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Archive for the ‘Biomedical Ethics’ Category

stethoscopeHeart

News today that Belgium has approved euthanasia for any age. From BBC:

Parliament in Belgium has passed a bill allowing euthanasia for terminally ill children without any age limit, by 86 votes to 44, with 12 abstentions.

When, as expected, the bill is signed by the king, Belgium will become the first country in the world to remove any age limit on the practice.

It may be requested by terminally ill children who are in great pain and also have parental consent.

Opponents argue children cannot make such a difficult decision.

It is 12 years since Belgium legalised euthanasia for adults.

In the Netherlands, Belgium’s northern neighbour, euthanasia is legal for children over the age of 12, if there is parental consent.

Under the Dutch conditions, a patient’s request for euthanasia can be fulfilled by a doctor if the request is “voluntary and well-considered” and the patient is suffering unbearably, with no prospect of improvement.

Today the Belgian people have ratified civilizational suicide. There is no turning back now, absent a national awakening through evangelization. There is so much wrong with this law that it hardly bears discussion. It is simply malevolent, and it brings me back to an experience of when Regina and I were engaged to be married.

It was 1990-1991 and Regina was still a new Pediatric Nurse at Cornell Medical Center in NYC. One of her patients (We’ll change his name and call him Daniel) was a young boy who was six years old and being treated for leukemia. This little charmer stole my fiancé’s affections, along with those of the entire nursing staff. The stories of Daniel’s antics were hilarious and non-stop. Against the backdrop of the hilarity was the constant encroachment of a disease that had a short-lived remission.

There came a point when “the trip” was brought up in regards to the timing of the leukemia’s progression; the trip to Disney for this little prince. Off went the family and an excited little boy who had never been to Disney World.

It was magical for him.

Pure joy.

For mom and dad, it was the unique blend of joy and dread experienced by so many parents of critically ill children. Back home, Regina steadied her young girl’s heart for the switch from heroic last-ditch efforts in oncology to palliative care not only for Daniel, but for his parents, who by now seemed like extended relatives. When the end came, it came hard and fast.

There was never an issue of unbearable suffering for little Daniel. His pain was adequately managed. I was at Regina’s apartment in hospital housing on that Sunday afternoon when the day-shift nurse called with the news. Daniel had slipped away peacefully and Regina needed to come over. Regina had a good cry and asked me to go with her. When we arrived, Daniel was there in his bed, surrounded by grieving family, nurses, and physicians. His father sat next to his dead son, encapsulated in a bubble of grief that was impenetrable. It was there that I finally met this extended family.

Daniel’s mother hugged Regina and the two just cried. She thanked her over and over for all of her kindness as his night nurse, for the loving way in which she cared for Daniel, and for all of the emotional and logistical support that Regina gave that went way over and above the requirements of her job.

I stood there in support but mostly a spectator to this beautiful, if heartrending, scene. There before me were some of the finest minds in medicine and nursing in the world, in an Ivy-League teaching hospital, in fast-paced and cynical New York City, and they cried, laughed, and loved unashamedly. To the very last moment of Daniel’s brief life among us, they lavished their finest clinical ministrations upon him, and supplemented that with generous amounts of love.

Children such as Daniel simply do not think about suicide. They are hard-wired for hope in the future. In Regina’s quarter of a century as a pediatric nurse, never once has she come across a terminally ill child who ever wanted to end it all, who ever thought in those categories. That is a category introduced by the adults in their lives. The permanence of death simply escapes children.

There is only one antidote for the Belgian experience, and it revealed itself to me through my young fiancé and her colleagues a long time ago. At the wake and funeral it was a celebration of love, and the entire staff turned out in force for the family and for each other. A month later, Regina received a video from Daniel’s family asking that she remember him. His prayer card remains on Regina’s dresser to this day. A few times through the years, I have taken out that video and watched, and remembered, and learned.

It’s all about the courage that comes from love. That courage propels us to advance the field of palliative medicine, while allowing families to work through their bitter sorrow without succumbing to despair.

In that private room so long ago, it was evident that death came like a silent thief amidst an enormity of love. Daniel didn’t die at the hands of Regina and her colleagues. He lived at their hands, and more fully and beautifully because of their love and the love of his family. And when it was all said and done, his parents took up the rest of their lives having been lovingly supported and affirmed by a staff of professionals who honored the love that begat the little prince who stole my fiancé’s heart.

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lost-babies

It is well-known that women who receive so-called poor prenatal diagnoses are pressured by genetic counselors and obstetricians to abort the baby. Often, as in the case of Down syndrome, the diagnosis comes with just a week or two left before the legal limit to have an abortion. In the midst of the shock and bewilderment, the feelings of inadequacy in the face of certain special needs (Feelings which are completely normal), often comes severe coercion by physicians who will refuse to treat unless an abortion is obtained. Mothers and fathers are asked why they would make their child suffer. Family and babies’ fathers threaten physical, financial, and emotional abandonment.

With Down syndrome over 90% of babies are aborted within this crucible.

I have heard first-hand accounts that are horrid, accounts where the truth of therapeutic options for prenatal surgeries, post-partum surgeries and therapies often make for very functional children. Even when such is not the option, there is hardly ever a referral to a support group for a different perspective.

Then there are the frequent horror stories of the baby aborted and found to have been perfectly healthy and normal. Modern medicine is on a eugenic rampage and the stories of these mothers and fathers need to be told.

Therefore, I am beginning a project to collect the stories of parents who have been victims of abusive physicians and genetic counselors, whether they aborted or carried the child to term. Both the triumph and tragedy need to be told. Names will be kept anonymous and stories will be printed only by permission and in the parents’ own words in an upcoming book. Please reach out to anyone you know with such a story, and then email me at:

gerardnadal60@gmail.com

All names will be kept strictly confidential, and only those stories will be published where written authorization to do so has been obtained.

Feel free to contact me with any and all questions.

God Bless.

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Just in case anyone doubts that the objective is to destroy all private health insurance, this video has Obama in his own words. It’s devastating.

When the government tries to control our very bodily autonomy, it’s time to change course. The midterm elections are a year away. God help us all.

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OctoberRosebud

Increasingly, I understand why it is that old people begin to welcome death as a friend.

News today from across the pond in The Telegraph of a young Somali girl who was smuggled into Great Britain for the purpose of harvesting her organs. From the story:

The unnamed girl was brought to the UK from Somalia with the intention of removing her organs and selling them on to those desperate for a transplant.

Child protection charities warned that the case was unlikely to be an isolated incident as traffickers were likely to have smuggled a group of children into the country.

The case emerged in a government report which showed that the number of human trafficking victims in the UK has risen by more than 50 per cent last year and reached record levels.
A total of 371 children were exploited, with the majority of them being used as slaves or sexually abused. They included 95 children from Vietnam, 67 from Nigeria and 25 from China. Others hailed from Romania and Bangladesh.

The figures also detail how 20 British girls have been victims of human trafficking. It comes after a series of court cases in which British girls were raped and exploited by gangs of Asian men.
Child protection charities warned last night that criminal gangs were attempting to exploit the demand for organ transplants in Britain.

Bharti Patel, the chief executive of Ecpat UK, the child protection charity, said: “Traffickers are exploiting the demand for organs and the vulnerability of children. It’s unlikely that a trafficker is going to take this risk and bring just one child into the UK. It is likely there was a group.”

According to the World Health Organisation as many as 7,000 kidneys are illegally obtained by traffickers each year around the world.

While there is a black market for organs such as hearts, lungs and livers, kidneys are the most sought after organs because one can be removed from a patient without any ill effects.
The process involves a number of people including the recruiter who identifies the victim, the person who arranges their transport, the medical professionals who perform the operation and the salesman who trades the organ.

The government’s report also found that there has been a rise in the number of adults trafficked to the UK, with the number of women rising by 12 per cent to 786 and the number of men by almost a third to 400. They include growing numbers of British men are being exploited for “paving or ground works” in this country or abroad.

Read the rest.

I don’t know what to say about this. I think its speaks for itself. I’m simply beyond words.

I understand old people more, and more.

Maranatha!

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DSC_0003[1]
It is difficult to imagine that any public official could possibly march to the left of Barack Obama or HHS Secretary Kathleen Sebelius, but today Federal District Court Judge Edward Korman did just that when he approved the sale of Plan B to children of any age. Previously, Sebelius ordered that based on the science, children were not capable of complying with the directions of safe use of the drug. Here is Sebelius in her own words not too long ago:

A Statement by U.S. Department of Health and Human Services Secretary Kathleen Sebelius

Plan B One-Step is an emergency contraceptive, sometimes referred to as the “morning after pill.” Plan B One-Step is currently labeled over the counter to women ages 17 years and older, but is sold behind the pharmacy counter. It is available by prescription only to women 16 years and younger. My decision does not change any current availability of the drug for all women.
In February 2011, Teva Women’s Health Inc. submitted to the FDA a supplemental new drug application for Plan B One-Step. This application sought to make Plan B One-Step available over the counter for all girls of reproductive age. The science has confirmed the drug to be safe and effective with appropriate use. However, the switch from prescription to over the counter for this product requires that we have enough evidence to show that those who use this medicine can understand the label and use the product appropriately. I do not believe that Teva’s application met that standard. The label comprehension and actual use studies did not contain data for all ages for which this product would be available for use.
FDA has recommended approval of this application in its Summary Review for Regulatory Action on Plan B One-Step. After careful consideration of the FDA Summary Review, I have concluded that the data, submitted by Teva, do not conclusively establish that Plan B One-Step should be made available over the counter for all girls of reproductive age.
The average age of the onset of menstruation for girls in the United States is 12.4 years. However, about ten percent of girls are physically capable of bearing children by 11.1 years of age. It is common knowledge that there are significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age. If the application were approved, the product would be available, without prescription, for all girls of reproductive age.
The Secretary of the Department of Health and Human Services is responsible, acting through the FDA Commissioner, for executing the Federal Food, Drug, and Cosmetic Act. Today’s action reflects my conclusion that the data provided as part of the actual use study and the label comprehension study are not sufficient to support making Plan B One-Step available to all girls 16 and younger, without talking to a health care professional. Plan B One-Step will still be available over the counter to women ages 17 and older.
Because I do not believe enough data were presented to support the application to make Plan B One-Step available over the counter for all girls of reproductive age, I have directed FDA to issue a complete response letter denying the supplemental new drug application (SNDA) by Teva Women’s Health, Inc..

Sebelius received Obama’s support for her decision. From news reports at the time of the ruling:

Obama said that as a father of two daughters, he thinks the government should “apply some common sense” to rules governing over-the-counter medicine. He said he understood Sebelius’ concern about letting medication with potentially adverse side effects be available to 10-year-old girls “alongside bubble gum or batteries” at drugs stores.
“I think most parents would probably feel the same way,” he said. Asked point blank if he supports Sebelius’ decision, Obama said, “I do.”

While the Judge today said that his decision was supported by science, it remains for the Judge to enlighten both the regulatory and scientific/medical communities as to what secret studies he was privy to in his decision-making. The truth is that every study, including those by Teva, the manufacturer of Plan B, indicate that half of all women taking the drug were incapable of following the directions on the product insert for correct use of the drug and/or failed to understand that Plan B is not meant to replace regular contraceptives or be used more than once in a menstrual cycle.

Further, studies have indicated that when used by teens the rate of Chlamydia infection rose (presumably from increased sexual activity). Additionaly, studies have indicated that the incidence of teen pregnancy was not lowered by the use of Plan B.

Perhaps even more disturbing is the lack of understanding by the judge that children’s medications are dispensed on a milligram of drug per kilogram of body weight basis. This is because standard adult doses would be double, triple, or even quadruple the necessary amount in children whose bodies are often 1/4 the mass of an adult’s. There are NO KNOWN STUDIES of the effects of the single, adult dose of Plan B on girls under age 18, which makes the specter of girls twelve and thirteen years old purchasing this drug over the counter just as frightening as can be. There are also no long term studies of Plan B’s. effects on adults, either. So the whole enetrprise is one, large human experiment.

It isn’t impossible to imagine a young girl whose body mass is half that of an eighteen year-old’s taking this dangerous hormonal drug after every act of sex, up to several in one month. This drug is several times the dose taken daily by women using oral contraceptives. Recall that half of all grown women studied couldn’t grasp this reality.

Our daughters have become lab rats in Judge Korman’s great experiment. Better he should leave such matters to those of us trained in the field, and that he stick to the law. It is now open season on girls, whose gynecologic standard of care would be improved if they were accorded the same standards that govern veterinary medicine. If vets did to animals what we do to our women, they would lose their licenses and be prosecuted for cruelty. That’s how far gynecologic medicine and its governmental regulation have sunk.

Below, an interview I gave earlier this year at a medical conference in Washington, DC, dealing with this issue of targeting children.

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Note: There seems to be two different protocols that have been reported on this, as Melissa points out in the combox below. I’ll track down the correct one and adjust accordingly.

News today from AP that a research team at Oregon Health and Sciences University has replicated work done a few years ago in Britain, constructing a human embryo by using the eggs of two mothers and a father’s sperm.

Read it at FoxNews

The goal here is to prevent diseases that arise from genetic defects within the energy-producing organelle of the cell known as the mitochondrion. These so-called mitochondrial diseases are very real and quite varied. As the article states:

About 1 in every 5,000 children inherits a disease caused by defective mitochondrial genes. The defects can cause many rare diseases with a host of symptoms, including strokes, epilepsy, dementia, blindness, deafness, kidney failure and heart disease.

So the diseases and the frequencies are significant. The ethics are a forgone conclusion. We’ll debate the ethics of taking the healthy nucleus from Jane’s egg and putting it into the egg of Lisa (which has had its nucleus removed), and then fertilizing that hybrid with Jane’s husband’s sperm. In this way, they will have children with 99% DNA from Jane and hubby, and only 1% DNA residing in the mitochondrion.

What effect will this have on the offspring, and will there be complications? We won’t know until we manufacture these babies and await the results not only over the course of the manufactured baby’s life, but in the lives of the descendants.

It won’t stop there.

The next step will be the genetic engineering of nuclear DNA by either replacing entire chromosomes, or at the least, defective nuclear genes. The guiding ethical principle?

Suffering is bad, and the noble end of preventing suffering justifies the means.

Emanating from this nobility comes the evil of intolerance of those who suffer, and who afflict us with their suffering. Consider the following from U.S. Supreme Court Justice Oliver Wendell Holmes, Jr. in his infamous majority opinion in the 1927 Buck v. Bell case which upheld the forced sterilization of the developmentally delayed:

Carrie Buck is a feeble minded white woman who was committed to the State Colony above mentioned in due form. She is the daughter of a feeble minded mother in the same institution, and the mother of an illegitimate feeble minded child…

An Act of Virginia, approved March 20, 1924, recites that the health of the patient and the welfare of society may be promoted in certain cases by the sterilization of mental defectives, under careful safeguard, &c.; that the sterilization may be effected in males by vasectomy and in females by salpingectomy, without serious pain or substantial danger to life; that the Commonwealth is supporting in various institutions many defective persons who, if now discharged, would become [p206] a menace, but, if incapable of procreating, might be discharged with safety and become self-supporting with benefit to themselves and to society…

We have seen more than once that the public welfare may call upon the best citizens for their lives. It would be strange if it could not call upon those who already sap the strength of the State for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence. It is better for all the world if, instead of waiting to execute degenerate offspring for crime or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Three generations of imbeciles are enough.

There’s nothing new in our age.

When suffering is to be avoided at all costs, the question becomes, “WHOSE suffering?”

The answer to that question then determines the lengths to which we will go to prevent that suffering.

The next step will be designer babies, and on what grounds could parents possibly be stopped? That it’s unethical to manufacture human beings in a lab? Are they humans in that Petri dish? If yes, why do we discard so many during normal IVF? Is that not murder? If the answer is no, then what harm is there? Isn’t genetic engineering for traits just a cleaner and more precise version of picking up a blonde-haired, blue-eyed stud in a bar, or picking out an Ivy-League sperm donor?

What is being lost in the process that now gives people pause?

That’s the only question whose answer matters.

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A response to the many queries I’ve been receiving about this topic:

The technological genie is out of the bottle.

We live in the age of Molecular Biology, where diagnostics (including those for Down Syndrome) are becoming much more accurate, sensitive, and inexpensive. It’s a blessed thing to behold.

That may come as a surprise statement to many, but the truth of the matter is that diagnostic testing for Down Syndrome has great potential for good, especially the newer blood tests that can detect Down Syndrome earlier.

First, letting parents know much earlier takes from the more eugenic Ob/Gyn’s the leverage that comes with the more traditional (and later) amniocentesis. Women often receive those tests results within days to a couple of weeks of the legal limit for having an abortion. It doesn’t give the woman time to emotionally digest the diagnosis, leaving her vulnerable to coercive pressure from genetic counselors, doctors and family.

Next, the earlier blood tests allow more time for women to sit with their decision, and to seek out and receive alternative advice without the deadline for abortion looming large on the horizon. Contrary to arguments that say the abortion rate will skyrocket with such testing, as early term abortions are easier to have, one need only consider that research from Harvard University shows that 93% of all Ds babies diagnosed are being aborted; so there’s little margin for any skyrocketing of abortions.

The glass is half-full here.

By itself, the technology is morally neutral. This technology can alert an Obstetrician to the need for more sonograms and the need for bringing onboard a perinatologist. Some Ds babies have anomalies that require immediate surgical intervention at birth. Early diagnostics can help to determine whether the birth should be vaginal or C-section, and whether or not a surgical team needs to be on standby.

Early diagnostics can help the parents emotionally come to terms with the reality of their child’s needs, and the unanticipated trajectory those needs will put the parents’ lives onto; all of which is critical for bonding.

Receiving a diagnosis of Down Syndrome is akin to the same reception of a diagnosis of autism. It’s like a small, tactical nuclear warhead exploding amidst the landscape of joyful reveries about our children and our hope for their futures. I was devastated by all of Joseph’s diagnoses, and would never want to repeat that experience.

Knowing the devastation that often comes with such diagnoses is key to helping parents through that difficult time, and the earlier the diagnosis, the more time we have to help them.

With so much potential good that can come from this technology (and so little room for matters to get worse), it is unwise, even counterproductive to fight against it. Science has actually given us a buffer zone.

We need to exploit it.

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