Bioethics

Biotechnology is like Star Wars’, “Force”: It has a dark side and a light side. CRISPR, the gene-editing technique that can alter any cell and life-form on the planet, exemplifies the point. It can be deployed to alter a bird flu virus to kill multitudes. It can be used for eugenics manipulations. And, in theory, it can save the lives of people afflicted with genetic diseases. That seems to have just happened. Baby KJ’s life was apparently saved or extended — at least for now — using the technique to treat a genetically caused liver condition. From the Stat story: For the first time, scientists say they have reached into the genome of a severely ill child and rewritten the Read More ›

The field of bioethics was established to work through the proper parameters of medical ethics and to grapple with the vexing public health policy questions that arose in an increasingly technological age. The field’s primary (but not only) contribution to the public good (in my opinion) came early, through the work of the late theologian Paul Ramsey. In his seminal work, The Patient as a Person, Ramsey argued that forcing patients to be hooked up to “machines” against their will treated them as less than equals. The resulting bioethical discourse resulted in the legal right we all have to informed consent and to refuse unwanted medical treatment, even if that could lead to our deaths. Alas, in the decades since Ramsey’s heyday, Read More ›

“Futile care” is a bioethics theory in which doctors are authorized to refuse wanted life-sustaining treatment based on their belief about the quality of a patient’s life. It can be cruel — and on occasion, mistaken. Prominent medical journals usually support futile-care theory. But the New England Journal of Medicine just published a contrary column by a compassionate doctor who rejected that approach in order to keep hope alive for his terminally ill patient and her family. The oncologist, Dr. David N. Korones, placed a young terminally ill cancer patient named Zoha in an experimental drug trial. At first all seemed well, then her condition worsened. From, “The Last Dose”: Although the rules of the trial allowed Zoha to remain Read More ›

Peter Singer, the internationally influential emeritus bioethics professor from Princeton, is known as a moral philosopher — which in his case is an oxymoron. Not only has he repeatedly endorsed the moral propriety of infanticide, but he has also yawned at bestiality and suggested experimenting on cognitively disabled people rather than animals if they are not “persons,” among other ethically depraved opinions. Singer and another philosophy professor — Katarzyna de Lazari-Radek — just took to the opinion pages of the New York Times to endorse geriatric suicide. It seems a noted 90-year-old psychologist named Daniel Kahneman committed assisted suicide last year at one of Switzerland’s death clinics. Kahneman wasn’t seriously ill or debilitated but feared the infirmities that he believed Read More ›

The New York Times has a long — and, I must say, generally fair — discussion of the contentious issue of embryo research. I won’t belabor most of the issues raised, but I want to highlight one aspect of the column that illustrates how some “expert ethicists” consider it a part of their job to conjure ways to bust through established moral limits.

When embryonic research first started, we were told that there would be a strict 14-day limit on researching embryos in petri dishes. At the time, I said it was all baloney, that the “ethicists” established the “14-day rule” only because embryos couldn’t be kept viable in a dish after that time. In other words, they were prohibiting something that could not yet be done. But, I predicted, once the permitted research found ways to keep embryos going beyond 14 days, the rule would be repealed. And so it came to pass.

Now, apparently, to further facilitate an anything-goes embryonic-research license — and in light of the potential that embryos can be manufactured outside of fertilization — some “ethicists” are arguing that the definition of “embryo” should be revised. From, “The Embryo Question Can’t Be Ignored” (my emphasis):

The mainstream bioethics movement aims to destroy human exceptionalism and Judeo-Christian morality as the philosophical foundations of society. Toward that end, the academic discourse repeatedly revels in the transgressive as bioethicists take to the most influential journals to advocate destroying “natural limits” and maximizing concepts of personal autonomy that are destructive of social cohesion. Latest example: An article published in Oxford’s Journal of Medical Ethics argues in favor of biotechnologically altering ova to permit lesbians to engage in same-sex biological reproduction. Bioethicist Adrian Villalba writes in “Queering the Genome“: The potential alteration of genomic imprinting opens the door for an oocyte [egg] to exhibit characteristics similar to a sperm, allowing it to fertilise another egg. This can be achieved by Read More ›

Twenty years ago today, Terri Schiavo’s feeding tube was withdrawn with court approval, commencing a cruel deprivation of sustenance that resulted in her death by dehydration 13 days later. For those who may not remember, the case became the most hotly contested bioethics issue since Roe v. Wade as Terri’s husband Michael fought in courts and in the media with her parents and siblings over his desire to remove all Terri’s food and fluids. In the end, he won — and Terri died. Now, two bioethicists on the influential Hastings Center blog decry the case as wrongly brought. They get some facts wrong and omit crucial information — like that Michael was living with another woman with whom he fathered Read More ›

Mainstream bioethics discourse is often just progressive politics by a higher-brow name. Now, the Hastings Center — the world’s most influential bioethics think tank — has published an advocacy essay by Loyola University bioethicist Mark G. Kuczewski, who urges his colleagues to convince hospital administrators to thwart the attempts of Immigration and Customs Enforcement to arrest illegal aliens at their institutions. Kuczewski laments the “fear” that the enforcement of immigration law is supposedly instilling in “immigrant communities,” somehow forgetting to note that whom he is really discussing are not immigrants in general but those here illegally. From “Supporting Patients and Students Who Are Immigrants: What to Do and Why Most Bioethicists Won’t Do It”: A devastating wave of fear now permeates immigrant communities. The rhetoric Read More ›

Moves are afoot in bioethics to require caregivers to withhold food and water by mouth from a patient made incompetent by dementia if that patient, while compos mentis, has signed such a request — and even if the patient willingly eats, enjoys meals, or asks for food. It is sometimes called “voluntary stop eating and drinking [VSED] by advance directive,” in the parlance.

I have frequently criticized VSED by directive as inhumane to the patient, cruel to caregivers (as it forces them to starve people to death), and designed to open the door to lethally jabbing those with advanced dementia as the less onerous alternative to their being made to starve to death.

Now, as supposedly some form of compromise, there is a proposal on the table to barely feed — i.e., malnourish — dementia patients who have previously signed such a directive. From, “Mr. Smith Has No Mealtimes,” published in the Journal of Pain and Symptom Management (citations omitted):

Minimal Comfort Feeding (MCF)…is the provision of only enough oral nutrition and hydration to ensure comfort. With MCF, eating and drinking is not scheduled; rather, caretakers offer food and liquids only in response to signs of hunger and thirst. Patients are neither wakened for regular mealtimes nor encouraged to eat or drink. Instead, they are offered frequent, fastidious mouth care, continued social contact, therapeutic touch, sensory distraction, and medications to relieve distress associated with apparent thirst or hunger before being provided with minimal amounts of liquid or food.