I’ve been having a long Facebook discussion with representatives of organizations, people who claim that I support coercion and killing patients because I defend the Texas Advance Directives Act, 166.0046. (TADA).
I want to respond as fully as I can. ( I’m bandwidth deprived today and will gradually add more links when I reach better signals. See here, here, and here for more explanations from earlier WingRight posts. Links to the law, the press, and previous blog posts by others can be found in those articles.)
It was easy to follow this case. There was a video published by Texas Right to Life (TRTL), a lot of press, statements to reporters by family, lawyers, and TRTL staffers, as well as a couple of lawsuits. I spent the better part of two days once again reviewing the public records.
(Edited 03/11/18 for typos, to add a link, and to clarify points originally made on Facebook in a long debate. BBN)
This is a line I may find occasion to quote in the future:
The author, Holman W. Jenkins, Jr., goes on to make the point that the Dems shot themselves in the foot by not exploiting the fact that Trump was himself a Dem or Dem-leaning until recently – or, even, perhaps working with him to pass the infrastructure funds.
My theory about the Russia accusations is that the Wassermann-Schultz IT scandal (an “unbiased” review by the Washington Post, here, and the Daily Caller’s more thorough review, here) as well as Podesta’s “password” password controversy (see the UK’s Guardian coverage, here) , along with the cheating to defeat Bernie Sanders, was serious enough to necessitate distraction. And we all know that there’s quite afew irregularities in the Comey and Lynch, etc., cover-up of Hillary’s illegal server and “carelessness” with government security.
(I couldn’t come up with a better title than Mr. Jenkins’ own.)
“To Be Determined,” or the Schrodingder’s cat* version of human rights.
Does the possession of inalienable human rights depend on unknown future facts? Can the moral worth of a human being be determined by the actions of another human being – or by fate, the available and utilized medical technology?
Sherif Girgis discusses the theory of Princeton philosopher, Elizabeth Harman, in today’s Public Discourse. The professor’s view that abortion is – or may be – a neutral act has been the subject of discussion since she appeared in the YouTube video, Philosophy Time, produced by actor James Franco and Eliot Michaelson.
Besides the obvious problems pointed out by Girgis of defining “consciousness” and the TBD “kind” of a human fetus, there are other problems.
First, any concept of “inalienable” human rights would need to be discarded. There goes the Declaration of Independence and the basis of the United States Constitution.
In addition, Professor Harman’s theory would presumably allow the use of bodies of the human species for the benefit of humans with “moral worth,” as long as those bodies are never allowed to become conscious. This is the current practice of researchers using embryos, including those created for the purpose of manipulation and destruction.
But there’s nothing in this philosophy to prevent the intentional manipulation of a human body for research or to benefit others, as long as the body is never allowed to develop consciousness. Continual sedation or mutilation of the brain from the beginning – before consciousness – would prevent the development or acquisition of moral worth and rights.
In the process, “human” rights would cease to exist. The actions of others, laws and location and the potential use of technology would finally determine who is human enough to possess the right not to be killed. (Forget the right not to be “enslaved.”
What happens if (as Girgis proposes) the abortion itself is aborted or fails? Or if the brain isn’t damaged sufficiently to prevent consciousness?
Forget about opening the box: don’t put humans in there in the first place.
*I saw this analogy on a Facebook thread, but thought the same thought before I stole it.
Edited to correct my misspelling of Dr. Harman’s name.
Last week, in a story about another baby boy, there was a a beautiful memorial to the “Bubble Boy,” David Vetter, too.
My granddaughter’s mother is one of those heroes, helped by doctors and nurses, my son and an extended family of friends. (I can’t help my prejudice that gives the mother most of the credit.) And then, there was a baby boy and his generous mother.
In addition to a very low white blood cells count, her bone marrow didn’t make enough red blood cells or platelets, either. She’s healthy and well, today, after one of the first cord blood bone marrow transplants in the world at the age of 15 months.
Although no matches were found for Sebastian, the baby in today’s story, Texas has a strong system for the registration of both bone marrow and umbilical cord blood donors. The Texas Cord Blood and MD Anderson Cord Blood Centers collect, store s and manage the distribution of donated cord blood collected at birth from moms and babies all over the State.
Families who store their baby’s cord blood privately are very unlikely to ever need it, except when there’s a known problem. The odds are less than 1:200,000. But if they donate to a public bank, the blood is much more likely to save a life and/or be used in life-saving research.
Bravo to all the parents and caregivers in children’s lives and prayers for Sebastian. There’s a Go-Fund-Me account for Sebastian’s expenses, if you are interested.
Edit: there’s a wonderful update: Sebastian was able to go home!
Sigh . . . There are still people out there trying to justify elective abortion of healthy babies in healthy mothers by claiming that the embryo is nothing special, since liver tissue is alive when it is harvested for transplantation and ” . . . a skin cell contains DNA that could be implanted into a human egg and be developed into a baby.”
That hypotheticals is, at this time, just that. No one has yet been able to clone humans beyond a very early blastocyst. In some way, these embryos don’t function well enough to maintain organized cell division, development and growth.
However, even if cloning a human were possible, that new human life would not begin at the harvesting of either the skin cell, the liver tissue or the oocyte destined to be enucleated. Just as with gametes in vivo, those cells are end-stage specialized cells that do *not* actually have the potential to be other types of cells – much less a new human – without fertilization or the manipulation that scientists might someday be able to discover.
The natural, in vitro, or someday-maybe cloned human life begins at fertilization or not-yet-achieved generation of functional clones. Each are – or would be, in the case of the hypothetical – verifiable by observing the organized cell function, development and division in the embryo, driven by the nucleus of the new organism. Intentional, interventional abortion ends that organized development and growth, causing the death of the organism.
I’m sure my explanation won’t stop those who really, really, reeeally want to abort unwanted humans from using junk science to justify killing humans. Most likely, they will just go back to those long essays discriminating between which humans are human-enough.
Bioethicists and transhumanists – and I – have long speculated on the ability and usefulness of drugs to enhance performance. However, assassins, murderers and the subgroup that are the jihadists, have a completely different goal for their “enhancement.”
“Captagon — a synthetic amphetamine-based pill — is considered the drug of choice for Islamic State fighters in Syria, Iraq and, now it seems, Paris.
‘When French police raided a hotel room at Alfortville, south-east of Paris, last week they found a stash of syringes, needles and plastic tubing.” (from http://www.abc.net.au/news/2015-11-24/captagon-the-drug-that-kept-the-paris-attackers-calm/6970464 )
Hat tip to BioEdge
Please read the link – or at least the entire quote I’ve pasted here – before commenting.
The immigration debate and its ability to divide the Republican Party and split the Conservative vote is not new. Here’s a commentary about the dispute in light of the 2012 Presidential election, written in 2011. (Scroll down the page to “On Immigration,” Saturday, May 21, 2011.)
Dr. Jerry Pournelle has served our Nation in many capacities (including serving in the Army during the Korean War), but he’s probably best known, to those who know his name at all, as the author of Science Fiction written from a conservative, libertarian-leaning viewpoint. I strongly recommend his essays, including this one from 2011:
“We aren’t going to deport them all, and no Congress or President will do that, nor could even if it were thought desirable. The United States is not going to erect detention camps nor will we herd people into boxcars. We can’t even get the southern border closed. Despite President Obama’s mocking speech, we have not built the security fence mandated a long time ago. We probably could get Congress to approve a moat and alligators, although there are likely more effective means. We can and should insist on closing the borders. That we can and must do. It won’t be easy or simple, but it’s going to be a lot easier than deporting 20 million illegals. Get the borders closed. We can all agree on that.
“That leaves the problem of the illegal aliens amongst us. We can and should do more to enforce employment laws; but do we really want police coming around to demand “your papers” from our gardeners and fry cooks and homemakers?”
This is not a trivial point. I advocate for the necessity of identifying illegal aliens and would prefer that the process begin in the country of origin. However, in practical terms, how would the “Maria” Dr. Pournelle describes, who was brought here as a child, “begin the process?”
Defense and security requires that we secure the border and that we identify as many who are here illegally as possible. A first step would be to better track people who enter on Visas: what are all those computers at border entry spots for?? We should also cease the fiction that our schools don’t know which families with children are undocumented. We should hold employers accountable, but be very careful about instituting new government papers and government computer lists of eligible workers.
We must determine common ground for the sake of success. As pointed out four years ago by Dr. Pournelle, errors will be used against us, with the hard cases like “Maria” will be splashed across media and social networks. Without common ground, and with emotional demands to “deport them all,” we’ll still be debating this four years from now. And our citizens – and the illegal aliens – will remain at risk from the violent and criminal, if not from the terrorist.
We should at least have as much care for the donation of tissue from aborted human fetuses and embryos as we do for the donation of organs from those killed by capital punishment. Both scenarios involve purposeful intervention to cause death and the collection of tissues, at least, must be carried out by licensed and regulated medical personnel.
Robin Alta Charo (a law and ethics professor at the University of Wisconsin) has an opinion piece in this week’s New England Journal of Medicine, “Fetal Tissue Fallout.” in which she claims that society has a “duty” to use tissues harvested after elective, intentional abortions.
I object to the idea that society has a “duty” to make use of the end products of either procedure. Both scenarios involve purposeful intervention to cause death by licensed and regulated medical personnel, making those of us who vote for the legislators who write laws complicit in the actions, at least remotely. Under a strict philosophy of ethics based on the protection of inalienable rights, each act should be weighed individually and should only be carried out when the one killed is a proven danger to the life or lives of others.
Robin justifies her elevation of the use of fetal tissues after elective abortion to that of a “duty” by citing past benefits of research using fetal tissues. She is more political and names past Republican supporters in an earlier op-ed, published in the Washington Post on August 4th.
Yes, society has benefited from these tissues. However, that picture at the side of this post depicts Dr. Frederick Robbins, one of the scientists who utilized fetal tissue in the 1950’s development of the Salk polio vaccine. Dr. Robbins is depicted smoking at work in the laboratory, while handling test tubes without gloves. We know better than that, now. Isn’t it time that science and medicine researchers catch up with our knowledge that the human fetus is a human being from the moment of fertilization?
Where are the Ethics Review Boards that monitor for the unethical behavior we’re hearing about in the videos from the Center for Medical Progress?
In 2013, the science journal, Nature, published an article covering the history and evolution of informed consent and compensation for donors of human tissues, including the fetal tissue culture, WI-28. Ms. Charo was quoted as supporting monetary compensation:
But, says Charo, “if we continue to debate it entirely in legal terms, it feels like we’re missing the emotional centre of the story”. It could be argued, she says, “that if somebody else is making a fortune off of this, they ought to share the wealth. It’s not a legal judgment. It’s a judgement about morality.”
Yes, “It’s not a legal judgment. It’s a judgement about morality.”
Pretty much whatever our politics, our client (sorry) lies in the past. Maintaining the programs of the Great Society? Returning to the vision of the Founders? Addressing as #1 priority the debt mountain we have built? Each of these is meritorious, and wherever our political lines lie for most of us each of them features. Point is not that they are misplaced priorities. It is simply that they hail from yesteryear. Left and right are stumbling into the future as their gaze is fixed on the past. (“How to bridge the Continental Divide; moving Camp David to the Valley; please, pols, start Asking Tomorrow’s Questions.” Nigel Cameron, President and CEO, Center for Policy on Emerging Technologies. )
“The shrill universal cry that we are at a “tipping point” is correct, but not as they would have us all believe, the tipping point that is fast approaching has to do with the old political and legal superstructures being torn apart from below by this powerful, complex, emergent force of scientific and technological evolution now unleashed. Reactionaries are doing all they can to bamboozle gullible people into helping support the status quo, to prop it up, which is unfortunate.” (Quote from C. James Townsend, in “The Singularity and Socialism, An interview with C. James Townsend” by BJ Murphy on Murphy’s “Serious Wonder” blog, distributed by the newslist/email of the Institute for Ethics and Emerging Technology.)
This week, two email subscriptions I follow converged with a common warning that government is reacting to and protecting the past. Each, one from the right and one from the left, urge politicians to allow innovation and technology to frame the debate on the economy.
We may not ever solve the problem of an irresponsible tabloid press and sensation-seeking media, since the freedom of speech is too important to infringe. But we do have power over those we license as physicians.
Dr. Walt Larimore enters the vaccine debate in his blog, not by suggesting forced vaccination, only the regulation of physicians. I wouldn’t support the recommendation without some leeway — I’m certainly not going to approve of every vaccine without a time trial in this very diverse lab that is the United States.
However, Dr. Larimore and his guest author, Dr. Russell C. Libby, are right to raise the ethical and medic0-legal responsibility of physicians who are licensed by the State and who advocate against good science and medical standards.
From the article:
“State medical boards must decide if the actions of healthcare practitioners who advocate against vaccination and undermine the public health efforts of their communities warrant investigation and intervention. There are a number physicians and other licensed healthcare professionals who trivialize and discourage immunization, whether it be for philosophical, financial, or self-promotional reasons.
“When the patients they influence contract preventable disease and have bad outcomes or they cause the spread to a vulnerable population, they should be held liable for malpractice. If it is in the midst of an outbreak or epidemic, medical boards need to sanction or suspend licenses.”
I’ve spent quite a bit of time — especially over the last week – attempting to educate interested people (including a family member) about the safety and usefulness or efficacy of vaccines. My motto for these arguments has always been that, “Truth will out,” and, “If we’re right, we should be able to teach and convince.”
However, within the last week, an irresponsible Texas radio host trotted out the discredited and un-licensed doctor who fabricated the MMR/autism fraud and a Canadian newspaper published a hit piece on Gardasil. (You can find them easily on Google – I won’t give them “hits” from my page.)
When licensed physicians – men and women who should know better – spread demonstrable lies, even after being found guilty of fraud or when demonstrably spreading harmful misinformation, there should be consequences.
Forty years ago the words “fertilization” and “conception” meant the same thing to doctors, lawyers, and embryologists alike: the joining of the 23 chromosomes in the sperm with the 23 chromosomes in the oocyte (“egg”) to form a new complete, unique human organism. “Contraception” was defined as any method that worked before the existence of the embryo by preventing fertilization. These were the hormonal treatments and devices that prevent ovulation of the egg and condoms, diaphragms and sterilization that serve as “barriers” between the sperm and egg. Drugs and devices that may or may not end the life of the embryo after fertilization were legally and correctly called “abortifacients.”
However, legalized abortion and the ability to accomplish fertilization through in vitro methods led to new legal definitions of “pregnancy” and “conception” as beginning at implantation rather than fertilization. Even in vivo, healthy human embryos in healthy mothers were deprived of legal protection as human beings for at least the first 5 – 10 days of their lives, the window of opportunity for implantation when the developing embryo grows to hundreds of cells organized in 2 or 3 recognizable tissue layers and interact with the mother’s body in ways that may affect the timing of birth or risk of diabetes and other health concerns. Possible abortifacients that work after fertilization but before implantation were redefined as “emergency contraception.”
In spite of what you may have heard on the news, the June 30, 2014 Burwell v. Hobby Lobby decision by the Supreme Court of the United States (SCOTUS) didn’t deny birth control for anyone. Everyone may still purchase his or her own FDA-approved birth control. SCOTUS simply ruled that the government can’t force some employers to buy things that they believe are immoral.
In fact, Hobby Lobby only asked to be exempt from purchasing insurance plans that paid for specific drugs and devices used for “emergency contraception.” Before the passage of the Affordable Care Act (“ObamaCare” or ACA), the company purchased insurance that included true forms of contraception, including,
- Those that prevent ovulation by preventing the normal ups and downs of the hormones estrogen and progesterone, such asBirth-control pills with estrogen and progestin (“Combined Pill”),Birth-control pills with progestin alone (“The Mini Pill”),Birth control pills (extended/continuous use), Contraceptive patches, Contraceptive rings,Progestin injections, andImplantable rods
- Those that act as “barriers” to fertilization by preventing the union of sperm and egg: Male condoms, Female condoms, Diaphragms with spermicide, Sponges with spermicide, Cervical caps with spermicide, Spermicide alone, Vasectomies, Female sterilization surgeries, and Female sterilization implants.
The problem is that regulations written by the Obama Administration mandated that all insurances pay for all pregnancy “preventatives” approved by the FDA, including drugs and devices that may function after fertilization to end the life of the new human embryo:
- Pills that mainly delay ovulation but may impair implantation and development of the placenta if fertilization takes place, such as over-the-counter Plan B and generic levonorgestrel tablets, and ella, which requires a prescription, and
- Devices that mechanically and hormonally make the uterus inhospitable to implantation by the embryo, such as intrauterine devices like the copper-T, Mirena, and ParaGuard. These are inserted up to 5 days after unprotected intercourse to prevent implantation and then left in place to prevent fertilization and implantation for as long as 5-10 years.
Although the words we use do not change the fact that the human embryo is the same human life before implantation as after, they can change his or her legal status.
The latest wins came this month, when the Office of Personnel Management announced that government-contracted health insurers could start covering the cost of gender reassignment surgeries for federal employees, retirees and their survivors, ending a 40-year prohibition. Two weeks earlier, a decades-old rule preventing Medicare from financing such procedures was overturned within the Department of Health and Human Services.
Unlike Obama’s support for same-sex marriage and lifting the “don’t ask, don’t tell” ban on openly gay troops, the White House’s work to promote transgender rights has happened mostly out of the spotlight.
Some advances have gone unnoticed because they also benefited the much larger gay, lesbian and bisexual communities. That was the case Monday when the White House announced that Obama plans to sign an executive order banning federal contractors from discriminating against employees on the basis of their sexual orientation or gender identity.
In other instances, transgender rights groups and the administration have agreed on a low-key approach, both to skirt resistance and to send the message that changes are not a big deal, said Barbara Siperstein, who in 2009 became the first transgender person elected to the Democratic National Committee.
Other sites besides Infowars.com have also been miscategorized by Blue Coat.
In the past, the company also labeled New Braunfels Republican Women, the web site of conservative commentator Carolyn Gargaro and Reunion Ministries as “pornography.”
Not only are the emails lost, but they hoped the notice would be, also:
Camp notes that the IRS decided to “bury” the claim of lost emails “deep in an unrelated letter on a Friday afternoon.” He isn’t kidding. It appears on the 15th page of the document, which is actually the seventh page of the first attachment to an eight-page letter, addressed to Sens. Ron Wyden of Oregon and Orrin Hatch of Utah, respectively chairman and ranking Republican of the Senate Finance Committee.
The IRS asserts that it has “determined that Ms. Lerner’s computer crashed in mid-2011. . . . The data stored on her computer’s hard drive was determined to be ‘unrecoverable’ by the IT [information technology] professionals.” The agency further claims to have “confirmed that back-up tapes from 2011 no longer exist because they have been recycled.”
And there’s more:
IT professionals from outside the administration say the Lois Stretch is quite a stretch, too. Norman Cillo, identified as “an Army veteran who worked in intelligence and a former program manager at Microsoft,” tells TheBlaze.com that if the IRS is telling the truth, it means the agency is “totally mismanaged and has the worst IT department ever.” According to Cillo, there should be multiple backups, on server hard drives as well as tape.
Cool! Security will need to be tight, though.
Google Glass was put to work as part of a system involving a QR code posted on the doorway to each patient’s room and software that can read the code and call up the record of the patient. Dr. Horng noted how each second counts in a hospital environment and fast access to timely information can be life-saving; Horng also said he wanted to use technology in a way that kept doctors in front of patients, not screens, away from the computer and back to the bedside
A machine lays down the titanium for the false hip, dot by dot, line by line as with a printer. In addition, the docs used the woman’s bone marrow stem cells to aide in healing.
Malwarebytes’ blog, UnPacked, is also promising protection to those of you who are still using Windows XP and understands the problems of switching to Windows 8 for some users:
Rest assured Malwarebytes will continue to offer support for XP, to assist users who find themselves in this unfortunate position.
Many readers of our blog are also the familial tech support, and trying to migrate grandma to Windows 8 might not only be an expensive affair but also a potentially traumatic experience. Windows 8 is proving to be … challenging.
One of my family members went back to his laptop with the broken hinge and wobbly screen rather than switch from Windows 7 to 8, so I can imagine there are many, many who won’t like to jump even more evolutionary leaps.
The rest is a description of switching to another sort of code, Linux Mint, that can be made to look and act like a (safer version of) Windows XP. I probably could do it with a lot of coffee and some new cuss words, but anyone with a genuine problem with switching operating systems would most likely need some help from someone more tech savvy.
The important message is that Malwarebytes will protect your computer, even if you won’t or can’t switch
In the Abolition of Man, C.S. Lewis notes that, “When all that says ‘it is good’ has been debunked, what says ‘I want’ remains.”
Last week, the New England Journal of Medicine published a “Perspectives” column, “Life or Death for the Dead Donor’s Rule?,” in which the authors illustrate Lewis’ point with their redefinition of non-maleficence to better serve a re-defined autonomy.
They would convince us that there is no harm in hastening the death of a dying patient even by intentionally causing it if he or his surrogates ask. They ignore a 2500 year old First Principle of Medical ethics,focused on the health of the patient in front of us: “Cure when possible, but first do no harm, ”
Autonomy, like all rights, is a negative right: the patient has the right to refuse invasive medical interventions that will harm him or that he does not want. Patients and surrogates, if they can compel the use of medical skills and invasive technology, can only do so for the medical benefit of the patient himself.
Illogically, in these times of reducing costs, the authors would have us consider taking a patient from the ICU to the OR “and then take him back to where life support would be withdrawn.” The return to the ICU is nothing but our own “medical charade.”
I want to thank Nancy Valko, who runs an email list covering a range of traditional ethics issues, her email alerting me to this editorial.
“But in some situations, you may see a redefinition of what ‘start’ means.” (Wall Street Journal quoting Obamacare consultant.)
President Obama and Democrats everywhere should be grateful to the Republicans for saving them from a huge embarrassment. Instead, the Dems continue to dig in, escalating their claims to have won a mandate on ObamaCare in 2012, in spite of the fact that the Republicans won enough seats in the House of Representatives to secure a strong majority.
House Republicans passed a new Continuing Resolution that compromises on Obamacare, by changing from refusing funding altogether to setting up a one year delay. Included in the Bill is a measure that would ensure that our military is paid in the event of a shutdown. The Bill also repeals the 2.3% tax on medical devices and the mandate that business owners with religious objections buy insurance that includes controversial “free” contraception.
The Wall Street Journal, in addition to reporting the redefinition of “start,” outlines the many ways that the Federal and State exchanges are not ready to launch Obamacare on October 1:
In the District [of Columbia], people who use the online marketplace will not immediately learn if they are eligible for Medicaid or for subsidies.
In Oregon, people will not initially be able to enroll in an insurance plan on the Web site.
In Vermont, the marketplace will not be ready to accept online premium payments until November.
In California, it could take a month for an insurer to receive the application of someone who applies for coverage on the exchange on Oct. 1.
. . . But as the launch nears, more delays are occurring. On Thursday, the administration announced a delay in the online shopping system for small businesses and confirmed that the Spanish-language site for signing up for coverage will be delayed until mid-October. Earlier in the week, officials said Medicaid applications will not be electronically transferred from the federally run exchange to states until November.
In 2008, when physicians from CareMore, an independent medical group based in Cerritos, California, heard news reports of a brutal heat wave, they began contacting their elderly emphysema patients. Physicians worried that the scorching heat would drive their at-risk Medicare Advantage patients to the emergency room. So when patients said they had no air conditioner, the physicians purchased units for them. The theory was that the roughly $500 cost paled in comparison to the cost of an emergency-department admission. As it happened, this non-medical “intervention” kept CareMore’s patients out of the hospital. But if they had needed to go and lacked transportation, CareMore would have offered a free ride.
CareMore has an expansive, counter intuitive approach to healthcare. The group fends off falls by providing patients with regular toenail clipping and by removing shag rugs—a common household risk for the elderly. Patients engage in iPhone conference calls with healthcare professionals and are remotely monitored with devices that feed data automatically to doctors; for example, patients with congestive heart failure are given a wireless scale that reports their weight on a daily basis—a key step in preventing hospitalization. They have singing pillboxes that chime when it’s time to take medications.
These unusual tactics produce enviable outcomes: CareMore’s hospitalization rate is 24 percent below average, hospital stays are 38 percent shorter than average, and the amputation rate among diabetics is 60 percent below average. Overall member costs are roughly 18 percent below the Medicare average.
A real-life, real medicine tale of the risk that doctors face – and are willing to face – when taking care of our patients under arbitrary and often outdated Medicare regulations. It will only get worse under ObamaCare and the IRS.
He was a slender-framed man, mid- to late-sixties, with a kind of ridden-hard-put-away-wet complexion. It was clear the years had not always been good to him, but being the kind soul that he was, he had plenty of friends. It was a beautiful summer day to spend with friends for a barbecue, but he arrived feeling puzzled why he collapsed at home earlier in the day.
He stopped at the keg and poured himself a beer in a red solo cup, and as he approached his friends with a smile, he did it again, this time which such gusto that his beer went flying and the thud he made when he hit the ground made everyone gasp. He laid motionless for a moment face down on the ground while his friends rushed to his aid. An ambulance was summoned as others rolled him over onto his back. He began to move – slowly at first – then more purposefully. As sirens approached, he asked his friends, “What just happened?’
Read the rest of the story here.
The author’s comments:
It is becoming abundantly clear that conflicts between the [sanctity] of human life will confront the government’s unwillingness to pay for procedures. No where is this more clear than with approval of payment for the implantation of an ICD, which might run in excess of $200K for the procedure at some instituions. As a result, doctors who strive to provide state-of-the-art care to their patients will continue to confront similar ethical dilemmas that risk their legal standing (and credentials) as they care for their sickest arrhythmia patients.
By publishing this case scenario, my hope was to draw attention to these ethical dilemmas that are becoming increasingly prevalent in medicine as a result of these outdated, inconsistent, and incomplete coverage decisions, guidelines for care, and “appropriateness use” criteria. Further, the potential for legal action against physicians y imposes real fear for do
ctors if they stray at all from these outdated decisions. This fear is to the point where it might do actual harm – and even cause death – to patients who are left without appropriate treatment as a result.
Texas Alliance for Life has posted the video of the speech given in the Texas House of Representatives by Representative Jason Villalba (District 114, Dallas) in favor of life and HB2. It’s a beautiful testimony to love and humanity, and an answer to all the claims that this Bill is simply a political ploy. Watch for the sonogram picture of the Villalba’s 13 week son and the Representative’s declaration that he will fight for his son and all the babies destroyed by elective abortion.
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).
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.
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)
Great news from Australia!
“In 2011 no genital wart diagnoses were made among 235 women under 21 years of age who reported prior human papillomavirus vaccination,” the authors noted. “The significant declines in the proportion of young women found to have genital warts and the absence of genital warts in vaccinated women in 2011 suggests that the human papillomavirus vaccine has high efficacy outside the trial setting. Large declines in diagnoses of genital warts in heterosexual men are probably due to herd immunity.”The study provided a glimpse of the impact of HPV vaccination in a real-world community setting as opposed to a clinical trial.
6:05/8:18 Farrar: “So, so, this diagnosis is missed, they
have a fetal anomaly, the spine’s outside the body or something, you say you would not have an exception for that situation.”
Watch the video at 6:05 (See below ++) of the April 10, 2013 Texas House State Affairs Committee meeting hearing on HB 2364, by Representative Jodi Laubenberg, as State Representative Jessica Farrar challenges a practicing OB/Gyn about his belief that abortion should not be performed when babies are found to have non-lethal “anomalies” after 20 weeks post-fertilization (or 22 weeks since last period).
I wonder how of you have heard of the trial of abortionist Kermit Gosnell* in Philadelphia, Pennsylvania? Most people, whether pro-choice or pro-life, are horrified by the way Dr. Gosnell and his staff treated the babies they delivered both alive and dead.
We also squirm at the intentional killing of children who could otherwise live.
The limit of viability for the unborn, using current medical technology, is 20 to 23 weeks gestation. There have been reports of survivors born before this time. Who will be surprised when the limit moves even farther back? What will history say about us?
In fact, here in Texas, we have made it clear with our Prenatal Protection Act of 2003, spurred on by the deaths of Lacy and Connor Peterson, that our definition of individual (or person) includes all humans from fertilization to natural death.
*(Gosnell is accused of killing the babies who survive, of committing abortions after the legal age limit, and of mutilating the bodies of the babies after they were dead. One gruesome account is here.)
The Committee Substitute was passed this afternoon with 9 yes votes in the House State Affairs Committee. The Chairman of the Committee, Byron Cook voted “yes,” after assuring the Committee that the Bill (which is not available online or in the Committee) will not outlaw human cloning at Universities.
Voting “no” were four brave Republicans – I’ll list them all as soon as I can verify and make sure I don’t miss anyone. Unfortunately, some of our conservative members weren’t present. I will also name them when I can do so without missing anyone.
I worked with Representative Raymond’s office to come up with good definitions, but I don’t know how much of those definitions made it into the final Bill.
Luckily, in spite of the lies we’ve read over the years, no one has yet been able to clone a human embryo.
What is now encouraged is the purposeful creation of a human embryo by cloning. The embryo may never be implanted, but the Bill declares that the nascent human should be killed and broken up
Laws relating to ethics debates are generally behind medical advances. This is good because it means that there *are* medical advances.
However, the debates often become emotional and heated, and the individuals who are affected face real dilemmas and emergencies. When law-making is controversial, it’s best to go back to the basics of ethics for guidance: the inalienable rights to “Life, Liberty and the Pursuit of Happiness,” the Declaration of Independence, and Constitution.
All laws limit our rights, but good laws strike a balance between seemingly conflicting rights: they are meant to prevent one person from harming another. Most laws prohibit or punish harmful actions, they don’t *compel* a desired action against our will. Nor do they prohibit actions based on thoughts and opinion. In other words, laws prohibit harming or taking from another, but they usually don’t make you protect, nurture or give to another.
However,since the right to life trumps the right to liberty and property, there are very rare circumstances when it is appropriate for laws to compel individuals to act for the benefit of another. Parents are required to care for and protect their minor children. Doctors and lawyers must be licensed, obtain certain levels of education, and follow specific, positive actions when they wish to withdraw from a professional relationship with a patient or client. These laws should only go so far as to protect the life and safety of the vulnerable, for a limited time with the goal of allowing safe transfer of the obligation of the person with more power to someone else.
On Tuesday, March 19, 2013, the Texas Senate Health and Human Services Committee, under Chair Senator Jane Nelson, heard testimony on two Bills that would change TADA: SB 303 from Senator (Dr.) Bob Duell’s and SB 675 by Senator Kelly Hancock.
The Texas Advance Directive Act of 1999 (TADA), in addition to describing “Advance Directives to Physicians” (a “Living Will), was an attempt to outline the procedure for resolving the disagreement between a doctor and patients or their surrogates regarding end of life care.
When I first read the Act, I (naively) thought it was malpractice protection for doctors who did not want to withdraw or withhold care, such as the Houston Methodist Hospital doctors who invoked the act when they repaired Dr. Michael Debakey’s aortic aneurysm against his previously stated wishes – http://www.theheart.org/article/762619.do – in 2006.
Most of the time, however, TADA is invoked in cases when the attending physician disagrees with a request to actively administer medical treatment that he or she believes is medically inappropriate. The steps laid out in the law involve the doctor’s notification of the patient or the surrogate, rules for assisting with transfer of care to another doctor who believes the treatment request is appropriate, and convening an ethics committee at the hospital. If there is no other willing doctor can be found and the ethics committee agrees with the doctor, the treatment can be withheld or withdrawn. It does not allow patients to be killed by medicines.
Unfortunately, the Act has become known as the “Texas Futile Care Law,” and divides even the pro-life community. One side says doctors and hospitals have too much power and are killing people. While I’ve heard horror stories about doctors who have abused or broken the law, I maintain that there is no “Futile Care Law,” only a difference of opinion as to who should decide what is medically appropriate treatment. In the few cases that have come under the Act, patients and their advocates report trouble finding other doctors willing to provide the treatment the first doctor thought was inappropriate. In my opinion, that difficulty is due to physicians’ common education and shared experiences.
Although TADA lays out requirements for hospitals and hospital medical ethics committees, the fact is that it applies to the “attending physician” who could be forced to act against his conscience. Texas law is clear that only doctors may practice medicine by diagnosing and treating patients directly or “ordering” other medical personnel. These treatments are not one-time events and they aren’t without consequences. They are interventions that must be monitored by observation and tests, and adjustments need to be made so that the treatment is effective and not harmful. Medical judgment is how doctors utilize our education, experience, and consciences as we plan and anticipate the effect of each medical intervention.
Senator Duell’s Bill, SB 303, significantly improves TADA. Among other things, the Bill would add protection of the patient’s right to artificially administered hydration and nutrition, increased access to assistance, records, and time before and after the ethics committee meeting, and prohibits so-called “secret DNR’s.”
Senator Hancock’s Bill, SB 675, focuses on the intentions and motives of the doctor, requiring the medical committee to decide whether the disagreement is due to: “(1) the lesser value the physician, facility, or professional places on extending the life of an elderly, disabled, or terminally ill patient compared to the value of extending the life of a patient who is younger, not disabled, or not terminally ill; or “(2) a disagreement between the physician, facility, or professional and the patient, or the person authorized to make a treatment decision for the patient under Section 166.039, over the greater weight the patient or person places on extending the patient ’s life above the risk of disability.”
Our laws normally prohibit actions and only very rarely compel people to act. Under the conditions laid out in SB 303, the doctor can be forced to act against his conscience and best medical judgment, but only for a limited, stated time. SB 303 improves the Texas Advance Directive Act by protecting the patient’s access to artificially administered hydration and nutrition. It also adds time to prepare for the ethics committee meeting and to transfer care a new doctor. It is an attempt to balance the patient’s wishes for medical intervention with the right of conscience of the doctor. In contrast, SB 675 would attempt to legislate intentions or thoughts, with none of the added protections of SB 303.
Edited 4/27/13 to fix the link to the article about Dr. Debakey and 4/30/13 for grammar and formatting – BBN.
Non-destructive induced Pluripotent Stem Cells used to test new drugs:
Rubin works mostly with iPSCs, derived from real patients. If his lab can develop drugs that they can identify in a screen as candidates that might be useful, they can test them across ranges of patients –many individual patients.
“And that can pretty much only be done, practically speaking, using an iPSC approach,” he said.
“So, as an example, we discovered a compound, something we were excited about for ALS. Kevin Eggan (also at HSCI) and I collaborated to test that compound on 60 different motor neurons in parallel, using a very interesting technology we developed in my lab from live cell imaging which was required.”