Decisions on when to maintain and when to remove artificial life support are difficult at all times. Ideally, the decision to remove artificial life support is made reluctantly but unaimously by all parties involved, including spouse, parents, siblings, and adult children. When there is disagreement, I believe that a hierarchy should prevail: First the patient, of course. If the patient is not able to express his wishes, and has left no written directive, then the decision belongs next to the spouse. That's the nature of marriage, as hard as that can be for parents to bear.
The case of Terri Schiavo is not as clear-cut as that, however. Although Michael Schiavo is legally Terri's husband, he has lived for years with another woman, and indeed has two children by her. It's hard not to sympathize with him, and many will see nothing wrong with his actions. Nevertheless, by so doing he has forfeited all moral and ethical, if not legal, rights as Terri's husband, and should leave all decisions concerning her care to her parents, who have demonstarted that they truly will stick by Terri, "for better, for worse, for richer, for poorer, in sickness, and in health, to love and to cherish, till death do us part."In May of 2001, Martin and Gracia Burnham took a one-day holiday from their busy work in the Philippines for the New Tribes Mission, celebrating their 28th anniversary at the Dos Palmas Resort in Palawan, a Philippine island province in the South China Sea. Their 29th anniversary would mark a year’s captivity among the Abu Sayyaf, a Filipino Muslim terrorist organization with ties to Osama bin Laden. They would not reach their 30th anniversary. Kidnapped from their beds along with several other people at Dos Palmas, the Burnhams were held for ransom under horrific conditions until a less-than-successful rescue attempt by the Filipino army on June 7, 2002. Gracia, wounded, was the only hostage to survive the rescue.
In addition to being a page-turner of an adventure story, In the Presence of My Enemies, along with Christianity Today magazine’s full coverage of the story, brings up several issues:
The problem of unanswered prayer Despite the prayers of thousands—maybe millions—worldwide for their deliverance, the Burnhams were held captive for over a year, and only one of them lived through the rescue. One day, frustrated after many months of seemingly unheard prayers for release, Gracia prayed for something small but apparently equally impossible: a hamburger. A few days later, they were brought hamburgers, French fries, and Cokes.
The question of ransom The purpose of the kidnapping was to gain ransom money, a major source of funding for the Abu Sayyaf. Many of the Filipino hostages were released because their families and/or businesses “knew the drill” and did what was expected. New Tribes, along with other missionary organizations and the American government, were operating under standing policies against paying ransom on the logical grounds that it both funds terrorism and encourages further kidnapping.
International politics There is little question that the U.S. military, with their experience and technology, could have brought about a more speedy, safe, and effective rescue. The constitution of the Philippines, however, forbids foreign troops fighting on Philippine soil, and despite much anguish our government chose to honor the laws and official policies of our ally.
Media accuracy Gracia had been warned, and was careful to read from written, prepared statements when talking to the press. Nonetheless, many inaccuracies crept in. “The one that really upset me originated with the Associated Press and was picked up by Time magazine. They quoted me as saying of Martin’s death: “That is God’s liking. That is probably his destiny.” I would never say such a thing. In fact, this sounds more like an Abu Sayyaf comment than anything else. I wrote Time to protest the blatant misquote and got back a letter passing the buck to AP. The magazine refused to run a correction.”
Grief and recovery One of the burdens of tragedy is that it is impossible to respond in a way that everyone thinks is right. If you grieve too much, you are mentally unbalanced and “need to get over it.” If your grief isn’t visible and you are getting along with your life, then you are also mentally unbalanced, in denial, or perhaps uncaring. If you pray and grieve for those who have hurt you, you are suffering from “Stockholm Syndrome.”
Preparing for the worst Despite having had “kidnapping training” as part of their missionary preparation, the Burnams were not as well prepared as the more worldly-wise Filipino hostages. During captivity, Martin often said, “If I had known this was going to happen, I would have paid attention in that seminar.” One thing they did remember was that obedience to the kidnappers is of prime importance in the first few moments, because that is when they are the most trigger-happy, and that soon after it is important to make eye contact and become a “real person” rather than an item to them. Some of the other captives were aware and prepared enough to grab suitcases and water to take with them. Clearly kidnapping was the last thing on the Americans’ minds, but others were more “street smart.” It reminds me, on a lesser level, of the time I was rousted in the middle of the night by a hotel fire alarm. I wasted what could have been precious moments struggling to find my pants, my shoes, and my key. Now when I stay in a hotel I make sure they are handy before retiring. A basic knowledge of your captors is also useful. The American hostage who was chosen to be beheaded by the Abu Sayyaf had, possibly unwittingly, offended against the values of his Muslim kidnappers. Finally, the time to develop a strong faith is before you find yourself in a difficult situation. Even with all their preparation and strength, the Burnhams found their faith tried and tested at every turn. Others, who had not given spiritual matters much priority in their lives, fared far worse.
The cluelessness of their captors The Abu Sayyaf may have been quick to be offended by those who don’t conform to Muslim values, but only two of the hundred or so the Burnhams knew about had actually read the Qur’an through—and it’s a small book. Even those two had only read it in Arabic, which they didn’t understand, on the grounds that translating it into a language they knew would have corrupted it. They were quick to quote what they had been told, such as “In Islam, if you're a thief, they cut off your hand. That's how things ought to be,” spoken by the man who had stolen Martin’s wedding ring. They were shocked when Martin suggested their actions might be wrong: “I hope my children don't take up the same attitude you have,” he told them. “I hope my kids back home in the States don't ever get a gun and shoot some Muslim because of what you have done to us.” “Done to you?” said one. “What's my sin against you? I've never done anything to you!”Let me state at the outset that I am in favor of vaccinations. I’m very grateful to all those folks whose work has given us some measure of victory over so many horrible diseases. (And to the animals involved, whose sacrifices are usually even greater.) That said, it needs to be more clear that those little jabs to which we subject ourselves, our babies, and our soldiers, are neither miracle nor magic.
There are always risks, and the only reason for a vaccination is if the risks from the disease exceed those from the vaccine itself. I first had my eyes opened to this when I asked my doctor why smallpox wasn’t on the list of recommended vaccines for our children: With smallpox all but wiped out, and biological terrorist attacks not even on the horizon, it would have been foolish to subject children to the dangers of the smallpox vaccine when their chance of being exposed to the disease was infinitesimal.
Worse than the natural, inherent dangers are the human failings: mistakes, hasty or slipshod work, ignorance, pride, political infighting, collusion, and cover-ups. Much of what I said in my comments on The Virus Within applies to this book as well.
When I first heard that the polio vaccine that my generation received as children had been contaminated because it was produced using monkey kidneys, I was incredulous. What did monkey kidneys have to do with producing vaccines? As Edward R. Murrow asked, when he interviewed Jonas Salk, the vaccine’s creator, “The only thing I know about this vaccine is that it starts with a monkey’s kidney and it ends up going into a child’s arm. Could you explain a little to us the process in between?”
Polio was a terrifying disease that reached from the poorest slum dweller to the president of the United States himself, and pressure to develop a vaccine was enormous. (The recent theories that Franklin D. Roosevelt had Guillain-Barré Syndrome rather than polio are immaterial—whatever the actual cause of his problems, it was believed at the time to be polio.) The task was especially daunting because the polio virus could only be grown in living monkeys: Inject monkey with virus, wait for monkey to get sick, kill monkey, extract virus-containing fluid from ground-up spinal cord. Repeat until you have enough virus to work with. Develop a vaccine to test. Inject vaccine into monkeys. If they get sick, start over—the vaccine isn't safe. If they don’t, infect the monkeys with the virus. If they get sick, start over—the vaccine doesn’t work. If they are protected, proceed to human field testing, first on a small scale that would require the use of hundreds of monkeys, then a larger trial with more monkeys, and finally mass testing requiring hundreds of thousands of monkeys. If your vaccine passes all the tests and is approved for production, it will take tens of millions of monkeys to produce enough for mass immunization. Even if that were possible, it would take years—and America in the late 1940’s did not want to wait years.
Enter the Harvard Medical School laboratory of John Enders, which demonstrated that it was possible to grow the polio virus in certain tissue cultures. (Enders and two of his coworkers eventually received the Nobel Prize in medicine for this work.) Their report was largely ignored by polio researchers, but Dr. Jonas Salk, then at the University of Pittsburgh, grabbed the idea and ran. By growing the polio virus in ground-up monkey kidneys suspended in a nutrient broth, Salk was suddenly producing large quantities of virus in little time. At last, a vaccine seemed possible.
And so it was. Those of us who were born post-vaccine cannot fully appreciate what a miracle the polio vaccine seemed to parents who lived in terror of this disease, which killed and paralyzed and particularly targeted children. But it wasn’t quite a miracle, because there was a time-bomb hidden in the vaccine: SV-40, a monkey virus that survived inadequate purification procedures to contaminate nearly every dose of polio vaccine between 1954 and 1963, affecting about a hundred million people in the United States alone. Even after the contamination was discovered, the dangers were downplayed—contaminated batches were not recalled, but continued to be used—because it was widely accepted that the monkey virus, being from a different species, would do no harm.
Unfortunately, that proved to be a false and costly assumption. SV-40 is now known to be carcinogenic, and since the mid-1990’s has been discovered in many formerly rare brain and bone cancers, as well as lymphomas and leukemias. Is this a cause and effect connection, or a coincidence? The government is still downplaying the issue, as you can see from the CDC’s much less alarmist version of the story. They may be right, and I certainly understand their dilemma, since they must weigh the risks of vaccines against the dangers of disease. Eradication of polio worldwide had nearly been accomplished by 2003. However, some Muslim clerics in Nigeria expressed fears that the vaccine had deliberately been contaminated in order to give Muslims AIDS or to render them infertile, and the vaccination program fell apart in that country. Before long polio had returned to twelve neighboring, polio-free countries, and hundreds of children had been paralyzed. So I understand why the government might be afraid of panicking parents into refusing all vaccinations for their children. Still, I’d be a lot less likely to panic if I were convinced that the government were doing its best to find, publish, and advertise the truth. The Virus and the Vaccine has not increased my confidence that this is the case.When you walk into Heather and Jon's house, you can't miss the Periodic Table that takes up most of one wall. It was an extraordinary gift to Heather years ago from an extraordinary friend.
Science museums around the world should hope to have such extraordinary friends of their own so that they can acquire the new interactive Periodic Table displays produced through a partnership of Theodore Gray and the Red Green and Blue Company. If you can't wait until the exhibit is available at your local science museum, check it out online. If you can be deal with the relatively long download times, you can click on the individual elements and get a glimpse of how wonderful the physical display must be. I was most fascinated by how many of what I thought were unusual elements turn up in common use, something I first learned from The Radioactive Boy Scout.
Folic acid advice has had little impact on birth defects
Recommendations for women planning a pregnancy to take folic acid supplements have had no impact on the number of babies born with neural tube defects, says an international team of researchers.
Recommendations on use of folic acid consumption have had no detectable impact on the incidence of neural tube defects, according to an international study.
Upon reading these headlines and summaries, wouldn't you, as a pregnant woman taking folic acid supplements on the recommendation of your doctor, begin to think that you had been misled and might as well throw away your remaining pills? Doesn't it sound as if the relationship between folic acid deficiency and birth defects has been disproved? Not so!Reading further, what the study shows is not that the recommendations are wrong, but that not enough people are following them. Birth defects haven't diminished because too many women are still not getting enough folic acid. When folic acid is added to fortified foods, such as enriched flour, birth defects do decrease. Whether or not it is ethical to sneak supplements into people's diets this way is another matter. What concerns me is that people will scan the headlines, not reading the stories, and come away with a subliminal impression that folic acid makes no difference in their baby's health.
(An aside relating to food fortification: I attended an otherwise excellent baking class given by the folks at King Arthur Flour. In explaining the benefits of their flour, the speaker emphasized that it is pure flour, with absolutely no chemicals added. What she meant was that the flour is not bleached nor bromated, but that's not what she said. When I questioned the breadth of her statement, asking "Isn't your flour enriched?" (I knew it was), she replied, "Of course. But there are no chemicals added.")Of the three recent major American professional sports contests, Boston has made quite a respectable showing:
World Series: 1Presidential Election: 0
Super Bowl: 1
Disclaimer: The above commentary on the current American election process is in no way meant to be disrespectful of democracy, and especially not of those, whether soldier or voter, who risk their lives for freely-elected government. Sometimes, however, I'm tempted to believe that the media circus that our electoral process has become bears no more resemblance to true democracy than our professional athletics to true sport.
Permalink | Comments
Category Everyday Life
Strictly speaking, this is not a review of Stephen Covey’s new book. The 8th Habit is in great demand at our library, so all I have done is read through it, making little attempt to think about the concepts, much less apply them. (I still have a long way to go in applying the concepts from Covey’s The 7 Habits of Highly Effective People and First Things First.) I will, however, allow myself a few comments:
The critical 8th habit is “Find Your Voice, and Inspire Others to Find Theirs,” which I'll admit doesn’t make much sense out of context. I believe there is much of value to be found here, although it’s not going to happen in a single reading—nor in any reading at all that is not accompanied by application. I was a bit frustrated in that it did not read as smoothly as Covey’s other books; I kept bogging down in what appeared to be repetitiveness, in the many charts and graphs, and in the business/corporate/organizational applications. The examples were wonderful to read, however, and I know the principles are applicable on a smaller (e.g. family) scale. I’ll probably come back to this book after I’ve done better at applying what I learned in the earlier books.
I wonder how much Stephen Covey, Richard Ryan, and Edward Deci are aware of each other. There’s much in The 8th Habit that reminded me of what I learned from a seminar Deci and Ryan gave at the University of Rochester, and from Deci’s book about understanding self-motivation, Why We Do What We Do.
The principles expressed in The 8th Habit are timeless and universal. The format of the book is not. Included with the book is a DVD, and the narrative is frequently interrupted by an exhortation to stop reading and watch a short movie. No doubt this works well for many people, but is annoying to those of us who do not own a DVD player, or who may be reading in the car or at the dentist’s office. That’s another reason I can’t review the book, because I don’t know what I’ve missed by not being able to watch the movies. Several footnotes suggest websites to visit for further information, which is useful, but also a sign of an author who is writing for this year’s readers, not those who might pick up his book ten or a hundred years from now.
