Child Psychiatry: raising some questions

I don't think this culture's problems can be more apparent than in the field of child and adolescent psychiatry and psychology. At every turn there is a contradiction and denial of the obvious. Here are some recent statistics (from a lecture I had) that are hard to digest:

Conduct disorders: 24.8% of boys (lifetime prevalence)
ADHD: 26.3% of boys (lifetime prev.)
Emotional disorders: 36.2% of girls (lifetime prev.)
Sexual abuse of kids: 1 in 4 girls, 1 in 8 boys
Self-abuse (cutting and burning): 20% of general kid population, 40% residential kids
Fetal alcohol syndrome: 3 per 1000 babies born

Not to mention drug abuse, drug induced psychosis, schizophrenia, eating disorders, suicides, etc...

If these numbers are true, and I suspect they are not far from the truth, what is wrong with us? Do more than half of North American children have a serious psychological disorder?

Perhaps a better way to explain these astounding statistics is this: we'll admit that they describe real behaviors (e.g. real depression and cutting and suicide attempts in 14 year olds who break up with first sexual partner, or real law-breaking behavior in adolescent boys). And that's pretty bad. Then we'll ask why they are now, apparently, so prevalent.

I would suggest it's because we would rather say that the problem is with the kids than with the parents, teachers, and society that raises them. For instance, it's much easier for the tired, overworked teacher to have her problem kids labeled "ADHD" so that the blame for their poor grades doesn't rest on her. And what can a teacher do anyway, if the parents don't back her up? So it's easier for the parents too to have this diagnosis. (This is not to say that real ADHD may exist, just much much rarer than it is diagnosed today).

Here's another example: the 14 year old girl who breaks up with first sexual partner is counseled in exactly this way "Don't worry, that relationship is just the first rung on a long ladder of life's relationships." Going by current numbers, this may be because the majority of counselors are on a long ladder of sexual relationships. But no wonder the girl is depressed! She has formed a deep (although apparently casual) psychological, emotional and physical bond with her partner, which can only properly exist in the context of a lifelong commitment. So of course the girl will may become suicidal or turn to self-injurious behavior to cope. She doesn't get the treatment she needs, and more importantly, no one was there to help her avoid the problem in the first place.

The list can go on and on. The point in common seems to be that adults are excusing their own actions and kids are being increasingly harmed by it...

Stem Cells and the Psychology of Sin

Man’s advancement in the sciences over the last several decades has revolutionized health care and dramatically changed the culture in which we live. An important new advancement in the biomedical sciences is the discovery of stem cells and the means to manipulate them. The ethical implications of this discovery for science and for our culture have generated intense political and theological debate, about which much has been written already. In this article I will review the current science of stem cells, discuss the ethical concerns, and finally consider the question of why so much interest in embryonic stem cell research.

What are stem cells?

“Stem cells” refer to cells which have the potential to develop into more than one kind of cell type. Once they are isolated and grown in a lab, they can technically be reproduced indefinitely. Current literature distinguishes between two kinds of stem cells: embryonic and adult stem cells. Embryonic stem cells are part of the developing baby in its first few weeks of life. The fertilized egg, in a sense, is the ultimate stem cell – by dividing it can generate all the different cell types of the mature adult organism. The single fertilized egg, called a “zygote,” grows by dividing again and again, becoming a multicellular organism, i.e. made up of many cells. During the initial three to five days, any of these cells may separate from the embryo and become a new embryo, called an identical twin. At a certain point, however, these cells cease to be totipotent but are still able to differentiate into every kind of tissue needed for growth and development of the embryo into a mature adult. As the baby develops and becomes bigger, these cells become more and more specialized and lose the ability to become other kinds of cells, so that, in the end, a heart muscle cell cannot become a skin cell, although they both may have come from the same stem cell a few weeks or years before. In the laboratory, scientists are learning how to coax stem cells to develop into whatever kind of tissue they please.

The other kind of stem cells are adult stem cells, found in various body tissues (e.g. brain, muscle, bone marrow), as well as umbilical cord and placental blood. We now know that they are much more common than was previously thought. Scientists had postulated that it would be harder to manipulate adult stem cells to change into different kinds of cells. However, the opposite appears to be true: while embryonic stems cells are proving extremely difficult to control (they often turn into tumours in patients who are treated with them), coaxing adult stem cells to change into the desired tissue and remain stable is a simpler process. The “plasticity” of adult stem cells is now well established. For instance, researchers in Italy have been able to take stem cells from an adult brain and turn them into skeletal muscle.[1] In fact, success stories about adult stem cell treatments are coming in so fast, that LifeSiteNews.com, a news agency that is closely following the issue, reports that they are having difficulty keeping up. As recently as January of this year, a young woman paralyzed in a car accident three years ago from her biceps down, is now walking with leg braces on a treadmill, after stem cells taken from her nose were implanted in her spinal cord.[2]

It is important to note that, to date, all the successful stories have come only from the use of adult stem cells, while most disease research organizations, such as the Juvenile Diabetes, Multiple Sclerosis and Canadian Cancer Societies, most governments, and most researchers continue to support the use of embryonic stem cells.

Is anything wrong with using stem cells?

There is nothing intrinsically wrong with the use of stem cells for research and therapy. However, in order to obtain embryonic stem cells, the newly formed, few day old baby has to die. Extraction of these cells from the embryo results in the death of the embryo, necessarily. On the other hand, obtaining adult stem cells is often as uncomplicated and morally neutral as a simple blood test.

It should seem evident that if the human embryo, a small living human being, is killed to obtain stem cells, then this use of stem cells represents a grave moral evil. However, there are many who disagree that the embryo is human, or that it is a person. But especially repugnant are the views of those today who hold that in spite of the fact that embryos are tiny, living, human beings, the value of their cells to the common good of society outweighs their right to live and grow and be born.

A second moral issue arising from the use of embryonic stem cells is issue of obtaining the incredible number of human ova (unfertilized eggs) necessary for research and development of such “products.” Developing nations especially are expressing serious concerns that their women in particular will be at risk of exploitation by private pharmaceutical and research companies to obtain the necessary human eggs.

Why so much interest in stem cells?

An interest, and indeed, an excitement about the potentials of stem cell research for treating diseases is understandable and should be encouraged. Drug therapy dominates the medicine of today. With the ability to manipulate stem cells to become any kind of tissue we want, the medicine of the future will be dominated by restorative therapies. For instance, instead of using drugs to treat heart failure following a heart attack, stem cells could be injected into the heart which could be influenced to grow into new heart muscle in the damaged heart. This kind of “therapeutic potential,” formerly science fiction, now appears to be right around the corner.

The real question, then, is why the grossly inflated interest in embryonic stem cells, which, besides being obtained from tiny human persons grown and killed for that purpose, have proven to be uncontrollable and ineffective? The answer is not simple, for many forces are at work.

First, with the successes, both real and imagined, of stem cell research, comes a renewed devotion to the cult of health, which already pervades the thinking of modern culture. Phrases such as “As long as you have your health!” and “If you have your health, you have it all!” illustrate the common principle that health is equivalent to happiness. The worship of health by the strong of our society, in pursuit of health and fleeing all suffering, leads to the oppression of the weak and defenseless.

Second, with such incredible “therapeutic potential” comes the possibility of incredible financial gain. A healthcare market dependent on stem cells will generate a multi-billion dollar industry for the companies and researchers who develop the technology and supply the cells. Government healthcare programs and giant insurance agencies stand to save billions in pharmaceutical products and time spent in hospital.

Ultimately, however, the question remains: why, in the face of the immense success of adult stem cells, are embryonic stem cells still disproportionately championed by a conspiracy of governments, the media, and the vast majority of researchers? For it almost seems as if there is an attraction to the sinful, the morally evil, and to all things previously considered taboo. The beginnings of an answer to this question emerge by considering that the use of embryonic stem cells is simply another face of the culture of death, whose other faces include abortion, infanticide and euthanasia. In his letter to the Romans Paul describes the culture of death, at work in every age, “who by their wickedness suppress the truth... they became futile in their thinking and their senseless minds were darkened” for they “exchanged the truth about God for a lie and worshiped and served the creature rather than the Creator” (Rom 1:18ff). He points to the fact that the consequences of living out the culture of death are intellectual darkness, impurity, and ultimately death itself, precisely what is being experienced by our culture today.

Our response to embryonic stem cell research should not be discouragement or dismay – we are confident in the power of the Gospel and the unshakeable foundations of the Kingdom of God. We are encouraged by the words of Pope John Paul II in his encyclical letter, The Gospel of Life:

“I repeat what I said to those families who carry out their challenging mission amid so many difficulties: a great prayer for life is urgently needed, a prayer which will rise up throughout the world… Let us therefore discover anew the humility and the courage to pray and fast so that the power from on high will break down the walls of lies and deceit; the walls which conceal from the sight of so many of our brothers and sisters the evil of practices and laws which are hostile to life.

“In this great endeavour to create a new culture of life we are inspired and sustained by the confidence that comes from knowing that the Gospel of life, like the Kingdom of God itself, is growing and producing abundant fruit (cf. Mk 4:26-29).”[3]

---

[1] Szabo, Paul. The Ethics and Science of Stem Cells. January 2002, p. 23. See www.paulszabo.com

[2] Taken from www.lifesite.net/ldn/2005/jan/05012007.html, referenced 2/27/05.

[3] Pope John Paul II, Evangelium Vitae, section 100.

Infanticide: the sky is the limit

The killing of newborns has, to the best of historical knowledge, been an integral part of every pagan culture. It should come as no surprise that, as our own culture becomes increasingly detached from its Christian heritage, the practice of infanticide should reappear as a socially acceptable and ethically defensible custom. After all, abortion has already won overwhelming approval, and the only difference between abortion and infanticide is the location of the child, i.e. inside or outside the womb.

Modern historians point out that infanticide flourished in areas where food was scarce (e.g. China and Inuit communities), that traditional patriarchal societies practiced female infanticide, and that disabled or deformed infants were routinely killed in almost every culture that has been studied. Some societies have even legislated infanticide, as is the case with the famous Patria Potestas law of ancient Rome. In Rome a father had absolute authority over the life and death of his children, and it was customary for a basin full of water to be present in the birthing room to drown the newborn child if the father so decided. In Sparta, the decision to keep a newborn child was left to a public magistrate. A notable exception were the Jews; Tacitus comments in his Histories that, interestingly, the Jews tended to raise all their young.

The unavoidable clash between Christian morals and pagan culture led finally to a complete ban on infanticide by emperor Valentinian in 374 AD. This triumph came not without a struggle. In fact, as Fr. Hardon noted in a lecture on contraception, the persecution of early Christians was generally not because they refused to offer incense to the emperor, as is often assumed, but because they refused to contracept, abort, or expose their infants. Thus it was then, as it is now, a struggle between the culture of life and the culture of death.

Today, as in ancient times, the Church of Christ fulfills her mandate to proclaim the Gospel of Life to the ends of the earth. Infanticide continues to be practiced with impunity in regions of Asia, especially in China and India. In these two countries “son preference” has decimated the female population, resulting in the “missing women” crisis of the early nineties. The gender ratio, usually 994 women for every 1000 men, reaches lows of 800 women to 1000 men in some Indian states, where sex-selective abortions and female infanticide are commonplace. Government censuses have revealed that over 60 million women are missing in Asia. It is estimated that by the year 2050 there will be a surplus of 90 million men in China alone. (Many have already written on the troubles to be expected from this exceptionally large population of young hedonist bachelors.)

While “son preference” is absent from North American culture, where sons and daughters are aborted at equal rates, the infanticidal mentality is not. Infanticide, where practiced, is rare or at least discreet. Remnants of western Judeo-Christian ethics, and the widespread and universal availability of abortion and contraception have rendered infanticide repulsive and unnecessary. However, the idea of infanticide is gaining favor, especially in academic circles.

The reconsideration of infanticide by western post-modern culture can be attributed to at least two causes. First, prominent bioethicists and physicians are beginning to promote it with unabashed and menacing urgency. And second, widespread abortion, especially partial birth abortion, encourages an infanticidal mentality. The gruesome and impious practice of infanticide is subtly but rapidly becoming the next battlefront in the war between the culture of life and the culture of death in North America.

A brief consideration of the philosophy of these bioethicists reveals fundamental confusion and a surprising shallowness. In the minds of these so-called experts, personhood is independent of human nature, and utilitarian ethics should prevail. For well-known Princeton ethicist Peter Singer, an adult cat has more of a right to life than a newborn human infant. For Singer, simply being human does not imply a right to life. What gives rise to fundamental rights, like right to life, is not being but having certain attributes like self-awareness or a desire to survive. Logically, then, higher animals like cats and primates enjoy the same rights as adult humans, while the rights of infants to live depend on extrinsic circumstances, such as whether they are wanted by their parents or can be afforded by society. Singer rightly points out that no metaphysical change in being occurs to the infant as it passes through the birth canal. Granting that abortion is ethically permissible, as he does, it is eminently logical to extend the abortive vulnerability to infants who have already been born.

Partial birth abortion laws encourage the acceptance of infanticide. This is one of the reasons given by the American Center for Law and Justice (ACLJ) for outlawing the practice in the United States. In a brief filed in the U.S. federal courts, the ACLJ contends that the government has a “vital and compelling interest” in preventing the spread of the practice of abortion into infanticide. “Partial-birth procedures represent the beachhead of abortion's assault on postnatal life, the bridge between abortion and infanticide,” the brief states. “Absent strong legal barriers and vigorous societal condemnation, partial-birth procedures open the way to legal infanticide.”

If Canadians already hear very little about abortion from the media, they hear nothing at all about infanticide. Yet there is well-documented evidence to prove that infanticide is practiced in some Canadian hospitals and many abortion clinics. Nurses and technicians from abortion clinics have reported that failed abortions, where the baby survives, are routinely followed by abandoning, drowning or otherwise killing the newborn. Infanticide is no longer merely a dream of pro-abortion academia, it is instead a quickly spreading reality, a nightmare already coming true.

In addition to infanticide, the insatiable appetite of the biotech industry has given rise to both cloning for experimentation and organ “harvesting”, as well as the horrific but undeniable market for fetal body parts that drives the partial birth abortion industry.

The culture of death wears many masks. Infanticide is just a new mask on the same selfish “non serviam” of Satan. It is another reason to worry for our country, for, as Donum Vitae makes clear, “When the state does not place its power at the service of the rights of each citizen, and in particular of the more vulnerable, the very foundations of a state based on law are undermined.” (Congregation of the Doctrine of the Faith, Donum vitae III) In these times, however, we remember the voice of Christ and find hope in His words, “Be not afraid!” And with prayerful confidence, we beg for the courage and wisdom to continue the fight that has already been won.

Life Support Not Obligatory

For someone who objected that the author of the last article should "lighten up a little" with regard to life support, i.e. not be so down on it:

I see your perspective on the whole subject now a little better - but I think you're getting the wrong message (for a good reason). In fact, you're catching this debate in the middle.

Here's what's been happening - in the Netherlands, Sweden, the UK, and now quite strongly in North America, the "Right to Die" movement has been promoting euthanasia and assisted suicide as a "basic human right." That means that we should all have the right to determine how we end our own life and be able to enlist physicians' help to end it. When someone is not "capable," physicians, hospital ethics boards, and "substitute decision makers" should be able to decide when the plug should be pulled. This was the case with Terri Schiavo, where her husband and judges and doctors decided she shouldn't live anymore. This movement is now gaining a lot of steam, since the principle guiding most people's thought on the matter is that the extrinsic "quality of life" (QOL in the medical literature) determines the intrinsic dignity or worth of a life.

Christianity (and natural law) recognizes the intrinsic dignity of man, who is made in the image and likeness of God. It understands that God, the author and beginning of life, has also the authority over the end of life. Now, a recognition of this authority of God over our life and death has to coexist with an understanding of our duty of stewardship over our bodies. Hence, given different circumstances, we seek more, or less, avidly to preserve our life in the face of illness and human frailty.

(For instance, a 35 year-old father of four might pursue aggressive cancer treatment or choose to be maintained on life support while trying "last resort" medical treatments for a disease that an 85 year old widower might not choose to pursue.)

Hence, also, we recognize that we cannot kill someone, by starvation or otherwise, to end what we determine to be a "life not worth living anymore." Instead, for dying patients or incurable suffering ones, we try our best to alleviate suffering, comfort, and help them see their dignity and understand God's plan for them.

However, the media and the majority of our culture today interpret this Christian understanding as inherently restrictive. "Are you saying we can't choose how and when to die? Do you mean we have to be hooked up to feeding tubes and respirators and IVs until we are absolutely dead?"

We reply that, no, human dignity does not necessarily that we seek always and agressively to prolong and preserve human life, which, after all, is only a brief prelude to eternal life. We just emphasize that no one has the right to end their own or another's life intentionally.

At this point, you walk into the debate, hearing us replying to the culture: "You don't HAVE to be hooked up to life support!" But recognize the objection it is meant to answer. We are emphasizing that no one is morally bound to choose to go on life support to prolong their life, which is what we're being charged with. We certainly don't say that life support isn't great and wonderful and necessary in many cases and good in many cases etc.

What is really at stake is the opposite: people want the right to end their own lives, to have doctors help them do it, and help them end the lives of their "loved ones" when they think it's time for them to go. With Christ and His Church, we affirm throughout the ages, life is good, life is dignified, life is a gift of God, life is not our own.

Excellent Article on "Care" vs Heroic Measures

The lessons of Terri Schiavo

The difference between taking care and heroic measures

Father Raymond J. de Souza

National Post (Canada)

April 1, 2005

Theresa Marie Schiavo has died. Despite her suffering, the human response is sadness at the loss of life because life is always, in even a weak or disabled state, a great good. We pray now that she might enjoy eternal life in the company of the saints in heaven, which is an even greater good.

And therein lies the delicate balance for the Christian believer, as Mrs. Schiavo was. For life is always good -- it is never "unworthy of life"; a human being never becomes a vegetable; life is never without inherent dignity. It is always wrong to destroy innocent human life, even -- or especially – life that is weak.

At the same time, life in this world is not the ultimate good. There are many goods greater even than earthly life -- the truth, faith, honour, loyalty, love. That's why a father does not hesitate in risking his life to protect his family; it is why the church honours the witness of the martyrs. Life in this world -- even for those with longevity -- is only a short prelude to eternity. That's why eternal life is the greater good.

So it is not necessary to prolong life in this world in the face of imminent death, or ravaging disease, or the demands that one's faith be betrayed.

But one cannot deliberately act to directly kill innocent life, whether one's own or another's.

The Schiavo case has given rise to much confusion. The fact that Pope John Paul II had a nasal feeding tube inserted on the day she died caused greater confusion still.

Classic moral thinking about such matters insists that, while there is an obligation to take care of one's own life and health, there is no need to undergo treatment that is disproportionate to the foreseen benefits. That's why many elderly people refuse the radiation or chemotherapy younger people would routinely take.

The key question relates to what constitutes medical treatment and what is just ordinary care. It is generally considered that ordinary care -- which does not constitute treatment -- includes warmth, hygiene, nutrition, hydration and pain control. Ordinary care is not "life support"; it is possible to die from infected bedsores, but preventing bedsores in a comatose patient is not "life support."

In case of imminent death, even ordinary care can be forgone. There is no need to use an IV for fluids if the patient will die tomorrow. But it would be wrong to withhold or refuse ordinary care, especially if it was intended to hasten death.

A good rule of thumb is to ask: What will cause the patient's death?

If it will be dehydration or starvation, then ordinary care, including food and water, should be provided. Otherwise, death is not the result of disease or trauma, but from lack of ordinary care. That's the moral difference between allowing someone to die, and actively causing death. Mrs. Schiavo was not dying; her death was the result of her food supply being cut off.

There are thousands of cases every day in which further medical treatment is refused on the grounds that it would be too burdensome. There are many cases in which even ordinary care is withdrawn because death is imminent, a matter of hours or a few days. No one need die hooked up to a vast array of machines. But it is a different matter to die for lack of food and water.

Yesterday's news also indicated that Pope John Paul II was not getting enough food after his tracheotomy, and so he has had a nasal feeding tube inserted to enhance his nutrition. He is obviously not on "life support" -- the feeding tube is the provision of ordinary care.

Some commentators speculated that the news was evidence that, if it came to that, John Paul would want to be on "life support" as long as possible. There is no evidence for that. The acceptance of ordinary care -- tube feeding -- does not imply anything about other treatment. Given his age and deteriorating medical condition, it would be perfectly understandable -- and morally permissible -- if John Paul indicated that he wished no more aggressive medical treatments.

About five years ago, John Paul himself wrote: "Despite the limitations brought on by age, I continue to enjoy life. At the same time, I find great peace in thinking of the time when the Lord will call me: from life to life!"

That is the balance -- to treasure life in this world and to look forward to life in the next. Death is part of life, killing is not. The lines can become blurred and the situations complex, but the principle remains: Life is always good, but not the greatest good.

© National Post 2005

The Tear of JL

JL is a man, and that is the point of this story.

Because JL is, at the moment, taking his last desparate breaths before going to the next life. As I work through this palliative care rotation, I've seen many responses from those at death's door: happiness, hope, elation, peace, sadness, despair, and ignorance. JL is not responding. He's been denied food and water for almost two weeks now, and defying death, and especially, denying the Culture of Death, he continues to live. His heart beats on and on, quicker every day as his body's supply of fluid runs dry.

JL is not responding, according to his daughter who made the decision to "forego" the "treatment" of food and water. He looks around when spoken to, but who knows what he sees or hears. Poor old man.

I found him alone yesterday (his family absent from their usual cold, bitter vigil). I spoke softly to him about dying. He did not drift back to sleep. I spoke to him about sin and forgiveness - he tried to voice a thought, but his dry hoarse throat just whined. I spoke to him about Christ and His love, His mercy, His hope, His call to repentence. A tear formed in the corner of the eye of this "comatose" man, and he looked at me intently. We prayed together. Now I knew it was WE who prayed together. And he drifted back to sleep.

Today he will die, I do not doubt, a victim of the Culture of Death, who has judged his quality of life too low to be worth living. But I believe he has felt his own dignity, if but for a moment, in the midst of starvation.

Resolutions at a Blank Slate

Perhaps the hardest thing for an artist, author, sculptor, or poet is the first step. The first line of a poem, the first tap with the chisel, the first line on a blank blog window...

Here is the forum for the exchange of ideas and the exercise in articulation. Like working out or jogging regularly, it demands motivation from within and time. If I truly believe this endeavor, this grand endeavor, is worthwhile, I will blog, and blog well.

Deuteronomy, the Old Law, and Smoking

Overlyconscious has objected to the general consensus that smoking is immoral (seriously or not) because it harms the body that we are bound, naturally and supernaturally, to nurture and non nocere. Now we can begin a good discussion.

While there are substantial principles upon which Overlyconscious may have based his objection (some of them subconscious perhaps), let us deal first with his use of Deuteronomy 14:26, from which he concludes that God encourages smoking, as he does drinking, as long as it is done "before the Lord."

The text of Deut. 14:26 should be considered, as all Scripture should, in its context.

Deuteronomy 1 begins with "These are the words that Moses spoke to all Isreal beyond the Jordan in the wilderness... Moses spoke to the people of Isreal according to all that the Lord had given him in commandment to them... Moses undertook to explain this law..."

Deuteronomy 12 begins with "These are the statutes and ordinances which you shall be careful to do in the land which the Lord ... has given you to possess." The enumeration of the statutes, now referred to as the "Old Law," continues for many chapters. Here are some examples:

Deut 12:15 "You may slaughter and eat flesh within any of your towns, as much as you desire, according to the blessing of the Lord..."
Deut 14:3 ff "You shall not eat any abominable thing. These are the animals you may eat: the ox, the sheep, the goat... And the swine, because it parts the hoof but does not chew the cud, is undlean for you. Their flesh you shall not eat, and their carcasses you shall not touch... You shall not boil a kid in its mother's milk."
Deut 21:10 ff "When you go forth to war against your enemies... and see among the captives a beautiful woman, and you have desire for her... then you shall take her home to your house and she shall shave her head and pare her nails... If you have no delight in her, you shall let her go where she will, but you shall not sell her for money... since you have humiliated her."

These, and others, are very interesting prescriptions, and we wonder if Overlyconscious follows them all, including Deut 24 - Moses' prescription for divorce (which Christ explained was allowed for the Jews' "hardness of heart" [Mt. 19:1-ff). The point is that the Old Law lays an enormous burden upon man which, according to St. Paul, did not have the power to save anyway. You can't choose part of the Old Law to justify your practices without swallowing the whole of it. And its bloody hard to swallow.

But Deuteronomy 14:26 doesn't allow for smoking in even the remotest senses of interpretation. Look at verse 22-23: "You shall tithe all the yield of your seed, which comes forth from the field year by year. And before the Lord, in the place which He will choose, to make His name dwell there, you shall eat the tithe of your grain, your wine, your oil..." Moses is prescribing what should be done with the tithed portion of an Isrealites property or wealth. As he goes on to prescribe in 24-25, if you live too far away to carry it all, turn it into money, and then, in your verse 26: "spend the money for whatever you desire, oxen, or sheep, or wine or strong drink, whatever your appetite craves; and you shall eat there before the Lord your God and rejoice, you and your household." And, being overly conscious, we wouldn't forget the next verse 27: "And you shall not forsake the Levite who is within your towns, for he has no portion or inheritance with you."

It's obvious that what is being laid out is what to do with the tithed portion of the yearly harvest. What you could possibly conclude about cigarettes from this verse is this : once in the place where the Lord has chosen, that you can buy them, if you use your money (preferably silver) obtained from exchanging the tithed portion of your yearly harvest (or income). When you have bought your cigarettes, you may eat them, in the presence of the Lord, all the while, of course, rejoicing.

Ark of the New Covenant, pray for us

Today is the feast of the Holy Rosary. It behooves us all (as Thomas a Kempis would say) to reflect a little today on the great gift we have in the Blessed Virgin Mary, mother of Christ and our mother. I would like to offer a brief consideration of the ark of the covenant in the Old Testament as a type for Mary in the New.

"Ark of the New Covenant" was a term coined by St. Athanasius, bishop of Alexandria, Confessor and Doctor of the Church; born c. 296; died 2 May, 373. No one doubts the orthodoxy of such an early and notable church father, nor his close chronological and geographical link with the apostles themselves. That's why I think it's not fantastic to interpret Revelation in the following way.

Let's turn to St. John's Revelation 11:19 and read,

Then God's temple in heaven was opened, and the ark of his covenant could be seen in the temple. There were flashes of lightning, rumblings, and peals of thunder, an earthquake, and a violent hailstorm.

St. John is writing to Christians who were Jews, who knew Scripture and Jewish history better than we've ever known anything. The ark of the covenant, crown and glory of the people of God, victory in war and seat of God Himself, had been missing for some 500 years. For John to say that he saw it in his vision is no small thing. "Tell us more, John!" is an appropriate response. But he goes on, in the next verse, to say

A great sign appeared in the sky, a woman clothed with the sun, with the moon under her feet, and on her head a crown of twelve stars.

She was with child and wailed aloud in pain as she labored to give birth.

"Wait a second, tell us more about the ark, John!" That's exactly what he's doing.

The ark of the covenant was a box of acasia wood, covered in gold, with two huge cherubim on top and an empty throne-like seat, for which the box was like a footstool. Inside the ark were placed three things: the tablets of the ten commandments, manna (the miracle bread), and the rod of Aaron that had blossomed. These are what made the box holy, holier than the holy of holies in which it was kept.

Is it not apparent that Mary was made holy, infinitely holier than the wooden ark, by what was inside her? The wooden box held the word of God in stone, she held the Word of God made flesh. The box contained the miracle bread, the manna from the desert; she held the Bread of Life Himself. The staff of Aaron was the power of the priesthood; Mary held the Eternal High Priest in her womb. She was thus the seat of the Godhead, sanctified by Sanctity within her.

The similarities are endless. Mary, like the ark in 2 Sam 6, went up in haste to the hill country of Judah. David leapt before the ark, as did a preborn John the Baptist... and on and on.

It's neat to think of the holiness of Mary (St. Thomas says she's holier than the combined holiness of every creature below her) and at the same time remember that Christ gave her to us on the cross.

Food for the smoking soul

Smoking cigarettes is strongly associated with numerous medical disorders, most of which are the top killers in North America. Many of us think that smoking only leads to cancer, which it does. But the evidence also suggests that smoking is largely responsible for the rising rates of heart disease, chronic respiratory disorders and diabetes (Type 1 and 2). These guys kill more poor fat North Americans than lung cancer does; they deal death a little slower and a little more painfully.

Now, considering the Aristotelian ethical tradition which considers good health somewhat of a responsibility and certainly a necessity for happiness, as well as the Christian revelation which reveals that our bodies are temples of the Holy Spirit, what next? What shall we conclude objectively as to the personal moral legitimacy of smoking...

Bloggers, comment away.

Personally Opposed on Sept. 29

Just don't think and you can entertain a proposition and its opposite at almost the same time.

I was in the "women's clinic" for a rotation the other morning. I met one of my Catholic collegue medical students, who's working in the clinic for a month. "You know they do terminations here?" she mentions. I know. I've dreaded coming into this dungeon-like basement unit for months. But today is the feast of St. Michael the Archangel, and with Mass and communion minutes behind me, I waltz into the valley of darkness. "I spent an afternoon watching them," she continues. The terminations, that is. Putting together the little pieces in a cold steel bowl to make sure nothing is left behind in ... mom.

What did she think? "Pretty disturbing" was quickly followed with, "but I'm glad it's an option for women who aren't ready to have babies yet." Good girl. You know what you're supposed to say. "I wouldn't do something like that myself," she assures me. Very interesting. OK, Catholic girl, let's have it out right here in the office of the women's clinic, across the hall from the (thankfully) empty abortion suite.

If these little hands and feet you've had to "fit together" are just tissue, abortion is a great choice, really. But if it's a baby who's being dismembered, whose pieces you're fitting together, and whose limbs you're counting in that bowl, then abortion can't be a choice. You can't be allowed to choose to murder. And you know, because you feel pretty disturbed, that it's a baby. End of story.

Time flies and habits die

Writing isn't easy.

Doing anything regularly isn't easy either.

(Except sleeping and eating.)

So that's why it's hard to write regularly.

We'll all find ourselves, at fifty years of age, in tears over the same faults, the same bad habits, in pursuit of the same virtues. All because we're too lazy, too disorganized, too proud, too discouraged, to do any better.

I think a passage of St. Msgr. Escriva is in order:

"'Tomorrow!' Sometimes it is prudence; many times it is the adverb of the defeated."

Triumph of the Cross & Chiropractic Theory

Today Catholics celebrate the feast of the Triumph of the Cross. It may seem odd that chiropracters have any light to shed on the theological meaning behind this feast, but here's what I heard from some chiropracters who were presenting/defending their art to my class today.

The old biomechanical model which forms the basis for the medical and chiropractic treatment of musculoskeletal disorders assumes that degenerative changes (e.g. to a joint) occur first, leading to structural changes with normal loading, which gives rise to pain.

Based on new research data, the new biomechanical model conceptualizes joint damage and its sequelae in the reverse order: structural damage occurs first (with improper loading, etc.), followed by inflammation and degenerative change, which leads to pain. What is very interesting here is the implication that by avoiding structural change (e.g. to your vertebrae, by poor posture, bad lifting, etc.) one can avoid degenerative change (osteoarthritis, lower back pain, osteoporosis, etc.). Since mechanisms for inducing structural change (e.g. habitual poor posture) proceed directly from the human will, it follows that the perfectly informed will would not make the bad choices that would ultimately induce (at least) degenerative types of disease. After all, degenerative change is only the response of the properly functioning bodily systems to damage from without.

But man before the fall possessed a preternatural will, capable of making the right choices and thereby avoiding bone and tissue degeneration. Which means that when sin entered the world, clouding man's will, so did the pain of degenerative disease. Lower back pain complaints account for the most visits to primary care physicians after respiratory disorders.

But today we celebrate the triumph of the cross, the cross by which Our Lord took upon his perfect body all the pain and agony of death, damage, degeneration and dispair. And by His stripes we are healed. Death no longer has a hold on us.

Pontius Pilate, Patron Saint of Modern Politicians

Here is a very insightful and readable article about the Passion, and the modern world's impression of how Pontius Pilate was betrayed. Of course, these days we meditate not so much on Pilate, but on the Truth standing before him, but this helps anyway.

http://nationalreview.com/comment/de_souza200404080847.asp

Fr. Raymond de Souza is Catholic Chaplain of Newman Center at Queen's University, Kingston.

Applying Double Effect in Medicine

[Email from professor]

I thought I'd follow up a little bit on our discussion
about the doctrine of double effect (DDE) today. The
intent is a primary component of the doctrine.

Let's take the example of the mother in labour whose
life is being threatened. In scenario 1, the baby's
head is too big to be delivered, the mother will die
secondary to labour (perhaps because her blood pressure
is too high) and the options are either to continue the
delivery because the baby cannot be pulled back out
via caesarian section and the likely outcome is that the
mother will die, and perhaps the baby too OR the
baby's skull is collapse resulting in its death but the
mother is saved.

In scenario 2, the mother is having life threatening
placental hemorrhage, and needs to have an emergency
hysterectomy to save her life. In this case, the baby
may die as a result of the emergency hysterectomy
because it is still in the uterus and cannot be delivered
without the mother dying in the process.

How are these 2 situations different?

In scenario 1, the method by which the mother's life
will be saved is through the death of the baby.
Therefore according to DDE it is not justifiable since the
"intent" is to kill the baby, which will result in
saving the mother. The intended outcome of the action
(killing the baby and ending the labour) is immoral, and
even if the indirect outcome (saving the mother) is
good.

In scenario 2, the method by which the mother's life
will be saved is via hysterectomy. It is justifiable
since the "intent" is to save the mother. The intended
outcome of the action (saving the mother by stopping
the hemorrhage) is moral, while the unintended although
inextricably linked outcome (death of the baby) is
only secondary.

Of course, the intent in this circumstance is linked
to the deontological rule/commandment "thou shalt not
kill", but the issue here is that in scenario 1 killing
is the intended action, where in scenario 2 it is an
unavoidable consequence.

Personally I have difficulties with DDE once I start
thinking too much about it. It can be "wrongly" used
to either justify problematic actions or inaction
(e.g., letting the mother die in scenario 1 when the baby
will die anyways, too). It can also be twisted when we
start thinking of withdrawing treatment or
administering palliative medications at the end of life--semantic
arguments about whether you believed someone was going
to die or whether you were letting the natural course
of their disease progress.

Anyways, I hope you enjoyed class and that I clarified
some of your questions about DDE.

Cheers,

[quisutdeus responds]

The principle of double effect allows one to perform an action which has two effects, one good and the other bad, provided the following four conditions are met simultaneously: (cf. Germain Grisez)

1. the act itself must be good or at least morally neutral,
2. the agent must intend the good effect,
3. the good effect must not result from the bad effect,
4. and there must be a proportionately grave reason to justify the act (good effect outweighs bad).

I'm not sure you properly apply DDE in the first of your two scenarios, even though I agree with the conclusions. In scenario 1, the action itself (collapsing the baby's skull) is always wrong, even apart from consideration of the good effect that follows, for to kill an innocent person is intrinsically immoral. For this reason it fails to satisfy the first criterion and double effect cannot apply.

The argument from "intent" fails to distinguish the two scenarios. Intent is an act of the will in a reasoning being capable of freely choosing. In both scenarios the effect primarily intended by most surgeons is to save the life of the mother. The surgeon achieves the desired end differently in each case (she DOES something differently). In both cases the death of the baby (hysterectomy resulting in baby dying and evacuation of baby's brain resulting in baby dying) is unintended by the agent. In one case, however, when the surgeon says, "we couldn't save your baby," she means that she killed your baby. In the other case she means she did all she could, but the baby died as was foreseen. The moral distinction between the two is made in reference to the act itself.

A couple of things follow from the four criteria that we may grapple with personally.

The first is that sometimes we will have to allow an innocent mother to die because we are morally unable to kill the innocent baby trapped in her birth canal. While this is extremely tragic (as well as exceedingly rare) there are profoundly positive cultural implications to be obtained by affirming life not only in principle (thou shalt not kill - dignity of personhood, etc.) but also in act.

Second, the principle of double effect can work the other way in scenario 1, where the (consenting) mother can be operated on to save the baby, with the high probability that she will die during surgery. The case of Gianna Bretta Molla, an Italian pediatrian, is similar. She refused surgery to remove a large ovarian cyst during her pregnancy because it would result in the death of her child. She died shortly after giving birth in 1962.

Third, the intent itself is enough to vitiate a morally neutral or even good act. In the second scenario, for instance, if the surgeon performing the hysterectomy intends to kill the baby to save the mother, the surgeon IS morally guilty of killing the baby.

I enjoyed your comments. Let me know what you think of these.

The Bioethics of Killing & Letting Die

There has never been a shortage of poor philosophers at the disposal of big business. The case of hospital bioethicists is no exception. And as a sure sign that they are poor philosophers, they are almost never financially wanting.

Bioethicists are a select group of co-affirming free thinkers who are hired, at good price, by the healthcare industry (hospitals, pharmaceutical companies, government departments) in order to sell hard policies. Bioethicists are proficient at manufacturing “ethical” arguments for previously unethical practices that promise to save their employers lots of money.

“Anyone familiar with medical research knows that ethics committees are indispensable – they have the important job of wringing their hands and furrowing their brows before writing the permission slips to cross lines that heretofore were thought impermissible to cross.” more

One current battlefield is the area of withholding and withdrawing treatment at the end of life. Physicians in intensive care units face death and dying on a daily basis. They are regularly an intimate part of the life and death decisions that face dying patients and their families. It is often the physician who counsels the patient and family, and inevitably the physician who implements the decision that has been reached.

Bioethicists, out to save their employers money, are trying to convince doctors not to save their patients. It is happening in hospitals everywhere in the “developed” nations, and it is becoming less and less subtle. Under the guise of “Futile Care Theory,” hospitals are putting in place procedural protocols which allow them to refuse treatment to sick patients, whether they want it or not, if the patient is deemed incurable or terminal. Treatment doesn’t just refer to new and expensive therapies; it extends to life-sustaining food, water and basic hygiene.

On the basis of “futile care theory,” Leslie Burke, age 44, is suing his hospital in the UK for the right to remain alive. Doctors there have refused (in advance) to provide him food or water when is condition deteriorates to the point of needing a feeding tube.

The parents of David Glass were shocked to find the same attitude from their doctors at St. Mary’s Hospital in Portsmouth. In 1998, at age 12, David suffered respiratory failure. Not only did doctors refuse to treat his life, but they sought to administer a “palliative” agent to David in order to hasten his death. They reasoned that David’s profound developmental and physical disabilities made his life not worth living, and therefore not worth saving.

And healthcare boards across North America are quietly implementing similar policies. Physicians, the final common pathway in the withholding and withdrawing that will bring lives to their end, are either unaware or don’t care. But those who don’t care have to be taught to overcome their intuitive instinct that killing is wrong. Enter the bioethicists. Some killing is okay. Some letting die is okay too. In fact, anything is okay given the right motivation, intention, circumstances and societal context.
Here are some delightful selections from my professor’s bioethics notes for tomorrow’s lecture on withholding and withdrawing treatment. She is also our hospital bioethicist. We’ll face-off at 8:30am EST tomorrow.

On Moral Intuition: “Often people will intuitively believe that while it is appropriate in certain instances to withhold treatment, it is never right to withdraw treatment.”

Intuition, however, is usually a sign of what is right for the most part. If the patient refuses an IV line, I won’t put it in. If his only source of food and water is his IV line, I won’t take it out. To do so would be to starve him, and removal of the line would mean death.

On Conscience: “It is important to keep in mind that because something “feels” right or wrong is not definitive in terms of deciding morality.”

But the exception of an ignorant or malformed conscience proves the rule that conscience is generally a good guide to moral action.

On Killing and Letting Die: “Is killing always wrong? Certainly murder is always wrong… it is wrong by definition. It is defined as the wrongful killing of one human being by another. But killing non-humans (animals) is largely accepted by most societies for food, clothes, some research, etc. Killing humans is largely accepted by most societies in certain instances like self defense and war. So, there are instances where we say killing is justified… To argue that something is wrong, a priori, simply because it is killing cannot be done successfully.”

Murder is properly defined as the taking of an innocent human life, to distinguish it from killing in self defense, for instance. The reason it is wrong is because it offends against the infinite dignity of the human person, a being capable of reason and free choice.

On Life after Death: “It may be that death is nothingness and nothingness has no positive or negative value. It is nothing… it may be that not being alive is arguably better than being alive.”

Somewhere in my remote past I learned what I already had known since I first knew anything: being is better than non-being. Something is better than nothing. It is true that suffering can be so intense that it makes us want to die to make it end. But avoidance of suffering is not the same as seeking death. It is precisely in these moments that a suffering patient needs comfort, relief and support. In the darkness of suffering, a physician can snuff out the flame of hope, or affirm, respect (and treat) the dignity of both human suffering and personhood.

Hate Crime Comes to Canada

OTTAWA, March 25, 2004 (LifeSiteNews.com) –
LifeSiteNews.com has learned that homosexual hate crime bill
C-250 was passed without amendment in the Senate
Committee this morning. The dangerous legislation which
threatens to shut down free speech on the issue of
homosexuality has been sent back to the Senate with a final
vote which could occur as early as Friday but more
likely Monday.


Bill C-250 is pending its final approval by Canada's "free-thinking" senators. Although it has received little or no coverage by the similarly "free-thinking" media, it represents a grave and imminent danger to Canadian's freedom of speech and religion.

Introduced by homosexual activist MP Svend Robinson, and passing through Parliament by a narrow
and to some, a questionable margin, Bill C-250 introduces the term "sexual orientation" into the current Hate Crimes criminal code.

Arguments for and against to follow...