The NEJM article was written by Robert D. Troug, M.D., and Franklin G. Miller, Ph.D.   Troug and Miller, after admitting that the scientific literature does not support the criteria for ‘brain death’ and ‘cardiac death’ as being real death, suggest instead that ethicists should simply remove the requirement for dead donors.  “The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead,” they write.

Troug and Miller suggest that this inconvenient finding should not inhibit organ donation as long as there is valid consent by the patient or surrogate.  Since doctors are already killing people both by organ removal and by ending life support, these decisions have been accepted as ethical.   In other words, if doctors decide the patient will die, it is ethical to take actions that help it happen.  The following paragraph presents their seriously flawed logic in support of euthanasia as an ethical means to obtain vital organs for transplant:

Many will object that transplantation surgeons cannot legally or ethically remove vital organs from patients before death, since doing so will cause their death.  However, if the critiques of the current methods of diagnosing death are correct, then such actions are already taking place on a routine basis.  Moreover, in modern intensive care units, ethically justified decisions and actions of physicians are already the proximate cause of death for many patients--for instance, when mechanical ventilation is withdrawn.  Whether death occurs as the result of ventilator withdrawal or organ procurement, the ethically relevant precondition is valid consent by the patient or surrogate.  With such consent, there is no harm or wrong done in retrieving vital organs before death, provided that anesthesia is administered.  With proper safeguards, no patient will die from vital organ donation who would not otherwise die as a result of the withdrawal of life support.

Tell that to the patients from Wyoming, Minnesota, Oklahoma, West Virginia, and Paris, France who were each declared ‘brain dead’ over just the last six months.  All of them were found to be alive under circumstances that delayed removal of their organs.  They all continue living and have each experienced recovery in varying degrees. 

These patients would all be dead using what Troug and Miller suggest is ethical medical procedure for obtaining donor organs.  Obtaining consent and other safeguards can never justify directly taking the life of any human being.  Euthanasia is immoral.

In his August 29, 2000 address to the 18th International Congress of the Transplantation Society, the late Pope John Paul II stressed: “vital organs which occur singly in the body can be removed only after death, that is from the body of someone who is certainly dead.”  He would never have accepted the justification of Troug and Miller as ethical.  Their admission that organ donors are not dead can only confirm that donation of vital organs is always unethical and immoral.

Bill Beckman 

The maxim says “If we ignore history, we are bound to repeat it.”  Some current headlines suggest we can look at some recent history with the opportunity to avoid repeating it, but only if we rise up against the vocal advocates of “comprehensive sex education” and condoms as the most reliable means to fight AIDS and other STDs.

The July 16th LifeSiteNews headline reads, “Britain’s ‘Culture of Promiscuity’ sees nearly 400,000 new STD Cases.”  The British Health Protection Agency (HPA) recently reported 397,990 new cases of sexually transmitted diseases in Britain, the highest number since record-keeping began thirty years ago.  In their report released July 2, the HPA found that half the cases of infection could be found in the 16 to 24 year age group, even though this group made up only 12% of the population.  

This unprecedented epidemic of sexually transmitted disease follows aggressive government expansion of sex education to reduce unwanted pregnancies and abortions. That result has not been achieved either.   Another recent study revealed that Britain’s abortion rate in 2007 rose 21% among young mothers under the age of 14 and 10% for mothers under the age of 16.

Is there a cause and effect relationship here?  The Family Planning Association said the solution is more sex education for children.  In contrast, a recent study by the government-sponsored Sex Education Forum revealed that the school system in Britain is already saturated with sex education.  One-third of secondary schools directly offer condoms and other contraceptives to students through “sexual health clinics.”  Pregnancy tests and morning-after pills are being offered in schools to hundreds of thousands of children, some as young as 11.  Might this sex education be the ultimate cause of the problem since it teaches young people that there is nothing wrong with promiscuous sex?  

Two weeks before this news broke, a commentary appeared on June 30th in the Washington Post. Entitled “Let My People Go, AIDS Profiteers” and written by Rev. Sam Ruteikara, this article reveals the facts about AIDS prevention in Uganda.  He writes that “in the fight against AIDS, profiteering has trumped prevention.  AIDS is no longer simply a disease; it has become a multi-billion dollar industry.”  He goes on to say that Uganda devised a strategy to prevent AIDS called ABC (Abstain, Be Faithful, or use Condoms), “but our main message was: Stick to one partner. We promoted condoms only as a last resort. Because we knew what to do in our country we succeeded.”  Indicting the international AIDS lobby, Ruteikara says, “But international AIDS experts who came to Uganda said we were wrong to try to limit people’s sexual freedom.  Worse, they had the financial power to force their casual sex agendas upon us... As fidelity and abstinence have been subverted, Uganda’s HIV rates have begun to tick back up.”

Whether the goal is to reduce unwanted pregnancies, abortions, sexually transmitted diseases, or specifically AIDS, the circumstances in Britain and Uganda provide the history that shows the folly of the push for comprehensive sex education over abstinence education.

Shall we let history repeat itself in our nation?  When the National Institutes of Health recently reported that U.S. teen pregnancies in 2006 rose for the first time since 1991, promoters of “comprehensive sex education” such as Planned Parenthood claimed that these statistics proved that abstinence education has failed and must be replaced.  Now that you know the history, you know their plan will only lead to failure.  Abstinence education is the solution, not the problem.

Bill Beckman 

This election cycle has given us the opportunity to re-educate ourselves regarding some of the fundamental issues of the pro-life fight.  Two in particular stand out.  When does life begin?  What about babies with birth defects and the quality of life?  The answers to these questions highlight the basic differences between pro-life and pro-abortion individuals.

When does life begin?   The scientific community agrees that life begins at fertilization and that life is undeniably human.  As Cardinal Edward Egan put it so eloquently:

“We are blessed in the 21st century with crystal-clear photographs and action films of the living realities within their pregnant mothers.  No one with the slightest measure of integrity or honor could fail to know what these marvelous beings manifestly, clearly and obviously are, as they smile and wave into the world outside the womb.”

It would seem as the question of when human life begins has been answered but for the pro-abortion side the question has been changed to when does that life get human rights.  As citizens of the United States we believe that all are created equal with the right to life, liberty, and the pursuit of happiness.  The unborn baby is a human life and should be protected by our laws from the moment of conception.

What about babies with birth defects and the quality of life?  During this election, this question has centered on Down syndrome, but the issue is much larger.  About 90 percent of the cases of Down syndrome babies diagnosed by prenatal testing each year are aborted.  As a result, the number of Down syndrome births has been declining.  As prenatal testing becomes more sophisticated, parents who are told their babies are less than perfect will most likely experience pressures from medical professionals and insurers to have an abortion.   As society continues to define the perfect baby, where does this end?

Just as prenatal medical testing has advanced, so has medicine advanced for those living with disabilities.   Generations ago, people with Down syndrome were often institutionalized.   Today people with Down syndrome live much longer and healthier lives, including an increase in high school graduation and independent living.  As long as we continue to judge the expected quality of life of the unborn baby and continue our quest for the “perfect” baby, there will be abortion. 

In addition to the basic pro-life issues, almost every week over the last couple months, a different life issue is discussed in the public forum including partial birth abortion, the born alive infant protection act, teenage pregnancy, and abstinence.  It provides an opportunity to educate ourselves and others.  This doesn’t occur very often unless there is an election, and we need to take advantage of these opportunities.  Just as the comments of a few powerful politicians have ignited more that 25 bishops to publicly state the Catholic Church’s opposition to abortion, we need to speak up and educate people on these pro-life issues.  Until a majority agrees that human life begins at conception, and at that moment the unborn baby has all the rights of a born baby, abortion will be legal.

Rosemary Hackett

Decisions about health care directives and hospice care should not be made in haste.  From the unusual encouragement to sign a DNR when moving into senior housing (see page 3) to abuses perpetrated by citing living wills, the watchword is caution when making end of life decisions. Similar concern should be applied when evaluating hospice care.

One suggestion to simplify the decision process is to avoid living wills and DNRs all the time and under all circumstances.  An August story from Rochester, NY local TV news reported on the case of Dorothy Livadas, 97, who lives with the aid of life support.  Though she had signed documents giving her daughter, Ianthe Livadas, the power to make medical, legal, and financial decisions for her, she had also signed a “living will” instructing that she be taken off life support if she lapsed into a state where there was no reasonable expectation of recovery.

The dispute over her mother’s condition forced Ianthe Livadas into a five-month legal battle against doctors, attorneys, and the Catholic Family Center.  “You don’t expect a hospital to be threatening you that they’re going to put aside your mother’s choice of health care proxy and power of attorney, and replace you,” Ianthe said.

Medical “experts” testified in court that there is no chance Dorothy will awaken or communicate.   Livadas’ daughter disagrees.  “Just the other day, I saw a sneer on her face when I mentioned someone she doesn’t like very well.  When you know someone all their life, you can tell what they’re thinking by subtle movements in their face that others would miss,” she said. 

However, the courts have ruled that Ianthe Livadas no longer has a say in her mother’s care as Justice Harold Galloway awarded custody to Catholic Family Center.  He said that Ianthe “fails to appreciate her mother’s true medical condition,” and that she “lacks the objectivity and insight to make necessary decisions.” 

This is just the latest known case where signing a “living will” allows the medical profession to stop “life support” of a conscious individual because they have “no hope of recovery” even when the agent designated by a durable power of attorney for health care disagrees.  The living will simply makes it that much easier for the medical profession to get the agent declared incompetent. 

Where else but in California?   A bill has passed that requires medical professionals to provide information and referrals to hospice whenever a terminal diagnosis is made. From the introductory text of California bill AB 2747, it states:

This bill would provide that when a health care provider, as defined, makes a diagnosis that a patient has a terminal illness or makes a prognosis that a patient has less than one year to live, the health care provider shall, upon the patient’s request, provide the patient with information and counseling regarding legal end-of-life options, as specified, and provide for the referral or transfer of a patient if the patient’s health care provider does not wish to comply with the patient’s choice of end-of-life options. 

What are these end-of-life options that a health care provider may not wish to comply with?  Under the definitions section of AB 2747, the following definition was originally included:

“Palliative sedation” means the use of sedative medications to relieve extreme suffering by making the patient unaware and unconscious, and in some cases, involves the withholding of artificial food and hydration. A patient’s death, however, is caused by his or her disease processes and his or her complications, and not from palliative sedation.

Apparently, making a declarative statement that denial of food and water is not the cause of death makes it reality, regardless of the actions taken to make the patient unconscious and then withhold food and water. Even though this wording was toned down slightly before passage of the bill, the original wording reveals what the supporters of this bill really wanted to achieve as part of their objective to promote more use of hospice. They wanted to define a standard of care within hospice that considers hastening death as a valid medical treatment.

This effort provides the evidence of their agenda for hospice, and confirms the concerns about hospice that we have expressed before. While there are still hospices that follow the original mission of hospice (to avoid artificially extending life, but never hasten death), caution and serious questions are necessary to select a hospice that has not been overtaken by the culture of death.

Bill Beckman

Most people consider the durable power of attorney for health care or the living will when selecting a health care directive.  IRLC has often advocated that selection of the living will is not a good choice.  The IRLC Patient Self-Protection Document is an excellent life-affirming version of a durable power of attorney for health care. 

IRLC has recently been running radio messages encouraging discretion in selection of a health care directive.  I received a call from a woman who wanted more information on the Patient Self-Protection Document and decided to obtain copies of it. 

During that conversation, she mentioned that she had recently moved into a senior residence in Wilmette.  The administration of this senior housing facility apparently encourages new residents to complete a do not resuscitate (DNR) order.  A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. 

It seems highly inappropriate that healthy seniors be encouraged to sign a DNR.  Along with the living will, IRLC strongly encourages that the DNR be avoided in almost all cases.  From experiences relayed to IRLC, a DNR very often leads to withdrawal of other standard care during any medical crisis because the DNR is often viewed as a declaration that the patient wants to die. 

When obtaining senior housing, IRLC recommends that any suggestions or encouragement to sign a DNR be declined without hesitation.

The headline reads, “President reaffirms support for natural family planning over artificial methods.”  What’s happening here?  Did Congress actually defund Planned Parenthood and dump the Title X program besides?  Did George W. Bush get more direction during Pope Benedict XVI’s recent visit than we thought? 

Actually, the headline applies to the President of the Philippines.  During her July 28th State of the Nation Address, President Gloria Macapagal-Arroyo reaffirmed her support for natural family planning over artificial methods such as condoms and pills, and declared her endorsement of the Catholic Church’s position on reproductive health issues. 

Are Filipino families having 8 or more children?   No, in fact, President Macapagal-Arroyo said her administration’s adherence to natural methods had actually trimmed the country’s population growth rate.  She denounced the campaign aimed at promoting the use of artificial contraception. 

She must have been referring to a report from the David and Lucile Packard Foundation, which funded pro-abortion/contraception population management projects in the Philippines last year.   That report criticized the Catholic Church and Mrs. Arroyo for opposition to their plans. 

What is the basis for the Packard Foundation criticism?  Are they against even a small increase in population, or are they just pushing their own agenda?  Their criticism is baseless.  Use of natural methods has also succeeded in keeping AIDS almost non-existent.  Exactly what does the Packard Foundation want to “fix” in the Philippines?  Maybe they are just against religion.