There is no quality of life when the patient is dead

On Tuesday November 4th 2008, and with just under a million votes counted, 56.47 percent of Washington’s voters had agreed to give Washington state residents the right to die in accordance with Initiative 1000, which is modeled after Oregon's unique Death with Dignity Act.

Under the banners of compassion and autonomy, some are calling for legal recognition of a "right to suicide" and societal acceptance of "physician-assisted suicide." Suicide proponents evoke the image of someone facing unendurable suffering who calmly and rationally decides death is better than life in such a state. They argue that society should respect and defer to the freedom of choice that people exercise in asking to be killed. There are many moral, ethical, and theological reasons as to why active euthanasia is inherently wrong. I would like to structure my argument around the fact that Suicidal Intent is most often transient. To legally entitle a suicidal individual to be left alone without genuine help and without addressing the real issue is to negate true understanding of the underlying origins of suicidal tendency.

Studies show that few people if any will simply sit down and make the calm, rational decision to commit suicide as propagated by those advocates of acts such as Initiative 1000. In St. Louis a study done by Dr. Eli Robbins showed that 47% of those committing suicide suffered from either schizophrenic panic disorders, depression, or bipolar disorders, and additional 25% suffered from alcoholism, 15% more had some recognizable but undiagnosed psychiatric disorder, 4% had organic brain syndrome, 2% were schizophrenic and 1% were drug addicts. The total of those with diagnosable mental disorders was 94%. [1] In a separate study conducted in Britain, it was found that approximately 24 percent of terminally ill patients desire death. Of those desiring death, nearly 100 percent had clinical depression, which is a treatable condition. [2]

The fact that mental illness is so prevalent in those desiring suicide is very significant. Psychologists recognize that a suicidal person suffering from depression undergoes severe emotional and physical strain, impaired basic cognition, unwarranted self-blame, inappropriate guilt, and helplessness. Those with terminal illness often feel as though they are a burden to their families and to others. These individuals often think in a very rigid ‘all or nothing’ mindset. They are unable to see the range of genuine alternatives. They generally maximize their problems while minimizing their achievements and are unable to see the larger context of their situation. Indeed, treatable depression, rather than the terminal illness itself, usually accounts for such a patient's expression of a wish to die.[3]

Most mental illness including depression can be treated, alcoholism can be overcome. [4] And even the pain associated with most of the terminally ill patients who would qualify for the right to be euthanized according to Initiative 1000 can be overcome. According to the Washington Medical Association "adequate interventions exist to control pain in 90 to 99% of patients." [5] The problem is that uninformed medical personnel using inadequate methods often fail in practice to bring patients relief from pain. With today's advanced techniques freedom from this suffering is possible.

World renowned psychiatrist Elisabeth Kubler-Ross outlined the 5 stages of the dying process -- denial, anger, bargaining, depression, and acceptance. Since that time, Dr. Kubler-Ross has worked with thousands of dying patients and their families to help them deal with the dying process. In a recent interview she said: Lots of my dying patients say they grow in bounds and leaps, and finish all the unfinished business. [But assisting a suicide is] cheating them of these lessons, like taking a student out of school before final exams. That's not love, it's projecting your own unfinished business. [6]

Intervention and treatment, a search for alternatives is the correct and best method to help those who desire physician assisted suicide. It is a fact that a very small minority of those who are rescued from their fleeting suicidal desires and then helped and treated will go onto commit suicide later. In an American study less than 4% of 886 suicide attempters actually went on to commit suicide after their initial attempt. [7] Intervention to keep the individual alive is the course most likely to honor the individual’s true wishes and respect the person’s autonomy.

Years of studies and experience give professionals a near automatic presumption that one who desires or attempts suicide is in need of psychological help. If suicide and physician-assisted suicide become legal rights then those seeking suicide would be legally entitled to be left alone without genuine help and without addressing the real issue. [8] And all of this, much more often then not, will be based on a distorted assessment of their own circumstances.

1 - Barraclough, Bunch, Nelson, & Salisbury, A Hundred Cases of Suicide: Clinical Aspects, 125 BRIT. J. PSYCHIATRY 355, 356 (1976) and E. Robins, THE FINAL MONTHS 12 (1981).

2 - Breitbart, MD; Rosenfeld, PhD; Pessin, MA; Kaim, PhD; Funesti-Esch, RN; Galietta, MA; Nelson, MA; Brescia, MD., Depression, Hopelessness, and Desire for Hastened Death in Terminally Ill Patients With Cancer, JAMA. 2000;284:2907-2911.

3 - Minkoff, Bergman, Beck & Beck, Hopelessness, Depression and Attempted Suicide, 130 AM. J. PSYCHIATRY 455

4 - Silverman, Silverman & Eardley, Do Maladaptive Attitudes Cause Depression? 41 ARCHIVES GEN. PSYCHIATRY 28, 29

5 - Albert Einstein, "Overview of Cancer Pain Management," in Judy Kornell, ed., Pain Management and Care of the Terminal Patient (Washington: Washington State Medical Association, 1992), p. 4.

6 - Leslie Miller, "Kubler-Ross, Loving Life, Easing Death,"USA Today, Monday, November 30, 1992, p.6D

7 - Rosen, The Serious Suicide Attempt: Five Year Follow Up Study of 886 Patients, 235 J.A.M.A. 2105, 2105

8 - A. Sullivan, Voluntary Active Euthanasia for the Terminally Ill and the Constitutional Right to Privacy, 69 CORNELL L. REV. 363

Evolution ...A theory: not a dreamy and unreliable speculation, but an explanatory statement that fits the evidence.

The current state of evolution theory makes it perfect for both the practical and theoretical exercise of learning the scientific method.

Another example of a theory: Gravity. All the knowledge we have on gravity is based on circular reasoning.

How do you tell how heavy a planet is? By its gravitational pull...
How do you tell how hard a planet's gravitational pull is? By how heavy it is...

Intelligence, at least the human variety, is not necessary for other animals to survive. A crocodile has developed instincts sufficient to sneak up and kill a water buffalo for food . All a bird has to do if find grain and berries and make a nest.

Humans really have no other means to survive. No way to stay warm, we lack the fur coats, the feathers that other animals use to stay warm. We are not fast enough to run down our prey, our teeth are not sufficient for killing. Our intelligence is what sets us apart and allows us to survive and procreate.

The human brain elevates it above the restraints on natural selection, we have defied the cycle of evolution and extinction. Man has, despite nature, taken a direct hand in our own evolution. We allow simple physical deformities, like poor eyesight, to flourish with the understanding that we are not simple physical creatures. We apply our ability to adapt and to artificially correct these deformities in order to allow the other aspects of these people to enrich us. Hawking is a perfect example. Completely deformed. Even to the point of a superior intellect. His work has moved his field forward by leaps and bounds. In fact, in general our species is becoming more physically abated. Look at what has happened to America in terms of obesity, and yet our civilization thrives and the average lifespan continues to increase here. By using our minds to overcome and exploit our frailties we subjugate nature.

Taking into account everything that I have said, I do not think that creationism, which is based on faith, and evolution are mutually exclusive. Creationism is based almost solely on faith not empirical evidence. Evolution, while not completely fleshed out yet, is the very best we have based on scientific observation.

My beliefs concerning evolution incorporate a view of evolution and creation. I believe that God organized the Universe, creating and using fundamental laws that we observe and use today; and established a way for life to form. I find that evolution is an elegant example of creationism. Perhaps the way a supreme creator would do it. I'm also mindful of the fact that many scientists believe in a 'god', although not always one that religious fanatics believe in. Physicists believe that according to the laws of motion there must have been a 'prime motivating factor', something that set the entire universe going, the ultimate 'external force'. That’s just as powerful an argument for the existence of God as any I've heard.

Everything we know exists within time. There is a beginning and there will eventually be an end. Matter and the laws of physics must have been in existence in order for the "big bang" to occur in the first place. If it is the beginning of all things it must have always existed; or an eternal God must have put a beginning to it. Sure organisms came from organisms, but where did those organisms come from? Where did those come from? Where did that matter come from? To say that matter was "always there" and it's infinitely backwards is something you cannot prove. There's no way you can prove something is infinitely backwards because no matter how far back you go you can always go still further back. ‘Nothing’ could not have been the origin of matter and the laws of physics - they must be infinite and eternal and an eternal God must have created them.

Humans by nature have a desire to break boundaries, to learn and progress. We observe the world and make deductions based on what we learn from our senses. We hypothesize, create theories and write laws based on empirical evidence and proof. The universe is governed by a set of laws and standards that, as far as our toolbox that is science affords us, are unbreakable. It is important to recognize the unclear nature of human understanding, and that even with our seemingly broad assortment of tools that science gives us, there is still room for doubt. Science is, for the most part, subjective. While it is based on empiric observations, history has shown that science is constantly subject to change, update and overhaul. The more we progress in the scientific domain, the more we realize that perhaps we weren't 100% accurate about a certain subject.

Some more food for thought. Tom stated that we can apply human logic to everything and figure anything out. The truth is that we do not know the limits of our knowledge, comprehension, and understanding. We are not even sure what we are capable of. Think of Plato’s ‘Allegory of the Cave.’ In his allegory humankind are all prisoners and the tangible world is our cave. The things which we perceive as real are actually just shadows on a wall. In the allegory, a prisoner breaks free of his chains and is able to see the shadows for what they are, a poor depiction or portrayal of a grand and intricate object (ie a tree, or a bird, perhaps a kitten). Another example: we cannot see microscopic organisms but does that mean they don't exist? Only by using the aid of a microscope can you see them. Human understanding changed significantly due to the invention of the microscope. There are sure to be major future discoveries and inventions that will change our way of thinking. One more example to illustrate my point: There are some animals that are colorblind. They never developed the ability to see the entire spectrum of color. So to them - if they had the ability to reason - certain colors wouldn't exist simply because they never evolved the ability to see color. Does that mean that color doesn't exist? We are basing our results of evolution based on what human logic we have. We know the extents of colorblind animals simply because we are more advanced. But there isn't anything more advanced than us to tell us some ability or logic we lack. We are limited by the breadth of our perception. But as I stated earlier evolution, while not completely fleshed out yet, is the very best we have based on scientific observation.

Personally I think that the empirical evidence overwhelmingly suggests that evolution by way of natural selection is a very acceptable theory of the development of life on this planet. The proof lies in genetics, common traits, survival of the fittest, fossils, geologic records, heredity, biodiversity, ecology, mass extinction, chemistry, the Animal Kingdoms, glaciers and rational thought.

All animals need simple requirements--food, water, safety. If these requirements are met, the animal does not need to change. Over time stronger offspring will succeed the weaker, earlier generations, more suitable adapted offspring will pass on their superior DNA and eventually we have a new, more powerful species.

Populations better themselves and acclimate to different habitats and changing environments through natural selection. Natural Selection is driven by competition against other species for limited resources. The fittest species survive, and weaker species must adapt or else they die. This is how, overtime, populations grow more suited to their environment.

Mutation also has a hand in evolution. All living things are prone to mutation. It's random and it happens relatively often. Any mutation that does not prevent the organism from procreating is carried on to the next generation. Any mutation that actually improves the chances of procreation and the survival of offspring has even greater chances of being carried on to the next generation. Very few results of evolution actually result in an improvement. The simplest model of this is in bacterium. It is well known that if a bacterial virus was added to a flask containing bacteria, the liquid in the flask would become clear, as if the virus had killed all the bacteria. Often however, with time, the flask would once again become cloudy as the bacterial population rebounded - now composed of virus-resistant bacteria. This happened even when all the bacteria in the flask were the clonal offspring of a single bacterium. Although such bacteria should have all been genetically identical, some of them were susceptible to the virus while others were resistant. Mutations that were already present in a minute percentage of the bacterium made it so they were already immune. Thus those mutations and immunities were passed onto the following generations creating more powerful bacteria.

What doesn't kill the subject gives it a chance of becoming a part of the larger gene pool. What happens when millions of micro-evolution events over eons change an organism to the point where it can't produce offspring with its original species? That is macro-evolution.

Whether or not there is a celestial guiding force is for each person to discover by himself. It is not the purvey of public institutions or government. The purpose of education is to provide a foundation of knowledge and the tools to further that knowledge. Evolution theory is one of the best examples of the scientific method, with examples that can be witnessed. It also helps broaden minds to accept that there are events beyond our limited personal scope but within our understanding.

Alan Greenspan, dietified or demonized?

My high-school AP Economics instructor had a shrine to Alan Greenspan in her classroom. No really, a shrine. Complete with a golden picture frame and candles. At the time it seemed a bit stalker-ish, but as I have learned more about the role of the Federal Reserve in our economy I have realized that such a shrine was not wholly unwarranted. At his retirement in 2006, many dubbed Greenspan the greatest Federal Reserve Chairman in history, but the subsequent recession has given them pause for thought. Specifically, “Was the Fed responsible for the housing bubble?”

While the invisible hand directs economic forces both micro and macro, fiscal and monetary policy can have a huge impact on the growth of an economy as a whole. Growth, as measured by real GDP, must be kept within sustainable limits. If the economy grows too quickly inflation can choke out any real gains in GDP and destroy capital investment. On the other hand deflation can bring even an explosive period of growth to its knees. Just ask the Japanese. The Federal Reserve’s control over interest rates has a direct impact on capital investment and therefore the rate of inflation, making it the most powerful monetary force in the country.

Few people understood the Feds role better than Alan Greenspan at the end of his tenure as Chairman of the Fed. For almost two decades he consistently pumped liquidity back into the market during times of economic crisis in a policy that would come to be know as the “Greenspan Put”. When consumer spending showed signs of slowing the Fed would respond by dropping the interest rate to re-stimulate the economy. This may have worked for the 1987 stock market crash, the Gulf War, the 1997 Asian crisis, Y2K, the burst of the internet bubble, and the 9/11 terror attack, but what about the current economic crisis? It is generally accepted that the housing market crash was at the heart of the 2008 economic meltdown, but what part did the Fed play in creating, or discouraging, the housing bubble.

Greenspan did take some credit for the housing bubble, claiming that it was “fundamentally engendered by the decline in real long-term interest rates.” But as noted, the Fed does not have direct control over long-term interest rates. Long-term rates are determined by the market’s confidence that interest rates will eventually come back down. By consistently lowering interest rates the Fed may indeed have created an atmosphere of confidence in the economy, but this hardly makes Greenspan responsible for the bubble. If anything this places the blame squarely on the shoulders of the financial institutions that took advantage of this confidence and sacrificed long-term stability for trade short-term gains.

If Greenspan had any significant impact on the 2008 crisis it would have been in the form of ideology rather than policy. A perennial advocate of free-market forces over government regulation, on Oct 28 2008 he testified before congress that his long held ideology was “significantly flawed” and did not sufficiently protect shareholders and investments from unscrupulous individuals. The evidences left by his 19-year tenure is an unquestionable testament to the power of the free market, but even a deity of high-school economics teachers cannot predict the behavior of the increasingly complex markets that make up our national and global economies.

A letter I recently recieved

Tumham Nala Turkey said...

Congratulations. Your profile has received 27 views since May 1st. That is roughly .18 views per day. Not bad... Oh wait yes it. .18 is nothing. Believe me. I know. Our family only eats about .18 pounds of food per day since you quit your job and left our people to become a blogger. For this purpose I am writing you this letter. Give up your foolish dreams and come home.

I have included the following reasons why.

1. The fashion industry has taken off. With the world at war, jock straps have become high in demand. I know that being a jock strap tester may not be the most appealing job in the world but no one could take a shot to the balls like you... No one!

2. True love waits you here. You arranged marriage was scheduled 3 months ago. Your wife and I waited all night for you come and you never did. However, she still waits for the day of your return. P.S. Your future wife is 3 months pregnant.

3. All these blogs seem to be affecting your mind and caused you to forget your true identity. For you often close in the wrong name. You are Mahmut Alan Turkey! Leader of our people.

4. I don't know who Craig is but I have never met one cool person named Craig.

Mahmut, your family waits for you. Please come home.

Your Brother,
Tumham Nala Turkey