From the conclusion:

Ellen Painter Dollar’s story is deeply moving, but when she attempts to move into the sphere of ethics, her efforts are deeply and fatally flawed . . .

The book fails in its central purpose of offering guidance for the decision-making process. Couples looking for guidance will find none. At the point at which this guidance might be offered, Dollar retreats behind her conception of narrative ethics and wants us to believe a community can come to a better decision than individuals — even though neither the individual or the community has a rubric through which to work their way toward making a wise decision.

Read the whole thing

Sigh. I like it when prominent politicians criticize euthanasia. But I wish they would be more careful with their words because when they get the details wrong, it can do more harm than good. Such might have been the case with Rick Santorum in an interview with James Dobson. He told the truth about Dutch euthanasia but goofed with some of the details. It was up to me to set the record straight. From, “Santorum More Right Than Wrong About Dutch Euthanasia”published in the Daily Caller:

The Dutch like their euthanasia — but sure are sensitive when a prominent person describes the horrors that medicalized killing has unleashed. Latest example: Republican presidential candidate Rick Santorum criticized Dutch euthanasia in an interview with James Dobson, stating in part:

Ten percent of all deaths, and half of those people are euthanized involuntarily, because they are old or sick. And so elderly people in the Netherlands don’t go into a hospital. They go to another country.

The Dutch media pounced, mocking Santorum for charging their doctors with “murdering” the elderly on “a grand scale.” Alas, he asked for it because he got the details wrong. When decrying the culture of death, one must be as accurate as possible. Otherwise, the fish wiggles off the hook

True, the elderly are not flocking to out-of-country hospitals. But the 10% number isn’t that far off the mark:

But realize, about 1/3 of the Dutch die suddenly, e.g. by sudden stroke, heart attack, or accident, without significant end-of-life medical intervention. Take those deaths away from the total count, and using the Dutch government’s estimate, the percentage of euthanasia deaths in cases involving end-of-life medical treatment rises to 3-4%.

But even that number is far too low. Repeated studies have shown that Dutch doctors fail to report at least 20% (or more) of actual euthanasia deaths, which means that hundreds of euthanasias aren’t included in the official statistical count. Moreover, about 1% of all Dutch deaths come as a result, to use Dutch parlance, of being “terminated without request or consent” — e.g. non-voluntary euthanasia. Such deaths are also not technically part of the official euthanasia count. That gets us up to about 6% of all deaths involving medical treatment at the time of death. Add in a few hundred assisted suicides each year where the patient takes the final death action rather than being lethally injected, and suddenly, Santorum’s 10% claim becomes far less problematic.

Wait, there’s more: Dutch doctors also kill patients by intentionally overdosing them with pain killers. I am not referring here to death caused as a side effect of legitimate pain control, but overdosing with the intent of causing death. The exact number of these deaths isn’t known, but the authoritative 1990 government study known as the Remmelink Report found that there were 8,100 deaths from intentional opioid overdose, of which 61% were done without the request or consent of patients. Now, add in, say, half of the nearly 10% of deaths that occur after Dutch doctors place patients into artificial comas and deny them food and water — that is, those cases in which palliative sedation is not medically necessary to control otherwise irremediable suffering — and we see that Santorum’s claim of a 10% euthanasia rate isn’t materially overstated at all.

I get into how the Dutch are moving steadily toward allowing the euthanasia/assisted suicides of the elderly “tired of life” and how the Dutch Medical Association advocates including non medical issues such as money and loneliness, in determining whether an older person is “suffering” sufficiently to be euthanized. I also describe how Dutch doctors are permitted ethically to help non euthanasia qualified patients to learn how to kill themselves. I discuss the infanticide in which some Dutch doctors engage and the mobile euthanasia clinics that are about to get rolling — all of which we have dealt with here. I conclude:

The Dutch media also mocked Santorum for claiming that thousands of Dutch citizens wear bracelets saying they don’t want to be euthanized. Fair is fair. Santorum was wrong. They don’t wear bracelets — they carry please-don’t-euthanize-me cards in their wallets or purses.

Enough. Rick Santorum is exactly right in his broader criticism that the Netherlands as leaping head-first off a vertical moral cliff. Maybe if Dutch reporters paid closer attention to what is happening under their very noses, they’d stop laughing at Santorum’s minor factual errors and start acting like journalists.

That would be a refreshing change in the USA about our own culture of death. One can always dream.

Scientists claim that the first hamburger made from stem cells may soon be available for consumption. From the Telegraph story:

By generating strips of meat from stem cells researchers believe they can create a product that is identical to a real burger. The process of culturing the artificial meat in the lab is so laborious that the finished product, expected to arrive in eight months’ time, will cost about £220,000 (EUR250,000).

But researchers expect that after producing their first patty they will be able to scale up the process to create affordable artificial meat products. Mass-producing beef, pork, chicken and lamb in the lab could satisfy the growing global demand for meat — forecast to double within the next 40 years — and dramatically reduce the harm that farming does to the environment.

Let’s fast forward those 40 years, a time in which steak, chicken breast, burgers, meat combinations, etc. can be purchased for the same price as those taken from slaughtered animals — and with nutrients added to maximize health:

1. Should we assume safety? Some people — not me — are upset by GM grain and such, and think it unsafe. What about meat created from stem cells?

2. What will it mean to human society if we can get our meat from labs instead of farms and ranches? Will we be harmed by the severing of our connection to the land and the domestication of food animals? We will certainly be changed materially with urbanization growing even more pronounced.

3. Would it be morally acceptable for vegans and vegetarians to eat lab grown meat since no animals were raised in its creation and we are biologically omnivores?

4. Once we got used to growing food in the lab, would it become easier to accept transhumanizing ourselves?

My stomach is queasy about this. Revolted, actually. My inner Luddite is screaming. But in this case, I don’t trust the wisdom of repugnance. I can see tremendous good, particularly in the alleviation of human hunger. But it would also cause great dislocation and transform human beings in culturally radical ways. And it would destroy ways of life that have nourished human thriving for millenia.

The test tube and the laboratory would become, in a sense, the center of human existence — particularly since it wouldn’t just be our food. Tower of Babel or merely the next step in human self design, akin to the move from hunter/gatherer clans to farm/animal domesticating communities? (The term “human evolution: would inapt here, I think. Only exceptional humans are capable of intentionally generating such transformations.) Probably both.

IVF was promised as a generally minor matter that would be available for married couples, otherwise unable, to have biological children. Of course, that relatively conservative agenda held for about two seconds. It is now a huge industry, with unmarried people using it to get pregnant, people renting wombs from objectified “gestational carriers,” embryos being made for experimentation, hundreds of thousands stored for future use, buying eggs, eugenically testing and discarding embryos as if they were cuts of meat, and turning procretion generally into a consumer activity about not having a baby, but the baby we want and to which we are entitled.

Surprisingly, the Dutch — of all people — have held a much firmer line, for example banning rent a wombs and requiring that even related women willing to be surrogates not want to have further children of their own. It is a sign of the times, that some want to change these modest restrictions so couples can go to India and use a destitute Indian uterus owner for their gestational powers. (Some, who have not wanted the baby so produced, have just never taken the baby home.). But there is some pushback. From the Radio Netherlands Worldwide story:

The criteria are that the child must have been conceived using an egg or sperm cells obtained from the parents themselves and that the identity of the surrogate mother must be known. This means surrogate mothers from abroad will soon be allowed to give birth to a child on behalf of Dutch parents as part of a commercial operation, even though this remains illegal in the Netherlands. René Hoksbergen, an Emeritus Professor on Adoption, is against the plan. “There are good reasons why this practice is banned in the Netherlands. Your starting point has to be the position of the child, and such a process cannot result in a happy child. They will end up having unsettling questions about who they are: ‘I emerged from an Indian womb and the Indian woman who bore me was a poor person who was given 1,000 dollars for her trouble. I was bought and sold.’ It’s ridiculous that laws are being amended to make this possible.” Professor Hoksbergen goes a step further in his criticism. “Commercial surrogacy amounts to reproductive prostitution. You make use of the bodily functions of another person to fulfil your own needs. That’s what happens in prostitution. It has nothing to do with the interests of the child.” He estimates that the commercial surrogacy industry in India already has a turnover of 1.7 billion euros.

Joyce sees the professor’s views as “a throwback to 1918. We have to move with the times. There are new technologies and possibilities. Hoksbergen has no idea what it’s like to want a child and not be able to have one.”

What is it like to be child without parents who no one will adopt because they are pursuing commercial gestational options?

I am sorry. We aren’t entitled to everything we want. Technological capability does not equal moral justification. The objectification and the exploitation of the destitute in this practice is such that I hope the Dutch hold the line — for once. IVF is too out of control already.

The Board of Directors of

The Center for Bioethics and Culture Network

extend a personal invitation to you for the upcoming

Paul Ramsey Award Dinner

Friday, March 23, 2012

Reception will begin at 6:00 pm
Dinner will begin at 6:30 pm

Lakeside Olympic Club
599 Skyline Boulevard
San Francisco, CA 94132

The recipient of the 2012 Paul Ramsey Award for Excellence in Bioethics is
Professor of Law at Harvard University, Dr. Mary Ann Glendon

The evening’s keynote speaker will be the national
best selling author and editor,
Dr. Joseph Bottum
on “Why Life and Death Matter”

Others scheduled to speak include:
Wesley J. Smith, J.D.
William Hurlbut, M.D.
Jennifer Lahl, B.S.N, M.A.

Please RSVP by March 2, 2012.
Seating is limited
Reserve One Seat ($125)
Sponsor One Table ($1,200)
Sponsor One Life Table ($2,500)
Sponsor One Paul Ramsey Table ($5,000)

The 2012 Paul Ramsey Award
Recipient: Mary Ann Glendon

The Center for Bioethics and Culture and the Paul Ramsey Nominating Committee are pleased to announce Professor Mary Ann Glendon as the recipient of the 2012 Paul Ramsey Award for Excellence in Bioethics. Prof. Glendon is the Learned Hand Professor of Law at Harvard Law School and served on the President’s Council on Bioethics from 2002 to 2005. In response to being selected the 2012 Paul Ramsey Award winner Glendon said, “I would be very glad to receive the Paul Ramsey award and am deeply honored to join the company of previous honorees whom I admire so much.”

The 2012 Paul Ramsey Keynote
Speaker: Joseph Bottum

Author of the national bestseller Dakota Christmas, an e-book memoir of his childhood on the prairie, Joseph Bottum is a contributing editor to the Weekly Standard and one of the nation’s most widely published essayists—with work appearing in journals from the Atlantic Monthly to the Wall Street Journal, Commentary, and the Washington Post. The former literary editor of the Weekly Standard and former editor in chief of First Things, he holds a Ph.D. in medieval philosophy and has done television commentary for networks from the BBC to EWTN, including appearances on NBC’s Meet the Press and the PBS NewsHour. His books include his latest poetry collection, The Second Spring, and he lives with his family far off in the Black Hills of South Dakota.

Paul Ramsey Award Dinner
Friday, March 23
6:30 pm
Lakeside Olympic Club
San Francisco, CA

The UK rations health care. In the UK, people who want life-sustaining or extending treatment can be refused under rationing guidelines or physician refusal. This is the system into which the British Medical Association wants Parliament to enact a “presumed consent” to organ harvesting law under which every patient is an organ donor unless they have opted out or family specifically refuses. Of course, in reality that is conscription, not donation.

But now, to make it more palatable, the BMA wants to change the words used to describe the project. From “Building on Progress: Where Next For Organ Donation in the UK?”

This system is often referred to as ‘presumed consent’ and this is the term the BMA has traditionally used. This term is, however, controversial with people arguing that ‘presumed consent’ is not ‘consent’ at all but something rather different. The BMA has found that this has resulted in debate focusing on the terminology and thus detracting from the important debate about the merits, or otherwise, of the system itself.

Another term that is frequently used, and which is a simple description of the system is ‘opt-out’ – individuals who do not wish to donate need to opt out. In order to differentiate between those versions of opt-out that involve the family and those that do not, the former is referred to as either ‘soft opt-out’ or ‘opt-out with safeguards’. In France the term ‘presumed solidarity’ has been used. The BMA’s preferred terminology is ‘opt-out with safeguards’.

This happens time after time. A new or radical proposal is made and a term coined by supporters to describe it. That term duly enters the lexicon allowing a reasoned pro-and-con debate in which everyone may be arguing, but they are arguing from a commonly understood frame of reference.

But when the “wrong side” seems to be winning the debate — often, as here, on the merits — the very people who coined the original term snap their fingers and change the lexicon to help them change the frame of reference and win the debate by word manipulation! Hence, “global warming” became “climate change.” “Physician-assisted suicide” morphed into “aid in dying,” in which an act of self killing ceases to even be suicide. And now “presumed consent” may become “soft opt-out.”

Here’s the thing about presumed consent/soft opt-out/presumed solidarity, whatever you want to call it: Very sick people could easily cease to be viewed as patients enjoying full human equality and dignity, and instead be looked upon as so many organ farms. Or to put it another way, their organs can come to be viewed as more valuable than their lives. The danger is especially acute in a country like the UK in which doctors have the legal power to cut off wanted life-sustaining/extending care.

So: I am currently an opt-in for organ donation on my driver’s license because I still trust I would be dead before any organ procurement would or could occur and consent would have to be obtained from my wife first, both to cease life sustaining treatment and take organs. I would opt out of a presumed consent system because I never want to be viewed as an object no matter how sick I become. As long as I live, I — and everyone else alive — should be viewed as a subject. This approach takes us in the wrong direction no matter how beneficent the motive to increase the organ supply.

Once, we looked to those who saved suicidal people from dying as the humane and compassionate heroes. After all, they valued the lives of everyone, even those unable to value their own.

My how times change. Today, suicide promoters are the heroes. Case in point: In the Netherlands, despite a liberal euthanasia license, how-to-commit-suicide gurus are extolled. From Radio Netherlands Worldwide:

“When you are ready, put the bag over your head. Then slowly open the helium valve.” An instruction film made by Dutch psychiatrist Boudewijn Chabot explains how someone can kill themselves using a roasting bag and two tanks of helium. Self-help methods are becoming less of a taboo. Euthanasia under certain circumstances was made legal in the Netherlands ten years ago. The law permits assisted suicide for people whose suffering is unbearable and hopeless. But for others who want to end their lives, there is no legal recourse. Suicide instruction films have been produced with them in mind. Dr Chabot has been involved in the issue of “self-administered euthanasia” for years. In addition to methods such as not eating and drinking, or a lethal combination of medicines, he has now released a film showing another suicide method

What kind of a person focuses so intently on helping people make themselves dead? For those who don’t know, Chabot won a case in the Dutch Supreme Court back in the 1990s stating he did no wrong in assisting the suicide of a healthy but deeply grieving woman who wanted to be buried between her two dead children. And so the so-called protective guidelines proved as porous as a spaghetti colander.

Don’t get me wrong. I am not singling out the Netherlands for criticism. Here in the USA, the would-be late human vivisectionist Jack Kevorkian was played by A-List movie star Al Pacino in a history-revising biographical hagiography — which omitted his taking the kidneys from one of his victims and offering them “first come, first served” at a press concerence. Final Exit Network promotes the same suicide method as Chabot, and Derek Humphry got famous and made a lot of money teaching people how to kill themselves in books and other media. Then there is Compassion and Choices that is working hard to redefine suicide as a medical treatment that isn’t even “suicide.”

Suicide prevention has become almost invisible. Today, it’s all about suicide promotion, baby! That will get you on the media and may even garner you big lecture fees. (Kevorkian was clearing a cool $50,000 per.) And the cost will be counted in the people who died who might otherwise have escaped the darkenss and become glad to be alive.

I saw a story this morning that created a conflict between my heart and my head. An imminently dying man and his pregnant wife wanted him to be able to hold their baby before passing. And so, doctors agreed to induce a two-week early birth to make that happen. From the AP Story:

Diane Aulger was about two weeks from her delivery date when she and her husband decided there was no time to wait: Mark Aulger had only days to live, and he wanted to see his child. Diane Aulger had her labor induced and gave birth to their daughter Jan. 18. When tiny Savannah was placed in his arms, Mark Aulger “cried, and he just looked very sad,” his wife said. He died five days later from complications related to his cancer treatment.

My heart is very glad Mark was able to hold his baby. My head says that doctors were wrong to induce an early birth for a wholly non medical reason.

Let’s dig a little deeper into this. The last two or three weeks of pregnancy are not superfluous. They have a purpose or birth would come at 38 weeks instead of 40. Here’s a general overview. From WEB MD:

Week 38

Baby: Your baby is about 21 inches from head to toe and weighs about 6.8 pounds. Most of the baby’s downy hair, lanugo, and whitish coating, vernix, is disappearing. Your baby is getting its antibodies from you to protect against illness. Baby’s growth is slowing, but fat cells under skin get plumper for life outside the womb. Almost ready for birth, your baby would do well if born now…

Week 39

Baby: Your baby is about 21.5 inches long from head to toe and weighs a little more than 7 pounds. Toenails and fingernails have grown to tips of toes and fingers. Muscles of your baby’s arms and legs are strong, and he’s practicing lung movements. Baby’s head has dropped into the mother’s pelvis if he’s head-down, which allows you to breathe a little easier…

Week 40

Baby: Your baby’s length is about 21.5 inches from head to toe and it weighs about 7.5 pounds. Boys often tend to weigh a little more than girls. Reflexes are coordinated so the baby can blink, close his eyes, turn his head, grasp firmly and respond to sounds, light and touch. More lanugo falls out, but some may remain at birth on shoulders, folds of skin and backs of ears.

My focus here is on the doctors. Was it wrong for them to agree to a non therapeutic inducement because of the high emotional quotient? Or, let me put it another way. Would they have been open to a malpractice suit if something went wrong? I think so because they agreed to do the procedure, they weren’t forced. Indeed, I think they should have said no because there was no health benefit to the baby whatsoever and a small chance that some harm could result.

But if I am wrong about that, where should the line be drawn? What if a family asks for an early delivery so they can take a cruise? I think most would say that doctors, as medical professionals, should say no. What about to allow a soldier deploying overseas to a war zone for a year to see his child “just in case?” At what point do doctors deprofessionalize themselves and become mere technocratic order takers? This case, as understandable as it might be, I think crosses that line.

I have a piece in the Daily Caller describing another in a long series of articles in professional journals arguing that it should be acceptable to kill for organs. From “The Killing-for-Organs Pushers:”

If you want to see where our culture may next go off the rails, read professional journals. There, in often eye-crossing and passive arcane prose of the medical intelligentsia, you will discover an astonishing level of antipathy to the sanctity of human life — to the point now that some advocate killing the profoundly disabled for their organs.

In this example, the method of getting from A to Z is to deconstruct the wrongness of killing:

Case in point: “What Makes Killing Wrong?” an article published in the January 19, 2012 edition of the Journal of Medical Ethics. The authors argue that death and total disability are morally indistinguishable, and therefore harvesting organs from living disabled patients is not morally wrong. Bioethicists Walter Sinnott-Armstrong, of Duke University, and Franklin G. Miller, from the National Institutes of Health’s Department of Bioethics (which should really get the alarm bells ringing!) arrive at their shocking (for most of us) conclusion by claiming that murdering the hypothetical “Betty” isn’t wrong because it kills her, but rather, because it “makes her unable to do anything, including walking, talking, and even thinking and feeling.”

They then change the scenario:

…Betty is not killed but severely brain damaged to the point that she is “totally disabled.” But their definition of that term encompasses hundreds of thousands of living Americans who are our mothers, fathers, children, aunts and siblings, uncles, friends and cousins — people with profound disabilities like that experienced by Terri Schiavo and my late Uncle Bruno as he lived through the late stages of his Alzheimer’s disease:

Betty has mental states, at least intermittently and temporarily, so she is not dead by any standard or plausible criterion. Still, she is universally disabled because she has no control over anything that goes on in her body or mind.

Since Betty “is no worse off being dead than totally disabled,” they opine, it is no worse “to kill Betty than to totally disable her.”

That definition, in which the patient has a mental state, is the key, because at the end of the article, the authors apply their theory to patients who are today considered legally dead (but which they claim, wrongly in my view, are really alive), which has the effect of muddying the waters. But their definition of universal or total disability would encompass people who are today, legally alive, and they believe it is not wrong to kill them because they are not thereby harmed:

…according to the authors, “there is nothing bad about death or killing other than disability or disabling,” and since she is already so debilitated, then nothing wrong is done by harvesting her organs and thus ending her biological existence. And thus, in the space of not quite five pages, killing the innocent ceases to be wrong and the intrinsic dignity of human life is thrown out the window, transforming vulnerable human beings into objectified and exploitable human resources.

I also quote a litany of other articles calling in different ways for opening the door to killing the profoundly disabled for organs. I conclude:

It is important to note here that transplant medicine remains an ethical enterprise and that doctors are not yet doing the deed. But if we want to keep it that way, it is important that these proposals not be allowed to germinate. Here’s the good news. Sunlight is the great disinfectant. Most people will oppose killing for organs. Thus, the best way to prevent this dark agenda from ever becoming the legal public policy is to expose it in popular media every time it is proposed.

Hence, I will continue to do my best to bring every one of these articles out of the shadows of academia/arcane journals and into the light of day.