Archive for the 'Medicine and Ethics' Category
Something I’ve been pondering on lately:
Every one of our actions could have unintended, serious consequences. History is full of casual events that have enormous causal significance.
Take, for example, the Battle of Gettysburg. If General Lee hadn’t believed an untested spy about the location of the Union Army, or if General Ewell hadn’t been afraid to take initiative and seized Cemetery Hill at the start of the battle, or if Lee had listened to General Longstreet and not attacked the then fortified Union position–not once, but twice, or if Colonel Chamberlain hadn’t made an audacious, nearly suicidal charge into the Confederate ranks to prevent the Union Army from being flanked, then the South would likely have won Gettysburg, and proceeded to Philadelphia or Washington, effectively ending the War Between the States.
What might the North American continent look like today if silly mistakes or outlandish risks hadn’t been taken?
We could take any major event in history and pry it apart like so.
It should make us wonder about our own actions. Sure, we’re not fighting in a major military battle, but what good might we be leaving undone? If we think that, say, one more person praying in front of an abortion clinic might not make much difference, just look back in history. What if, as you stand by the highway praying, a friend drives by who’s struck by your witness as she is agonizing over what to do with her unintended pregnancy?
1. Do we actually want to live twice as long?
2. Do we actually want to be seven times as active? Can you imagine what that would do to human society?
3. As the article rightly points out, this has to do something to the mice’s brains. What might it do to ours?
WARNING: What follows is going to be a pretty bitter rant. Let me qualify everything I may say (since I won’t have time to edit it) with this: no, I have not lost my faith. I am still every bit the traditionalist, pro-life, wholeheartedly believing Catholic I was. I’ve simply seen too much in the past few days to believe that we’re having any success whatsoever at reaching those who need us more than anyone else: the poor.
We’re fighting the wrong battle. Abortion is so visible; it attracts so much attention; but, it’s a wicked feint. We’re like French soldiers haplessly manning the impregnable Maginot Line while the Germans, ruthlessly efficient, simply marched around. We feel so good praying our Rosaries in front of abortion clinics; we might even spend time showing others the horrors of “termination” with graphical photos of dismembered fetuses. We donate to pro-life causes; we volunteer at agencies that promote support of pregnant women. We really do make a difference.
But for every person we help lead back to a culture of life, we lose countless others who fall victim to the ultimate modern seduction. It goes by a simple name; it is a simple ploy; and unfortunately, it works. It’s called the Pill, and it may be the Enemy’s perfect weapon.
Think about it: what else can you procure that will instantly divest you of any responsibility for anyone but yourself? Just take a pill every day (or even better, a shot every three months or a patch every week), and you no longer have to worry about kids interrupting your pleasure. It’s no wonder that the vast majority of poor Hispanic women, of whom a large number are nominally Catholic, fall for it. Why have a brood of children when you can have sex with your boyfriend (and why bother to get married for that matter?) with impunity?
And yes, there are consequences to this libertine mentality. Sexually-transmitted diseases are rife. But there’s another subtle aspect to this sabotage of fertility: an often warranted faith in the infallibility of modern medicine. If we do get sick, the doctors can fix it. What’s scary is that, in many cases, we can.
So, on the one hand, we have the Catholic ideal: accepting the God-given gift of marriage and fertility, loving children as we procreate them, supported by a community–a Church–that makes the raising of future faithful generations possible. It’s an incomparably beautiful vision–but it relies upon self-denial. On the other hand, we have the modern ideal: planned parenthood. Sex is for your pleasure only; if you want to, you can let it follow its “natural” course to produce children; if you don’t, it’s not a problem. Hedonism rules under the guise of liberty, and self-denial is the ultimate evil.
Look at the evidence and tell me which of these two visions is winning the hearts of the one group of people that we are commanded above any other to serve: the poor. We well-catechized Catholics can see the beauty of the culture of life–and even we, if we really look into our hearts are seduced to some extent by the other side. Imagine those who do not know their Faith–those who often simply struggle from day to day to make ends meet. They are provided–usually for free, by our health care system–access to the modern vision of freedom. We Catholics, on the other hand, offer an alternative that is costly. Beautiful and true, yes, but at a price that most people today are unwilling to pay.
So what can we do to stem what I’ve described as an inexorable tide? I really don’t know, but here are some thoughts.
We have failed first and foremost in community. If a woman has a child in an adulterous relationship, we should step and help her to take care of him. If she can’t, then we should take the child in. We must, for our own souls’ sake, rely upon others of like commitment.
We have also been failed by our priests. If Father neither preaches from the pulpit nor counsels in private that contraception is a problem, then the message is obvious: that it’s OK. Even worse, if he actively counsels his flock in private (or in public) that it’s OK to contracept and have sex outside of marriage–and I know this happens in our parishes daily–there is no way we will be able to convince people otherwise. Especially not in a hierarchical Latin-American society where the padre, for some reason which escapes me, still commands a vestigial position of authority. Our pastors must be men of faith who preach and practice what the Church teaches. Yes, they are human and they will sin, but that does not change the Truth they proclaim.
And we have failed, and will continue to fail, individually. Original sin still haunts us and will continue to do so. So, in the end, despite my bitterness, I am compelled to write that there indeed is hope. We are not intrinsically different from our fathers; they failed but the possibility of life eternal continues. We should pray; we should start attempting to rebuild, on a small scale at first, the communities, pastored by good priests, that make living the Catholic life possible. It was possible before despite our sinfulness; it is still possible. Maybe, as Alasdair Macintyre suggests, we do need a new St. Benedict to lead us into the desert and teach us to purify our souls.
We rightly fight the evil of abortion, but by all means, we mustn’t lose sight of the real battle.
Do they really think that’ll cause people to change? I once saw a patient who had had half of his larynx and a lobe of his lungs taken out on separate occasions for lung and larynx cancer, and still smoked a pack a day. Such disincentive might lead to some people eating healthier and stopping smoking, but for everyone that does that, five will end up sicker or dead from lack of care.
Heaven help us if John Edwards becomes president. I think I might actually pull for Hillary.
What a spectacularly bad idea: mandatory preventive care. I don’t even know where to begin. On the surface, it makes some sense. A substantial percentage of our GDP is spent on health care that would not be necessary if folks took better care of themselves. Some part of that would be reduced if diseases were caught early and corrected. To make people go to the doctor would lead to physically healthier lives. But at what (non-monetary) cost?
Stay tuned. I have some time to post for once….
I should be studying (as always) before heading off to Latin Mass this afternoon, but I had an odd series of ideas yesterday that need hashing out in words. This is what tends to happen when I have a couple of days off from the ridiculously hectic schedule of medicine….
We’ve spent the past 148 years trying to work out the ramifications of Charles Darwin’s dangerous ideas. If all the living creatures around us are the products of natural selection, then, likely, so are we. The mechanism behind the variation which enables nature to select for the fittest is simple enough: changes in DNA produce changes in proteins that result in changes in function. These changes are almost always deleterious, but at least theoretically, a change in protein structure could enhance efficiency or produce new functions. Over time, as creatures encounter changing environments and compete with each other, various changes in their genetic material are selected for and maintained down the generations. It’s an elegant theory, one that can explain how the vast array of biological life came to be. Yes, it has problems, particularly with explaining large-scale changes and speciation, but I’m not interested–at least not in this essay–in exploring the whole evolution-vs.-creation controversy.
But what about the timescale of evolution? How fast can things biologically change? Organisms with short generation times or error-prone genetic replication systems can evolve remarkably rapidly. Take, for example, the production of antibiotic resistance in bacteria. Or, if we consider viruses to be alive, the champion evolver is the constantly changing HIV virus that stays one step ahead of our immune systems. A bacterial species that doubles in number every couple of hours can adapt genetically to almost any environmental change. But what about us? Our 70+ year life expectancy and long generation times mean that it would take thousands of years to produce the same changes that bacterial populations undergo in a matter of days. Are those changes possible? Sure. They’re even likely.
However, mankind throws a wrench into the mechanism by being creative. We think, ponder, discover, invent at a rate that far surpasses generational genetic changes. While Cro-Magnon Man and I are, on a genetic and biological level, essentially identical, our worlds are radically different, not because of biological evolution, but because of our abilities as sub-creators. Our bodies cannot keep pace with our minds–especially not with the rapidly accelerating rate of technological change over the past hundred years. What ramifications might that have? There are countless possibilities: I’ll focus on a few.
The human body, for all the vast array of diseases to which it is subject, is a finely tuned machine. Left to its own devices, it is fairly good at healing itself and fighting off any number of microscopic and macroscopic invaders. We creators think we can enhance things, though. Sometimes we can, but not without unforeseen consequences. Why is it that there is an epidemic of allergies and autoimmune diseases in the developed world? I pin the blame on two advances: hygiene and immunization. Would I take either of those back? Of course not, but our immune systems, from a biological angle, are intended to combat bacteria, viruses, fungi, parasites, etc. If we have a lower burden of those, I suspect that immune cells have a higher chance of attacking things that they shouldn’t–like things in our own bodies–or are hypersensitive to external things that shouldn’t be a bother–like cat dander. I wouldn’t trade millions of bothersome allergies for millions of deaths from infection, but the principle holds: we’ve short-circuited a slow evolutionary process and have to face the reality that our bodies react to our creations in less than ideal ways.
Allergies and autoimmunity are physical examples of what happens when we meddle with our biological selves, but what about the costs of modern technological society on a more abstract level? I have, as usual, more questions than answers. Is our modern plague of depression, anxiety, and mental illness the result of, quite simply, not having to deal daily with what our ancestors bravely faced: death or survival? Are we consumed with ourselves because we’re insulated from stark reality? Do we fear death more, and as a result quixotically seek physical immortality, because we can push the reality of our mortality out of our minds for extended periods of time? Are we losing belief in God because we surround ourselves with our own creations? Has our incredible store of knowledge about things led to a paradoxical loss of understanding of ourselves?
The problem is the same whether you believe that we are the special creations of God or the result of millions of years of evolution–or both. It is undeniable: we biologically cannot adapt at the same pace at which modern human society is changing. Genetics won’t allow it. We’re cavemen in modern garb (with apologies to Geico). Does that mean I want to turn back the clock and return to the Stone Age? Far from it. Modern medicine and science have changed our lives for the better. But we ought to step back and think about why we react as we do to modernity. Look beyond the technology that surrounds us to the fact of death. Look past the anxiety that can consume us and accept that, despite appearances to the contrary, we really can’t control everything. We have just postponed and disguised the inevitable by our creations. Know thyself, not just the world around.
“Yes, but you have to wager,” said Blaise Pascal in response to agnosticism. In the end, death intervenes, and not deciding on God’s existence is ultimately tantamount to choosing against Him. Choose for belief, and at best you gain salvation; choose against, and at best you gain nothing at all. Of course, if the probability of God’s existence is precisely zero, then all bets are off, but you’d have to be rather myopic to make that claim, which you cannot prove. No, when all is said and done, you have to wager.
The same goes for the current debate on embryonic stem cell research. A wild jump, you say, to go from discussing Pascal’s wager on belief to public policy? Not so, because at the core of our endless arguments on stem cells is a dilemma which requires a wager and has no definitive materialist answer. Is the human embryo a human life? If we were simply studying the embryo, observing its development, awestruck at the formation of a human being from one cell, then yes, contrary to Pascal’s conclusion about God, you could abstain from a wager. No action has been committed against the embryo; it is allowed to develop naturally.
But, we aren’t merely observing; we are destroying. Once that decisive step has been taken, then we must wager. Either that destruction is blameless, or it is murder. There is no question as to the embryo’s innocence; the best argument for abortion, the violinist argument, falls apart since we’re not destroying an embryo because it’s infringing upon the mother’s rights. The intentional killing of an innocent life is murder; therefore, unless my reasoning is terribly mistaken, the creation of stem cells by disaggregating a human embryo’s cells is one of two things: if a human being, then murder, if not, then no big deal.
But how do you decide between those two options? You cannot turn to science. Any embryology textbook shows what a seamless process embryonic development is from the moment of fertilization until birth. Unless impeded by faults determined by the interplay between its own genetics and the environment provided by its mother’s womb (otherwise known as miscarriage), it will be born 40 weeks or so after it was but a single cell. Markers such as the heart beginning to beat, or the first neuron firing, or development of a recognizably human face, are mere symbols devoid of any real meaning. Since at this moment, it would be terribly difficult to select an embryo that could not develop into a human being and would be intrinsically miscarried, then use its cells, we still must wager.
Science cannot tell you whether a human embryo is a human being at the stage in which it would be dismembered to create stem cells. If anything, the evidence points firmly toward its humanity. But, we deeply want to cure crippling, deadly diseases like Alzheimer’s and Parkinsonism. We would do almost anything if we could make the lame walk. However, if we were told tomorrow that the cure to Alzheimer’s disease was present within the brains of a family with a newly discovered genetic variant, but we would have to kill them to get it, we would all recoil in horror. Why do we not flinch at the production of stem cells? I suppose it’s because a “blob of cells” simply doesn’t look human. In the end, though, looks aren’t everything, and you have to wager. You cannot claim ignorance; what you may be supporting has the possibility of being murder. Is it worth the lebensraum?
The Caveman has discovered why we should not mix human and animal DNA to create a hybrid. Don’t say I didn’t warn you before clicking.
First it was Vioxx and Celebrex, which really helped arthritis but unfortunately, due to their mode of action, also increased the risk of heart disease. Now, a major new drug used to treat type II diabetes, Avandia (rosiglitazone), may be in trouble. Preliminary studies (which must be confirmed with a larger sample size) indicate an over 40% greater risk of heart attacks for patients on Avandia than in control groups receiving other standards of care.
Avandia works by activating a receptor in the cell, PPAR-gamma, which then modifies the transcription of various genes having to do with lipid metabolism, and other things. It is useful in diabetes because it sensitizes cells to insulin, supposedly helping to reduce hyperglycemia and other side effects of insulin resistance. But, it appears that there is either a non-specific effect leading to increased heart attacks, or PPAR-gamma has some other role yet to be discovered. We’ll see–the results publicized in the news are just preliminary, but it proves the adage that my old clinical medicine instructor drilled into us: “The only drugs without side effects are new drugs.”