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Archive for the ‘Biomedical Ethics’ Category

For the second time within a year, England has a high-profile case of court-mandated murder of a desperately ill child. The first was Charlie Gard, and now comes Alfie Evans.

Alfie missed several developmental milestones in his first seven months of life, which did not alarm physicians at the time. It’s not known precisely what his neurodegenerative disorder is, and some say it may be something akin to Charlie Gard’s Mitochondrial Depletion Syndrome (MDS). That’s key to understanding the full horror and depravity of the English judiciary in this case, as well as that of the National Health Service (NHS).

While the English physicians are quite certain that Alfie cannot recover, they do not know what they are facing. They are so possessed of medical certitude that they have not only sought to end life-sustaining treatment, but have argued against the boy being brought abroad for treatment.

Why?

And why the complicity of the courts?

And since when are parental rights to seek treatment for their desperately ill children abrogated by the physicians who can’t even identify the disease, and the courts with no evidence of incompetence on the part of the parents?

What’s worse is that the global narrative has shifted from arguing over whether a patient is still alive, cardiac vs. brain death, to arguing that they have no hope of recovering their former functionality and quality of life. In other words we are now squarely within Eugenics and Euthanasia.

This particular expression of euthanasia is actually First Degree Murder. When Alfie’s ventilator was removed, along with oxygen, food, and hydration, Alfie breathed on his own, and continues to breathe on his own. After several hours of fighting with staff, Alfie was given oxygen and hydration. At this writing,more than 48 hours later, he continues to live, and the courts have determined that he may not be taken abroad.

Alfie. MUST. Die.

The police ringing the building are a frightening testimony to this malignant judicial resolve.

The courts have stated that parents understandably want to hang on after hope has been lost. Tragically, there are far too many physicians, nurses, and judges who have never understood that hope is the irrational driving force behind many medical and scientific breakthroughs.

Take cancer for example. Hope drives cancer research, and the trillions of dollars and hundreds of millions of researcher hours over the past half-century. Looking at the daunting challenge in the 1950’s, before we knew anything about DNA and its role in cancer, how irrational would it have sounded if trillions of dollars, and millions of collective years of research would be required to cure this umbrella group of diseases? Yet, here we are, with many cancers either curable, or with outstanding five-year remission rates. A similar story could be told of HIV/AIDS, and the fact that it is a very manageable disease today.

Imagine if the pessimists were in the driver’s seat at the outset. As the AIDS quilt tells the tale, a frightening number of people died on the way to today’s manageability. The same for cancer.

As any cancer or HIV researcher will attest, even in cases of seeming futility, experimental protocols yield vital data for future treatment designs. They also will attest that surprises happen when we least expect them to. Alfie has already surprised everyone by his continued breathing. Imagine if he were given a fair chance.

Fair chances point toward a central reality in biomedical research: You can’t advance the therapeutic ball if you kill all the hard cases.

There is a war on for the soul of humanity. The Culture of Death has been holding high carnival for decades with abortion, and now the slippery slope from physician-assisted suicide, to euthanasia, to outright court-sanctioned murder rooted in a pervasive eugenics. There is no room in this worldview for faith, hope, or love. There is only expedience, and expedience in the place of faith, hope, and love, never solved a biomedical riddle. None of us who has ever labored in a lab was ever driven by expedience sans hope. The work of healing research requires a soul, the kind of soul missing in action in the Gard and Evans decisions. Faith, hope, and love are the forces that sustain our greatest minds in science and medicine. They inspire and sustain in the face of repeated failure and setback.

So what’s it all about, Alfie? It’s about faith, hope, and love, Alfie.

Alfie.

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In speaking with young people (and not-so-young people) who support gay/lesbian “marriage,” transgender medicine and sociology, abortion, contraception, cohabitation, and all the rest of the agenda on the other side of the great divide, two words are constantly thrown down as the great gauntlets of the left:

Choice and Consent.

To those given to support of the aforementioned lifestyle choices, choice and consent are the imprimaturs of the end behaviors and lifestyles. For them it is quite literally the case that having arrived at a given behavior through choice and consent that the behavior is imbued with all moral virtue, because it has been chosen by the individual and consented to.

“My body, my choice.”

It is radicalized autonomy on parade. The self determining all that is right and good.

At first blush it seems to be a return to the Fall of Man in the Garden of Eden. But there, Adam and Eve blushed at their nakedness after their eyes were opened. Nobody blushes today when they taste evil. It is celebrated precisely because it was chosen, because it was consented to. At least our original parents had the moral sense to hide from God after getting a taste of evil.

To an intellectually and morally mature person, choice and consent are immediately recognized not as moral virtues, but as capacities and components of the moral decision-making process. They are neither objects, nor ends. They are components of reason and free will. They are used to arrive at what is good and what is evil. As Pope John Paul II said,

“Freedom consists not in doing what we like, but in having the right to do what we ought.”

Boil down all of the differences on both sides of the great divide and it comes down to that last word from John Paul: “Ought.”

“Ought” presupposes a locus of moral agency outside of the self that makes certain demands.

Demands. Not suggestions.

Adam and Eve knew that, because they were in intimate relationship with that Moral Agent. He was their loving Father and Creator. His only demand was that they not opt for experiential knowledge of good and evil, that they abide in Him in faithful obedience. The narcissism and hedonism of the other side today can no more abide in faithful obedience to demands that run counter to the will than light can coexist with darkness at the same point in space.

Such is the spiritual malaise that conflates choice and consent with moral goodness. The sickness that is narcissism and hedonism sees the desires of the self as good, and cannot abide any suggestion to the contrary. One need only look to the persecution of those who dare to stand in the way of the LGBT agenda to see how disordered desire is elevated to the heights of moral acclaim simply because such a lifestyle has been chosen and consented to. Bakers and florists have been sentenced to Maoist reeducation for having the temerity to choose fidelity to their God over obeisance to the gods of hedonistic desire in customers. And this leads to the greatest of all moral confusion regarding choice and consent.

Choice and consent are the moral coin of the realm only insofar as certain deities are being obeyed. To the narcissist and hedonist the god of self cannot desire anything other than that which is good, and so it is that the God of revelation becomes the false deity. It is Cardinal Ratzinger’s tyranny of moral relativism. The moral relativists of our day see choice and consent as virtues precisely because they have become twisted hallmarks of the narcissism and hedonism afflicting them, persons who never experienced an impulse they didn’t love.

In the end, both sides of the great divide speak radically different languages. The narcissist and hedonist never moves past the impulses of self-indulgent disordered desire. The one who sees choice and freedom as consisting of having the right to do what they ought, knows and practices sacrificial love for God. That one prays and practices the prayer of St. Ignatius of Loyola:

“Take, Lord, and receive all my liberty, my memory, my understanding, and my entire will, All I have and call my own. You have given all to me. To you, Lord, I return it. Everything is yours; do with it what you will. Give me only your love and your grace, that is enough for me.”

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.image via: https://moa.byu.edu/events/exhibition-opening-art-after-dark/

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Ninety-eight years ago, Edgar Lee Masters penned his famous Spoon River Anthology, a towering work of poetry set in the graveyard of mythical Spoon River. It is a small town whose deceased residents speak frankly from beyond the grave about the gritty reality of what was their life on earth. The most haunting and instructive of these for me as a young college student was that of George Gray:

I HAVE studied many times
The marble which was chiseled for me—
A boat with a furled sail at rest in a harbor.
In truth it pictures not my destination
But my life.
For love was offered me and I shrank from its disillusionment;
Sorrow knocked at my door, but I was afraid;
Ambition called to me, but I dreaded the chances.
Yet all the while I hungered for meaning in my life.
And now I know that we must lift the sail
And catch the winds of destiny
Wherever they drive the boat.
To put meaning in one’s life may end in madness,
But life without meaning is the torture
Of restlessness and vague desire—
It is a boat longing for the sea and yet afraid.

As they have so many times in my life, these words came back as I read this week of yet another academic group calling for infanticide’s new euphemism: Post-birth abortion.

Read the article here. This also follows an article in the Journal of Medical Ethics two years ago, giving cold rationalization for murdering newborns. And that was atop Princeton’s Peter Singer who has advocated this for years.

Every argument is being offered around the world for infanticide in the case of terminal conditions, and even genetic conditions such as Down syndrome. The arguments are the same “quality of life” arguments used to justify abortion. Realizing that infanticide could never sell, as such, the proponents now claim that a newborn is closer developmentally to a fetus than to an adult. What the proponents gloss over is the human identity of the one they seek to murder in cold blood.

Yes, being handed devastating diagnoses for one’s child is enough to make one’s blood run cold. When Regina and I were told that Joseph might well need a group home one day, my faith in myself as a father was put to the test. It was shattering to hear one of the world’s leading authorities say these words. In that moment I had only two things left to me:

The certain knowledge of Regina’s steadfastness and of God’s steadfast providence.

Today that boy stands ready to become an Eagle Scout in two months at the age of fifteen. I don’t think I could have seen that or believed it possible eleven years ago, and therein lies the great trap for so many parents facing the eventual counsel to engage in, “what’s best for the child,” as infanticide takes hold. It is nothing less than love being inverted.

A little more than a century before Masters penned his poem, Thomas Jefferson wrote a letter to his daughter Patsy, where he advised,

Every human being must be viewed according to what it is good for. For not one of us, no, not one, is perfect. And were we to love none who had imperfection, this world would be a desert for our love.

Jefferson grasped that our love only takes root in the soil of human imperfection in others. Far from merely affirming what we find desirable and admirable in others, love complements and completes others. It is a balm for their wounds and a fortress for their weaknesses and fears. It is safe refuge, a place to safely grow.

Jefferson grasped that love, true love, is sacrificial in nature and has nothing to offer humans who might be perfect. Imagine a world that was a desert for our love.

Arid and lifeless.

That is not so much the world that might be, but the world as it is in large swaths of what was once western civilization. The intolerance of imperfection, the disillusionment of our life’s goals being suddenly derailed by the acute and chronic needs of a child or elderly parent, all run hard against our thirst for meaning, but fear of sacrifice and its cost. We are doing something wrong as a people, as a Church, for such fear to rule. In a season of hope, we need to search within for some hard answers to the question of how it is that we have come to this, and what we must do to offer hope and vision to those stumbling around in the darkness.

Could it be that alienation from God precipitates the alienation of love, true love from people’s lives? Is that it?

Masters grasped it, I think. I would only add that the meaning of which Masters speaks is wrought by Jefferson’s love:

To put meaning in one’s life may end in madness,
But life without meaning is the torture
Of restlessness and vague desire—
It is a boat longing for the sea and yet afraid.

I think that somewhere in there is the way out for a civilization in free-fall.

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In our long stride toward the inevitable designer babies, the first manipulation has been the noble goal of creating babies free of the mitochondrial diseases carried by their mothers. This series will examine the issue rather thoroughly in four basic segments:

1. The basic cell biology involved.
2. The problem of defective mitochondria.
3. The technique involving three-parent embryo creation.
4. The current state of the ethics debate among governmental bodies here and in the United Kingdom.

Cell Biology

In order to understand the fullness of the debate, we need to understand some very basic facts about cells. Every human cell contains specialized compartments called Organelles (meaning, Little Organs). Just as the human body has organs for specialized function (heart, lungs, stomach, intestines, brain, liver, kidneys, etc.) so too every cell has little organs for specialized function:

Ribosomes make protein.
Nucleus houses the Chromosomal DNA.
Lysosomes do recycling of worn out parts.
Golgi Bodies modify and ship proteins to appropriate destinations
Endoplasmic Reticula make lipids and are sites of protein synthesis.

and then come the Mitochondria.

The mitochondria are frequently referred to as the powerhouse of the cell, because they take in by-products of glucose and extract large amounts of energy for use by the cell. It takes a great deal of energy for cells to function properly, and the mitochondrion is the place where that happens. That having been said, it is one of the gross oversimplifications in biological education to leave it at energy production and move on where the mitochondrion is concerned. In fact, there are two scientific journals devoted entirely to mitochondrial research that immediately come to mind: Mitochondrion, and Mitochondrial Research. Suffice it to say that the scope of the mitochondrion and its effects on human physiology are broad and complicated.

For purposes of understanding three-parent embryo creation it helps to know the following. It is thought in evolutionary biology that at one time the mitochondrion was a free-standing, free-living cell that became incorporated into larger cells, with the result being a marriage that worked for both. It’s called the Endosymbiont Theory. Mitochondria replicate themselves within cells, so when cells divide, each new cell gets an appropriate number of mitochondria. In this way, the mitochondria act somewhat as independent organisms would. Along the way, most of the mitochondrion’s 3,000 genes ended up being transferred to the cell nucleus. The following description comes from the United Mitochondrial Disease Foundation website. I have found them to be an excellent clearinghouse of information with writing that is very easy for the scientific layperson to follow:

The conventional teaching in biology and medicine is that mitochondria function only as “energy factories” for the cell. This over-simplification is a mistake which has slowed our progress toward understanding the biology underlying mitochondrial disease. It takes about 3000 genes to make a mitochondrion. Mitochondrial DNA encodes just 37 of these genes; the remaining genes are encoded in the cell nucleus and the resultant proteins are transported to the mitochondria. Only about 3% of the genes necessary to make a mitochondrion (100 of the 3000) are allocated for making ATP. More than 95% (2900 of 3000) are involved with other functions tied to the specialized duties of the differentiated cell in which it resides. These duties change as we develop from embryo to adult, and our tissues grow, mature, and adapt to the postnatal environment. These other, non-ATP-related functions are intimately involved with most of the major metabolic pathways used by a cell to build, break down, and recycle its molecular building blocks. Cells cannot even make the RNA and DNA they need to grow and function without mitochondria. The building blocks of RNA and DNA are purines and pyrimidines. Mitochondria contain the rate-limiting enzymes for pyrimidine biosynthesis (dihydroorotate dehydrogenase) and heme synthesis (d-amino levulinic acid synthetase) required to make hemoglobin [Note by G.N.: This is the molecule that binds oxygen in every red blood cell]. In the liver, mitochondria are specialized to detoxify ammonia in the urea cycle. Mitochondria are also required for cholesterol metabolism, for estrogen and testosterone synthesis, for neurotransmitter metabolism, and for free radical production and detoxification. They do all this in addition to breaking down (oxidizing) the fat, protein, and carbohydrates we eat and drink.

Do visit their website for specific information on the range of mitochondrial diseases.

Now, without frightening off the non-scientist or non-medical person, the above quote cracks the door ajar ever so slightly to allow a glimpse of the complexities involved at the biological level. Adding further, there needs to be coordination between the genes encoded on mitochondrial DNA (mtDNA) and the mitochondrial genes encoded on the DNA in the nucleus of the cell (nDNA). To date, there are still too many unknowns in the cell biology and the pathophysiology at the cellular level (That’s why the journals devoted to mitochondrial research are going strong, and will be for years to come.). We don’t know all of the coordinated function between mtDNA and nDNA within a given individual, and what other factors there may be (as yet unknown) that govern such function. In other words, are all mitochondrial defects solely attributable to mitochondrial genes (mt DNA and nDNA), or are there other genetic/biochemical defects in the individual at play here? It matters when someone wishes to take the mitochondria from an egg cell, leaving the nDNA intact, and introducing mitochondria from another individual. It matters because the issues are not always so simple as mutations in genes.

Indeed there are other factors around the major genetic factors, and these are known as epigenetic factors. Epigenetics looks at factors involved in the regulation of genes, and when they get turned on and off. Adding still further to the complexity, there may be epigenetic factors in the nDNA that are unknown and alter the epigenetics of the mtDNA., and all of these factors in one kind of cell may well influence mitochondrial function in distant types of cells within the body.

Confused and bewildered yet?

That’s the point. We don’t know what we don’t know, and in mitochondrial disease there is quite a bit that we don’t know. It will be fertile ground for research for decades to come, and that points toward the abomination of three-parent embryo creation in human beings as a vast and unregulated medical experiment. In the next post (Nov. 20, 2014), we’ll look at several mitochondrial diseases and consider what we do know of their etiology, and what we suspect we don’t yet know. Then in the third post we’ll consider the technique involving three-parent embryo creation and consider the ethical dimensions involved.
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Photo Credit: Photo Via http://www.dailymail.co.uk/sciencetech/article-2838705/Three-parent-babies-unsafe-warns-scientist-Adviser-issue-says-unresolved-safety-concerns-years-testing-required.html

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Every now and then the biomedical community and the legal system are presented with the opportunity to rediscover our collective humanity through the lens of animal rights and animal cruelty. More often than not that lens has insufficient power to correct their distorted perception of human dignity. Having just passed the ninth anniversary of Terri Schiavo’s death by starvation and dehydration, word comes today of the starvation and dehydration death of Roxy the dog, a boxer in England, who died at the hands of his solicitor-in-training owner, Katy Gammon.

Ms. Gammon has been in the employ of a law firm specializing in……

Medical Negligence.

It seems that Ms. Gammon retained Roxy who originally belonged to a boyfriend after the relationship ended. The dog was kept locked in the kitchen because it wasn’t housebroken. All was well until Gammon began staying with her mother a few blocks away and stopped coming to feed the dog after she injured her knee. A window into the collective soul from MailOnline:

Bristol Magistrates’ Court had previously heard that Gammon had confined the dog by tying a rope to the kitchen door handle and fixing it to a hook in the hall.

Roxy had frantically clawed at the door, leaving fragments on the floor, as she tried to escape before her death, which would have taken around six days…

Asked if she had deliberately locked her in the kitchen and left her to die, Gammon replied: ‘Yes, basically.’

The article continues with a description of what Roxy’s death was probably like. At this juncture it is worth noting that humans and dogs have very similar anatomy and physiology, and that dog experimentation has often been the last step before human trials of new medicines and medical treatments, because of our shared similarities. More from the article:

A vet said the pet would have taken up to six days to die gradually and painfully, becoming blind and falling into a coma before passing away…

‘A number of items had desperately been pulled out of cupboards. We believe this was a desperate attempt at searching for food or water.

‘Roxy suffered a slow, painful death which could have been prevented.’

And so it goes with human beings who are deprived of food and hydration as a means of hastening death. It is a slow and agonizing demise, as Roxy’s story indicates. Often the patient is unresponsive, but as the parent of any teenager knows, lack of responsiveness does not indicate a lack of sensory reception, or internal processing. Terri Schiavo was perhaps the most publicized case of the Roxys of our species.

However, shared physiology is where our paths diverge. Lower animals now possess greater dignity (from the Latin, meaning “standing”) in western jurisprudence than human beings. Consider the words of the sentencing magistrate as Gammon received 18 weeks in jail, and a lifetime ban on owning pets, for her crime:

Sentencing, magistrate Rod Mayall said: ‘You have shown limited remorse. You failed to behave as any normal person would have. This is the most serious case of animal cruelty encountered in these courts.’

And here is where the magistrate misses the mark by a mile. Humans are also animals. Additionally, we are a higher order animal, capable of at least as much pain (physical state) as a dog, and perhaps even more suffering (a psychological state). If this is the worst case of animal cruelty he has seen before the court, then it is because humans have lost their standing in the very courts they have created. Gammon has been sentenced to jail and a lifetime ban from owning pets so that she may never again be in a position to practice such barbarism. That’s a good thing.

However human beings who, on a daily basis, pull members of their own species apart, limb-by-limb, in the womb, and who similarly starve and dehydrate members of our own species to death do so with government-issued licenses and are considered practitioners in good standing.

The outrage in all of this isn’t that Gammon was punished for her crime against Roxy, it’s that the deaths of the Terri Schiavo’s among us aren’t considered criminal at all. It is that our legislators and judges do not, “behave as any normal person would have,” protecting humans with the same ferocity as they would if the subject in consideration were a dog.

The greatest tragedy of all is that humans have a long way to go before we enjoy equal dignity, equal standing with our pets in a court of law.

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Wesley J. Smith has a disturbing article dealing with Oxford bioethicist Julian Savulescu’s proposal to screen human embryos for intelligence. Smith quotes Savulescu:

A common objection is that being smarter does not make your life better. In this study, researchers were concerned with those with an IQ between 70-85. Below 70 is classified as intellectual disability but an IQ of 70 to 75 is similar to mild intellectual disability.

Even for individuals with an IQ between 75 and 90 there are still significant disadvantages. Job opportunities tend to be the least desirable and least financially rewarding, requiring significant oversight…Individuals with this lower level of intelligence are at significant risk of living in poverty (16%), being a chronic welfare dependent (17%) and are much more likely to drop out of school (35%) compared to individuals with average intelligence.

Studies show that there is also an increased risk of incarceration and being murdered.

Read it all.

When it comes to eugenics, there is simply no end to the killing until a just people rises up and either kills or incarcerates the practitioners, as was the case with Nazi Germany. When forced sterilizations weren’t enough, there were detention camps, which gave way to concentration camps where people were shot and buried. When that proved too slow and cumbersome to effect the eugenic goal, gas chambers were built, with exhaust fumes from tanks pumped in. When that proved still too slow, larger chambers using cyanide gas were built, and ovens to cremate the remains.

Eugenics has a malignant mania that increases with demonic furor the further in one goes. When we go from preventing birth to active killing, a point of no return is reached and the killing can only be brought to an end by brute force. Consider Savulescu’s argument.

He begins with screening embryos for genetic signposts pointing to potential cognitive capacity. He justifies the killing by pointing to undesirable outcomes such as poverty, welfare dependence and dropping out of school, ignoring that the risks are all very low. Poverty, welfare dependence, and being a school dropout are reason enough in Savulescu’s cramped worldview to kill those who might end up there. By that logic, why should we tolerate those who do end up there? Ought we not have camps for such “human weeds,” as Margaret Sanger called them? And what happens when we tire of supporting the camps?

There are certain cardinal virtues that go with being a Ph.D. My life’s mentor, Father Luke McCann, Ph.D., once told me that those cardinal virtues are contained in the three little letters of the title:

Prudence.

Humility.

Decorum.

I would submit that Savulescu and his fellow travelers are bereft of all three. They are also bereft of the very intelligence they stake such a claim to possessing, as intelligence goes beyond capacity for factual recall, but involves the capacity for problem solving. Advanced intelligence goes beyond mere problem solving and involves the capacity for vision guided by empathy and moral principle. Ph.D.’s are not awarded our degrees for merely taking classes and passing tests. We are awarded the degree for making novel discoveries, for advancing the knowledge within our field of endeavor. In other words, one must demonstrate vision and match the vision with corresponding accomplishment. So where does Savulescu and his cohort get it wrong?

PRUDENCE

Their vision becomes constricted and they lose perspective on life. Intellect for its own sake becomes the pursuit, and they can’t tolerate the aboriginals spoiling their view of an idealized landscape. It becomes easier to kill the marginalized than to create systems that incorporate them more fully into society. How academia has fallen.

There have been several movements in psychology and medicine to give more humane treatment to the “insane.” Forward thinking physicians tried “Moral Therapy” as it was known, where patients were no longer locked in asylums that resembled dungeons. Instead, they were housed in the country and visited regularly by the physician who would bring a small cake, or other gift. In the 1970’s, the warehousing of the mentally retarded ended, and the Group Home movement began, a modern reincarnation of moral therapy. To society’s surprise we learned that “retards” could actually be taught and gainfully employed. So successful has this been that the terms “mentally retarded” and “retard” are uttered today only by boors. People enhanced with an extra chromosome are now graduating from college!

The community of parents with children who have autism are similarly on the march. Marginalization only happens when ignorance and fear trump reason and compassion.

HUMILITY

The jobs that exist on the margins are only marginal to pompous, effete academics. A closer look reveals the central importance of the work that the lowest-paid workers perform. Taking deliveries and stocking shelves in stores is vital work for those who do not produce their own food. So too for cashiers and maintenance workers, cleaning crews, and kitchen staff. They are the unsung and thankless jobs that make civilization civilized. When Martin Luther King Jr. called for blacks to stay at home and not go to work, whites got a good taste of how indispensable those they disdained truly are.

The rarefied air of universities often induces a case of intellectual and spiritual anoxia in those who never darken the chapel door. Savulescus are the result.

DECORUM

Savulescu above all should know that doctors are not free, but constrained. There are simply some groups that one never, ever goes after. If the privileges of the faculty club are the perks for years spent in advanced study and intellectual pursuits, then the unspoken rule is that one NEVER goes after others of unequal academic accomplishment because of their unequal accomplishment. This is especially true for those of unequal capability. There was a time when Savulescu would have been shunned by the academic community for doing so.

One of my professors in graduate school once told me that the Ph.D. is no big deal. “It’s a union card, Gerry. Nothing more. If you want to do this work, you need the union card. The big deal is your publication list at your retirement party.” How very true. It isn’t the degree, but what one does with it that counts.

Oxford now has some soul-searching to do. Do they tolerate a Savulescu in their midst under the soiled banner of “Academic Freedom?” Do they show him the door? If we are to salvage a crumbling western civilization, then the formation of our young in universities and colleges will need to be done by Ph.D.’s who understand and live the three cardinal virtues of academics:

Prudence, Humility, Decorum.

Absent brute military force, that’s the only non-violent response to eugenics.

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This letter is addressed to every physician, scientist, and genetic counselor who believes in a eugenic agenda that targets the unborn specifically because of diagnosed genetic anomalies. It asks a series of penetrating questions that invite thoughtful response, and are not meant to be rhetorical.

The first question is: WHO?

Who taught you in medical school or graduate school that we doctors of science and medicine are the custodians of the human gene pool? Who was it that told you it was your job to keep that pool “clean?” They are serious questions, as I never encountered this philosophy, let alone mandate, in my premed studies at Columbia University, grad studies at St. John’s University, or post-doctoral studies at the City University of New York. Neither in the Ivies, Catholic, or Public universities did I ever encounter this mandate that has seized hold in our hospitals. Whence comes this thinking?

In my undergraduate studies in the 70’s and 80’s liberal arts professors taught extensively about the corruption of the Third Reich, and the eugenic agenda in Hitler’s camps. What we were never taught was that this agenda predated Hitler and arose within the medical community of the 1920’s in Germany. Regardless, the properly educated man or woman in American universities in the 70’s and 80’s was taught that eugenics was repugnant, Master Race and all of that stuff… It leads to the next question:

HOW?

How have we progressed from that understanding to where we are today? How is it that we have come to view genetic anomalies as so terrifyingly painful that those who bear them are deemed “incompatible with life,” which is strikingly similar to Hitler’s, “Life unworthy of Life?” On what basis do you make such an assessment, especially in the case of Down Syndrome? Is this rooted in firsthand clinical experience? It can’t be, as these children and adults are some of the most beautiful and happy individuals among us. How is it that we celebrate “diversity’ with near-fanaticism in society while we shoot for genetic homogeneity with similar near-fanaticism? That of course leads to the question:

WHAT?

What is it that you believe you have been entrusted with that leads to this neo-eugenics? When I went to graduate school, we were entrusted with great knowledge of biology across the spectrum of life, and in my course of studies, great knowledge of human and microbial physiology. We were entrusted with the knowledge and training in molecular biology, techniques so powerful that they have equal ability to destroy life on earth as well as advance the cause for life on earth. What we did not receive enough of was training in ethics, and not the sort of algorithm flow chart-based policy crap devoid of any training in metaphysics and human anthropology. I received all of that in undergrad, thank God. It was expected of us that we would use this great knowledge and power only for good, but therein lies the problem.

How do we define the good? Who defines the good? What is the good?

It’s easy for those of us who were obviously born with all of the genetic capability to earn doctorates to look down upon the disenfranchised with disdain. It comes from an insecurity within that says, “I can’t imagine living like that,” which is precisely the soil in which a eugenic mentality takes root. A little guilt added in to spice up the toxic brew, and here we are. But ask yourself this question.

If you rise above the genetics and epigenetics and consider the quality of life to which you appeal in your headlong pursuit of stamping out the unfit, what training do you have in anthropology, psychology, sociology, comparative religion, transcultural psychology, aesthetics, philosophy? How well did you apply yourself to these studies when you were in pre-med, or were these the B.S. courses you needed to endure on the way to medical or graduate school?

I would submit that most physicians and scientists I have met who are pro-choice are severely deficient in these areas, and as such cannot render an informed opinion as regards quality of life, and only speak from their very narrow and cramped worldview.

The new colonialism.

Of course, this all begs the further question:

When?

When was it that we stopped looking for cures and enhanced therapies, and started taking the cheap way out? When did death and non-existence become the answer, rather than healing and wholeness? When did we receive a mandate to kill every baby we could in order to aid the patient in avoidance of suffering?

I would submit that the answers reside in the radicalization of the liberal arts over the past thirty years, and in the watering down of the college curriculum in that time. It’s a formation issue, from my perspective, one that has left many of our finest and brightest physicians and scientists impoverished and without the necessary spiritual and intellectual protections against the power of our biotechnology to twist and distort its practitioners.

Do you disagree?

I’m open to feedback and answers to the questions

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