The Briefing 02-21-17

Part I

---

Oregon considering bill that blurs line between physician-assisted suicide and state-sanctioned murder

When the sanctity of human life is sacrificed at one end, the sacrifice continues at the other end of the spectrum. I’m speaking here of birth and death. So even as the Roe v. Wade decision became the landmark for abortion on demand in the United States, similarly, the Oregon assisted suicide bill that was adopted back in 1997 became something of a milestone in terms of the physician assisted suicide movement, sometimes simply called assisted suicide, also increasingly euphemized as physician assisted death. One of the techniques of a moral revolution is to change the language to something that is less alarming and less offensive. If you talk about physician assisted death, that sounds very different than physician assisted suicide. But the reality we should note has not changed.

Now Ian Tuttle reports in National Review that Oregon—that, as we said, back in 1997 became the first U.S. state to legalize assisted suicide—is considering, he says, “tweaking the laws surrounding advance directives, the legal documents by means of which a person can dictate ahead of time his desires for end-of-life care.”

Tuttle continues telling us,

“The innocuous-seeming changes that Senate Bill 494 proposes would permit the state to starve certain patients to death.”

Tuttle points back to the original 1997 legislation and makes very clear that that law had defined basic care—that is not any kind of extended care or unusual care, but just basic medical care—that was not at stake in terms of a decision for assisted suicide as including feeding or hydration “by cup, hand, bottle, drinking straw or eating utensil.”

But Tuttle then tells us that last year,

“Bill Harris of Ashland, Ore., asked a state court to order a nursing facility to stop providing food and water to his wife, Nora, who suffers from Alzheimer’s disease.”

Nora, we are told, had lost fine motor skills to be able to feed herself and had also lost the ability to communicate. The facility that was caring for her had begun feeding her by means of spoon feeding, and the nursing facility was clear that Nora herself continued to choose whether she wanted to eat or not. The facility never coerced her.

“Nonetheless, her husband maintained that when she stated in her advance directive that she did not want artificial nutrition, she intended all forms of feeding.”

Now at this point, it’s very important to recognize the legal reality, but also the moral danger of these so-called advance directives. These days when you register with your local family physician, much less enter into a hospital, you’re almost assuredly going to be asked if you have an advance directive, and many medical professionals will encourage you as a patient to do just that to establish in advance the directives you would want someone to follow in terms of making end-of-life decisions. The danger in this we need to recognize is that language always requires interpretation. And many of these advance directives are simply too vague to be abundantly and adequately clear concerning what an individual’s actual intentions might be, leaving the subject to interpretation as opening the door for someone to make a decision that the patient him or herself actually did not intend to make.

Furthermore, it’s not only the what question that’s important. It’s also the who, and the who in this case it’s not just the patient who might develop this advance directive and have it on file, but anyone who might be at that point in charge of making medical decisions. Bill Harris lost his case in court. That is, the court did not allow him to force the care facility to stop spoon feeding his wife. But as Tuttle tells us, now the Oregon Senate through Senate Bill 494 is considering legislating exactly what Bill Harris demanded. As Tuttle tells us, the bill under consideration would remove “the statutory definition of ‘tube feeding’ and ‘life support,’ and replaces the word ‘desires’ with ‘preferences.’”

As Tuttle explains, the requirement in its advance directive form, “my healthcare representative must follow my instructions to the extent appropriate.”

Now hold on just a minute. Consider the fact that we’re talking about medical decisions that in most cases are likely to bring about death, if not a faster death, and then you come to understand that this language proposed in the Senate bill changes the explicit instructions from the fact that a healthcare representative must follow my instructions, adding the words “to the extent appropriate.” Just imagine the elasticity and the danger in those words, “to the extent appropriate.” Who’s going to decide what’s appropriate? Well what’s very clear in terms of this bill is that it is an effort to try to broaden the categories under which assisted suicide could take place and furthermore, without doubt now, to open the door to assisted suicide being assisted without the clear intention of the patient.

Federal Judge Neil Gorsuch, President Trump’s nominee to the United States Supreme Court, in his doctoral dissertation written at Oxford University in his consideration of assisted suicide and euthanasia pointed out that the entire moral category of assisted suicide is basically just a relabeling of euthanasia. We’ve noted on The Briefing time and again that there is indeed a slope, it’s a deadly slope, not just a slippery slope, when it comes to assisted suicide and euthanasia. It begins with what is called assisted suicide, as we’ve seen sometimes repackaged as physician assisted death, it then slides into euthanasia. But the euthanasia, we are told, is entirely voluntary. That is, it is performed only on those who desire and demand it. But all too quickly what was assisted suicide that turns into euthanasia, voluntary euthanasia opens the door for involuntary euthanasia, and that’s exactly what we’re looking at here. Remember the patient at the beginning of the story was a woman with Alzheimer’s disease who had lost the ability to communicate and the fine motor skills to feed herself and had not given any advance directives that she would intend for that spoon feeding to be defined as extraordinary care.

But there’s another part of the story from Oregon that is both ominous and sinister. As Tuttle tells us, Senate bill 494 would also leave questions about the interpretation and even the wording of these legal documents known as advance directives up to the courts or up to a new regulatory body that this bill creates ex nihilo, known as the Advance Directive Rules Adoption Committee.

According to the law, this committee would be appointed entirely by the governor “and have sole authority to revise the state’s advance-directive forms — that is, to continue the subversive work of the legislature without meaningful oversight.”

Ian Tuttle gets it exactly right when he tells us,

“Having destroyed the professional oath to which doctors are bound, Oregon would destroy the basic ethic of care that is the mark of a humane society — the expectation that says to tend the sick, to clothe the naked, to shelter the homeless.”

He says,

“Under the auspices of a false mercy, Oregon would demand the opposite: to greet Nora Harris, or someone like her — a person who is conscious, who is mobile, who expresses emotion and harbors desires — and to reject her. Human beings meet each other in the recognition of mutual vulnerability. Oregon would craft a society only for the strong.”

Sadly, we simply note that in crafting what it might consider to be a society of the strong, it will end up inevitably only as a society of the strongest.

Part II

---

A crime for not much longer? British police are looking the other way on assisted suicide

Second also on the issue of assisted suicide, we’re being told that even as it is not legal in Great Britain, The Economist reports police are increasingly turning a blind eye to its practice. The Economist reports,

“Although aiding a suicide remains illegal, updated guidance from the Crown Prosecution Service (CPS), which decides when it is in the public interest to proceed with charges, has narrowed the circumstances in which a prosecution will go ahead. Its guidelines, issued in 2010 and updated in 2014, state that a prosecution is less likely to be in the public interest if, for example, ‘the victim had reached a voluntary, clear, settled and informed decision’ and the suspect’s actions ‘were of only minor encouragement or assistance.’”

Now notice again how this kind of subversion of human dignity and sanctity of human life finds its way to move forward in elastic language. Look again at the language, it is “a voluntary, clear, settled and informed decision.”

Who decides that? And the one who might be charged with assisting suicide is going to be judged as not worthy of prosecution if the individual was involved only in minor encouragement or assistance. What defines minor? What defines encouragement? The Economist is also onto something else of importance, and that is this. A crime that is no longer prosecuted is a crime that will not long remain a crime. We’re looking here at a major moral shift in Great Britain, and the clear call on the part of many is simply that Parliament should catch up with the prosecutors, that is to effectively legalize assisted suicide.

Meanwhile, we sadly note that Washington D.C., that is the District of Columbia, became the sixth jurisdiction in the United States of America to legalize assisted suicide that law taking effect this past Saturday. We should receive that news as a signal warning. This means that physician assisted suicide, a form of euthanasia is now fully legal in the District of Columbia, our own nation’s capital.

Part III

---

Acceptance is outstripping research on health risks as more pregnant women and retirees use marijuana

Next, while we’re doing our best to track the moral revolutions that are taking place in this country, we also need to think from time to time about the role that the media play not only in reflecting the revolution, but sometimes in serving as agents driving the revolutionary change. Just take the issue of marijuana, just recently over the course of just a few days, the New York Times ran two front-page stories in terms of the unusual or unexpected use of marijuana and its potential consequences. Both of these stories appeared on page one of the newspaper.

Now when you think about the cultural elite in the United States, that particular segment of society has been overwhelmingly in favor of legalizing marijuana. That’s not a new development. In one sense it can be historically tracked all the way back to the campus activities of the 1960s. But the baby boomers who were college students in the 1960s are now well advanced in middle age or perhaps even older, the earliest baby boomers now reaching the age of retirement.

But the issue of marijuana is now front and center and it’s intergenerational. That’s actually one of the points of the New York Times coverage. One of the stories that appeared yesterday has to do with the use of marijuana increasing amongst the elderly. Winnie Hu reports that the use of marijuana amongst the most aged Americans has been growing even as marijuana remains a Category I classified illegal substance in the United States of America. There is no doubt that the use of marijuana is being morally normalized in the United States, and a part of that is reflected in the fact that several states have now legalized marijuana. But, we need to note, our federal government profoundly has not. But what Winnie Hu was reporting on is the fact that in many nursing homes and care facilities, marijuana is increasingly being used by elderly and aged Americans, often times with authorities basically looking the other way.

Speaking of the increased use of marijuana in healthcare facilities and in retirement centers, one authority, Brian Kaskie, who is a professor of public policy at the University of Iowa and co-author of a study, recently published on the use of cannabis among older Americans, said,

“This is an elephant we’re just starting to get our hands on.”

The reporter then tells us that a medical marijuana education and support club started by residents of Rossmoor Walnut Creek—that’s a retirement community east of San Francisco—has grown to 530 members. So many, we are told, that it has changed meeting rooms three times. The advocates of legalizing and normalizing marijuana in the United States obviously see this as a very positive development and perhaps even good PR for their movement. But there are medical doctors who clearly are not sold. Some doctors warned that the aged are particularly prone to the misuse of drugs, and there are too many people who want to medicate their problems.

“Dr. Thomas Strouse, a psychiatrist and palliative care doctor at the University of California, Los Angeles, said that just as sleeping and pain medications could harm older people, marijuana could possibly make them confused, dizzy or more likely to fall.”

The doctor said,

“There is no evidence that it is particularly helpful to older people, and some reason that it could be harmful.”

But the article also tells us in the New York Times that many nursing homes are basically taking a “don’t ask, don’t tell” policy and looking the other way.

Just a few days prior to that an article appeared in the very same placement in the print edition on the front page of the New York Times. This one with the headline,

“Pregnant and Smoking Pot, With Risks Unclear”

Catherine Saint Louis reports,

“During her pregnancy, she never drank alcohol or had a cigarette. But nearly every day, Stacey, then 24, smoked marijuana.With her fiancé’s blessing, she began taking a few puffs in her first trimester to quell morning sickness before going to work at a sandwich shop. When sciatica made it unbearable to stand during her 12-hour shifts, she discreetly vaped marijuana oil on her lunch break.”

Stacey said,

“I wouldn’t necessarily say, ‘Go smoke a pound of pot when you’re pregnant. In moderation, it’s O.K.””

The reporter then tells us,

“Many pregnant women, particularly younger ones, seem to agree, a recent federal survey shows. As states legalize marijuana or its medical use, expectant mothers are taking it up in increasing numbers — another example of the many ways in which acceptance of marijuana has outstripped scientific understanding of its effects on human health.”

Wait just a minute, that’s a bit of a blockbuster admission. The reporter for the New York Times tells us that the acceptance of marijuana has outstripped the medical knowledge of the effects of marijuana on human health. That’s not, I want to hasten to add, what you’re hearing from so many in the mainstream media and from the cultural influencers who are doing everything they can to normalize and legalize marijuana. Saint Louis goes on to tell us,

“Often pregnant women presume that cannabis has no consequences for developing infants. But preliminary research suggests otherwise: Marijuana’s main psychoactive ingredient — tetrahydrocannabinol, or THC — can cross the placenta to reach the fetus, experts say, potentially harming brain development, cognition and birth weight. THC can also be present in breast milk.”

Dr. Torri Metz obstetrician in Denver said, and I quote,

“There is an increased perception of the safety of cannabis use, even in pregnancy, without data to say it’s actually safe.”

The Times cites statistics telling us that there’s a fairly rapid increase in the number of expectant mothers using marijuana. It’s not surprisingly tilted towards younger, expectant mothers. But The Times tells us that evidence on the effects of prenatal marijuana use is still limited and sometimes contradictory. But there is no clear that there’s no ample ground for warning. Dr. Lauren M. Jansson, director pediatrics at the center for addiction and pregnancy in the Johns Hopkins University School of Medicine, points out that,

“Most troubling, children of mothers who used marijuana heavily in the first trimester had lower scores in reading, math and spelling at age 14 than their peers.”

She said,

“Prenatal exposure can affect the adolescent pretty significantly.”

Just consider that. Here you have a professor of pediatrics at Johns Hopkins University saying that when mothers use marijuana in the first trimester of their pregnancy it is tied to a loss of reading, math, and spelling ability when their children reach age 14. At this point the article also underlines what we already know which is that the use of marijuana among adolescents is particularly dangerous. As The Times said,

“It is already well documented that the developing brains of teenagers can be altered with regular marijuana use, even eventually reducing I.Q.”

The use of marijuana by expectant mothers is sufficiently serious that the American College of Obstetricians and Gynecologists advises its own members to ask pregnant women whether they use marijuana and if so to urge them to quit. The Times article concludes by going back to Stacey—that’s the mother, the expectant mother cited in the beginning of the article—her baby’s been born, and according to Stacy her baby is very healthy. But we’re also told that she continues to use marijuana, and the reporter notes that the toddler is playing on a rug that features a big marijuana leaf. Evidently there was more to it than just an expectant mother using marijuana to deal with the nausea of morning sickness.

The legalization of marijuana is not the biggest crisis facing this nation, but it’s not insignificant either. And for Christian worldview purposes, it fulfills the purpose of helping us to understand that moral revolutions never travel alone. The LGBT revolution has also facilitated other revolutions, including the legalization of marijuana. But before even the LGBT revolution, there were moral revolutions on divorce, and moral revolutions on contraception, and moral revolutions in terms of non-marital cohabitation. All of these revolutions ride on one another. You can see successive revolutions coming like successive waves on the shore. Christians need to understand that’s because the basic fundamentals of the society had been changing.

You couldn’t have something like the legalization of marijuana and the normalization of its use if you didn’t have other major more foundational changes taking place. Americans are increasingly shifting to a personal autonomy morality in which the one thing that matters above all is that I as an individual am happy. We are also increasingly embracing a rather relativistic understanding of morality at least on so-called lifestyle issues, and that’s reflected in this particular topic as well. But that’s why this last story in the New York Times is of particular importance. It’s because morality can never be reduced to just the individual. One example of that is when the individual is an expectant mother. It’s not just about the mother’s use of marijuana. It is also about the child, the unborn child receiving the very same marijuana and also with documentation of its impact even when the child reaches the age of 14.

Part IV

---

Learning from children: Are kids bad at paying attention, or are adults not paying enough attention?

Meanwhile in last weekend’s edition of the Wall Street Journal in the Mind and Matter column, Alison Gopnik tells us that rather than to take a hallucinogenic drug one might simply take a walk with a child if the goal is seeing the world in a new way.

Alison Gopnik has written a great deal about children and how they know the world. She says that she has often suspected that children see things that adults do not. But now she says there is scientific evidence of just that. She talks about a pattern change study in which the foreground issues were in red, the background issues were in green. The shapes in red changed, and on the test of measuring the change, adults did better than very young children. They saw the red objects changing and were able to remember those changes better than the children. But the surprising thing is that the background images had the opposite effect. The green background images also changed, and it was the very young children to remember those changes better than even the adults. One of the explanations given for this is that evidently adults pay more attention to the foreground while children, especially very young children, may pay even closer attention to the background.

Gopnik reports the research this way,

“Adults were better than children at noticing when the red shapes had changed. That’s not surprising: Adults are better at focusing their attention and learning as a result. But the children beat the adults when it came to the green shapes. They had learned more about the unattended objects than the adults and noticed when the green shapes changed. In other words, the adults only seemed to learn about the object in their attentional spotlight, but the children learned about the background, too.”

Now all mothers and teachers of young children should be alerted as Gopnik says to the fact that this explains why something that would distract a child might not distract an adult, a bee flying by or a piece of lint on the carpet. Why? It’s because that young child is actually paying much more attention to those background issues than the perhaps busier adult. Gopnik also writes this very interesting summary,

“We often say that young children are bad at paying attention. But what we really mean is that they’re bad at not paying attention, that they don’t screen out the world as grown-ups do. Children learn as much as they can about the world around them, even if it means that they get distracted by the distant airplane in the sky or the speck of paper on the floor when you’re trying to get them out the door to preschool.”

Gopnik continues,

“Grown-ups instead focus and act effectively and swiftly, even if it means ignoring their surroundings. Children explore, adults exploit. There is a moral here for adults, too. We are often so focused on our immediate goals that we miss unexpected developments and opportunities. Sometimes by focusing less, we can actually see more.”

So she summarizes,

“If you want to expand your consciousness, you can try psychedelic drugs, mysticism or meditation. Or you can just go for a walk with a 4-year-old.”

That sounds like a very good idea.