Category Archives: medical ethics

“Blame the drugs.” “Blame the parents.” “Lock up everyone with mental illness.”

Madman commits an act of violence. People blame a) “mental illness” (or the specific “condition”); b) “psychotropic drugs”; c) “the parents”; etc. Let’s look at the real process:
1) Mental health is largely genetic. People self-medicate with drugs or alcohol, have kids, the kids either grow up with the addict parents or go to foster homes or adoption, then we blame “the parents” or “the foster system” or “adoption,” when so many others in the same situations do not end up as bad. If we look at the parents’ behavior, they’re dealing with the same basic mental DNA as the kid. Certainly, environment plays a major role, but we’ll get back to that.
2) Boys are more often put on stimulant ADHD meds than girls. These meds trigger dopamine. They’re between caffeine and cocaine in the degree to which they stimulate dopamine and endorphins. People speak of marijuana as a “Gateway drug,” and maybe it is, but for the past few generations, Ritalin and Adderall have been the biggest gateway drugs of them all. In my experience as a parent and a teacher, I’ve seen a few students and adults who were helped by these meds. I’ve seen very few who were helped on them without finding it made them angry. I had a college student once who told me he took Adderrall all week, stopped it on the weekends and slept to keep it from driving him insane.
3) A major problem in mental healthcare is the process. They start with largely outmoded Freudian analysis (refer back to 1). Then they try drugs. And they try the drugs in a trial and error fashion. Only under certain circumstances, and/or with much insistence, do psychiatrists and developmental pediatricians normally do actual medical tests on their patients. It’s “Oh, you exhibit this set of behaviors? Let’s try [Ritalin/Prozac/Xanax]….That didn’t work? How about [….]”
Just as a heart med that will help someone with one kind of heart condition may kill someone with another, or the med has a “side effect” of doing to other autonomous systems what it does to the heart, so too the wrong mental health drug can cause either other disorders by its side effects or have an adverse effect if it’s the wrong condition. Put someone with bipolar on an antidepressant, and they get manic.
Put someone on an anti-epileptic who doesn’t have the correct kind of neurological problem(s), and they develop epilepsy.
That doesn’t mean all psych drugs are bad for everyone, but they’re overprescribed and misprescribed.


“Why did he do it?”

A young woman goes to college.  She comes from a decent home and family that has its issues like any family.  She maybe has a genetic propensity for autism or bipolar or something that wasn’t quite caught because his parents were able to manage it with love, discipline and counseling from time to time.  She was never really engaged in her faith, and whichever comes first, the usual college combination–skipping Mass, “partying” and collectively anti-Catholic ideology among professors and classmates–cause her to abandon the Church.
She meets a boy. He considers himself an atheist.  They base their relationship on sexual attraction and what bands they like but say religious, philosophical and political matters are irrelevant to their relationship.  They *might* discuss a bit of modern philosophy or New Age “mysticism,” and they might talk pop psychology.  They start fornicating.  Then they decide they “love” each other.  They use contraception, unknowingly conceiving and aborting several babies.  At one point, one of the babies escape all the “Plan B” mechanisms and manages to implant.  Worried about her career, she has an abortion.
Then they decide that maybe they should get married.  They “wait” to have children till they’re “ready.”  They spent 10 years living for careers and vacations and things, having a relationship based on a self-centered “love.”  Maybe they self medicate with booze or cigarettes or worse.  Maybe they go to the professional drug dealers and get Prozac or Ritalin.
After a few years, they decide they’re “ready” to have kids.  They have their boy and girl.
They say they’re going to raise their kids “open minded” and refuse to have them baptized.  Maybe they expose them to bits and pieces of Islam, Buddhism, Wicca, any anything but Christianity.
Believing that children need lots of “stuff” to be happy, wanting their kids to have whatever they believe they were deprived, and believing that they have to limit themselves to 2 kids, so they want the most of the experience, they fill their kids’ lives with toys, video games, movies, etc.  But they also fill their kids’ lives with workaholism and competitiveness: sports, scouting, fine arts, clubs, and lots and lots of homework.
Their son can’t keep up, and starts acting out.  Quite often, the child in this all-too-familiar scenario is probably just stressed.  “I don’t want to give him an MRI,” says the doctor.  “That might have dangerous side effects, and it’s really expensive.  Let’s see how he does on Ritalin first.”
So the kid goes on Ritalin.  He’s on the equivalent of 2-4 cups of coffee a day.  He focuses better at school and his many activities, but his schedule is still stressful with no time for true relaxation or recreation.  He still needs to burn his energy, and he’s stimulating it chemically with a drug that produces rage as a side effect.  So he starts bullying other kids.  And he starts trying to channel his rage through video games and movies.  Oh, and since he’s chemically stimulating his dopamine and endorphins, he loses his ability to feel satisfaction from oxytocin.  He just starts craving more dopamine and endorphins, so more video games and more movies.
Now, if he was relatively neurotypical and just stressed, this would be bad enough.  If he even legitimately had ADHD it would be bad enough.  But what if he actually has something else, like bipolar?  So the the effect of the stimulants is even worse.
They try different meds over the years, never actually doing medical tests to see if and what meds he needs, even though they have tests available that in many cases the DSM says to do first.  Hundreds of dollars a month in prescriptions and doctor visits are so much more cost effective than a few thousand dollars at one time to actually find out what’s wrong.
Meanwhile, the daughter goes on similar spiral, but this, as Aslan might say, is not her story.
Meanwhile, the parents who didn’t put much thought into values before they married start to do so.  They realize they have little in common.  They rarely spend time together.  Going off “the Pill” to have kids then going back on changed her hormonal reactions to him and vice versa.  They’re burdened with stress of money, jobs, the kids’ demanding schedules and the kids’ mental and behavioral issues.
Maybe the mother decides to start taking the kids to church, and they fight about that.
There’s some anger and abuse.  One or both commits adultery.  They divorce.
Now the kids, as Maggie Gallagher documents in _Abolition of Marriage_, have lost their trust in relationships.  They both come to think of marriage as something temporary and mutable.  They have lost their one mooring in life.
The son starts expressing his anger at his Christian classmates, arguing all the time in favor of atheism, abortion, etc.  The daughter becomes sexually active.  The son starts using marijuana and other drugs.  All those resume-building activities begin to implode: grades collapse; he starts dropping out of his activities.  He spends most of his time watching violent movies and pornography and playing video games.  All the activities meant to “build social skills” never taught him to make friends.  His original genetic propensity, whether it’s for autism or schizophrenia or bipolar, is now largely irrelevant except that it’s compounding his lifetime of stress, betrayal, materialism, overstimulation, drugs, etc.  He doesn’t know how to approach girls, and girls find him creepy.
His parents have tried to give him everything the world has to offer but they’ve deprived him of the most important things a  human being needs: God and a stable family.
Depending on who reaches into his life at this point, and whatever his earlier issues, he grabs onto whatever sense of hope and acceptance he can find.  We could go several ways from here, but this all-too-common story lends itself to several results.
But our particular instance is following the path to hate and violence.
He’s been inoculated against Christianity, of course, by his parents and by the schools.  He’s been taught that Islam is a “religion of peace,” so he starts reading the Koran.
He’s been taught that socialism is a great thing and capitalism is bad, so he starts reading Marx.
He starts reading  Hitler.
Eventually, the violence he imagines becomes reality.  Maybe his mother has found true Faith in her middle age, and desperately tries to get him to come to church with her as she tries to atone for her younger lifestyle.  Maybe he is interested in a girl who’s not interested in him.  Maybe he’s had a girlfriend who recently broke up with him.  Maybe he’s been taught by the media, the movies and the few books he’s read that Christians are the real enemy.  Maybe he’s just filled with hate for all the institutions he’s come to mistrust.
Thousands upon thousands are in his situation.  Many turn to suicide.  Many turn to matricide or patricide.  Many murder the girl they’re interested in.
Many join gangs and commit gang murders.  Many just retreat into themselves and into the games and drugs, committing a slow suicide.  Many live lives of abuse and fighting without actually killing.  Many find Jesus and overcome the hate.
So what makes one person “snap”?
If any of these few circumstances could clearly explain why people commit mass murder, then it should happen far more often than it does.  If guns are the reason, it should happen far more than it does. If guns are the reason, then there wouldn’t be suicide bombers and fertilizer bombs and madmen driving trucks through crowds.
If, as the Joker claims, all it takes is “one bad day” to make someone like him, why aren’t there?
There’s a movie called Conspiracy Theory where a guy says all notorious assassins owned the same book, and to the extent that it’s been reported, all the notorious mass murderers in the US in the past 20 or 30 years have had one thing in common: hatred of Christianity.  Many of them have shouted or posted “Allahu Akbar.”  Most of them seem to have some sort of admixture of Communist, Anarchist and Nazi leanings.
As long as a person has some faint fear of God, he’s going to have a line of conscience.  Once we strip that line of conscience away from him, it doesn’t matter what tool he uses, he will find a way to kill as many people as possible before he kills himself.  He might do it in the name of “The Revolution,” or “The Master Race,” or “Satan” or “Allah,” but he will do it.  Should we put tougher restrictions on certain kinds of weapons?  I don’t know.  It seems to me the government should do a better job of enforcing the gun laws that are already on the books.
But to address the real problem is to address, across the board, the moral and spiritual rot of our society and requires each of us to look at our own responsibility, not for our political choices but for our moral ones."Occupy Rome" Protestors Desecrate a Statue of Our Lady

Living the Good Samaritan

This afternoon, our younger two kids had an appointment at pediatric specialists at the over-renamed MCG/GRHSU/GRUHealth/AUHealth.  It was raining, so my wife was going to get the car. I hadn’t had lunch yet, and the kids were hungry, so we stopped at Subway with the intention of eating while she got the van.
As she was about to leave, we saw a lady walking down the sidewalk, crying and gesticulating.  She appeared to be having some sort of seizure.  My wife went out and talked to her and tried to calm her down, bought her a meal, got some of her story, enough to know she’d been at the ER and discharged somewhat prematurely, and had no one to pick her up.
Various professionals passed by.  A few stopped momentarily.  Three campus police officers arrived and seemed to be treating her as more a suspect than a victim.
My 8 year old daughter looked out the window and said the lady looked like she’d been beaten up.  My wife thought the same–she had recent injuries that had been bandaged by the ER.
The kids remained patient remarkably long for their temperaments, but as our son hit his limit, we had to slip away.  We drove past to see if she was still there, but she, and campus police, were gone, so hopefully they got her the help she needed.

But *why* does our society have to be so litigious and bureaucratic that no one can help anyone?  Doctors and nurses passed by, too “terribly busy” or too afraid of being sued or fired to help (cf. the story of the firefighters who got in trouble for using their truck to get the little girl to the hospital before EMS could get her).  And why do ERs discharge people when they’re clearly not treated??

I’ve had several occasions that I’ve been discharged with papers saying, “Come back if you experience XYZ,” and I’ve been like “Should I turn around and come back in since I mentioned that when I got here, and you didn’t do anything?”



What’s your price?

We’ve all heard the story, attributed to various writers, of the British humorist sitting next to the beautiful woman at the banquet and asking, “Would you sleep with me for 1 million pounds?” “Of course!” “Would you sleep with me for 10 pounds?” “What kind of woman do you think I am?” “We’ve established that; now we’re just haggling over price.”
Chesterton said that men do not differ so much over what they consider evil as what evils they consider acceptable.
It is the easy compromise that keeps the culture of death going. Every one of us who refuses to compromise gets labelled an “extremist” precisely because of the easy way people sell out.
Every time the Republicans gain ground in national office, pro-life and pro-family issues are a major reason for the voters, but the Republicans never follow through because they claim they won’t be reelected. “Next time,” they tell us.
In the 1970s, the National Right to Life Committee developed a “long term strategy” for overturning _Roe v. Wade_. The first law passed was the Hyde Amendment, banning federal funding of abortion. 40 years later, “progress” is the Republican House passing a new ban on such funding.
Meanwhile, does anybody even talk about embryonic stem cell research anymore? George W. Bush’s “if the babies are already dead, might as well put the remains to good use” reasoning has crept not only into the NRLC’s positions but into the Catholic commentariat. And that’s the same position we hear on vaccines derived from fetal tissue.
In 2005, the Pontifical Academy for Life (pro Vita, or PAV) issued a statement supporting conscientious objection to vaccines derived from from fetal tissue research. There were already position papers from several organizations, most notably the so-called “National Catholic Bioethics Center,” saying such vaccines were acceptable. For most people, this isn’t even an issue. The sheer fact that the Vatican bothered to issue a statement should lean any ambiguities in favor of conscientious objection. Many have tried to twist the document to say it opposes conscientious objection. If so-called “anti-vaxxers” are a minority of extremists, why would the Vatican, which so often fails to address prevalent problems of theological discipline, bother to tell “anti-vaxxers” to comply?
Yes, the document explains the parameters of remote material cooperation (more on that later). Yes, the document explains there are conditions which mitigate culpability for such cooperation. Yes, if somebody feels compelled to vaccinate, the document says they should voice their objections, but that is supposed to be the exception, not the rule.
In 2008, a lot of people said, “I’m pro-life, and I voted for Obama because I figure that, if he knows pro-life people voted for him, maybe he’ll change his views.” Yep, that’s how politics works.
If nobody stands up and says, “I won’t support this,” what is to motivate those in power to change?
There are very few vaccines for which the only form is derived from fetal tissue research, and all of those are diseases that have other means of treatment or prevention and/or are rarely life threatening. The most life threatening diseases (e.g., polio) have alternatives that exist, but they’re increasingly unavailable. When our eldest was a baby, there were separated forms of measles and mumps vaccine available, but they were hard to get, and you had to find a doctor willing to order them. The ethical rubella vaccine is not available in the US because of “FDA” regulation, even though it’s proven effective in other countries.
If there were more people standing up and saying, “We want ethical alternatives and will not vaccinate until you provide them,” things would change pretty quickly, but as it is, a) most people just vaccinate, with or without “stating their objections”; and b) the rest just become out right “anti-vaxxers,” objecting to all vaccinations and tying in other issues to fetal tissue. So thus of us who merely object to specific vaccinations on specific ethical grounds are left without support. It is so disheartening to have to file for a “religious exemption” at Catholic institutions when we’re Catholic, and explain to Catholic school and parish officials why we object. It is disheartening to find that most state regulations and doctors’ offices take an all-or-nothing approach, so we can’t get the ethical vaccines, either.

The original NCBC position paper from the 1990s had two related points that really irk me.
1) They, and most subsequent “the good of the vaccines outweighs the evil” ends-justify-the-means arguments, hold that parents have a “moral obligation to protect the life and health of their children.” To a certain extent, this is true. However, this moral obligation gets transmuted into saying it’s mortally sinful to get someone sick. This is also applied in the question of whether you should go to Mass when you’re sick, and other situations. Now, if such moral obligations and sinful circumstances exist, and I have a 50% chance of passing on Marfan syndrome, which will be far more likely to be fatal than any virus, to my children, I think one can see why I take some offense to this, especially when so many people who *do* have Marfan syndrome insist on contraception, IVF and/or abortion for that reason.
2) The original NCBC document grants that conscientious objection constitutes heroic virtue (and I think most of us on that side would agree), but argues that parents do not have the right to make decisions of heroic virtue for their kids. The problem with this (and the previous premise) is, what about Catholic parents in Muslim and Communist countries? Should they not baptize their children for fear of putting their children’s lives at risk and making decisions of heroic virtue?

If you’ve decided that vaccination was the right choice for you and your family, and you feel no pang of conscience about it, then why be so hard on “anti-vaxxers”? Aren’t you and your kids safe?

If we, as Catholics, mistrust the medical establishment on contraception and other issues, why is the rhetoric on vaccines to do as you’re told by Big Pharma?

If measles is making a comeback, why won’t Merck provide the ethical, separate measles vaccine it discontinued in favor of MMR? Why is Merck so adamant about forcing people to violate our consciences?

What is truly a “slap in the face”?

We’ve all heard by now of the suicide of Brittany Maynard, a 29 year old brain cancer victim who decided to become the poster woman for so called “death with dignity,” and then got mad when people criticized her “personal choice.”  The Pontifical Academy for Life issued a statement condemning assisted suicide, and calling her death “reprehensible.”  Maynard’s mother has now posted an article on some site called “Compassion and Choices“, saying that PAV statement is “immoral” and “a slap in the face.”  The Culture of Death is now calling it “the Pope’s sin.”  I submitted the following to “Compassion and Choices.”  Re-posting here:

You posted an article by Brittany Maynard’s mother, claiming that the Pontifical Academy for Life’s statement on her daughter’s suicide is a “slap in the face” and “immoral.” No, Brittany Maynard’s suicide, and your entire “death without dignity” movement is immoral and a slap in the face to every one of us who deals with debilitating, life threatening illnesses. I have Marfan syndrome. I have suffered horrible pain every day of my life. I have dealt every day with the knowledge it could be my last. I have also dealt quite regularly with the temptation to “end my suffering” in this life–but a death with *true* dignity, the death of a Saint, is far more appealing to me. The risk of eternal suffering in Hell, and the knowledge that Jesus died undeservingly for my sins, and continues to suffer that infinite pain of the Passion for me, make it worth it to me to share His sufferings now for love of Him. Leon Bloy said the only tragedy is not to be a Saint.
What is reprehensible is the notion that people with terminal illnesses should be killed or pressured to kill ourselves because we are a “burden” to others. What is reprehensible is saying that it is dignified and courageous to die the death of a coward.
I pray that Brittany Maynard was not culpable for her decision, or that she repented in her last seconds, but what she did was neither moral nor compassionate, for herself or others.

John C. Hathaway, OCDS

“He who seeks to keep his life will lose it; he who loses his life will save it.”: Vaccines versus viruses; prepping versus providence

If there’s one thing the Bible is clear about, it’s not putting our trust in princes, in mortal men in whom there is no help, not trusting in our own devices, etc., for God chooses the weak things of the world that no flesh may glory in His sight. The foolish man cannot know this, and the fool cannot understand.
From the time when Satan refused to trust God, then tempted Adam and Eve to “be like Gods who know,” to the Tower of Babel to Israel being punished over and over for not doing things Gods way, while those who were justified were justified by their absolute trust in God, even when His instructions were foolishness to human wisdom, the Bible tells us over and over that we should, as Jesus says, “Consider the lilies of the field,” for we know no the day nor the hour. Just when we are saying “peace and security,” the Lord will come like a thief in the night and say, “You fool! Don’t you know this very night your life will be demanded of you?”
I am always dismayed by Christians who insist that they should put their trust in worldly goods, rather than building up treasure in Heaven, be they investors, “preppers,” etc. Obviously, there is a common sense level of protecting ones health and family, and keeping an emergency reserve if possible, but some people seem way too concerned about storing up treasure on earth.
Then there’s the vaccine issue. Again, nothing wrong with protecting health, but doing so at the expense of other people’s lives should be avoided, and it is difficult to suppress the instinct to say, “I told you so,” when the efforts people cling to prove futile in the face of worse and worse viruses and bacteria strains. We hear about “herd immunity” (a term that’s offensive in itself), and see arguments about what that does or does not mean. We see arguments about old viruses returning supposedly because of unvaccinated families, though others arguing they’re spreading among the vaccinated and that they’ve gotten worse because of resistance. Now, there is apparently a virus spreading that mimics a cold or flu but is far worse and they barely even know what it is. . . .

Drugs, the law, and morality

For some reason, it’s a headline that the Pope is against legalization of recreational drug use. At first thought, I tend to agree, but I am not sure it’s so simple in practice.
Much has been written on the subject lately, and I completely agree that it’s sinful to
a) use any otherwise acceptable activity excessively (Cardinal Virtue of Temperance/Aristotelian Mean)
B) intentionally impair one’s judgement so as to make moral decisions more difficult
C) cause direct harm to one’s body.

It’s very clear when some drugs do all three, but what about tobacco, alcohol and even caffeine? Those would be considered acceptable in moderation, but cause damage long-term.

All three of those standards could apply to food as a drug. Certainly, gluttony is a mortal sin, but should it be a crime?

What about self-medication? Various layers of mental health? Prescription drug use?

It’s a complicated matter when it comes to legalities, civil liberties, etc., and enforcing laws. In the name of making it harder to abuse prescription drugs, the FDA has made harder and more costly for those of us with actual health problems to get our meds. Then there’s the issue of drug testing for employment, etc., and people having to reveal medical problems to their employers.
That’s not getting into things like “no knock” raids that have made headlines recently, where SWAT teams invade homes of “suspected” drug dealers/addicts and burst in without warning to avoid “flushing.” Innocent bystanders and even innocent suspects get injured or killed, even if they have the wrong house altogether.
They’ll do the whole “witch hunt” thing and send innocent family members to prison for the “crime” of not knowing anything while the actual criminals make deals and name names. Then property involved in illegal drugs can be seized. Back in Virginia about ten years ago, there was a case where a man bought a house from a judge’s ex-wife shortly after their son was arrested for dealing marijuana. Somehow, the judge’s wife got to keep the money from the sale but the buyer lost the house to the state.
Then there’s the so-called “right to privacy” that selectively applies to birth control.

I don’t think drug use should be legal, but it shouldn’t be “illegal,” either. It should be treated as a medical and psychological matter.