The dignity of Mr 66 Garage


When there’s talk of border crossings and illegal Mexican migrants, my thoughts used to turn to the ugliness of Donald Trump’s dream: "I will build a great wall -- and nobody builds walls better than me, believe me --and I'll build them very inexpensively. I will build a great, great wall on our southern border.”

But after reading a remarkable feature in California Sunday Magazine, I’m trying to think about 66 Garage instead. The name of Mr 66 Garage may not ring a bell with you, but to be fair, it doesn't ring one with him either. He is an undocumented migrant whose truck overturned on a border crossing in June 1999. He hit his head and never woke up.

Ever since, 66 Garage has lived in a persistent vegetative state in a San Diego nursing home where he is given round-the-clock care. What a country America is! It produces a politician who treats illegal migrants as if they were cockroaches and nurses who treat them as if they were their own family.

Anyhow, this 18-20-year-old man had taken the “undocumented” part of his journey seriously. He could not be identified and the nursing home christened him 66 Garage, although some of the staff protested that it was undignified. A wonderful woman named Paula visited him every week for 15 years and wondered who he was.

There are thousands upon thousands of missing migrants and their relatives are desperate to find them. A photo of 66 Garage has been shared more than 300,000 times on Facebook. Earlier this year a friend of Paula’s took an interest in the case and 66 Garage was finally fingerprinted. A match led to his sister in the southern state of Oaxaca. Now she can wave at him over Skype on his birthday.

It’s a remarkable story about vulnerability, dignity, blood ties, and American generosity. Read it.

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Reflections on California’s assisted suicide legislation


California’s assisted suicide law came into effect on June 9. Betsy Davis, an artist with ALS, also known as Lou Gehrig’s disease, was one of the first to take advantage of the legislation. She drank a lethal cocktail on July 23, after a long party with close friends. I’m afraid that we missed the story at the time.

Reading her sister’s account of Betsy’s death, which is full of loving sorrow at her passing, I was struck by how quickly Californians started to ignore all the careful safeguards. It is clearly specified in the law that the person must “self-administer” the drug. But she was too weak to hold the cup and drink it quickly, so her friends held it for her. They may have broken the law.

People tend to think that a lethal barbiturate brings about death quickly. This wasn’t true in Betsy’s case – she lingered on for four hours. Given that the drug was a homemade cocktail of morphine, pentobarbital and chloral hydrate which smelled like paint, her friends were “lucky” that it worked. Some assisted suicide patients in Oregon have woken up to discover that their suicide has failed.

It wasn’t a good beginning for the law. 

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The ethics of Santa Claus disclosure


There is quite a bit of literature in bioethics journals about the ethics of telling white lies to patients, especially with terminally ill patients. There is much less discussion about a far more common ethical conundrum: whether children should be told the truth about Santa Claus. This, thankfully, has been remedied. Two psychologists have written an article in The Lancet Psychiatry arguing that children’s moral compass could be permanently deranged by the disappointment of learning that their parents have been telling them lies.

Kathy McKay, a clinical psychologist at the University of New England, Australia and a co-author, told The Guardian: “The Santa myth is such an involved lie, such a long-lasting one, between parents and children, that if a relationship is vulnerable, this may be the final straw. If parents can lie so convincingly and over such a long time, what else can they lie about?”

The psychologists follow in the footsteps of Richard Dawkins, who saw through the myth of Santa Claus at the tender age of 21 months. He told a conference in 2014: “Is it a good thing to go along with the fantasies of childhood, magical as they are? Or should we be fostering a spirit of scepticism? I think it's rather pernicious to inculcate into a child a view of the world which includes supernaturalism.”

We’d like to open up comments on BioEdge to a discussion of this issue. 

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Sanctity of life


In 2005 Peter Singer confidently forecast the demise of the "sanctity of life" by 2040. His objections to the idea were mainly philosophical, but he cited two piece of evidence. One was the amazing success of a South Korean scientist named Hwang Woo-suk in creating embryonic stem cell lines. The other was the continuing advance of legal assisted suicide and euthanasia. 

Within months, Hwang Woo-suk was exposed as one of the greatest scientific frauds of the last century. As for euthanasia, Singer could still be right (although fears do persist that it could become, in his words, a "holocaust)". One out of two is not an impressive result and does little to inspire confidence in his prediction. 

But there is another problem with Singer's critique of the sanctity of life argument, as we report this week. A British bioethicist, David Albert Jones, director of the Anscombe Bioethics Centre, points out that it was not Christians who "invented" the sanctity of life, but Singer and his cronies. In a very thought-provoking article in The New Bioethics, he says that "sanctity of life" is just a straw man set up to label discredit arguments against Singer's "quality of life" approach. It is a controversial thesis which deserves to be debated. 

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Margins of error


The shock of this week’s Presidential election in the United States has overshadowed other winners and losers on election night. Big Marijuana was a winner. Four states have legalised recreational marijuana and another four medical marijuana. Assisted suicide was a winner, with voters in Colorado passing a ballot initiative legalising it.

A big loser was the polling industry, which failed to predict Trump’s astonishing victory. This comes after other surprises (ie, failures) in the Brexit debate and the peace accord in Colombia.

And this has made pollsters’ clients suspicious. “A corporate market research project, you don’t know if your polling is shit because there’s no election day,” Dan Wagner, head of Democratic research firm Civis Analytics, told the Wall Street Journal. In politics, “there’s a day where you’re going to find out whether you were right or whether you’re an idiot.”

Since polling has become a weapon in bioethics policy debates on issues like euthanasia, abortion, or stem cell research, perhaps we can feel a bit more justified in our scepticism about polls which purport to show what the public thinks. It would be silly to say that polling is broken, but it certainly needs a good grease-and-oil change.   

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Angels of mercy


It appears that Canada has experienced a visitation from an “angel of mercy”, a media euphemism for a medical serial killer. Arrested this week, Elizabeth Wettlaufer allegedly killed eight patients in Ontario nursing homes since 2007. The Canadian media is describing her as one of Canada’s worst serial killers.

She faces stiff competition in other countries. In Italy, Daniela Poggiali, a nurse, was sentenced earlier this year over 13 deaths. In the US, Charles Cullen, a nurse. was sentenced in 2006 over the deaths of about 40 patients. In Germany Stephan Letter killed at least 29 patients in 2003 and 2004. And then there is Dr Harold Shipman, the quiet English doctor who killed 250 patients.

These horrors never seem to be mentioned when the legalization of euthanasia is being debated, but they should be. The existence of these mad “angels of mercy” demonstrates that some healthcare professionals feel compelled to kill the defenceless people entrusted to their care.

Legalisation creates a class of people who do the same thing but without the secrecy. In Belgium and the Netherlands, the bulk of the euthanasia business seems to be carried out by a handful of doctors. Some of them have killed scores of patients. What does that do to them? Why do they volunteer? Will there be more “angels of mercy” in jurisdictions where euthanasia is legal? These are all questions that need to be asked and answered. 

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We goofed. Sorry


We goofed and we're eating humble pie. Wednesday, October 19, was World Bioethics Day. I'm afraid that it passed unnoticed at BioEdge, perhaps because every day is World Bioethics Day here. But was also the first time it was celebrated, so we shall be better prepared next year.

However, it appears that very few people were popping champagne bottles in the UK and US even though they must have the larges number of bioethicists. No events were planned in the United Kingdom, only one in the US, and 29 in India. World-wide, there were events in 55 countries, most on the theme of the Day, "human dignity and human rights". 

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Remembering Tanonius Marcellinus, a fun guy to be with


In the 19th Century a statue of Tanonius Marcellinus, consul of Campania (now the region around Naples) was unearthed in the town of Benevento. It bore a remarkable inscription, one which may be unique in the history of Western Civilization. It described him as a “most worthy patron, on account of the good deeds which rescued the population from endless boredom”.

Boredom -- taedium in Latin -- will soon be a reason to be euthanised in the Netherlands, as we report below. Of course it won’t be a spur of the moment decision. There will be a bit of boring paperwork to fill out first and some boring interviews to be endured, but in the end you get your needle.

It’s hard to understand why Dutch politicians think that this is a good thing. The worthy consul Tanonius Marcellinus was memorialized for rescuing his people from boredom with good deeds, not with lethal injections. Isn’t that the proper role of governments: to foster a society in which people feel glad to be alive? 

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A world without Down’s?


British actress Sally Phillips has made a magnificent documentary about Down Syndrome for the BBC. (You can watch it here on a legally dodgy YouTube link.) Her own son Ollie has Down Syndrome and Ms Phillips is convinced that Ollie has been a jolly good thing for her and her family. It grieves her to see that most mothers treat a diagnosis of Down Syndrome as a catastrophe. In the UK about 90% of women abort their Down Syndrome child after screening; in Iceland 100% of mothers do. That's 100%.

Ms Phillips tells the camera, as she chokes back tears, “The type of characteristics that these people share are so benign. It’s like when the Western explorers encountered the dodo. This nice, curious bird comes up and gets … wiped out. Through not being suspicious enough. Or violent enough.” This makes her concerned about what the Brits call NIPT (non-invasive pre-natal testing) which is being rolled out across the country.

The documentary is unashamedly emotional. That’s the way it should be. Thank God somebody has the courage to feel emotional about Down Syndrome people. I started to get angry when I read a scathing review in the New Statesman dismissing the doco as “profoundly anti-choice”. But there’s no point in being angry with someone whose attachment to an ideology blinds them to the splendour of being human. 

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What can be done about Duterte?


Yes, the American president is the most powerful man in the world. Yes, he has the launch codes. But there is something unhealthy in the preoccupation of the world’s media with the US presidential campaign at the expense of other world trouble spots.

Donald Trump, who must be the worst major party candidate ever, seems to have incited violence at some of his rallies and has even made vague threats to Hillary Clinton. If you Google “Trump violence”, you will get 82,700,000 results. It’s a live issue, at least in the media.

Google “Duterte violence” and you will get only 971,000 results – about 1% of the figures for Trump. But Mr Duterte has incited thugs, vigilantes and police to kill drug dealers and since he took office on June 30. The Filipino president now has the blood of 3,500 of his own countrymen on his hands. And he is not a buffoon running for President. He is the President.

But it could get worse. This week he cheerfully compared himself to Hitler. “Hitler massacred three million Jews ... there’s three million drug addicts. There are. I’d be happy to slaughter them,” he told a press conference. “You know my victims. I would like (them) to be all criminals to finish the problem of my country and save the next generation from perdition.”

The number of murders in July, August and September is more or less equivalent to the number of civilians killed in Syria. Why doesn’t the world care? It’s probably because Duterte’s victims are drug addicts and dealers. Even if they are, they have a right to life and a right to justice. They are human beings; they are not scum.

The world is demanding the removal of Syria’s President Assad because of the atrocities committed by his regime. It’s time that world leaders called for the removal of President Duterte. 

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