have been discussing the Bill on an earlier post. She referred to my “list of endorsements.” This is a fairly strong list of endorsements, at least for those of us who are believers, don’t you think?
The Texas Baptist Christian Life Commission is ” is pleased that SB 303 was recently voted out of the senate.”
Texas Catholic Bishops letter to members of the Texas House of Representatives urging support for SB 303
The Morality and Wisdom of Incremental Legislation: The Case for SB 303 by Rev. Tadeusz Pacholczyk, Ph.D.
Texas Catholics Bishops Conference been very active over in the many efforts over the years to reform of the Texas Advance Directive Act and all have signed the endorsement strongly urging passage of SB303 http://www.txcatholic.org/press-releases/336-texas-catholic-bishops-strongly-urge-house-vote-on-end-of-life-care.
I’ve relied on the National Catholic Bioethics Center ( Marie Hilliard and Father Tad) for their consistent and coherent efforts to preserve traditional medical ethics. NCBC has also endorsed the Bill, and written an excellent response to criticism of SB303.
Added 5/11/13 at 11:00 AM, more endorsements and information:
Here is another discussion about the end of life for my Catholic friends who are trying to decide whether to support SB 303.
Life, however, is not an absolute good.
Treatment and life support
Questions about the use of medical treatments and life-support systems are distinct from—and yet often associated with—euthanasia. The scriptural insights can be very helpful with these issues, even if they cannot give details. As good stewards, we believe that death is not the final word, that life is not an absolute good. Therefore, we do not have to keep someone alive “at all costs.”
The Catholic tradition helps with the details, providing this guidance: ordinary means must be used; extraordinary means are optional. Ordinary means are medicines or treatments that offer reasonable hope of benefit and can be used without excessive expense, pain or other inconvenience. Extraordinary means do not offer reasonable hope of benefit or include excessive expense, pain, or other inconvenience. What is important to remember is that “ordinary” and “extraordinary” refer not to the technology but to the treatment in relation to the condition of the patient, that is, to the proportion of benefit and burden the treatment provides the patient (see the Vatican’s Declaration on Euthanasia, #IV, 1980).
Many people remember when Cardinal Joseph Bernardin of Chicago decided to stop the treatment for his cancer. The treatment had become extraordinary. He did not kill himself by this choice but did stop efforts that prolonged his dying. He allowed death to occur. (This distinction between allowing to die and killing, as in euthanasia or assisted suicide, is of great significance in the Catholic tradition. The rejection of this distinction by several U.S. courts raises serious concerns.)
Within the Catholic Church, debate still surrounds the question of providing medical nourishment through a feeding tube. Let’s look at two positions.
1) “Life must almost always be sustained.” This position holds that the withdrawal of medically assisted nutrition and hydration cannot be ethically justified except in very rare situations. The fundamental idea for this position is the following: Remaining alive is never rightly regarded as a burden because human bodily life is inherently good, not merely instrumental to other goods. Therefore, it is rarely morally right not to provide adequate food and fluids.
This position acknowledges that means of preserving life may be withheld or withdrawn if the means employed is judged either useless or excessively burdensome. The “useless or excessive burden” criteria can be applied to the person who is imminently dying but not to those who are permanently unconscious or to those who require medically assisted nutrition and hydration as a result of something like Lou Gehrig’s or Alzheimer’s disease. Providing these patients with medical nourishment by means of tubes is not useless because it does bring these patients a great benefit: namely, the preservation of their lives.
2) “Life is a fundamental but not absolute good.” This approach rejects euthanasia, judging deliberate killing a violation of human dignity. On the other hand, while it values life as a great and fundamental good, life is not seen as an absolute (as we saw in the section on scriptural foundations) to be sustained in every situation. Accordingly, in some situations, medically assisted nutrition and hydration may be removed.
This position states that the focus on imminent death may be misplaced. Instead we should ask if a disease or condition that will lead to death (a fatal pathology) is present. For example, a patient in a persistent vegetative state cannot eat enough to live and thus will die of that pathology in a short time unless life-prolonging devices are used. Withholding medically assisted hydration and nutrition from a patient in such a state does not cause a new fatal disease or condition. It simply allows an already existing fatal pathology to take its natural course.
Here, then, is a fundamental idea of this position: If a fatal condition is present, the ethical question we must ask is whether there is a moral obligation to seek to remove or bypass the fatal pathology. But how do we decide either to treat a fatal pathology or to let it take its natural course? Life is a great and fundamental good, a necessary condition for pursuing life’s purposes: happiness, fulfillment, love of God and neighbor.
But does the obligation to prolong life ever cease? Yes, says this view, if prolonging life does not help the person strive for the purposes of life. Pursuing life’s purposes implies some ability to function at the level of reasoning, relating and communicating. If efforts to restore this cognitive-affective function can be judged useless or would result in profound frustration (that is, a severe burden) in pursuing the purposes of life, then the ethical obligation to prolong life is no longer present.
Disagreements in the Church
How are these significantly different positions judged by the Roman Catholic Church? There is no definitive Catholic position regarding these two approaches. Vatican commissions and Catholic bishops’ conferences have come down on both sides of the issue. Likewise, there are Catholic moral theologians on both sides.
Emphasis by underlining is mine. Edited 5/10/13 BBN
For my Catholic readers who are concerned about SB 303 and the discussion about a doctor’s decision that it’s medically appropriate to withhold artificial food and nutrition by feeding tube or IV:
Such persons, if treated with a feeding tube and intensive nursing care, can sometimes live for months or years. When they die, it is typically due to complications of feeding-tube treatment, such as pneumonia caused by food placed in the stomach going up the esophagus (foodpipe) and down into the lungs.
Thinking about using feeding tubes in a rare condition such as post-coma unresponsiveness is very different from thinking about using feeding tubes in more common diseases such as cancer, AIDS, Alzheimer’s disease, Lou Gehrig’s disease or Parkinson’s disease. Tube feeding in these types of patients will often result in great burden, no net benefit and multiple complications.
In very many such cases, tube feeding will meet the criteria by which it could be considered extraordinary or morally optional. These diseases continue to progress and get worse-no matter what treatment is offered. Complications such as pneumonia are much more common when feeding tubes are used for such patients.
Patients with dementia sometimes pull the tubes out and would need to be restrained in order to be fed. In fact, in these conditions it has even been difficult to show that the use of feeding tubes actually makes the patients live longer. Clearly, in many such cases, the burdens of treatment can be judged disproportionate with respect to the benefits, and the treatment could therefore be judged extraordinary or morally optional.
If there’s no such thing as right and wrong or good and evil, why are we arguing in the first place?
If you crack the egg of a bird on the Endangered Species List, it won’t matter that the bird was a fetus or embryo. You’ve still broken Federal law. Why is the species of an (unhatched) animal so clear cut under law, but human embryos have no protection under current law? Legal follies such as this underscore our lack of seriousness and consistency when contemplating our children of tomorrow. My concern is that we are not teaching them why they should treat us kindly, much less giving them a good example.
Bioethics dilemmas and most political disputes may seem to be new problems, but they’re not. Every “new” problem is another facet of the potential to deny the existence of right and wrong or to infringe on the inalienable rights of our fellow humans. Knowledge of the basics can guide decisions and actions.
If there’s no such thing as right and wrong or good and evil, why are we arguing in the first place? These truths transcend relative social considerations and laws, including religious beliefs, ideology, or the wants and wishes of the powerful or majority. They even transcend time and space: if you take a close look at the big debates, the speakers aren’t simply talking to each other: we’re arguing with the great thinkers of the past and trying to convince people who come along after us.
The unique nature of the species Homo sapiens sapiens is the source and the definition of “human dignity,” and the reason that all members of the species and our offspring are human beings who should be valued equally, without discrimination.
And of course, we are unique, since It looks like we’re the only species having this conversation. We’re the only species that, when an individual has safety, food and sex, doesn’t just go to sleep. Our species makes art, records history, and argues about the nature of the universe. Humans seem to naturally “know” “that’s not fair,” even at 3 or 4 years old. We seek Unconditional Justice, Truth, Love, Beauty and Knowledge. And we value Unconditional Love most of all.
The Negative rights to Life, Liberty and Property are owned and endowed upon individuals; they are not the property of or gift of societies or governments. These exist in a necessary order; a hierarchy of importance and power to call on society for protection. The right not to be killed trumps the right not to be enslaved, which precedes the right not to have your property taken from you by force or fraud. If they can kill you, there are no limits on how much they can enslave you or take from you. We must be secure that others won’t take our property against our will, because earning and owning property is how we avoid enslavement to others and how we make plans and lay by the staples of life to support the lives of ourselves and our families, both immediately while we can earn, and later when we are unable to work.
Society and government must protect these “inalienable” rights of individuals, but only as far as to ensure equality of opportunity, not the equality of outcome. These are protections against the actions of others, not against words or thoughts. It is not protection or promotion of someone’s personal tastes and not the right to not be offended. We must be very, very careful when we tax and even more careful if we presume to force the actions of others.
Good politics and science cannot exist in a moral vacuum. The powerful, the majority, the surging mob. the man with the biggest gun or governments cannot do good when their actions infringe on the life, liberty or property of the individual. To claim that people must act or give up property indefinitely for the greater good – Utilitarianism – ends in domination without measurable or objective limits.
And yet, to function in society carries responsibilities. Extraordinary privileges like those given to lawmakers, doctors, and scientists to do good, may also result in extraordinary power to do evil through abuse of unequal power of weapons, tools, numbers or even knowledge and skill. This is where conscience and the first principle of “first do no harm” come in. The right of conscience is a function of the liberty of an individual not to be forced to act against his understanding of good and evil, right and wrong.
Medicine and science have held a unique position to advocate for the protection of human rights, at least since Hippocrates, who formalized the now 2500 year old oath to “heal when possible, but First, do no harm” Non-maleficence, or not acting in order to avoid harm, must precede and be incorporated in the desire to do good or beneficence.
Once again, we come back to that first point: all of our offspring, descendants deserve the same value and protection of their rights to life, liberty and property without discrimination. It’s possible that we already have offspring among us who are not of our species. Science has created human embryos with more than two biological parents and others who have been the subject of genetic manipulation. Also out there are is the Humanity+ or Transhumanism movement in all its permutations, along with more accessible enhancement of the human mind and body through technology, medicine, machines, and manipulation at the nano-level.
We must consider how our children of tomorrow will consider us. It is true that humans aren’t perfect, we will make mistakes, and some humans will purposefully infringe on the rights of others. However, what values and principles will the pattern of our governments and individual action reflect? Will it be our respect and love for one another? Will they respect and love us or will they look back in horror or disgust?
(I want to thank Robert Spitzer, who wrote “Healing the Culture,” one of the best Ethics books in existence.)
This is a March, 2011 post from LifeEthics. org. Why Ethics? | LifeEthics. Edited 5/10/13 to move to top of the list.
Texas Senate Passes Pro-Life SB 303 to Help FamiliesProtect Loved Ones Near the End of LifeLt. Governor David Dewhurst and Sen. Donna Campbell M.D. Deserve Thanks!April 24, 2013Dear Larry and Beverly:Very good news! Last week the Texas Senate passed SB 303, a strong pro-life bill that will change current law to help families protect their loved ones near the end of life. Supported by pro-life Lt. Governor David Dewhurst and authored by Sen. Bob Deuell (R-Greenville), the full Senate passed SB 303 on a decisive 24-6 vote.Your Texas state senator, Sen. Donna Campbell M.D., voted to support SB 303, a pro-life vote. Please thank Lt. Governor Dewhurst and Sen. Campbell for their support. See sample messages below.SB 303 is strongly supported by broad coalition of pro-life and provider organizations including Texas Alliance for Life, the Texas Catholic Conference of Bishops, and the Texas Baptist Christian Life Commission.Voting for SB 303 were: Campbell, Carona, Davis, Deuell, Duncan, Ellis, Eltife, Estes, Fraser, Garcia, Hinojosa, Huffman, Lucio, Nelson, Nichols, Rodriguez, Schwertner, Seliger, Uresti, Van de Putte, Watson, West, Whitmire, and Zaffirini.Voting against SB 303 were: Hancock, Hegar, Patrick, Paxton, Taylor, and Williams. Senator Brian Birdwell was absent.
Prevents secret DNAR orders (“Do Not Attempt Resuscitation”). Current law allows doctors to order DNARs without even notifying the patient or family.
Prevents the involuntary denial of food and water, except in extreme circumstances when the treatment would harm the patient or hasten his or her death.
Increases the time of the dispute resolution process from 12 to 28 days when a family and patient disagree about appropriate end of life care.
Significantly limits the class of patients to whom the dispute resolution process can be applied.
Requires doctors and hospitals to treat all patients “equally without regard to permanent physical or mental disabilities, age, gender, religion, ethnic background, or financial or insurance status.”
Preserves conscience protections so physicians are not required to provide futile or harmful procedures indefinitely.
A great deal of false and misleading information about SB 303 has been spread by several groups, especially by one group in particular that is based in Houston. In response, the Texas Catholic Conference of Bishops issued a strongly-worded letter to set the record straight. Please see this: http://txcatholic.org/news/327-misstatements-against-end-of-life-care-reform-corrected-in-letter-to-lawmakers
See my earlier post about the rebuke TRTL received from the Texas Catholic Bishops Conference. – http://wp.me/p1FiCk-XW – and an even earlier explanation (long winded, I’m afraid) – http://wp.me/p1FiCk-Wb
Edited 4/27/13 to add that last paragraph – BBN
Using words such as “egregious,” “cynical,” “outrageous,” and “deceive,” the Texas Catholic Bishops Conference have published the letter that they sent to Texas Legislators concerning the actions of Texas Right to Life concerning Senate Bill 303 and its companion, House Bill 1444 on April 15, 2013.
Since employees and representatives of TRL continue to “stoke fear through ridiculous claims,” (and to harass those who support the Bills) here’s the letter (I’ve reproduced the emphasis is in the original):
The Texas Catholic Conference is compelled to publicly correct the misstatements and fabrications that continue to be perpetuated by the Texas Right to Life organization against legislation to improve end-of-life care by reforming the Texas Advance Directives Act.
It has been said that all is fair in love, war and Texas politics. However, the actions of Texas Right to Life have been so egregious and cynical, especially when comes to misrepresenting the moral and theological doctrine of the Catholic Church, that the TCC cannot stay silent.
Texas’ Advance Directives Act needs reform. Current law lacks clarity given the complexity of end-of-life care, contains definitions that could permit the withdrawal of care for patients – including food and water – and permits unilateral Do Not Resuscitate Orders without the permission of, or even consultation with, the family.
Senate Bill 303 and House Bill 1444 are based on Catholic moral principles and reasonable medical standards for defending human life and protecting the conscience of both families and physicians. Both billsprevent unilateral DNRs, improve communication between medical providers and families, ensure a clear and balanced process for resolving differences, and give families the right to challenge Do Not Resuscitate Orders before a medical ethics committee.
In both its materials and communications with legislative offices and staff, Texas Right to Life has tried to stoke fear through ridiculous claims of nonexistent “death panels” and assertions that doctors are “secretly trying to kill patients.” Both claims are absurd. The truth is, many factors are involved in the sausage-grinding process of public policymaking. Some have less to do with making good laws and more about individual personalities and fundraising opportunities of organizations.
It is outrageous that an organization purportedly committed to the rights and dignity of life would resort to such disingenuous tactics that deceive honest and caring people. What is worse is doing so in a way that perpetuates current law and may cause unnecessary patient suffering.
Texas Right to Life has no authority to articulate Catholic moral teaching, and certainly does not have permission to represent the views of the Roman Catholic Bishops of Texas. If you have any questions, please feel free to contact us at the Texas Catholic Conference. We are more than happy to answer any questions or provide the Texas Catholic Bishops’ position on any issue before the Legislature.
(Edited for spelling and grammar, 4/25/13 BBN)
You can comment, let the New England Journal of Medicine editors and the world know your thoughts.
Do you believe that Mr. Wallace should be able to receive life-terminating drugs from his physician? Which one of the following approaches to the broader issue do you find appropriate? Base your choice on the published literature, your own experience, and other sources of information.
To aid in your decision making, each of these approaches is defended in the following short essays by experts in the field. Given your knowledge of the patient and the points made by the experts, which option would you choose? Make your choice and offer your comments at NEJM.org.
My opinion is that poisoning Mr. Wallace, or writing the prescription so that he can attempt to intentionally commit suicide, is a direct infringement of Mr. Wallace’s inalienable right not to be killed.
Jesus lives! And it’s a good day to remember His love for us, which led Him to become Emmanuel and give His sinless life for us. The tomb is empty and death is conquered.
Love you all in His name.
By the way, the victim’s name is Leo Johnson.
FRC’s Tony Perkins again calls on SPLC to Stop Reckless Labeling of Christian Organizations
WASHINGTON, D.C. – Earlier today, Floyd Lee Corkins, II, pleaded guilty to three charges including a District of Columbia charge of committing an act of terrorism. The charges stem from the August 15, 2012 shooting at the Family Research Council’s headquarters.
Today’s hearing also revealed that in the interview with the FBI right after the shooting, the shooter admitted his guilt, which was captured on video. He said he intended to “kill as many as possible and smear the Chick-Fil-A sandwiches in victims’ faces, and kill the guard.” The prosecutor said they reviewed the family computer and found that he identified his targets on the Southern Poverty Law Center’s web site.
I’m in the middle of reading Willie Nelson’s latest book, the semi-biographic stream of consciousness, Roll Me Up and Smoke Me When I Die: Musings from the Road.
I enjoy the stories about his life and family, but I’m continually irritated by his confused comments on politics and ethics.
It really knocks me for a loop when I encounter someone like Mr. Nelson, who has obviously thought long and hard about certain issues but doesn’t seem to understand the basics of ethics or logic. Because he doesn’t know *why* some things are right and others are wrong, he ends up proving one of the homey proverbs he quotes in the book: if you don’t stand for something, you’ll end up falling for anything.
I love to hear Willie Nelson and his songs. My husband and I went to see his band play at the Majestic Theater in San Antonio last January and were very impressed by the Nelson concerts — both of them. Lukas Nelson’s band, Promise of the Real, opened for his father and sons Lukas and Mikah joined the Nelson family on the stage.
It’s tempting to reference Laura Ingraham’s book, Shut Up and Sing, along with the theory and demand behind it. Just because a person is a great singer, songwriter and guitar player, doesn’t mean he’s a great person, much less that he’s a great philosopher or thinker. It certainly shouldn’t mean that his philosophy should be given greater weight than that of other people because of his celebrity and access to the press.
The fact is that Mr. Nelson is a leader and he influences a large number of people. It’s a shame it’s not for the right reasons.
In this book, Mr. Nelson praises the Occupy Wall Street protests, says he agrees with Warren Buffet “that it just ain’t fair for people like us to have all the advantages,” and states that the Second Amendment shouldn’t apply to today’s weapons because they aren’t designed for hunting, only for killing people. His religious comments are mostly just silly ramblings.
However, the cause Mr. Nelson is best identified with – and the one for which it would be simplest to correct his logical errors – is the legalization of marijuana. He writes about his founding of the “TeaPot Party” in the book. Mr. Nelson’s reason for legalizing marijuana is simply that people want to smoke it and there are other legal substances that are worse. And he proposes a Statist’s plan as flimsy as his utilitarian ethic: “Tax it, regulate it and legalize it!” to raise money for the Government:
It’s already been proven that taxing and regulating marijuana makes more sense than sending young people to prison for smoking a God-given herb that has never proven to be fatal to anybody. Cigarettes and alcohol have killed millions, and there’s no law against them, because again, there’s a lot of money in cigarettes and alcohol. If they could realize there is just as much profit in marijuana, and they taxed and regulated it as they do cigarettes and alcohol, they could realize the same amount of profit and reduce trillions of dollars in debt.
Nelson, Willie; Friedman, Kinky (2012-11-13). Roll Me Up and Smoke Me When I Die: Musings from the Road (p. 20). William Morrow. Kindle Edition. (accessed 12/03/2012)
It might surprise some people that I – the self-proclaimed “hot air under the right wing” – agree that marijuana shouldn’t be illegal to grow, own or use. I base my belief on a plain reading of the US Constitution. How on Earth can our Federal government outlaw a plant that literally grows like a weed and doesn’t require manufacturing or processing to use? In fact, my theory as to why the plant is illegal is because it would be hard to regulate and tax.
Or maybe not.
Back in the mid-1990’s, I attempted to grow a traditional herbal medicine garden and ran into trouble obtaining Oriental poppy seeds, Papaver somniferum. Most of the orders I placed were cancelled, so I started doing some research. I learned that the Clinton Administration was raiding gardens and arresting people for growing and sharing the seeds of heirloom plants passed down from their mothers. This was in spite of the age-old use of the plants in gardens and herbal medicine, as well as the ready availability of food grade fertile Oriental poppy seeds for cooking and baking.
The more I thought about it, I came to the conclusion that the Federal government’s “War on Drugs” is not Constitutional and it’s not conservative. I agree with Mr. Nelson that this “war” is a costly abuse of government that strengthens organized crime and too many American freedoms have fallen as collateral damage. But the reason is not because people want to abuse drugs or because the Government could make money off the taxes. It’s because there’s no justification for outlawing a plant in the Constitution.
This is what happens when we the People don’t know our own Constitution and allow our Legislators to habitually pass abusive laws: the infringement of our inalienable rights.
Daniel 4:30-35 “And the king answered and said, “Is not this great Babylon, which I have built by my mighty power as a royal residence and for the glory of my majesty?”
“While the words were still in the king’s mouth, there fell a voice from heaven, ‘O King Nebuchadnezzar, to you it is spoken: The kingdom has departed from you and you shall be driven from among men, and your dwelling shall be with the beasts of the field. And you shall be made to eat grass like an ox, and seven periods of time shall pass over you, until you know that the Most High rules the kingdom of men and gives it to whom he will.’
” Immediately the word was fulfilled against Nebuchadnezzar. He was driven from among men and ate grass like an ox, and his body was wet with the dew of heaven till his hair grew as long as eagles’ feathers, and his nails were like birds’ claws.
“At the end of the days I, Nebuchadnezzar, lifted my eyes to heaven, and my reason returned to me, and I blessed the Most High, and praised and honored him who lives forever, for his dominion is an everlasting dominion, and his kingdom endures from generation to generation; all the inhabitants of the earth are accounted as nothing, and he does according to his will among the host of heaven and among the inhabitants of the earth; and none can stay his hand or say to him, ‘What have you done?'”
(E-Sword English Standard Version)
“We the People” rule this Nation, which is a democratic republic. When I hear the usual justification of the fictitious “separation of church and state” as, “Give unto Caesar that which is Caesar’s, and unto God,that which is God’s,” I know that the People are Caesar.
Not only that, but that we are each, individually, to do our own personal duty to the Lord. No where does the Bible say that we should take from others for the common good or force others to give unto either Caesar or God!
Are we more like another king, Nebuchadnezzar of Babylon, who thought his success and security lay within himself? Are we paying for our hubris and that of our neighbors because we don’t give God the glory He is due?
Pray that our reason returns to us.
We all know that what that woman is choosing is to end the life of her own child. Usually, nearly 97% of the time, both mom and baby are healthy. And far too often, she doesn’t feel like she really has a choice.
I contend that the protection of the right not to be killed should be the first reason to vote against Obama and all Democrats, from the President on down to the local County and State offices.
The right to life – the right not to be killed – of a human being is the primary inalienable right. If that right is not protected, then all other rights are subject to the power of others; they are also infringed. What is liberty, if one human or the State can determine that some humans aren’t human enough to have their God-given right not to be killed defended by the rest of us?
The fact is that all women undergoing an elective abortion already have a sonogram. The standard of care for abortion or any procedure requiring instrumentation of the uterus now includes a an ultrasound examination. The law in Texas not only ensures that the standard of care is followed, but that the timing allows the woman to be fully informed before the abortion, and before she is sedated and prepped for the abortion.
The same law that ensures that the woman will be offered a chance to see her sonogram and hear the heartbeat also makes sure that she’s referred to agencies that will help her actually have a “choice.” The Woman’s Right to Know Act included the mandate that women and girls be given access to a ) list of all the resources (State, Federal, private and charities) that are available to help the mother while she’s pregnant and after the baby is born. The State Department of Health Services compiles the list, using funds raised by licensing those abortion facilities.
The purpose of Government, according to the Declaration of Independence is to “secure” our inalienable rights to life, liberty and the pursuit of happiness. The Preamble of the Constitution of the United States goes further, stating that the government not only protects those of us who are citizens, but must also “secure the Blessings of Liberty to ourselves and our Posterity.” Vote to protect our “Posterity,” the children of tomorrow.
Health care policy expert, Sally C. Pipes, spoke to our @D4PC meeting this morning about the Benjamin Rush Society. The Society is an organization that she founded in order to inform and enable medical students and residents to defend the traditional medical ethic that the doctor should work for the patient, not a third party, and “certainly not one that wields the coercive force of law.”
While the topic of the talk was the Benjamin Rush Society, Ms. Pipes also discussed her own experience as a former citizen of Canada and about her mother’s death from colon cancer after being refused a colonoscopy under the Canadian health care system. The reason given was that “Seniors” weren’t given colonoscopies and that those under 65 years old had a several months long waiting period, even if bleeding. When Ms. Pipes’ mother began bleeding from the colon, she spent 3 days in the Emergency Department and passed away 2 weeks later with metastatic colon cancer.
There were also comments from members in the audience about the United Kingdom’s National Health Service, which has even longer wait times for services, including heart surgery.
Ms. Pipes is married to Charles Kesler, whose book, I AM the Change, Barack Obama and the Crisis of Liberalism, will be released on September 11. Mr. Kesler spoke to out group yesterday.
Robin Alta Charo, the lawyer/ethicist-for-hire, one time Clinton advisor turned Obama transition advisor then FDA consultant, has been appointed to 2 new positions at the National Institutes of Health.
In her new role, Charo will advise on ethical and regulatory issues raised by translational research, such as privacy and civil rights concerns raised by research using human tissues residing in large biobanks or public health implications of deploying genetics and personalized medicine to target drug development toward narrower segments of the population. She will also participate in overseeing the peer review process for research proposals submitted to NCATS.
Ms. Charo, the inventor of the “Endarkenment,” supports sex-selection abortion, believes cloning will finally prove there’s no God, and frequently writes op-eds for the New England Journal of Medicine, specializing in her opposition to conscience rights. She likens Medicine to a “public utility, obligated to provide service to all who seek it. Claiming an unfettered right to personal autonomy while holding monopolistic control over a public good constitutes an abuse of the public trust — all the worse if it is not in fact a personal act of conscience but, rather, an attempt at cultural conquest.”
It’s difficult to write about a respected medical journal which promotes “Aid in Dying” without resorting to emotional words such as “horrifying,” “shocking,” or “murder,” but I’ll try. However, I will not call the practice “physician aided death” or “aid in dying.” It is, at best “physician assisted suicide,” and at worst, “euthanasia,” or the use of medical technology and procedures to actively end the life – to intentionally kill – a patient. This is not “medicine” as I understand it.
Chest is the journal of the American College of Chest Physicians. These are the Internal Medicine subspecialists who focus on lung disease, cardiac care, and sleep medicine. They are likely to be the doctors who care for the most vulnerable patients, especially in the Intensive Care Unit at your hospital.
Under the heading “Medical Ethics,” in the July, 2012 issue is an article titled, “Aid in Dying: Guidance for an Emerging End-of-Life Practice,” authored by Kathryn L. Tucker, J.D. The article is available online as a web page, here, and as in pdf., here.
Beginning with a principle that virtually all of us can agree with,the right to refuse intentional medical intervention, the article quickly moves to the very controversial opinion that the first principle ensures the “right” to request “treatment” that is intended to end the life of the patient – to kill:
•A patient with decision-making capacity has the legal right to refuse or request the withdrawal of any medical treatment or intervention, regardless of whether he or she is terminally ill and regardless of whether the treatment prolongs life and its withdrawal results in death.
•A patient with decision-making capacity has the legal right to request and receive as much pain medication as necessary for relief, even if it advances the time of death.
•Principles of autonomy that underlie respecting patient rights to refuse or direct withdrawal of life-prolonging interventions or to request pain medication even if it advances time of death support the choice for aid in dying. Aid in dying is increasingly accepted in law and medicine in the United States.
•Provision of aid in dying does not constitute assisting a suicide or euthanasia. Aid in dying is a practice with growing support in the public and medical and health policy communities and is likely to become more widely requested in the future.
•A clinician cannot be compelled to provide treatment that conflicts with his or her personal values. In these circumstances, the clinician cannot abandon the patient but should refer the patient to a colleague who is willing to provide the service.
Four prima facie principles have been used to characterize most ethical concerns in medicine: respect for patient autonomy, beneficence, nonmaleficence, and justice. Respect for patient autonomy refers to the duty to respect patients and their rights of self-determination; beneficence refers to the duty to promote patient interests; nonmaleficence refers to the duty to prevent harm to patients; and justice refers, in part, to the duty to treat patients and distribute health-care resources fairly.11 When applied to the care of an individual patient, however, these principles may conflict with one another. For example, a patient’s values, preferences, and goals may be at odds with a clinician’s perception of how best to help and not harm the patient. Clinical ethics identify, analyze, and provide guidance on how to resolve these conflicts.
While I believe that there may come a time when it is ethical to stop trying to keep a patient alive – when treatment is only making the dying process longer – I will never assist in an act that can only end in the death of my patient. The way I explain this is that I will assist in removing a ventilator under certain circumstances, but I won’t then put a pillow over the patient’s face to make sure she can’t breathe on her own afterwards. The intent of medicine is to diagnose and treat disease, not to end the life of patients suffering from disease.
KVUE.com, Austin’s ABC television affiliate, sent a crew to Tampa to cover the Texas Delegation to the Republican National Convention. The reporter, Tyler Sieswerda, interviewed Larry and me after this morning’s meeting of the Delegation.
I also told Mr. Sieswerda about my Texas Alliance for Life and Christian Medical Association pins, but they didn’t make the cut — although a view of the back of my T-shirt did! (I’m not as fat as the rear view makes me look!)