By Andrew Coyne, National Post - May 7, 2001 Reprinted with permission

Introducing draft legislation that would ban human cloning and other controversial techniques made possible by advances in reproductive technology, Allan Rock declared the need to draw "a line in the sand," barring those practices that degrade human dignity. This was appropriate, if only in an ironic sense: Sands shift, sands wash away, and the line so sharply drawn today may disappear by tomorrow. Indeed, hardly had the Minister of Health unveiled his proposals before news came of the birth of the world's first genetically modified babies B one of the very practices the Minister hopes to ban.

But time and the tide of technology are not the only reasons the Minister's line may not last B if it can be discovered at all. In the absence of a coherent underlying philosophy, any attempt to impose legislative order on the new reproductive technologies will prove hard to sustain against the demands of science and the desires of frustrated parents. This is the problem: The line in the sand, far from distinguishing right from wrong, in fact merely divides sand from more sand. Buttressed as it is by nothing more than a series of arbitrary moral distinctions, it must soon collapse of its own weight.

Among the list of activities the draft legislation would prohibit, for example, one finds "payment for surrogacy." It would not be illegal to offer one's services as a surrogate mother; only to accept payment for it. Likewise it would be prohibited to act as an intermediary, soliciting payment on a surrogate mother's behalf. An accompanying background paper explains the ban on commercial surrogacy on the grounds that "it treats children as objects." Worse, it "treats the reproductive capacity of women, and reproduction in general, as economic activities."

So: Thou shalt not treat children as objects. Thou shalt not exploit a woman's reproductive capacity for cash B except, of course, when it comes to abortion. Under the proposed legislation, it would be illegal to accept payment to start a pregnancy, but entirely legal to accept payment to end one.

This is the great (though not the only) inconsistency running throughout the draft legislation. It attempts to define the state's interest in the welfare of the unborn child, without officially recognizing that the state has such an interest. It defends the "dignity" of human embryos B at least after 14 days B in matters of research or reproduction, even declares they have a "special status" based on "their potential to become human beings." Yet what is our present abortion law, or lack of one, but a denial that they have any such rights?

It proposes to ban development of embryos outside the womb beyond the 14-day limit. Why 14 days? Because, the background document explains, "it is at that point that the embryo starts to develop its nervous system." The implication is clear: It would be inhumane to experiment upon the embryo past that stage, an affront to human dignity that must be prohibited by law. Yet, it remains legal to destroy a fetus right up to the moment of its birth.

It would likewise be illegal, under the draft legislation, to "perform any procedure ... for the purpose of ensuring or increasing the probability that an embryo will be of a particular sex." Any procedure? Surely not. Parents with a preference for one sex or another may be prevented from using, say, sperm-sorting techniques. As the background document puts it, "attempting to select the gender of a child runs counter to the Canadian belief in the equal value and status of both sexes." But they could hardly be prevented from selectively aborting a fetus on the basis of its sex, whatever our Canadian beliefs. For that would mean abortion was not a basic There are more such inconsistencies and anomalies in the draft legislation. It would, for example, be forbidden to create an embryo solely for the purpose of experimenting upon it, as in stem-cell research. But not because we have any principled aversion to experimenting on "potential human beings." No, the reason is that there are already plenty of leftover embryos on hand in in vitro fertilization clinics, which would otherwise just be thrown out. Might as well strip them for parts B just as long as we don't sell them, since, as the background paper solemnly advises, "an embryo should not be treated as a commodity or object."

This is where we have been led by our unwillingness to revisit the abortion question. The Supreme Court regularly twists itself into illogical knots to avoid ascribing any legal rights to the fetus, even declining to place an addicted glue-sniffer in treatment until the child she was carrying was safely delivered. But even the Supreme Court never tried to suggest that the fetus was both protected in law and not protected; had rights but no rights; was a potential human being one minute, and so many spare cells another woman's right, but something that the state could allow or prohibit at its discretion. And we can't have that.

Dr. Will Johnston

The harried pharmacist in the chain store near me posts a quaint privacy policy by the cash register. It asks lined-up customers to hang back a bit to avoid overhearing too much. To this austere clinical outpost, beside the dairy dept., our government urges womenC even young girls, their parents cut by statute from having a clue C to report any Morning After to receive a bracing toot of sex hormones.

The College of Pharmacists welcomes this promotion of their highly educated members from dispense-on-demand employees to the role of independent health professionals. Hence their stern "Code of Ethics," warning anyone with an urge to act like an independent health professional to "ensure access" to the Morning After Pill (MAP) by dispense-on-demand or mandatory referral. It’s unclear if sexual diseases, abuse and incest detection, true informed consent, alienated parents and repeated MAP use (already reported) will be issues here, but some pharmacists perceive an abortion equivalent and have lost their jobs rather than be complicit in it.

In general, we Canadians welcome diversity of belief and tolerate wide variations in opinion. We can respect the intentions of, for instance, the Jain monks of India who sweep their path lest they tread on an insect. Surely we can accept that those who act out of respect for the immense worth of the just-conceived child believe that this tiny mote is simply what a child looks like at that age.

Hormonal bulldozer

When a building has collapsed in an earthquake, a bulldozer can sweep away the rubble, but the possible presence of a single child hidden in the ruin changes our entire concept of how to proceed. One person’s honest perception of a surviving child is enough to win the caution and patience of others who may not share that belief, and certainly no one would accuse the bulldozer driver of foolishness for not wanting to immediately plow through the situation. And with all due respect to those who promote the MAP, its opponents see it as a hormonal bulldozer meant to sweep the rubble B the threat of pregnancy B away.

It’s fair to say that we don’t really know how the MAP works. If it happens to be taken just before the LH surge it may postpone ovulation past the five-day viability of the sperm and be contraceptive. Otherwise, anti-implantation or embryotoxic effects are explicitly abortifacient. Unfortunately, some promoters of the MAP choose to disparage objectors’ motives rather than grasp this concern. The objection is simple: a human being shouldn’t need to have a name or be a certain size to be of inestimable worth. Is this principle too high? With nothing less can we continue to build a sane and compassionate society in a time of revolutionary and chaotic science.

Honour the scruples which place the MAP outside the kind of medicine some of us wish to practice. Consider that some outlandish reproductive innovation may soon enough challenge your conscience too, and that you’ll need similar respect to avoid coerced participation. At a minimum, we should let people of good will truly and freely differ on the MAP, and that requires a new kind of conscience-respecting dialogue in Canada’s healthcare system. A good beginning can be made by viewing www.consciencelaws.org

Will Johnston is a Vancouver family physician and President of Canadian Physicians for Life.

Oxford Group Adds New Wrinkle to Disinformation
By Joel Brind, Ph.D.

As night follows day, knee-jerk reactions follow whenever evidence for the abortion-breast cancer link (ABC link) is published, whether it appears in the medical or the popular press.

But disproving the old adage you can't teach an old denial new tricks, a group of Oxford University epidemiologists has just published an ABC study that is a novel new addition to the disinformation genre. The forum is the April 2001 issue of the British Medical Association's Journal of Epidemiology and Community Health.

The new Oxford study, by M.J. Goldacre et al., appears to be a backlash by the professional British medical establishment against the credibility attained by the ABC link last year.

Last spring, the Royal College of Obstetricians and Gynaecologists (RCOG) publicly acknowledged, although it still considered all the evidence inconclusive, that the comprehensive review and meta-analysis of the ABC link that I wrote in collaboration with colleagues from the Penn State College of Medicine "could not be disregarded." When the British popular press learned of the RCOG statement late in the summer, the issue surfaced briefly B very brieflyB in the London tabloids.

On the surface, the Oxford study appears to be the ideal type of study which includes two key components only rarely found together: a case-control record-linkage study.

Most epidemiological studies include a group of breast cancer patients ("cases") who are compared to a group of women of similar age and other important characteristics, but who do not have breast cancer ("controls"). But the "record linkage" part means that a study does not depend upon information provided by the study's participants gleaned from interviews or questionnaires. Rather, information has already been recorded as part of the subjects' medical records.

Consequently, there is not even the possibility of so-called "response bias." This hypothetical scenario imagines that women with breast cancer are more honest about a past abortion than are women who do not have breast cancer, thus skewing the results. The possibility of such bias has often been invoked by the nay-sayers to explain away the repeated finding of an ABC link in case-control studies which do not rely on record linkage.

The results of the Oxford study would certainly appear to refute the ABC link: Overall, breast cancer occurred only 83% as often in women who'd had an induced abortion (as opposed to spontaneous abortion, a.k.a. miscarriage, for which the authors obtained similar results), compared to women without a history of induced abortion. This finding was also statistically significant, that is, it was more than 95% certain not to be due to chance.

Moreover, this number did not vary significantly with the time period after the abortion. This leads to the authors' conclusive literal bottom line: "The fact that the relative rates did not increase with increasing time intervals between abortion and breast cancer indicates that interruption of pregnancy, whether spontaneous or induced, does not increase the risk of breast cancer."

Hold the phone. A look at the "Methods" section reveals a huge deficiency.

True, all the abortions took place between 1968 and 1998C after elective abortion had been legalized in the U.K. in 1967. However, whereas almost all abortions in the country are performed in free-standing clinics, the only abortions which appear in the medical records of the study subjects were those done in hospitals. Moreover, the authors admit, "It was common for abortions to be coded without qualification of whether they were induced or spontaneous."

Thus, one key question here is, how many induced abortions are recorded in the Oxford database? Out of a total of 28,616 breast cancer cases, only 300Cjust over 1 percentChad a recorded, induced abortion in the hospital over the 30-year span of the study.

Considering that the abortion rate in England over the same period has averaged about 2.5 percent of the women of child- bearing age per year, we can conservatively estimate that at least 95% of induced abortions done on this population of womenCboth in and out of the hospitalCdo not appear on their records at all.

Translation: over 95% of the women who did have an induced abortionBboth cases and controlsBwere misclassified as not having had an abortion. What this really means is that the Oxford database is useless for determining anything about the effect of abortion, since the vast majority of abortions in the study population were unrecorded.

Then what really tips the Oxford group's hand is its misrepresentation of the published record. The group begins its "Discussion" section with this statement: "None of the cohort or record-linkage studies have shown a significant increase in breast cancer risk after exposure to induced abortion."

The only problem with this statement is that it is a patent falsehood: The only other record linkage case-control studyCthe New York state study by Howe et al. published in 1989 in the International Journal of EpidemiologyCreported a statistically significant, 90% increased risk with induced abortion.

The tack taken by the Oxford groupBpackaging an unsuitable database as a refutation of the ABC linkB has a familiar ring to one familiar with the ABC literature. When we look back to 1982, in fact, we find a group at Oxford, including D. Yeates, one of the authors of the current Oxford study, published a study on the ABC link in the British Journal of Cancer (BJC).

That study was explicitly in response to the 1981 study by Malcolm Pike and colleagues at the University of Southern California, also published in the BJC. It was the first U.S. study of the ABC link, and it reported a 140% increase in breast cancer risk for young women who'd had an abortion before having a child.

In contrast, the Oxford study of 1982 claimed to be "entirely reassuring," reporting a relative risk of 0.84, i.e., a 16% decrease in breast cancer risk with abortion in women who had not yet had any children.

But how many of the women in the 1982 study had had any induced abortions? "Only a handful," admitted the authors in their "Results" section!

Some things, it seems, never change. Nineteen years after we are "reassured" that there is no ABC link, we are given a similar message from Oxford, again with data that contribute nothing meaningful to the debate about the ABC link.

Adapted from NRL News June 2001. Used with permission. Joel Brind, Ph.D., is a professor of biology and endocrinology at Baruch College, City University of New York.

By Gene Edward Veith

In 1729, when the Irish were crushed by poverty, thanks to the brutal economic policies of their English overlords, Jonathan SwiftC the conservative Irish clergyman who became the world's greatest satiristC wrote up A Modest Proposal. In deadpan prose and in a kindly, benevolent style, he suggested that Irish babies be sold for food. That way, he argued, there would be both more food to go around and fewer mouths to feed. Besides, baby skin would make a really soft leather, making possible a new industry that would create jobs and boost the Irish economy.

Swift, the Christian pastor, was lampooning the moral utilitarianism of the Enlightenment, which taught that anything could be morally justified if it were "useful," giving the greatest tangible benefit to the greatest number. Swift showed where this kind of thinking, if pursued logically, would lead. Indeed, his A Modest Proposal did wake up the conscience of a good number of his readers, who realized that no noble social end could possibly justify the consumption of babies, and no moral philosophy that could justify such a thing could possibly be valid.

Today, when English professors teach A Modest Proposal, they often find it hard to make students realize Swift is joking. (Actual response: "Well, I don't completely agree with him, but he does make some really good points.") Thinking about moral issues in utilitarian terms has become so culturally ingrained that many Americans are unable to think in any other terms. If somethingBno matter how reprehensibleBhas a positive outcome, it must be okay.

Now we are facing a similar modest proposal, but it is dead serious. Since the original cells of a fetus can develop into all the organs of a human body, why not use these so-called "stem cells" to regenerate damaged tissue in adults? Doctors could grind up all of that fetal tissue from abortions and unwanted test-tube embryos at the fertility clinics into a really good medicine.

Harvesting embryonic children for their stem cells is little different from Swift's proposal to harvest just-born children for food. But whereas Swift's audience pulled back in revulsion, much of the American public thinks this is a swell idea.

Even many pro-lifers have been taken in by this spurious reasoning: Those extra fertility clinic embryos, conceived in test tubes, the argument goes, are going to be tossed anyway. Why not use them for a good cause? At least this way, they won't have died in vain. To be implanted in the brain of a Parkinson's disease victim would at least turn something bad into something good.

One of the most fundamental moral principles is that the ends do not justify the means. Concentration camps cannot be justified in the name of national unity. Slavery does not become good, even if it helps the local economy. Murder is wrong, even if there is a good reason, such as increasing the murderer's happiness.

Pro-lifers need to realize that legalizing the use of fetuses for stem cells will, in many ways, go far beyond Roe vs. Wade in setting a precedent for the culture of death. Abortion is legal and broadly accepted, but usually with a guilty conscience. Now, the destruction of unborn life is seen as a necessary evil. Stem-cell research turns the destruction of unborn human life into a positive good: Killing these unborn children, the logic goes, can cure Parkinson's disease, generate new organs, and increase the quality of life for untold numbers of the sick and suffering! The abortion proponentsB including the formerly ambivalent publicB can feel positively righteous about all of the good they are doing.

Another fundamental moral principle in any civilized society is that adults sacrifice themselves for their children C not the other way around. Adults are supposed to provide for, protect, and, if necessary, give their lives to defend their children. They are not supposed to sacrifice children for their own well-being, much less use a baby's tissue to cure the diseases of old age.

In the unscrambling of means and ends, it is evident that pro-abortionists are not advocating stem-cell research because they want to help people with Parkinson's disease. They want to use the issue to legitimize the taking of unborn life. The fact is, embryos and fetuses are not the only source of stem cells. They can be found in an adult patient's own cells. They are present in human fat, of which we have an abundant supply. Research that.

As I was writing this column, the final warning was to be that if we allow stem-cell research from human embryos, and if it turns out to have all of the medical benefits that are touted, the supply from fertility clinics could scarcely meet the demand. The next step would be to mass-produce stem cells, by joining eggs and sperm in thousands, millions of conceptions. Factories could then process them into tons and tons of disease-fighting tissue.

Such an extrapolation, though, might not be a valid argument. The approval of stem-cell research might not necessarily lead to a slide down such a slippery slope. To make such a projection into the future would be a Swiftian exaggeration.

But before I could finish this column, the day's paper brought the news that the fetus factories have already gone into operation. The Jones Institute for Reproductive Medicine of Norfolk, Va., admitted to conceiving embryos for the express purpose of extracting their stem cells. The process was commercialized to the point of paying 12 women $1,500 to $2,000 each for donating their eggs. Fifty embryos were conceived, and 40 were destroyed to obtain those stem cells.

Swift, in his most misanthropic nightmares, might never have been able to exaggerate to this degree; nor might he have believed that human beings would be capable of doing this to their own children.

July 28, 2001 WORLD Magazine Reprinted with permission.

The Canadian Institutes of Health Research (CIHR) received public response to its recent Discussion Paper " Human Stem Cell Research: Opportunities for Health and Ethical Perspectives " until June 29th. A final report with recommendations and guidelines is expected in January, 2002. The paper can be accessed on-line at: http://www.cihr.ca/news/forums/stem_cell/issues_e.shtml

For a copy of the response submitted by Canadian Physicians for Life, please contact our office (see reply card) or visit www.physiciansforlife.ca

By:  Leon R. Kass, MD

President Bush appointed Dr. Kass as head of the new Presidential Council on Bioethics on August 9. Adapted from The Chicago Tribune - July 31, 2001. Used with permission of the author.

The chronically ill, desperate for help, are easy marks for grand promises of imminent cure. In earlier times, many a quack or preacher took advantage of their gullibility. Today they still are being exploited, only the cures are being promised by biotech entrepreneurs. The latest panacea is a fiction called "therapeutic cloning," now being peddled to sabotage an urgently needed legislative ban on cloning human beings.

Most Americans oppose human cloning and want it banned. A tough anti-cloning bill before the House seeks to stop human cloning before it starts, by banning the first step, the creation of the embryonic human clone. It wisely recognizes that once cloned embryos are farmed in laboratories, we will be unable to control what is done with them. Through substantial criminal and monetary penalties, it will effectively deter renegade doctors or scientists, as well as clients who would bear cloned children.

Limited in scope, the bill poses no real threat to scientific research or legitimate therapy. It does not interfere with cell and molecule cloning, in vitro fertilization, or efforts at gene therapy. And, despite allegations to the contrary, the bill does not limit research with embryonic stem cells derived from non-cloned embryos.

Yet the bill is being vigorously opposed by the biotech lobby and scientific organizations. They want to clone embryos for research. And they abhor even the slightest restriction of their freedom. Regarding themselves better informed and purer in motive, they believe they know better than ignorant politicians and their untutored constituents what is good for us. They, after all, will help us conquer dreaded diseases -- not with snake oil, but with something they have dubbed "therapeutic cloning." Who but rigid abortion opponents could vote against cloning research that could cure juvenile diabetes, Parkinson's disease and Alzheimer's?

What, you ask, is "therapeutic cloning"? Here's the grand idea. To replace my dead heart tissue after my heart attack, I need an infusion of healthy heart muscle cells, cells that scientists will create by programming embryonic stem cells to grow into heart muscle. But such "foreign" material will be rejected. I will need either immunosuppressive therapy or, better, cells that are not "foreign." Enter cloning: what I need are muscle cells derived from my own embryonic twin "sibling" who can be created by cloning. Harvest an unfertilized egg from a female donor and remove its nucleus. Insert a nucleus taken from one of my own adult cells. Grow the resulting embryo clone, remove its stem cells, turn them into heart muscle cells, and give me back "my own" cells. Presto: a cure.

Before one starts arguing the morality of embryo farming, we should know that the whole matter is science fiction. The egg containing my nucleus is not fully my genetic twin. It also contains residual DNA B mitochondrial DNA B from the woman who donated the egg. The cloned embryo and all cells derived from it remain partly "foreign," enough to cause transplant rejection. The transplantation-rejection problem that is supposedly solvable only by cloning cannot be solved by cloning B except in the unusual case where a (pre-menopausal) female patient donates both nucleus and egg. (Even without this problem, the whole idea is preposterous: where would we get enough eggs to provide each of us with our own embryonic twin for strip mining?)

There is a second route to "therapeutic cloning." Scientists could learn, through cloning research, how specialized nuclei introduced into eggs "reprogram" themselves to regain multi-potency. Using that knowledge, they could then reprogram any somatic cell, turning it into a stem cell that would indeed be genetically "our type." But this is today pure fantasy, a project for decades and one with no current evidence to indicate a successful outcome. It is pure pie in the sky.

Not content to peddle science fiction as therapeutic fact, the biotech lobby also is practicing sophistry: Embryo clones arise not by joining egg and sperm and we want them only for research and not for reproduction. Hence, the scientists claim, they should not be called "embryos" but "activated cells."

This is an Orwellian lie. Embryonic clones, if transferred to a uterus, could become cloned children, like Dolly the cloned sheep who began her life as an embryonic clone, indistinguishable from an embryo produced in vitro or in vivo, except that it was a genetic near-copy of her "mother."

In a word, we have everything to gain and nothing to lose by enacting the ban. We uphold human dignity; we forego no needed cures.

Scientists want complete freedom to experiment at will. For the most part we gladly grant this freedom. Occasionally, however, they must accept the need for limits, when their doings threaten core human values -  in this case, the taboo on designing human children. Under these circumstances, scientists who claim that a strict ban on human cloning will impair their constitutionally protected freedom to inquire resemble those National Rifle Association members who insist that their constitutionally protected right to bear arms is hopelessly compromised by a law banning the sale of submachine guns to minors. And by engaging in science fiction and doublespeak, the scientists debase the cause of worthy science. They of all people should not be trying to gull the desperately ill.

NOTE:   On July 31, the U.S. House of Representatives voted by a wide margin to ban human cloning. The Senate will next debate the bill, where it has far less support.

According to the National Post, Bloc Québécois MP, Pauline PIcard says Canada should follow suit. "The Liberal government is dragging its feet. They should move much faster on this very critical issue..." Picard recently introduced a second private member's bill to prohibit human cloning.

Minister of Health, Allan Rock, says he will not speed the legislative process to ban human cloning in Canada. The House of Commons is expected to adopt a bill dealing with this issue in May, 2002, at the earliest, a senior official from Mr. Rock's office said.

Bonnie Brown, the Liberal MP for Oakville and chairwoman of the Health Committee, described as "stringent" the rules contained in the bill passed in the U.S. "Historically in Canada on most of these issues, we usually end up somewhere between Europe and the United States. We usually try to find a balance," she said.

In Britain, therapeutic cloning is legal.

The second-largest U.S. medical organization has declared its opposition to physician-assisted suicide, saying that the wish to die among patients is partly the result of inadequate health care. The American College of Physicians, which represents 90,000 U.S. doctors, said it recognized that some physicians supported assisted suicide but that the ramifications of adopting the practice were too disturbing. It argued that many patients wanted to die because they received improper treatment, lacked compassionate caregivers, or were worried about burdening their families with huge medical bills.

"To the extent that this is a dilemma partly due to the failings of medicine to adequately provide good care and comfort at the end of life, medicine can and should do better,'' the organization concluded in a position paper published in Annals of Internal Medicine on August 7, 2001. Says the paper's co-author, Dr. Daniel Sulmasy, "We must solve the problems of inadequate care at the end of life, not avoid them through practices such as assisted suicide." Source: Associated Press, Reuters.

The United Nations Human Rights Committee criticised the Netherlands in July 2001 for its controversial legalisation of euthanasia. The committee's spokesman, Eckart Klein, said the growing number of assisted suicides could lead to them becoming routine. "The main worry is not only the actual practice, but also the fact that this new law could create precedents that dilute the importance and trivialise this act," he said.

The committee, made up of independent experts who hold three sessions a year, said it was not convinced the Dutch system would detect and prevent cases where pressure could be exerted on a patient to get round the legal criteria. Other worrying factors in the law, it said, included the fact that checks were only carried out after the patient had died, and that it covered children aged 12 to 16 who had the backing of their parents in a euthanasia request. It is also concerned about reports that medical personnel have ended the lives of new-born handicapped babies.

The Dutch government should look at the law again in the light of these observations, the draft report declared. Source: Reuters, UK BBC News

Loss of self, more than unbearable pain or prolonged suffering, is why many people suffering from life-threatening illnesses consider euthanasia and assisted suicide, according to study results published August 4, 2001 in The Lancet.

"Participants desired euthanasia or assisted suicide because of disintegration and loss of community, which combined to create a perception of loss of self,'' said James Lavery, who led the study. "Our results suggest that an understanding of loss of self, which is a metaphysical phenomenon, is essential to understand desire for euthanasia or assisted suicide."

Although their study involved only 32 Canadian patients with HIV/AIDS, the researchers said the findings are applicable to people with other debilitating, degenerative diseases or illnesses affecting the elderly and other marginalized sections of society. The report said guidelines in the Netherlands do not address the social circumstances that contribute to a desire for euthanasia.

In an accompanying commentary on the research, Anthony Back and Robert Pearlman, of the University of Washington in Seattle, described the study as a "road map into the world of a person'' contemplating assisted suicide. "The complexity of loss of self suggests why simpler explanations, such as pain, depression, or high-control personality, each fail as individual explanations for the desire for assisted suicide." Source: Reuters, Lancet

TALKING TO THE PLANETS
www.humanehealthcare.com

Our mission: To facilitate dialogue and the exchange of ideas regarding the spiritual, psychological and social basis of human well-being and to explore the inter-relatedness of mind, body and spirit.

Talking to the unseen world through the Internet has much the feeling as astronomers may have as they beam signals to a distant planet and then sit waiting for a reply. By an electronic "magazine," we hope to continue an effort begun in 1985 to encourage discussion about the foundations of humane health care. The journal Humane Medicine (later called Humane Health Care International) is available in its entirety on this new website.

At www.humanehealthcare.com you will find all the past issues of Humane Medicine plus an excellent engine where you can search for articles by author name and by subject and you can access the table of contents for each number.

We are now soliciting and will publish on this website original articles, such as "Compassion and Mercy in the Practice of Medicine," by D.G. Oreopoulos. Also we have a "chat room" where individuals can discuss ideas on the subject that they consider interesting. We are planning to create a network where all those interested in humane health care can receive the posted comments. They will have an opportunity to reply and their replies will be communicated to all the members of the network. By so doing, we will begin to build, via this website and email, a network of kindred spirits, who will support us and one another as we strive to improve the quality of health care.

D.G. Oreopoulos, MD, PhD, FRCPC - Professor of Medicine, University of Toronto, Editor-in-Chief - John O. Godden MD, Executive Editor - Source: American Philisophical Association, May 2001

THE BIOETHICS MESS
by Dianne N. Irving, Ph.D
www.lifeissues.net

… As bioethics supplants traditional ethics before our very eyes, few seem to question its underlying premises. But we should know it for what it is: a form of extreme utilitarianism in both its theoretical and practical forms.

It bears no relation to the patient-centered Hippocratic ethics that for nearly 2,500 years required physicians to treat every human being in their care as worthy of respect, no matter how sick or small or weak or disabled. It certainly bears no relation to Catholic medical ethics, which continue the Hippocratic tradition in light of church teachings on moral law. And bioethics offers little concrete guidance to physicians and scientists even on its own terms.

Perhaps one of these days, society will come to grips with the moral and practical mess that bioethics has created and come up with something to replace it. This time society will perhaps not rely so heavily on the self-proclaimed scientific and moral experts.

Crisis Magazine - May 2001. See www.lifeissues.net for complete article, and others of interest.

Canadian Medical Association Journal B Letters

CMAJ 2001;165(1):15

Having read the well-written article by Laura Eggertson,[1] I feel that her thrust (and that of Planned Parenthood, the Canadian Abortion Rights Action League, Health Minister Allan Rock, etc.) is that it is a scandal and surprise that a "medically necessary" operationB abortionB is not universally accepted like other procedures.

You do not hear most of the old debating arguments about abortion any more, but the one that will not go away concerns whether abortion is a medically necessary operation.

What happens, by and large, if a woman who has an unwanted pregnancy is denied an abortion? Her attitude changes dramatically from disappointment, perhaps desperation, to acceptance and often to love. It is no wonder many people question the provision of abortion on demand or without good medical reasons, and that others question it for moral reasons.

Abortion is both a moral and a medical issue, and we should not be surprised if people do not regard it as a necessary procedure in the same way they view other operations. Patrick G. Coffey, Surgeon (retired)- Newcastle, Ont.

Your homey analogy of abortion as a patchwork quilt - a warm, comforting and maternal object if ever there was one - furthers the dishonourable tradition of euphemizing the medicalized killing of small human beings.[1] Most appealing, this is a quilt with holes - patching, perhaps before the fire with a kettle on for tea, is needed. Not easily would the reader suspect that an oppressive abortion-rights orthodoxy, with a paranoid determination to avoid straight talk about what abortion really is, seeks to stifle even the few pathetic remnants of resistance to this national tragedy.

CMA members remain deeply divided on these issues. An even-handed editorial and reporting style would show respect for this diversity of opinion. Will Johnston, MD, Vancouver, BC

A call for Intelligent combativeness
By: Clarence Thomas

Excerpts from Francis Boyer Lecture 2001 by Mr. Justice Clarence Thomas, US Supreme Court, American Enterprise Institute for Public Policy Research, Washington, D.C. -- February 13, 2001

Complete text published in The American Enterprise Magazine, April/May 2001. Available on-line at http://www.aei.org/boyer/thomas.htm

…Today, no one can honestly claim surprise at the venomous attacks against those who take positions that are contrary to the canon laid down by those who claim to shape opinions. Such attacks have been standard fare for some time. Complaining about this obvious state of affairs does not elevate one’s moral standing. And, it is hardly a substitute for the courage that we badly need.

If you trim your sails, you appease those who lack the honesty and decency to disagree on the merits, but prefer to engage in personal attacks. A good argument diluted to avoid criticism is not nearly as good as the undiluted argument, because we best arrive at truth through a process of honest and vigorous debate. Arguments should not sneak around in disguise, as if dissent were somehow sinister. One should not be cowed by criticism.

In my humble opinion, those who come to engage in debates of consequence, and who challenge accepted wisdom, should expect to be treated badly. Nonetheless, they must stand undaunted. That is required. And, that should be expected. For, it is bravery that is required to secure freedom.

…Even if one has a valid position, and is intellectually honest, he has to anticipate nasty responses aimed at the messenger rather than the argument. The objective is to limit the range of the debate, the number of messengers, and the size of the audience. The aim is to pressure dissenters to sanitize their message, so as to avoid being subjected to hurtful ad hominem criticism. Who wants to be calumniated? It’s not worth the trouble.

But is it worth it? Just what is worth it, and what is not? If one wants to be popular, it is counterproductive to disagree with the majority. If one just wants to tread water until the next vacation, it isn’t worth the agony. If one just wants to muddle through, it is not worth it. In my office, a little sign reads: "To avoid criticism, say nothing, do nothing, be nothing."

None of us really believes that the things we fear discussing honestly these days are really trivial—and the reaction of our critics shows that we are right. If our dissents are so trivial, why are their reactions so intense? If our ideas are trivial why the headhunting? Like you, I do not want to waste my time on the trivial. I certainly have no desire to be browbeaten and intimidated for the trivial.

…We all share a reasonable and, in many ways, admirable reluctance to leave the safety and peacefulness of private life to take up the larger burdens and challenges of active citizenship. The price is high, and it is easier and more enjoyable to remain within the shelter of our personal lives and our local communities, rather than the larger state. To enter public life is to step outside our more confined, comfortable sphere of life, and to face the broader, national sphere of citizenship. What makes it all worthwhile is to devote ourselves to the common good.

…I do believe that we are required to wade into those things that matter to our country and our culture, no matter what the disincentives are, and no matter the personal cost. There is not one among us who wants to be set upon, or obligated to do and say difficult things. Yet, there is not one of us who could in good conscience stand by and watch a loved one or a defenseless person—or a vital national principle—perish alone, undefended, when our intervention could make all the difference. This may well be too dramatic an example. But nevertheless, put most simply: if we think that something is dreadfully wrong, then someone has to do something.

…I do not believe that one should fight over things that don’t really matter. But what about those things that do matter? It is not comforting to think that the natural tendency inside us is to settle for the bottom or even the middle of the stream.

This tendency, in large part, results from an overemphasis on civility. None of us should be uncivil in our manner as we debate issues of consequence. No matter how difficult it is, good manners should be routine. However, in the effort to be civil in conduct, many who know better actually dilute firmly held views to avoid appearing "judgmental." They curb their tongues not only in form but also in substance. The insistence on civility in the form of our debates has the perverse effect of cannibalizing our principles, the very essence of a civil society.

… Pope John Paul II has traveled the entire world challenging tyrants and murderers of all sorts, speaking to millions of people, bringing them a single, simple message: "Be Not Afraid."

He preached this message to people living under Communist tyranny in Poland, in Czechoslovakia, in Nicaragua and in China "Be not afraid." He preached it to Africans facing death from marauding tribes and murderous disease "Be not afraid." And he preached it to us, warning us how easy it is to be trapped in a "culture of death" even in our comfortable and luxurious country "Be not afraid."

Listen to the truths that lie within your hearts, and be not afraid to follow them wherever they may lead you.

Those three little words hold the power to transform individuals and change the world. They can supply the quiet resolve and unvoiced courage necessary to endure the inevitable intimidation.