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CAT | Medicine

Mar/17

11

Compassion That’s Not

Writing in America Magazine, Jean Welch Hill, director of the ominously-named Peace and Justice Commission for the [Roman Catholic] diocese of Salt Lake City, argues against peace and justice for the terminally ill:

Imagine telling someone who is unable to walk that their life no longer has value. Or telling a loved one who needs help eating that they have lost all dignity. Or explaining to a friend that you can’t visit them anymore because their illness has made them unattractive.

Few would say any of these to a stranger, let alone a loved one. Yet the message of assisted suicide amounts to telling people who have lost the ability to function as they have in the past that they should just cease to exist. This has been the message we have heard for three years in Utah from proponents of assisted suicide legislation.

The definition of dignity implied in these proposed laws, which have followed the Oregon model, is not about the inherent worth of the person but about their physical state. We should keep in mind the great injustices that occur when we decide that human worth depends on perceived mental capacity or physical attributes.

This, I am afraid, is at best misleading and at worst dishonest.

What assisted suicide is about is allowing terribly ill people to decide for themselves that enough is enough. It is about autonomy, it is about dignity and, often, it is about the ability to bring unbearable suffering to an end.

Of course, there are many who have profound religious and philosophical objections to the idea of assisted suicide (even when it is accompanied with the sort of safeguards seen in Oregon). They are free to follow those principles up to the very end. But to insist, by force of law, that others should do likewise is about coercion, not compassion, a coercion made worse by the condescension in which it is wrapped. These poor dying folk, you see, are simply incapable of deciding what is right for themselves.

After all, they might even be nuts.

Hill:

[M]ost terminally ill patients will overcome these fears with proper mental health care. Britain’s “Care Not Killing” Alliance cites a 2006 study by the Royal College of Psychiatrists, in which almost all patients who sought assisted suicide changed their minds after competent and effective ongoing psychiatric treatment.

One study.

It’s worth adding that in 2014, the Royal College of Psychiatrists issued a statement on assisted dying for the terminally ill that ended as follows (my emphasis added):

As individuals and citizens we also cannot fail to acknowledge that notwithstanding our appropriate cautions and caveats,  there will still be those who continue to believe that their current circumstances are unendurable and unacceptable.  Each of us will have our views on how we should respond to these situations.  We do not think that the College should take a specific position on this.  Finally, the decision on whether to legalise physician assisted suicide is a matter for Parliament and the Courts. The only position the College takes on this matter at present is that we will always act within the law.

As is usual in this debate, Ms. Hill isn’t slow to start talking about the slippery slope, citing some (genuinely) disturbing (at least as presented) data from The Netherlands appearing to show that, in some cases. doctors not patients are taking the decision to end patients’ lives. If that’s true, it’s very wrong, and the way to stop it is well-crafted legislation. But using the slippery slope as an argument against the autonomy of those who have slid very far down a hideous slope of their own is to add insult to appalling injury.

Hill concludes with a call for better care for those at the end of life, noting, not inaccurately, that it is not always available. She wants, she claims, to “fix the existing problems within our health care system and allow all people to truly die with dignity.” The first half of that sentence may be sincere, but it is also boilerplate. The second half is disingenuous. Ms. Hill only wants people to “die with dignity” on her terms, terms that not a few patients will find remarkably arrogant and, yes, horribly cruel.

And they would be right to do so.

Feb/17

20

Dr. Paltrow Presumes: Iodine

The Independent:

Another week, another piece of questionable advice from Gwyneth Paltrow’s Goop.

This time, however, the website may have made its most dangerous recommendation yet, as a doctor has called out the latest post saying: “Almost everything in this article is wrong and potentially dangerous.”

In the Goop piece titled ‘Why We Shouldn’t Dismiss Iodine,’ the lifestyle site speaks to “Medical Medium Anthony William” who apparently heals people’s illnesses “using wisdom passed on to him from a divine voice he calls Spirit.”

William claims he “was born with the unique ability to converse with a high-level spirit who provides him with extraordinarily accurate health information that’s often far ahead of its time.”

So yes, Goop appears to be taking medical advice from a ghost.

In the interests of fairness, I went over to Williams’ website, medicalmedium.com. There’s plenty there to see, and there’s plenty to buy, including the book Life-Changing Foods (my emphasis added):

Life-Changing Foods: Save Yourself and the Ones You Love with the Hidden Healing Powers of Fruits & Vegetables delves deep into the healing powers of over 50 foods—fruits, vegetables, herbs and spices, and wild foods—explaining each food’s properties, the symptoms and conditions it can help relieve or heal, and the emotional and spiritual benefits it brings. I also arm you with the truth about some of the most misunderstood topics in health: fertility; inflammation and autoimmune disorders; the brain-gut connection; foods, fads, and trends that can harm our well-being; how angels play a role in our survival, and much more.

Scroll on down and you’ll find an endorsement from Robert Thurman, Jey Tsong Khapa Professor of Indo-Tibetan Buddhist Studies, Columbia University (and Uma’s dad):

“Anthony’s book [Medical Medium] is truly ‘wisdom of the future,’ so already now, miraculously, we have the clear, accurate explanation of the many mysterious illnesses that the ancient Buddhist medical texts predicted would afflict us in this era when over-clever people have tampered with the elements of life in the pursuit of profit.”

So much New Age Groupthink crammed into one blurb: the reverence for “exotic” ancient texts, the fear of “mysterious” illnesses, the grumbling about “the pursuit of profit” and the reference to “over-clever people” and the rejection of reason that that implies.

But back to The Independent:

William explains that he thinks we should all take iodine supplements to boost our immune systems, help with thyroid hormone production and even prevent cancer.

According to Canadian doctor Jen Gunter though, this is all wrong.

In a retort to the Goop article on her website, Dr Gunter spoke with board-certified endocrinologist, Elena A Christofides, to stress the point that William’s advice is not an accepted scientific method, he has no medical training and has not published any data.

She completely shuts down William’s advice:

“Mr. William’s spirit must not know too much about iodine because he swings and misses right off the bat. He says, ‘Iodine is essential for two main reasons: (1) your immune system relies on this mineral to function, and (2) iodine is a natural antiseptic.’

“Later on he says, ‘while iodine does also help with thyroid hormone production, that’s one small aspect of why iodine is important for your health.’

“The body needs iodine because without it you can’t make thyroid hormone and then you will slowly die. It will be a long and drawn out process. All of the symptoms of iodine deficiency are related to resulting thyroid dysfunction and 70-80% of the body’s iodine is stored in the thyroid. This is not a ‘small aspect’ this is THE ASPECT.”

Dr Gunter calls out William’s assertions as “bulls***. I just don’t know any other way to say it.”

She also reveals that Dr. Christofides has seen just one case of iodine deficiency in 19 years. And it’s nowhere near as common as William’s tries to make out:

“While iodine is essential, we actually need very little because it’s a micronutrient […] basically eating out even a couple of times a month gets us enough iodised salt to suffice.”

…According to Dr Christofides, taking excessive iodine with a normal thyroid actually “blunts the thyroid and actually causes hypothyroidism.” She has even seen women take so much iodine that they give themselves the condition. So yes, taking too much iodine actually causes the problem William says it will prevent.

“Almost everything in this article is wrong and potentially dangerous,” says Dr Gunter.

“We need very little iodine, that little bit is important but if you eat a healthy diet and have a little iodised salt here and there you will be just fine.

“If you take iodine supplements when you do not need them you could actually cause hypothyroidism, develop an autoimmune condition, or even get cancer.”

She stresses that iodine is not an internal antiseptic or immune booster as Gunter claims.

Goop includes a disclaimer at the end of its Q&A with Williams:

The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

On the other hand, The Independent notes that Gwyneth Paltrow has said that William’s work feels “inherently right and true”.

Feels.

Post-modernism + superstition > science.

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May/15

17

California Injects Some Sense on Vaccination


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Or at least it’s getting closer to doing that. This from Reuters/Religion News Service:

California parents who do not vaccinate their children would have to home-school them under a bill passed Thursday by the state Senate, the latest move in a battle between public health officials and “anti-vaxxers” who fear vaccines are dangerous.

The bill, which eliminates the so-called personal beliefs exemption allowing parents to forego vaccinations if opposed to them for any reason, was introduced after a measles outbreak at Disneyland last year that sickened more than 100 people.

….

Under the bill, which still must be approved by the Assembly, unvaccinated children who do not have a medical exemption would have to study at home or in organized, private home-schooling groups.

Home-schooling has nothing to do with being educated about vaccines of course, but demanding it represents a sufficient enough burden for most parents such that it should definitely help get vaccination numbers up.

Relatedly, the Lifetime Network is doing its part on the vaccine front by showing the stars of “Terra’s Little Family” getting their infant, “Penny,” vaccinated. (Yes, I watch this program. Judge me not!* ) Mom Terra struggles with the decision because she’s “heard” about the literally ill effects of vaccine. But in the end she does the right thing.

It’s good to see the MBA-holding female decision-makers at Lifetime – or Television for Women ™ – doing right by their downscale viewers. Especially because the thrust of the anti-vaccination zeitgeist is coming from the relatively upscale. David Hume has more on that here.

* I’m also a fan of other reality TV, like “Return to Amish.” This while media attention is far more focused on e.g. Mad Men. Here’s why I prefer the former.

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Mar/15

21

Lamenting Those Who Lament Down Syndrome

 

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You don’t have to be an anti-natalist, much less some kind of nihilist, to defend the decision on the part of a majority of would-be mothers to abort fetuses showing signs of Down syndrome. But over at The Week, Pascal-Emmanuel Gobry sheds tears over the “ghosts” of Down syndrome babies who never were:

I do not know a single family with a child with trisomy 21 who has not regarded them as a joy, much less regretted their existence. The expression “ray of sunshine” has become such a cliché, but here it is perfectly applicable. It’s always striking how joyous many people with trisomy 21, especially children, appear.

Regardless of how one feels about abortion policy, this is a treachery of unspeakable magnitude that shames our entire society. We go about in the world surrounded by the ghosts we have made, and we do not even have the good taste to be haunted.

If there is a God, we had better all pray that He is merciful.

Whew, powerful words.

Gobry acknowledges the generally observed intellectual disability that comes with DS, though he omits any mention of the increased risk of early dementia and even leukemia, among other ills. In fact here’s what the Alzheimer’s Association has to say about it:

Studies suggest that more than 75 percent of those with Down syndrome aged 65 and older have Alzheimer’s disease, nearly 6 times the percentage of people in this age group who do not have Down syndrome.

One is struck – or at least I am – by Gobry’s seeming embrace of individuals with DS due to their childlike qualities, to the detriment of a perspective taking into account the complete life cycle. And linking the discussion to abortion only strengthens the focus on DS’ early years.

Gobry observes that on average, a person with DS “will have the intelligence of a normal 8 or 9 year old child.” Ah, but of course those are great years for parents, it’s no small thing to point out, sandwiched as they are between the chaotic toddler and rebellious teen phases. I suspect there’s more than a bit of warm, glowing self-interest smuggled into Gobry’s argument.

DS last popped up in the news in mid-2014, when Richard Dawkins was being lambasted for suggesting would-be mothers of fetuses with DS “abort it and try again.” Blunt language to be sure, but as The American Interest’s Walter Mead (I think, there’s no byline) said at the time, most people would seem to agree. At least if we’re judging them by their actual behavior and not what they’d be brave enough to admit to in mixed company:

One of the main reasons why people abort them is the same reason why people support physician assisted suicide and other “mercy killings”—because, the argument goes, one ought to spare someone from living a low quality of life.

Indeed.

Oct/13

16

Left-Right synergy that could have been

This is not the time to be talking about Left-Right alliances. I know. But this piece by Kevin Drum got my attention. He’s responding to the fact that asthma inhalers are very expensive because of the way pharmaceutical companies have gamed intellectual patent law. Here’s Drum:

In other words, pharmaceutical companies didn’t just take advantage of this situation, they actively worked to create this situation. Given the minuscule impact of CFC-based inhalers on the ozone layer, it’s likely that an exception could have been agreed to if pharmaceutical companies hadn’t lobbied so hard to get rid of them. The result is lower-quality inhalers and fantastically higher profits for Big Pharma.

As someone with asthma I have kept track of this issue more than most. There’s someone else who pointed out how ridiculuous banning CFC-based inhalers was in light of their trivial contribution, Sen. Jim DeMint aims to overturn inhaler ban:

“It’s a stupid regulation,” DeMint told POLITICO. “It’s just one more example of just out of control regulation that’s harming the quality of life for Americans.”

DeMint argues the inhaler emits just a tiny fraction of chlorofluorocarbons.

While Republicans especially have gone after a series of Obama administration EPA and other regulations this Congress, the FDA rule actually traces back to the George W. Bush administration.

FDA began public discussions about the use of CFCs in epinephrine inhalers in January 2006 and finalized the phase-out for using CFCs in the inhalers in November 2008. It is part of the U.S. commitment under the international Montreal Protocol agreement that aims to reduce ozone-depleting substances.

Many inhaler manufacturers are now using a more environmentally friendly propellant called hydrofluoroalkane. Primatene Mist — marketed by Armstrong Pharmaceutical Inc. — is the only FDA approved inhaler for relieving mild asthma that is sold over-the-counter without a prescription.

FDA last month said there are “many other safe and effective inhalers to treat asthma symptoms,” which would require a prescription.

In general I agree with those conservatives who believe that the Republicans have been emphasizing style over substance recently. But it’s a reminder that people like DeMint on the “Far Right” have who adhere to principle over pragmatism can sometimes surprise those Left critics would argue that Republican populism is always a facade.

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