Thursday, January 23, 2014


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The Slippery Slope is sometimes described as a logical fallacy.

Perhaps it is, but human behavior is not always logical.  Most of us can think of instances in which a first step taken hesitantly in a given direction made it easier to take the next couple of steps that had previously been unthinkable.

Historical examples in medicine have seen doctors beginning with the Hippocratic Oath and its mandate to respect life and then progressing by degrees to routine murder.

To illustrate, we somehow found our way from here:

Hippocratic Oath:

"I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art."     Translation from Wikipedia.

To Here:

The doctor was surprised to be charged with murder.

Do not imagine for a minute that these people want to limit the medical killing of human beings to fetuses.

The 'Slippery Slope' is an expression sometimes used to describe the risks associated with expanding the legal boundaries for experimenting on or killing human beings.

Historically, the medical killing of people generally begins with genuine desires to relieve misery when no hope exists for a recovery.  In that context, particularly when the patient wants to die, it is difficult to argue that he should endure avoidable suffering simply to die 'naturally'.

One reasonable approach is to treat pain with powerful drugs that, as a side effect, lead to loss of consciousness, suppressed respiration, and death.  So long as the expressed purpose of the treatment is to control pain rather than to kill, it does not easily open the door to a procedure done for the sole purpose of killing.

The danger for society is that once professionals become casual about ending life in extreme circumstances, it becomes easier to think about the previously 'unthinkable' and begin ending life under less demanding restrictions . . . and then even less demanding . . . and even less.  And there is the 'slippery slope'.  By degrees that seem reasonable with each step we open another door that we assured ourselves was permanently sealed.  Once open the temptation to go through that door is very great.  Killing becomes easy and profitable, for once money is in play it is still harder to hold back.

A top Obama healthcare adviser and an architect of Obamacare, Dr. Ezekiel Emanuel,  "believes that "communitarianism" should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those "who are irreversibly prevented from being or becoming participating citizens ".   Well, then, goodby Steven Hawking if Dr. Emanuel has anything to say about it.

So, how does Dr. Emanuel's idea of national health care work with people on welfare?  The addicted?  The retarded?  Families with low IQ's?  Races with risk factors for costly chronic illnesses?  Too bad Dr. Emanuel can't ask Dr. Mengele.   Dr. Mengele knew.

Of course Dr. Emanuel will want 'safeguards'.  But the Slippery Slope history warns that safeguards can be breached.  They have been before.  In Germany the Holocaust began with the sterilization and later murder of "unfit" Germans with disabilities.  Nazi Persecution of the Disabled: Murder of the Unfit.

Despite that history, modern ethics experts argue that killing babies is no different from abortion.  It isn't?  Then perhaps we should take a closer look at abortion protocols before moving on to killing babies.

That some people in the medical industry are already comfortable with killing babies is evident from the testimony of one physician that babies born with severe disabilities in the UK have been put on the "Liverpool Pathway" to death, a process of killing by withholding care.  For infants the process can take about 10 days as the child grows progressively "smaller and shrunken" and, in the end, death.

Lifton's book, The Nazi Doctors, describes a scene in which visitors from the UK were shocked and disgusted when a German doctor gave a tour of a facility that killed less than perfect babies.  Oddly, the Nazi technique seems more merciful than the British "Liverpool Pathway" because the Nazi kept the babies heavily sedated so that they remained unconscious and, unmoving, slipped rapidly away with pneumonia.  Letting an infant die of thirst sliding down the Liverpool Pathway seems harsher and crueler.  One wonders what the disgusted UK visitors to the Nazi clinic would have to say about modern British medical treatment.

Stretching to the other end of the age line, other experts recommend killing patients with dementia.  Dehydrate dementia patients to save money: British Medical Journal Editorial.  If we really want them to die, why bother to look for her when granny wanders away and gets lost?  Her body will turn up sooner or later.  Here is the actual British Medical Journal article.

If this thinking were confined to pipe-smoking academics bickering with each other in the faculty lounge it might not be so worrying, but some people act on it.  According to The Mail Online, UK's NHS "kills off 130,000 elderly patients every year."

It almost seems that if you are elderly or young and severely disabled, when you check into the hospital for treatment you need to make sure they give you a wrist band rather than a toe tag for identification. 

Of course, 'saving money' is going to be a factor in these decisions.  Money more than 'mercy' will drive these protocols.  Even mobster 'hits' (murders) usually come down to money disputes.

In this video a disturbing number of ordinary people appear ready to kill older people to control health care costs.

In the State of Oregon, the Oregon Health Plan declined to cover a woman's treatment for cancer but did offer to kill her.   Killing is cheaper than treating.

Maybe it would save a lot of time and cold, hard cash just to deliver death to the homeowner's door, like delivering a bottle of milk or the afternoon newspaper.  In fact, the Dutch have already hit on that idea.  Dutch mobile euthanasia units to make house calls.

Understandably, doctors who embraced their profession to preserve life might get a little squeamish about actually killing their patients, so a couple of bright folks wrote an article for the prestigious New England Journal of Medicine recommending that the act of killing patients be taken out of the hands of morally fussy physicians and placing it in the hands of lovable and friendly government bureaucrats, you know, people like the postman or the ever efficient and enthusiastic clerk behind the counter at the Department of Motor Vehicles.

Of course, they are not so crass as to say it will be done by DMV clerks.  What they actually say is:  "We believe there is a compelling case for legalizing assisted dying, but assisted dying need not be physician-assisted,"  emphasis added.  "We envision the development of a central state or federal mechanism to confirm the authenticity and eligibility of patients' requests, dispense medication, and monitor demand and use" emphasis added.

Their article can be found in the July 12, 2012, New England Journal of Medicine, Julian J.Z. Prokopetz, B.A., and Lisa Soleymani Lehmann, M.D., Ph.D., Redefining Physicians' Role in Assisted Dying..

So often these horrific ideas are dressed up in euphemisms: assisted dying.  "Oh, poor man, you seem to be having a little trouble dying there.  Here, let me assist you."  Maybe we can start calling mob hits 'assisted dying'.  The attack on the World Trade Center involved the 'assisted dying' of about 3,000 people.

It is not assisted dying; it is killing.  And if you cannot bring yourself even to say it, perhaps you shouldn't be doing it.

Meanwhile, people who pay attention are beginning to wonder, "Do No Harm?  Should Patients Still Trust Their Doctors?"

Where did we begin this comment?   The Hippocratic Oath:  "I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art."  

At the end of WW II that Oath formed part of the legal basis for convicting and hanging about 44 doctors who participated in 'assisted dying' on a very large scale.  Perhaps that should be remembered by the 'assisted dying' enthusiasts.

Also of interest:

Lifton, Robert Jay, The Nazi Doctors - Medical Killing and the Psychology of Genocide (New York, Basic Books, 1986)

Aly, Chroust, & Pross, Cleansing the Fatherland - Nazi Medicine and Racial Hygiene (Baltimore: The Johns Hopkins University Press, 1994)

Wellsome, Ellen, The Plutonium Files: America's Secret Medical Experiments in the Cold War

Movie: Soylent Green 1971

Movie: Logan's Run 1976

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