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Feb/16

4

“Three Parent” Babies? No, More Like 2.001 (If That)…

ThreeParentBabiesBioethicists are, for the most part, a pretty presumptuous bunch: who on earth do they think they are?

In this case, however, highlighted by the Washington Post, they have got things right:

An elite panel of scientists and bioethicists offered guarded approval Wednesday of a novel form of genetic engineering that could prevent congenital diseases but would result in babies with genetic material from three parents.

The committee, which was convened last year at the request of the Food and Drug Administration, concluded that it is ethically permissible to “go forward, but with caution” with mitochondrial replacement techniques (MRT), said chairman Jeffrey Kahn, a bioethicist at Johns Hopkins University.

No, I’m not sure why it is up to them to decide what is or is not “ethically permissible”, but still…

But the advisory panel’s conclusions have slammed into a congressional ban: The omnibus fiscal year 2016 budget bill passed by Congress late last year contained language prohibiting the government from using any funds to handle applications for experiments that genetically alter human embryos.

Thus the green light from the scientists and ethicists won’t translate anytime soon into clinical applications that could potentially help families that want healthy babies, said Shoukhrat Mitalipov, a pioneer of the new technique at Oregon Health & Science University in Portland, Ore.

“It seems like the FDA is disabled in this case by Congress,” Mitalipov said. “At this point we’re still not clear how to proceed.”

Congress should get out of the way.

The FDA released a statement Wednesday saying it will carefully review the report from the advisory committee, but added that the congressional ban prohibits the agency from reviewing applications “in which a human embryo is intentionally created or modified to include a heritable genetic modification. As such, human subject research utilizing genetic modification of embryos for the prevention of transmission of mitochondrial disease cannot be performed in the United States in FY 2016.”

The new clinical procedures should be used rarely, with extreme care and with abundant government oversight, and they initially should be applied only to male embryos, the advisory panel said. The group delivered its report at a morning news conference at the National Academy of Sciences headquarters in Washington.

The report comes at a time of dazzling advances in genetic engineering and a commensurate struggle to understand the ethics of “playing God,” a phrase uttered twice Wednesday by committee member R. Alta Charo, a professor of law and bioethics at the University of Wisconsin.

Then again, as it’s most unlikely that God played God…

The FDA last year asked the Institute of Medicine, now part of the National Academies of Sciences, Engineering and Medicine, to review the ethical implications of MRT since this other method of genetic engineering would result in what has been loosely referred to as “three-parent babies.” British officials have already approved investigatory experiments involving the technique.

Certain serious congenital diseases can be passed from a mother to child via the tiny amount of genetic material contained in the mitochondria, which are small organs within a cell that are often described as the cell’s energy factories or power plants. New experimental techniques involving in vitro fertilization make it possible to replace mutated and potentially disease-associated mitochondrial DNA (mtDNA) with non-pathogenic mtDNA donated from another woman.

Mitochondrial DNA contains 37 genes and is distinct from nuclear DNA (nDNA), which in humans has upwards of 20,000 genes. The mitochondrial DNA is not found in sperm, only in eggs, and thus is passed only from mother to child. That’s why the panel recommended limiting the experimental procedures at first to male embryos.

The males-only guideline is intended to prevent the introduction of unwanted, irreversible genetic changes to the human species. Any genetic changes associated with this kind of engineering will meet a dead end in males.

“If there are adverse events, they would not be reverberating down the generations,” Charo said.

The procedure should be extended to female embryos only after the long-term effects of such novel genetic engineering are better understood, the committee concluded.

Nuclear DNA is by far the more significant form of genetic material for determining most human characteristics. As the committee put it, “[W]hile mtDNA plays a central role in genetic ancestry, traits that are carried in nDNA are those that in the public understanding constitute the core of genetic relatedness in terms of physical and behavioral characteristics as well as most forms of disease.”

As a result, the modification of mitochondrial DNA “is meaningfully different.”

But panel members said that they took the philosophical issues seriously, noting that someone with genetic material from two different maternal bloodlines would potentially have to wrestle with questions about identity, kinship and ancestry.

Not really.  The babies who benefit from this technology will have about 0.1 percent of their DNA attributable to a third party. It’s a (very) crude way of looking this, but think how many great, great-grandparents away it would take to account for 0.1% of someone’s ancestry….

To describe the donor as a third “parent” is, to put it mildly, a stretch.

And, as a reminder of what this is about:

The donor provides only their mitochondria. Often called the “power plants” of the cell, the mitochondria converts energy from food into energy that can power a cell. When someone’s mitochondria don’t function properly, it’s bad news indeed…

As one ‘ethicist’ notes:

It is not part of what makes us genetically who we are.It doesn’t affect height, eye color, intelligence, musicality. It simply allows the batteries to work properly…

And as to what’s at stake;

Mitochondrial diseases can cause a whole host of life threatening problems, and it’s estimated that as many as 4,000 children are born with such conditions in the United States each year.

Again, politicians should get out of the way.

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Nov/15

29

Free Speech is not a ‘European Value’

VaginaprotestThe Local (Spain):

[Three Spanish feminists] are facing charges for crimes against religion for mimicking Spain’s Easter processions – replacing the Virgin Mary with a giant plastic vagina. Three women who carried a giant plastic vagina during a march to celebrate Worker’s Day, held every year on May 1st, are facing charges of “crimes against religious sentiment”.

The three women, who have not been named, allegedly mimicked Spain’s famous Holy Week processions that take place in the run up to Easter. The women “carried a plastic vagina a couple of metres high in the style of the Virgin Mary,” said the Seville-based judge.

Many Spanish religious festivals feature processions during which locals carry a statue of the Virgin Mary above their shoulders. The prosecution argue that the women made a mockery of this religious practice by lifting the plastic vagina onto their shoulders and parading it during a march organized by the Spanish union the General Workers’ Confederation (CGT) on May 1st 2014.

Some of the women also wore mantillas, the black lace veils commonly worn by devout Catholic women during religious celebrations in Spain while others sported the conical hoods commonly worn by the members of religious brotherhoods over Easter. The three women have been ordered to appear in court in February 2016 for a crime against religious sentiments….

Childish?  Sure, but it should not be criminal.

And as for the precedent that is being set, well…

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Nov/15

20

Multiculturalism, Free Speech: Choose One?

blasphemyNational Secular Society:

Labour MP Keith Vaz has expressed his support for the reintroduction of UK blasphemy laws – provided they “apply equally to everybody.”
His comments were reportedly made at an event organised by the Muslim Council of Britain to explore responses to terrorism and extremism, held in London on 12 November. During discussions on how to respond to ‘slurs’ and “grossly irresponsible” coverage of Muslim issues in the media, attendees called for Britain’s Independent Press Standards Organisation (IPSO) to use its powers to pursue complaints of discrimination against groups of people, such as those of Muslim faith, even if no individual is specified in an offending article.

Miqdaad Versi, Assistant Secretary General of the MCB, said “Muslim communities need to be able to respond to accusations [against] Muslims, or against the Prophet, in a more effective way.”

He added: “Whether there should be legislation is something that really is a more complicated question.”

But in response to discussion on new blasphemy legislation, Vaz, who is the chairman of the influential Home Affairs Select Committee, told Al Arabiya that under certain conditions he would have “no problem” with the reintroduction of blasphemy laws in the UK.

“Religions are very special to people. And therefore I have no objection to [a blasphemy law] … but it must apply equally to everybody,” the longstanding Labour MP added.

Free speech, it seems, is not so “very special”.

Oct/15

11

Jerry Brown Gets It Right

Jerry BrownCredit where’s credit is due: I am not exactly a member of the Jerry Brown fan club, but the California Governor’s decision to sign his state’s cautiously drafted assisted suicide law (perhaps too cautiously: to take one example, those with Locked-In Syndrome might still be left trapped in their hell) deserves some praise, not just for his signature, but also the reasons he gave for it.

The New York Times:

Gov. Jerry Brown of California gave a deeply personal explanation on Monday for his decision to sign legislation allowing terminally ill patients to obtain a lethal dose of painkillers from a doctor to hasten their death. When the law goes into effect next year, California will become the fifth state, after Oregon, Washington, Montana and Vermont, to enact and retain aid in dying or physician-assisted suicide laws. Many other states are considering similar laws; they ought to follow the example of these pioneers.

The California law has robust protections to protect patients from recklessly taking their own lives. Two different doctors must certify that the patient has six months or less to live before prescribing the drugs, patients must be able to swallow the medication themselves, and they must be of sound mind and not under coercion from their families. Hospitals and doctors can decline to participate.

Governor Brown, a Democrat, said that he had carefully read the opposition materials presented by a number of doctors, religious leaders and champions of disability rights and had considered religious arguments that shortening one’s life is sinful. He also consulted with a Catholic bishop, two of his own doctors, and former classmates and friends, who took a variety of positions.

In the end, he reflected on what he would want in the face of his own death. “I do not know what I would do if I were dying in prolonged and excruciating pain,” he wrote. “I am certain, however, that it would be a comfort to consider the options afforded by this bill. And I wouldn’t deny that right to others.”

Well done, Governor Brown. That said, it remains troubling to read that, even after the vote in the California legislature, Brown thought it worth considering ‘religious arguments that shortening one’s life is sinful’. Much as I might disagree with them, there are good practical arguments to be made against assisted suicide, but why, beyond a certain point in the democratic process in a nation with a constitution providing for the separation of church and state, religious arguments should be given special consideration escapes me.

There’s been a lot of talk in recent years about how ‘religious liberty’ is under attack in the US, but that’s a stance that can easily turn into an insistence on religious privilege, an altogether less praiseworthy objective. Under the circumstances, the determination of various churchmen to ensure that all Californians should be forced to submit to the prescriptions of a faith that they might not share was more than a touch ironic.

And for all the other arguments that those churchmen make, that infamous slippery slope and so on, in the end their objections are religious, based, at their core, on the argument that the rights of their God trump those of the profoundly sick, an argument made none the more palatable by attempts to elevate ‘suffering’ into some sort of sacrament.

I posted a bit about this phenomenon the other day, but clear signs of a morbid cult of suffering can be found in an article in America magazine by Jessica Keating, the program director of the Office of Human Dignity and Life Initiatives at the University of Notre Dame. It was written in response to the assisted suicide of Brittany Maynard in Oregon earlier this year.

Keating:

For those who cannot see beyond the material horizon of death, suffering that does not appear to have proximate material benefit is emptied of the possibility of meaning.

Well yes.

Indeed, euthanasia and physician-assisted suicide are as much about unseemliness and fear of suffering as they are about death.

Pretty much.

With the advance of utilitarian idealism and medical technology, it seems that nothing but a peaceful death will be acceptable, wherein peace is reduced to the absence of pain, emotional and physical suffering or the loss of cognitive and physical abilities.

To describe the wish for a peaceful death as ‘utilitarian idealism’ is telling. Fundamentalism is what it is.

There is another narrative that is routinely neglected or, worse, rejected out of hand, a narrative grounded in the logic of the Cross. This is a narrative in which suffering unto death can be penetrated and transfigured by the mystery of love—particularly in cases like Ms. Maynard’s, when one is surrounded by loving family and friends. This transfiguration occurs in hidden intimacies. Choosing to die early forecloses such possibilities. Had she not taken her own life with the assistance of a physician, she, like many who suffer terminal illness, almost assuredly would have been stripped bare of her abilities, perhaps even her mind. Indeed, there was nothing material for her to gain in suffering, only loss. Almost assuredly there would have been no inspiring recovery story to tell at the end. Rather, Ms. Maynard might have become unproductive, unattractive, uncomfortable. She would just have been. But she would have been present in a web of relationships. Even had she fallen unconscious, she likely would have been read to, washed, dressed and kissed. She would have been gently caressed, held and wept over. She would simply have been loved to the end.

That was a destiny that was hers to choose or to reject. ‘The logic of the Cross’, backed by coercion, would have denied her that freedom, that autonomy, that dignity, that relief.

As I said, ‘religious privilege’.

 

· · · · ·

Kim DavisWhile there is something more than a little unattractive about the relish with which the jailing of Kim Davis, the errant county clerk (a Democrat, as it happens) unwilling to issue marriage licenses to same sex couples, has been celebrated by some, she has both abused her position and provided a useful reminder of the fact that many of those now calling for ‘religious freedom’ (a good thing) really want religious privilege (not so much). So far as Ms. Davis is concerned God’s law (as she understands it) not only trumps the law of the land, but is something that she is prepared to impose on others. But Thomas More is, mercifully, long dead. That sort of thinking is more commonly associated these days with the realm of Shariah than the West.

And those in the US pushing for an expansive definition of what they call religious freedom should pay more attention to stories that illustrate the direction in which things are going, stories like this:

CNN: A Muslim flight attendant says she was suspended by ExpressJet for refusing to serve alcohol in accordance with her Islamic faith. In a bid to get her job back, Charee Stanley filed a discrimination complaint with the Equal Employment Opportunity Commission on Tuesday for the revocation of a reasonable religious accommodation.

She wants to do her job without serving alcohol in accordance with her Islamic faith — just as she was doing before her suspension, her lawyer said.

“What this case comes down to is no one should have to choose between their career and religion and it’s incumbent upon employers to provide a safe environment where employees can feel they can practice their religion freely,” said Lena Masri, an attorney with Michigan chapter of the Council on American-Islamic Relations.

Stanley, 40, started working for ExpressJet nearly three years ago. About two years ago she converted to Islam. This year she learned her faith prohibits her from not only consuming alcohol but serving it, too, Masri said.

“Noone should have to choose between their career and religion?”

Noone.

Ever?

Masri and Davis are pointing the way to a sectarian, Balkanized America, a path that will not end well.

Davis should resign. And so should Stanley.

Link
http://www.cnn.com/2015/09/05/travel/muslim-flight-attendant-feat/

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Aug/15

30

The Cult of Suffering

JesusMexicoIn the course of commenting over on the Corner to a list of the ‘ten best revolutionaries’ (yes, the list was as dumb as you can expect), I included an extract from Paul Berman’s excellent Slate response to The Motorcycle Diaries, a hagiographic Che movie made about ten years ago.

Some of Berman’s piece was an attempt to insert a little accuracy into the historical record, but this too caught my eye:

[T]he entire movie, in its concept and tone, exudes a Christological cult of martyrdom, a cult of adoration for the spiritually superior person who is veering toward death—precisely the kind of adoration that Latin America’s Catholic Church promoted for several centuries, with miserable consequences. The rebellion against reactionary Catholicism in this movie is itself an expression of reactionary Catholicism. The traditional churches of Latin America are full of statues of gruesome bleeding saints. And the masochistic allure of those statues is precisely what you see in the movie’s many depictions of young Che coughing out his lungs from asthma and testing himself by swimming in cold water—all of which is rendered beautiful and alluring by a sensual backdrop of grays and browns and greens, and the lovely gaunt cheeks of one actor after another, and the violent Andean landscapes.

The cult of suffering—the idea that suffering is itself somehow ennobling—has long been a feature of some of the more morbid outgrowths of Christian tradition, and it can easily be detected in some of the opposition to assisted suicide.

In the course of an article for the Boston Pilot,a nun, Sister Constance Veit, wrote:

Compassion, or “suffering with” another, manifests what is best in us as members of the human family. As Little Sisters of the Poor we often witness the extraordinary things that happen at the bedside of our dying residents — striking acts of faith, graces of personal conversion and family reconciliation and exceptional gestures of empathy on the part of our staff members.

This past winter we were hit with a particularly tough strain of the flu. Several residents succumbed to the illness, including a woman who had been caught in the downward spiral of Alzheimer’s disease for over 15 years. In his funeral homily the priest, a family friend, suggested that as Alzheimer’s progressively robbed her of all that she had enjoyed in life, he had been tempted to wonder, “Why is she still here?”

The priest had a ready response to his own question, though: despite her silence and complete dependence this woman remained among us for so long to bring out the best in her caregivers, to teach us how to love. Father’s answer echoed an insight that St. John Paul II had shared 30 years ago in his apostolic letter on human suffering:

“We could say that suffering, which is present under so many different forms in our human world, is also present in order to unleash love in the human person, that unselfish gift of one’s ‘I’ on behalf of other people, especially those who suffer. The world of human suffering unceasingly calls for, so to speak, another world: the world of human love; and in a certain sense man owes to suffering that unselfish love which stirs in his heart and actions.”

What a mystery — these suffering souls whose mission it is to call the rest of us to a more noble existence, a more loving and generous gift of self! The graces bestowed on those who care for the ill and dying parallel those received by the sick who recognize God as the Master of Life and entrust themselves to him. One of the reasons why assisted suicide is so tragic is that it would deprive the sick and those who accompany them of these important graces.

That last paragraph is, I have to say, disgusting. Sister Veit’s argument that those wrestling with the later stages of a cruel disease are on a “mission” on behalf of the rest of us, a mission that they had never asked to be on, is an expression of fanaticism, terrifying in its absence of empathy for her fellow man.

We are often to told that assisted suicide could represent a slippery slope to moral catastrophe. To read Veit’s words—and to understand what, in practice, they really mean— is to realize that we are already there.

Links
http://www.nationalreview.com/corner/423275/lovable-rogues-all-andrew-stuttaford
http://www.slate.com/articles/arts/culturebox/2004/09/the_cult_of_che.html
http://www.thebostonpilot.com/opinion/article.asp?ID=173351

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Aug/15

15

Against the “Ultimate Indignity”

Locked in Syndrome The Economist is a magazine (or ‘newspaper’ as it likes to style itself) that has badly lost its way, abandoning the quirky classical liberalism of a three or four decades ago for a bien pensant Davos liberalism that is as condescending as it is misguided.

On occasion though, hints of the old Economist can emerge, as a recent piece in support of doctor-assisted suicide demonstrates.

Here’s an extract:

The idea fills its critics with dismay. For some, the argument is moral and absolute. Deliberately ending a human life is wrong, because life is sacred and the endurance of suffering confers its own dignity. For others, the legalisation of doctor-assisted dying is the first step on a slippery slope where the vulnerable are threatened and where premature death becomes a cheap alternative to palliative care.

It is worth interrupting to add that the argument of a slippery slope will have little resonance with someone, suffering say from locked-in syndrome, who may well believe that he has already slid down the slope and into the ditch to which the likes of Boston’s Cardinal Sean O’Malley (a prominent opponent of Massachusetts’ sadly unsuccessful 2012 right-to-die initiative) would so prayerfully consign him.

Back to The Economist:

These views are deeply held and deserve to be taken seriously. But liberty and autonomy are sources of human dignity, too. Both add to the value of a life. In a secular society, it is odd to buttress the sanctity of life in the abstract by subjecting a lot of particular lives to unbearable pain, misery and suffering. And evidence from places that have allowed assisted dying suggests that there is no slippery slope towards widespread euthanasia. In fact, the evidence leads to the conclusion that most of the schemes for assisted dying should be bolder.

The popular desire for assisted dying is beyond question. The Economist asked Ipsos MORI to survey people in 15 countries on whether doctors should be allowed to help patients to die, and if so, how and when. Russia and Poland are against, but we find strong support across America and western Europe for allowing doctors to prescribe lethal drugs to patients with terminal diseases. In 11 out of the 15 countries we surveyed, most people favoured extending doctor-assisted dying to patients who are in great physical suffering but not close to death.

No wonder that, just as adultery existed in Spain before 1978, so too many doctors help their patients die even if the law bans them from doing so. Usually this is by withdrawing treatment or administering pain-relief in lethal doses. Often doctors act after talking to patients and their relatives. Occasionally, when doctors overstep the mark, they are investigated, though rarely charged. Some people welcome this fudge because it establishes limits to doctor-assisted dying without the need to articulate the difficult moral choices this involves.

But this approach is unethical and unworkable. It is unethical because an explicit choice that should lie with the patient is wholly in the hands of a doctor. It is hypocritical because society is pretending to shun doctor-assisted dying while tacitly condoning it without safeguards. What may turn out to be more important, this system is also becoming impractical. Most deaths now take place in hospital, under teams of doctors who are working with closer legal and professional oversight. Death by nods and winks is no good.

Better is to face the arguments. One fear is that assisted dying will be foisted on vulnerable patients, bullied by rogue doctors, grasping relatives, miserly insurers or a cash-strapped state. Experience in Oregon, which has had a law since 1997, suggests otherwise. Those who choose assisted suicide are in fact well-educated, insured and receiving palliative care. They are motivated by pain, as well as the desire to preserve their own dignity, autonomy and pleasure in life.

Another fear is that assisted dying will downgrade care. But Belgium and Holland have some of the best palliative care in Europe. Surveys show that doctors are as trusted in countries with assisted dying as they are in those without. And there are scant signs of a slippery slope. In Oregon only 1,327 people have received lethal medicine—and just two-thirds of those have used it to take their lives. Assisted dying now accounts for about 3% of deaths in the Netherlands—a large number—but this is less a rush to assisted dying than the coming to light of an unspoken tradition in which doctors quietly brought their patients’ lives to an end.

How, then, should assisted dying work? For many the model is Oregon’s Death with Dignity Act. It allows (but does not oblige) doctors to prescribe lethal drugs to patients with less than six months to live who ask for them, if a second doctor agrees. There is a cooling-off period of 15 days.

We would go further. Oregon insists that the lethal dose is self-administered, to avoid voluntary euthanasia. To the patient the moral distinction between taking a pill and asking for an injection is slight. But the practical consequence of this stricture is to prevent those who are incapacitated from being granted help to die. Not surprisingly, some of the fiercest campaigners for doctor-assisted dying suffer from ailments such as motor neurone disease, which causes progressive paralysis. They want to know that when they are incapacitated, they will be granted help to die, if that is their wish. Allowing doctors to administer the drugs would ensure this.

Oregon’s law covers only conditions that are terminal. Again, that is too rigid. The criterion for assisting dying should be a patient’s assessment of his suffering, not the nature of his illness. Some activists for the rights of the disabled regard the idea that death could be better than a chronic condition as tantamount to declaring disabled people to be of lesser worth. We regard it as an expression of their autonomy. So do many disabled people. Stephen Hawking has described keeping someone alive against his wishes as the “ultimate indignity”.

Indeed it is.

But it is an indignity that men like Sean O’Malley, prelates who have been so busy of late proclaiming the primacy of ‘religious liberty’, are prepared to insist on. Liberty, it seems, is not for all.

Links
http://www.economist.com/news/leaders/21656182-doctors-should-be-allowed-help-suffering-and-terminally-ill-die-when-they-choose?fsrc=scn/tw/te/pe/ed/therighttodie
http://www.usccb.org/about/leadership/usccb-general-assembly/2012-november-meeting/cardinal-omalley-ballot-initiative-on-physician-assisted-suicide.cfm

Apr/15

4

Religious Liberty!

WallsBalkanization moves on merrily along.

WABC:

– A man is suing Costco for religious discrimination.

He tells Eyewitness News exclusively that when he refused to work with pork, the major retailer sent him outside to gather carts.

“Just because you have a different belief, that doesn’t give anybody the right to treat you different,” said Jean Camara, suing Costco.

That’s why Jean Camara says he’s doing what he’s doing, suing Costco for religious employment discrimination. The devout Muslim says he was working as a cashier’s assistant at the Costco in Sunset Park Brooklyn in September of 2012 when pork came across the conveyor belt. It’s against his religious beliefs to touch either pork or alcohol.Camara says after telling his managers this, they transferred him outside collecting the shopping carts.

Camara says they never told him why he was reassigned.

“I think that as the case progresses in the trial we are in now, I think the facts are going to come out and they’re going to speak for themselves,” said Chauncey Henry, Camara’s attorney.

Camara says he asked his managers if he could work in the electronics department, but his requests were repeatedly denied.
He ended up filing a human rights complaint against the company. 16 days later, he was fired for insubordinate conduct.

“We all share different beliefs so we all should be treated equally no matter what belief we have,” Camara said.

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Nov/14

8

Brittany Maynard’s Choice

brittany-maynardBrittany Maynard died tragically young, but with dignity and in as much control as an unkind fate had allowed her, taking advantage of the law in Oregon that allowed her to obtain a prescription for the barbiturates that would end her life before cancer did its terrible worst.

Writing in the Dallas News, Marcia Angell, the widow of a physician denied similar relief thanks to the cruelty of Massachusetts law, makes a powerful case for other states to follow Oregon’s example.

Here’s an extract:

Whereas hastening an inevitable death was once regarded almost exclusively as a medical issue, we are beginning to focus on what patients want, on their right to self-determination. And people are increasingly asking why anyone — the state, the medical profession, religious leaders — would presume to tell someone else that they must continue to die by inches, against their will….

The Supreme Court has twice maintained that that’s a medical question and as such should be left to the states, which regulate medical practice. The medical profession, meanwhile, has been among the main obstacles to more laws like Oregon’s. The American Medical Association’s official policy is that physician-assisted suicide is “fundamentally incompatible with the physician’s role as healer.” One possible explanation for this opposition, particularly among palliative care specialists, is that assisted dying underscores their limitations in dealing with suffering at the end of life.

But that stance puts the focus in the wrong place. This is not primarily about physicians or their self-image; it’s about patients — specifically patients for whom healing is no longer possible. We give patients the right to hasten their deaths by refusing dialysis, mechanical ventilation, antibiotics or any other life-sustaining treatment. Why deny them what is essentially the same choice, especially since it is limited to terminally ill patients?

In 2012, I was among the lead petitioners to put a Death With Dignity law on the ballot in Massachusetts, and I campaigned hard for its passage. Until a month before the election, polls showed overwhelming support. But in the final weeks, the Catholic Church, both nationally and within the state, began pouring money into TV ads implying that people would be coerced into killing themselves, and physicians and pharmacists would be required to help them. After opponents outspent proponents by about 5 to 1, the referendum lost.

This, of course, is the same Roman Catholic Church that has spent so much of the last year or so talking about ‘religious freedom’. It’s important to understand that’s a concept where both words matter. When the church makes that argument, it is not arguing for the cause of liberty in any generalized sense. Rather it is insisting on the right, under certain circumstances, of churches and their followers to assert their beliefs over the general law.

There is something very appropriate in the way that Thomas More was often cited as an inspiration for the church’s campaign. Contrary to what his modern apologists, papal and otherwise, have liked to claim, More was no supporter of freedom of conscience. What he wanted was his conscience to prevail over the consciences of others, consciences for which he had little regard. Dissent was not an option.

It’s not too difficult to draw a line between More and the way that the Catholic Church (aided by other religious groups) did so much in Massachusetts to insist that its views on ‘assisted suicide’ should be imposed on others. Of course, that imposition was the result of a democratic vote. That matters. Nevertheless the fact that the church did so much to suport that imposition on all the people of Massachusetts, regardless of religious affiliation or their own views on this matter, is a useful reminder of its distinctly narrow notion of freedom.

Meanwhile the National Catholic Reporter writes:

The Vatican’s top ethicist condemned Brittany Maynard’s decision to end her life, saying there was no dignity in her physician-assisted death…

“Assisted suicide is an absurdity,” Carrasco de Paula told the Italian news agency ANSA. “Dignity is something different than putting an end to your own life….”

“Killing yourself is not a good thing; it’s a bad thing because it says no to life and to all that means in relation to our duty in the world and to those close to us,” Carrasco de Paula said.

The fact that life was effectively saying no to Ms. Maynard seems to have passed de Paula by, as does the fact that Ms. Maynard’s decision appears to have been supported by her loved ones. As to his remark about duty, it says a lot that de Paula doesn’t say to whom this “duty” is owed.

And of course the slippery slope makes its inevitable appearance in an argument that ignores the fact that the terminally ill have already slid down it:

Carrasco de Paula said assisted suicide was also dangerous because it offered a potential “solution” for a society that sought to abandon the sick and quit paying the costs of their illnesses.

De Paula, who is head of the Pontifical Academy for Life, an institution described by the NCR as being responsible “for ethical issues in the Catholic church” is, of course, entitled to his views. They are what they are, and they are unlikely to change. Roman Catholic teaching is what it is. But so is its refusal to respect the freedoms of those with which it disagrees. Its behavior in Massachusetts was a disgrace.

Maynard’s closing statement included this:

“Today is the day I have chosen to pass away with dignity in the face of my terminal illness.”

And so she did. RIP.

· ·

Oct/14

17

“A Kind of Hydraulic Effect”

Hobby LobbyWriting in the New Yorker, Jeffrey Toobin wonders where the Hobby Lobby decision might lead:

The great Oliver Wendell Holmes once observed that important Supreme Court decisions “exercise a kind of hydraulic effect.” Even if the authors of such decisions assert that their rulings will have limited impact, these cases invariably have a profound influence. So it has been with Burwell v. Hobby Lobby Stores, Inc., which is less than six months old….

Justice Samuel Alito insisted, in his opinion for the Court, that [the] in decision [in Hobby Lobby] would be very limited in its effect. Responding to the dissenting opinion by Justice Ruth Bader Ginsburg, who called it “a decision of startling breadth,” Alito wrote, “Our holding is very specific. We do not hold, as the principal dissent alleges, that for-profit corporations and other commercial enterprises can ‘opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs.’ ” Ginsburg, though, wondered where the guidance was for the lower courts when faced with similar claims from employers with religiously grounded objections to blood transfusions (Jehovah’s Witnesses); antidepressants (Scientologists); medications derived from pigs, including anesthesia, intravenous fluids, and pills coated with gelatin (certain Muslims, Jews, and Hindus); and vaccinations (Christian Scientists, among others).

The problem is not (necessarily) what was decided in the Supreme Court but how that decision will be interpreted in lower courts where, for the most part, it will stay:

A sampling of court actions since Hobby Lobby suggests that Ginsburg has the better of the argument. She was right: the decision is opening the door for the religiously observant to claim privileges that are not available to anyone else.

One such matter is Perez v. Paragon Contractors, a case that arose out of a Department of Labor investigation into the use of child labor by members of the Fundamentalist Church of Jesus Christ of Latter-day Saints. (The F.L.D.S. church is an exiled offshoot of the Mormon Church.) In the case, Vernon Steed, a leader of the F.L.D.S. church, refused to answer questions by federal investigators, asserting that he made a religious vow not to discuss church matters. Applying Hobby Lobby, David Sam, a district-court judge in Utah, agreed with Steed, holding that his testimony would amount to a “substantial burden” on his religious beliefs—a standard used in Hobby Lobby—and excused him from testifying. The judge, also echoing Hobby Lobby, said that he needed only to determine that Steed’s views were “sincere” in order to uphold his claim. Judge Sam further noted that the government had failed to prove that demanding Steed’s testimony was not, in the words of the R.F.R.A., “the least restrictive means of furthering that compelling governmental interest.” That burden seems increasingly difficult for the government to meet…

To repeat a point I made in an earlier post:

It ought to go without saying that religious freedom is part of the bedrock of American liberty, but so too is the notion of equality before the law. There has to be unum, so to speak, as well as pluribus.

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