Ethics & Morality

Dancing With Death

Dr Bob

Dancing with Death

The war rages on. It is a battle with ancient roots, deeply embedded in religion, culture, and the tensions between rich and poor. It is a war of contrasts: high technology and primitive cultural weapons; knowledge versus ignorance; speed and urgency against the methodical slowness of an enemy who knows time is on his side.

It is a war in which enormous strides have been made, with countless victories large and small.

The enemy is death. The avenger is medicine. And the war is going very poorly indeed. In many ways, the gains of modern medicine against death and disease are truly impressive: longer life expectancy; progress and cures against heart disease, cancer, and diabetes; surgical and procedural marvels hard to imagine even 15 or 20 years ago. Yet, it is these very advances which seem to lie at the heart of a growing problem. We are so engaged in the battle, so empowered by our growing capabilities, that we have lost sight of the bigger picture. While pushing back the adversary of death, we are ever so steadily being destroyed by the very battle itself.

Several recent experiences have driven this dichotomy home for me. Last week, I was asked to evaluate a man who had been hospitalized for a over a week. A nursing home resident in his late 80’s, his overall health was fair to poor at best, and he suffered from severe dementia. He was unable to communicate in any way, and could recognize no one — not even his wife of many years, who remained in possession of her full facilities. He was admitted to the hospital with a severe urinary tract infection with a highly resistant bacteria, and septic shock. When he arrived at the ER, the full extent of his dementia was not apparent to the physicians there, and his wife insisted that all measures be engaged to save him. Aggressive medical care was therefore initiated — intensive care unit, one-on-one nursing care, hemodynamic monitoring, drugs to support blood pressure, intravenous nutrition, and costly antibiotics. After nearly two weeks of such intensive therapy, the patient largely recovered from his life-threatening infection — returning to his baseline of profound dementia. Yet the underlying risk factors which led to it — his age, a chronic bladder catheter and bacteria-harboring stones, diabetes, — remained in place, lying in wait for another, inevitable opportunity, in a matter of weeks or months. The cost of his hospitalization was easily in 6 figures.

In another situation, an elderly women presented to the hospital with signs of a serious, life-threatening infection in her abdomen. A healthy widower, she lived independently with her sister prior to her illness. Emergency surgery was performed, and an abscessed kidney removed. Her medical condition deteriorated after surgery, with coma due to stroke and failure of her remaining kidney brought on by the infection.

The patient’s sister and living companion communicated the clear final wishes of the widower: a women of strong faith, she wished no extraordinary measures, such as ventilators or dialysis, to extend her life needlessly. She was comfortable with death, and not afraid. The staff prepared to allow her to die gracefully, comfortably, and in peace.

But such was not to be. There was no living will, and the sister did not have legal authority to make such decisions. But the widower’s daughter, a nurse living out-of-state with little recent contact with her mother, arrived in town demanding that aggressive measures be taken to save her. A nephrologist (kidney specialist) was called in. A superb physician, compassionate and dedicated, he had been successfully sued in a similar case after recommending that dialysis be withheld in a patient with a grim prognosis. This was a mistake he would not make twice: the widower was transferred to another hospital, placed on dialysis, and died 3 weeks — and a quarter of a million dollars — later, in an ICU. She never woke up.

The issues which these two cases bring up are numerous, complex, and defy easy answers. They touch upon the subjective measure of quality-of-life and what it is worth; the finite limit of economic health care resources; the relative responsibilities of physicians, patients, and their families in end-of-life decisions; the pressures placed on the health care system and its practitioners by after-the-fact second-guessing in an aggressive tort environment; and a host of others greater or lesser in weight and substance, up to and including the meaning of life itself.

All the players bear responsibility in this passion play. Physicians excel at grasping what they can accomplish, but are woefully inadequate for the task of deciding whether such things should be done. In the urgency of acute care, delay to consider the ramifications of a decision to treat may cost an opportunity to save a patient for whom such treatment is desirable; better always to err on the side of salvage. Pressured by family, potential litigation, or instinct, the path of least resistance is to follow your training and use your skills. And physicians themselves are uncomfortable with death, though inundated in its ubiquity.

Family members naturally resist the agonal separation of their loved ones, often harboring unrealistic hopes and expectations of recovery in the face of inevitable death. A curious dance of denial often ensues between physician and family, as each, unwilling to face the unpleasantness of the inevitable, avoids the topic at all costs. The physician hides behind intellect, speaking of blood counts, medications, and ventilators, or at best tiptoeing around the core issue with sterile terms like “prognosis.” Family members hesitate to ask questions whose answers they already know. Too rarely are the physician and family willing to place the subject squarely on the table, in all its ugliness and fearfulness. Decisions which need to be made are put off, unspoken and deferred. The clock ticks on, the meter is running, and only the outcome is not in doubt.

The tort system provides a ready outlet for the anguish and anger of death of a loved one. In such a period of intense emotional turmoil, the real or perceived indifference of physicians (often a mechanism of detachment by which doctors deal with the horrors of death and illness); the parade of unfamiliar medical faces as no-name consultants come and go during the final days; the compounding burden of crushing financial load from the extraordinary costs of intensive terminal medicine; the Monday-morning quarterbacking by the tort system of complex, often agonizingly difficult medical decisions in critically-ill patients: all present a toxic and intoxicating brew which impels the health care system forward to leave no avenue untravelled, no dollar unspent in prolonging life beyond its proper and respectful end.

This march of madness is not without resistors. Seizing on the high costs, the futility, and especially the lack of personal control fostered by impersonal, highly technical terminal care, the euthanasia movement is maneuvering into the gap. Cloaked in slogans of personal autonomy and “Death with Dignity”, active euthanasia proponents seek to replace the sterile prolongation of a now-meaningless life with the warm embrace of Death herself. Terrified by an out-of-control dying process, an end of a life which embodies all meaning, they seek to control death as their final act of significance. But Death will not be controlled, and those who dance with Death are seduced by her siren. Euthanasia starts with compassionate intent, but ends with termination of the useless. Man does not have the wisdom to control death; The Ring-bearer is corrupted by its power.

Our discomfort with death is our confusion about life. Man is the only species cognizant of his coming demise — who then, in the ultimate paradox, lives his entire life pretending it will not happen. Our Western culture, enriched with a wealth of distractions, allows us to pass our living years without preparing for the inevitable. When the time arrives, we use all the weapons at our disposal — wealth, technology, information, law — to resist the dragon. We drive it back for a time — at enormous cost, personal, financial, physical and emotional. Death always wins — always.

I am not of course yearning for a return to the past, a passive resignation to the inevitable anabasis of disease and death. The benefits of medicine and the forestalling of death are precious and powerful gifts, which have greatly benefited many. But like all such great powers, they are useful for good or ill. When the defeat of death becomes an end in itself, detached from the meaningfulness of life lived, it has great destructive energy.

We must learn how to die. And to learn how to die, we must learn how to live — how to seek the transcendent, the power of love, and sacrifice, and giving which makes life rich and enduring. The selfish, the superficial, the transient all gratify for a time, but when this is all we possess, we grasp desperately to their threadbare fabric when beauty and health give way to weakness, fear and death. All great religions understand this: the meaning of life transcends life. In the Judeo-Christian view, life is an opportunity to draw ourselves and others closer to the light and goodness of God, with the promise of an even greater life and deeper relationship after death. Yet even for the agnostic or secular among us, service to others — personal and social — has the potential to endure long after us. None of us will be remembered for our desperate clinging to life in its waning days, but rather for the lives we touched, the world we made better when we lived.

The Children Whom Reason Scorns

Dr Bob

The Children Whom Reason Scorns

You Also Bear the BurdenIn the years following the Great War, a sense of doom and panic settled over Germany. Long concerned about a declining birth rate, the country faced the loss of 2 million of its fine young men in the war, the crushing burden of an economy devastated by war and the Great Depression, further compounded by the economic body blow of reparations and the loss of the German colonies imposed by the Treaty of Versailles. Many worried that the Nordic race itself was threatened with extinction.

The burgeoning new sciences of psychology, genetics, and medicine provided a glimmer of hope in this darkness. An intense fascination developed with strengthening and improving the nation through Volksgesundheit: public health. Many physicians and scientists promoted “racial hygiene” — better known today as eugenics.

The Germans were hardly alone in this interest — 26 states in the U.S. had forced sterilization laws for criminals and the mentally ill during this period; Ohio debated legalized euthanasia in the 20’s; and even Oliver Wendall Holmes, in Buck v. Bell, famously upheld forced sterilization with the quote: “Three generations of imbeciles are enough!” But Germany’s dire circumstances and its robust scientific and university resources proved a most fertile ground for this philosophy.

These novel ideas percolated rapidly through the social and educational systems steeped in Hegelian deterministic philosophy and social Darwinism. Long lines formed to view exhibits on heredity and genetics, and scientific research, conferences, and publication on topics of race and eugenics were legion. The emphasis was often on the great burden which the chronically ill and mentally and physically deformed placed on a struggling society striving to achieve its historical destiny. In a high school biology textbook — pictured above — a muscular German youth bears two such societal misfits on a barbell, with the exhortation, “You Are Sharing the Load!–a hereditarily-ill person costs 50,000 Reichsmarks by the time they reach 60.” Math textbooks tested students on how many new housing units could be built with the money saved by elimination of long-term care needs. Parents often chose euthanasia for their disabled offspring, rather than face the societal scorn and ostracization of raising a mentally or physically impaired child. This widespread public endorsement and pseudo-scientific support for eugenics set the stage for its wholesale adoption — with horrific consequences — when the Nazi party took power.

The Nazis co-opted medicine fully in their pursuit of racial hygiene, even coercing physicians in occupied countries to provide health and racial information on their patients to occupation authorities, and to participate in forced euthanasia. In a remarkably heroic professional stance, the physicians of the Netherlands steadfastly refused to provide this information, forfeiting their medical licenses as a result, and no small number of physicians were deported to concentration camps for their principled stand. As a testimony to their courage and integrity, not a single episode of involuntary euthanasia was performed by Dutch physicians during the Nazi occupation.

Would that it were still so.

In April 2001, the Netherlands became the first country in the world in which euthanasia and assisted suicide could be legally performed — although preceded by several decades of widespread illegal, but universally unpunished, practice. The Dutch had come into the public consciousness periodically over the previous 15 years, initially with the consideration of assisted suicide laws in Oregon, Washington, Michigan and elsewhere in the early 90’s, and again with their formal legalization of physician-assisted suicide and euthanasia in 2001.

Again in 2004, they showed up on the ethical radar, with the Groningen Protocol for involuntary euthanasia of infants and children.

The Groningen Protocol was not a government regulation or legislation, but rather a set of hospital guidelines for involuntary euthanasia of children up to age 12:

The Groningen Protocol, as the hospital’s guidelines came to be known, created a legal framework for permitting doctors to actively end the life of newborns deemed to be in similar pain from incurable disease or extreme deformities.

The guideline stated that euthanasia is acceptable when the child’s medical team and independent doctors agree the pain cannot be eased and there is no prospect for improvement, and when parents think it’s best.

Examples include extremely premature births, where children suffer brain damage from bleeding and convulsions; and diseases where a child could only survive on life support for the rest of its life, such as severe cases of spina bifida and epidermosis bullosa, a rare blistering illness.

The hospital revealed it had carried out four such mercy killings in 2003, and reported all cases to government prosecutors. There were no legal proceedings against the hospital or the doctors.
While some are shocked and outraged at this policy of medical termination of sick or deformed children (the story was widely ignored by the mainstream media, and received only limited attention on the Internet), it was merely a logical extension of a philosophy of medicine widely practiced and condoned in the Netherlands for many years, much as it was in Germany between world wars. It is a philosophy where the Useful is the Good, whose victims are the children whom Reason scorned.

Euthanasia is the quick fix to man’s ageless struggle with suffering and disease. The Hippocratic Oath — taken in widely varying forms by most physicians at graduation — was originally administered to a minority of physicians in ancient Greece, who swore to prescribe neither euthanasia nor abortion — both common recommendations by healers of the age. The rapid and widespread acceptance of euthanasia in pre-Nazi Germany occurred because it was eminently reasonable and rational. Beaten down by war, economic hardship, and limited resources, logic dictated that those who could not contribute to the betterment of society cease being a drain on its lifeblood. Long before its application to ethnic groups and enemies of the State, it was administered to those who made us most uncomfortable: the mentally ill, the deformed, the retarded, the social misfit. While invariably promoted as a merciful means of terminating suffering, the suffering relieved is far more that of the enabling society than of its victims. “Death with dignity” is the gleaming white shroud on the rotting corpse of societal fear, self-interest and ruthless self-preservation.

It is sobering and puzzling to ponder how the profession of medicine – whose core article of faith is healing and comfort of the sick – could be so effortlessly transformed into a calculating instrument of judgment and death. It is chilling to read the cold scientific language of Nazi medical experiments or Dutch studies on optimal techniques to minimize complications in euthanasia. Yet this devolution of medicine, with some contemplation, is not hard to discern. It is the natural gravity of man detached from higher principles, operating out of the best his reason alone has to offer, with its inevitable disastrous consequences. Contributing to this march toward depravity:

  • The power of detachment and intellectualism: Physicians by training and disposition are intellectualizers. Non-medical people observing surgery are invariably squeamish, personalizing the experience and often repulsed by the apparent trauma to the patient. Physicians overcome this natural response by detaching themselves from the personal, and transforming the experience into a study in technique, stepwise logical processes, and fascination with disease and anatomy. Indeed, it takes some effort to overcome this training to develop empathy and compassion. It is therefore a relatively small step with such training to turn even killing into another process to be mastered.

  • The dilution of personal responsibility: In Germany, the euthanasia of children was performed with an injection of Luminal, a barbiturate also used for seizures and sedation of the agitated. As a result, it was difficult to determine who was personally responsible for the deed: was it the nurse, who gave too much? The doctor, who ordered too large a dose? Was the patient overly sensitive to the drug? Was the child merely sedated, or in a terminal coma? Of course, all the participants knew what was going on, but responsibility was diluted, giving rationalization and justification full reign. The societal endorsement and widespread practice of euthanasia provided additional cover. When all are culpable, no one is culpable.

  • Compartmentalization: an individual involved in the de-Baathification of Iraq said the following:

    There is a duality in Baathists. You can find a Baathist who is a killer, but at home he’s completely normal. It’s like they split their day into two twelve-hour blocks. When people say about someone I know to be a Baathist criminal, ‘No, he’s a good neighbor!’, I believe him.
    Humans have the remarkable ability to utterly separate disparate parts of their lives, to accommodate cognitive dissonance. Indeed, there is probably no other way to maintain sanity in the face of enormous personal evil.

  • The banality of evil: Great evil springs in countless small steps from lesser evil. Jesus Christ was doubtless not the first innocent man Pilate condemned to death; soft porn came before child porn, snuff films, and rape videos; in the childhood of the serial killer lies cruelty to animals. Small evils harden the heart, making greater evil easier, more routine, less chilling. We marvel at the hideousness of the final act, but the descent to depravity is a gentle slope downwards.

  • The false optimism of expediency: Solve the problem today, deny any future consequences. We are nearsighted creatures in the extreme, seeing only the benefits of our current actions while dismissing the potential for unknown, disastrous ramifications. When Baby Knauer, an infant with blindness, mental retardation and physical deformities, became the first child euthanized in Germany, who could foresee the horrors of Auschwitz and Dachau? We are blind to the horrendous consequences of our wrong decisions, but see infinite visions of hope for their benefits. As a child I watched television shows touting peaceful nuclear energy as the solution to all the world’s problems, little imagining the fears of the Cuban missile crisis, Chernobyl and Three Mile Island, the minutes before midnight of the Cold War, and the current ogre of nuclear terrorism.

    Reason of itself is morally neutral; it can kill children or discover cures for their suffering and disease. Reason tempered by humility, faith, and guidance by higher moral principles has enormous potential for good – and without such restraints, enormous potential for evil.

    The desire to end human suffering is morally good. Despite popular misconception, the Judeo-Christian tradition does not view suffering as something good, but rather something evil which exists, but which may be transformed and redeemed by God and grace, to ultimately produce a greater good. This is a difficult sell to a materialistic, secular world, which does not accept the transformational power of God or the existence of spiritual consequences, or principles higher than human reason.

    Yet the benefits of suffering, subtle though they may be, can be discerned in many instances even by the unskilled eye. What are the chances that Dutch doctors will find a cure for the late stage cancer or early childhood disease, when they now so quickly and “compassionately” dispense of their sufferers with a lethal injection? Who will teach us patience, compassion, unselfish love, endurance, tenderness, and tolerance, if not those who provide us with the opportunity through their suffering, or mental or physical disability? These are character traits not easily learned, though enormously beneficial to society as well as individuals. How will we learn them if we liquidate our teachers?

    Higher moral principles position roadblocks to our behavior, warning us that grave danger lies beyond. When in our hubris and unenlightened reason we crash through them, we do so at great peril, for we do not know what evil lies beyond. The Netherlands will not be another Nazi Germany, as frightening as the parallels may be. It will be different, but it will be evil in some unpredictable way, impossible to foresee when rationalism took the first step across that boundary to kill a patient in mercy.

Cult of Death or Heart of Man?

Dr Bob

Cult of Death or Heart of Man

BeslanDavid Brooks, in a NY Times Op-Ed piece after the Beslen school massacre, in 2016, said the following about the Muslim terrorists:

We should be used to this pathological mass movement by now. We should be able to talk about such things. Yet when you look at the Western reaction to the Beslan massacres, you see people quick to divert their attention away from the core horror of this act, as if to say: We don’t want to stare into this abyss. We don’t want to acknowledge those parts of human nature that were on display in Beslan. Something here, if thought about too deeply, undermines the categories we use to live our lives, undermines our faith in the essential goodness of human beings.
It should come as no surprise to me — yet it still does — that people have any confidence remaining in idea of the “essential goodness of human beings.” Yet this is perhaps one of the most durable myths of our modern secular age. It underlies both public policy and private perception, and forms the basis of many failed government and social programs. If you have the stomach for it and the honesty to look objectively, even a brief glance at human history both ancient and modern reveals vastly more evidence of the depravity of man than his essential goodness. Consider briefly the following examples: the Inquisition, slavery, Ghengis Kahn, the Holocaust, the Bataan Death March, the Cambodian killing fields, Rwanda, Idi Amin, Columbine, Saddam’s rape rooms and shredders, suicide bombers on school buses and in pizza parlors, the rape of Nanking, the gulags, and Wounded Knee. And these are only the large historical events, easy to bring to mind. Left unmentioned but vastly outnumbering these are the countless murders, rapes, child molesters, serial killings, drug dealing, and any number of other smaller – but still profoundly evil – events which now barely if ever make the news.

I am not a misanthrope, and am fully aware of the potential for man to achieve great goodness and nobility. From the selfless volunteer at an inner city school to Mother Theresa, countless examples of such goodness and nobility exist, often hidden and far less noticed than deeds of evil. The issue is about the natural inclination, the deep inner nature of man – is it toward good, or rather toward evil? Your answer to this question profoundly affects your worldview.

By taking the position that man is essentially good, you are left with the problem of understanding inexplicable evil, such as torturing school children and shooting them in the back as they flee, as occurred at Beslan. In evil of lesser scope, psychology and social theory are often recruited for this task: the child molester or rapist was abused as a child; inner city crime is a result of racism; the root of terrorism is poverty, injustice, and the oppression of the Palestinians by the Jews. Even there the answers fall short. But could any such combination of social liabilities give rise to such extreme evil, as seen at Beslan or Auschwitz – particularly in beings whose natural bent is toward goodness?

The Judeo-Christian viewpoint on man’s essential nature is that man is fallen: created by a good God to be by nature good, but given free will either to submit to the good or to choose evil. Having rejected the good for personal autonomy independent of God, the natural gravity of the soul is away from God, not toward Him. In God is an unspeakable and unimaginable goodness; in His rejection is the potential for equally unimaginable evil. The Judeo-Christian solution is redemption, not psychology; inner transformation, not social programs.

To resist evil, you must know the face of evil, and recognize the face of good. The secularist denies the existence of God (or counts Him or it irrelevant), and therefore all goodness must have its source within man. The religious liberal believes God is good, but impotent, and therefore man is responsible to do the heavy lifting of all good works. The traditional Christian or Jew understands that man, created by God with enormous potential for good, but corrupted by failure to submit to God and therefore by nature far more prone to evil than good.

Religious affiliation is an unreliable indicator of good or evil behavior. The combination of evil motives with the compulsion of legalistic religion is a potent and dangerous mix, where men pursue their evil goals under the lash of and laboring for an angry god of their own making.

Man’s tendency to evil can be restrained, either by force of law, by force of arms, or ideally by inner transformation, repentence and submission to the power of humility and service. Wishful thinking and false assumptions about the goodness of man will prove woefully inadequate for the encroaching and fearsome evil of our current century.

Intellectual Giants, Moral Midgets

Dr Bob

Intellectual Giants, Moral Midgets


(Note: This post has been edited from the original to include citations from the article in the New York Times Magazine in 2004 on selective abortion, which is no longer available free of charge).

Amy Richard’s article on her selective fetal reduction in the NY Times Magazine (registration required) was previously reviewed in the National Review Online (see here) and elsewhere. It should be read by everyone with an interest in the abortion debate, or the general state of the culture wars in 21st century America.

Richards begins her story:

I’m 34. My boyfriend, Peter, and I have been together three years. I’m old enough to presume that I wasn’t going to have an easy time becoming pregnant. I was tired of being on the pill, because it made me moody. Before I went off it, Peter and I talked about what would happen if I became pregnant, and we both agreed that we would have the child.

I found out I was having triplets when I went to my obstetrician. The doctor had just finished telling me I was going to have a low-risk pregnancy. She turned on the sonogram machine. There was a long pause, then she said, ”Are you sure you didn’t take fertility drugs?” I said, ‘I’m positive.’ Peter and I were very shocked when she said there were three. ‘You know, this changes everything,’ she said. ‘You’ll have to see a specialist.’

My immediate response was, I cannot have triplets. I was not married; I lived in a five-story walk-up in the East Village; I worked freelance; and I would have to go on bed rest in March. I lecture at colleges, and my biggest months are March and April. I would have to give up my main income for the rest of the year. There was a part of me that was sure I could work around that. But it was a matter of, Do I want to?

I looked at Peter and asked the doctor: ‘Is it possible to get rid of one of them? Or two of them?’ The obstetrician wasn’t an expert in selective reduction, but she knew that with a shot of potassium chloride you could eliminate one or more.

Having felt physically fine up to this point, I got on the subway afterward, and all of a sudden, I felt ill. I didn’t want to eat anything. What I was going through seemed like a very unnatural experience. On the subway, Peter asked, ‘Shouldn’t we consider having triplets?’ And I had this adverse reaction: ‘This is why they say it’s the woman’s choice, because you think I could just carry triplets. That’s easy for you to say, but I’d have to give up my life.’ Not only would I have to be on bed rest at 20 weeks, I wouldn’t be able to fly after 15. I was already at eight weeks. When I found out about the triplets, I felt like: It’s not the back of a pickup at 16, but now I’m going to have to move to Staten Island. I’ll never leave my house because I’ll have to care for these children. I’ll have to start shopping only at Costco and buying big jars of mayonnaise. Even in my moments of thinking about having three, I don’t think that deep down I was ever considering it.


At every level, Ms. Richard’s story displays the moral vacuousness of the contemporary secular mindset. First, there is the impermanence of the relationships which will bear and raise children. She never indicates any consideration of marriage to her boyfriend, either while anticipating a pregnancy or after her child is born. Then there is the casual nature of the decision to have a child. She stops the pill because of hormone-driven moodiness, nobly deciding to keep the inevitable trophy child rather than suffer the agonies of monthly menstrual misery. She never once considers the implications for her child, or the society he or she will inhabit, inherent in her decision to raise him in an intrinsically unstable and uncommitted parental relationship. Finally there is the stunning reflex decision to terminate one or more of her unborn children when the serpent jaws of a self-gratifying lifestyle arise. No thought of a moral or ethical dilemna ever crosses her mind as she clutches for the salvation of a syringe of potassium chloride.

Ms. Richards sees her specialist, and relates the experience of her selective reduction:

The specialist called me back at 10 p.m. I had just finished watching a Boston Pops concert at Symphony Hall. As everybody burst into applause, I watched my cellphone vibrating, grabbed it and ran into the lobby. He told me that he does a detailed sonogram before doing a selective reduction to see if one fetus appears to be struggling. The procedure involves a shot of potassium chloride to the heart of the fetus. There are a lot more complications when a woman carries multiples. And so, from the doctor’s perspective, it’s a matter of trying to save the woman this trauma. After I talked to the specialist, I told Peter, ‘That’s what I’m going to do.’ He replied, ‘What we’re going to do.’ He respected what I was going through, but at a certain point, he felt that this was a decision we were making. I agreed.

When we saw the specialist, we found out that I was carrying identical twins and a stand alone. My doctors thought the stand alone was three days older. There was something psychologically comforting about that, since I wanted to have just one. Before the procedure, I was focused on relaxing. But Peter was staring at the sonogram screen thinking: Oh, my gosh, there are three heartbeats. I can’t believe we’re about to make two disappear. The doctor came in, and then Peter was asked to leave. I said, ‘Can Peter stay?’ The doctor said no. I know Peter was offended by that.
Let us not forget about the professional, clinically detached physician who delivers the deadly syringe to carefully selected unborn babies. The lifesaving miracle of high resolution ultrasound and fetal intervention selecting those twins whose crime was being several days too young.

Despite the high-minded rhetoric about “choice” in the abortion debate, at its heart abortion is about unfettered sex, or in the larger moral context, the pursuit of self-gratifying behavior while refusing to accept its inevitable consequences. Spiritual principles, much like the laws of physics, cannot be violated without consequences. No matter how fervently I believe I can fly, flapping my arms while jumping off tall buildings will always make me an unsuitable client for my life insurance company. Violating spiritual laws results in even more pervasive effects, since the spiritual tsunamis roll not merely through our own lives, but those of everyone we touch, both near and far. Unlike the violation of physical laws, however, the consequences are far more easily denied, rationalized, and minimized when they are in the realm of the spirit.

In the secular mindset, sexual “freedom” trumps all; the death of the unborn fruits of this behavior is not considered too high a price to pay. Any moral qualms about the ghastly consequences to the child can be mitigated by redefining language – an unborn child becomes a “fetus,” a “product of conception”—to move us a few steps farther away from the uncomfortable and convicting truth. Then we change the subject to a more defensible arena: abortion is about “freedom”, and “choice,” and “women’s health,” and “rights”—all straw-man targets far harder to attack than the crumbling and indefensible edifice at the core of the issue: snuffing out a unique, defenseless human being to promote and enable a self-centered, self-gratifying way of life. Amy Richards has given us a rare, inadvertently honest look into the dark soul of secularism, and its holy sacrament of abortion. We should look long and hard, and never forget, what the inevitable outcome of contemporary secularism will produce: shallow, empty humanity, exterminating our young to preserve our shopping preferences.

Our culture is advanced beyond the wildest imaginations of those even a century ago. We clone sheep; take stunning pictures of Saturn from its rings; perform robotic surgery; retrieve information in seconds with web browsers that formerly took years to acquire, if ever. We as a society are intellectual giants in history. Yet as our knowledge increases exponentially, our wisdom withers: we are just as truly moral midgets.

Liberalism & Gnosticism

Dr Bob

Liberalism & Gnosticism

Sunset Sky
It takes only a brief review of conservative web sites, print media, and pundit blogs to be left with the impression of a deep frustration with liberalism. Not merely the disagreement with their beliefs and priorities, mind you — that is a given — but rather with their peculiar unresponsiveness to arguments of reason and logic. The scenario goes something like this: Some Democrat in Congress or liberal pundit makes an outrageous charge about conservatives, or foreign policy, or Republicans, or Christians, or whatever. The conservative blogs explode with the news, followed shortly by detailed rebuttal of the charges, or ample testimony to prior events proving the hypocrisy of the attack. Well-reasoned, factual defense is generally the rule rather than the exception. Yet all is to no avail. Those on the Left either shrug, or respond with even more outrageous accusations, or go ad hominem. I often wonder whether all this energy and effort has accomplished anything beyond making us feel better about ourselves and venting our frustration.

I believe the problem is that we don’t understand liberals and liberalism–at least in its current manifestation. Now, before you start thinking I’m having a kumbaya moment, hear me out: we don’t understand liberals because contemporary liberalism is the new Gnosticism.

Gnosticism as a religion is ancient–predating Christianity by at least several centuries, and coexisting with it for several more before largely dying out. It was in many ways a syncretic belief system, drawing elements from virtually every religion it touched: Buddhism, Indian pantheism, Greek philosophy and myth, Jewish mysticism, and Christianity.

Gnosticism (from the Greek gnosis, to know, or knowledge) was manifested in many forms and sects, but all shared common core beliefs: dualism, wherein the world was evil and the immaterial good; the importance of secret knowledge, magical in nature, by which those possessing such knowledge could overcome the evil of the material world; and pantheism. It was also a profoundly pessimistic belief system. As J.P. Arendzen, in his excellent summary of Gnosticism, explains:

This utter pessimism, bemoaning the existence of the whole universe as a corruption and a calamity, with a feverish craving to be freed from the body of this death and a mad hope that, if we only knew, we could by some mystic words or action undo the cursed spell of this existence—this is the foundation of all Gnostic thought … Gnosticism is pseudo-intellectual, and trusts exclusively to magical knowledge.
So in what ways is modern liberalism Gnostic in nature?

First and foremost, in modern liberalism, what you believe is more important than how you act. Gnostic sects were often hedonistic – after all, since you possess special knowledge of the truth, and the physical world is evil, why pursue noble behavior with an inherently wicked material body? While not all – or even most – liberals are hedonistic (although Hollywood does come to mind…), contemporary liberalism has enshrined tolerance of hedonism as a core belief.

More fundamentally, there is a disconnect in liberalism between belief and action. As a result, there is no such thing as hypocrisy. So the National Organization of Women, tireless in its campaign on violence against women, sexual harassment, and the tyranny of men in the workplace and in society, stood wholeheartedly behind Bill Clinton, who used a dim-witted intern for sex (in the workplace, moreover!), and who was credibly charged with sexual assault on Juanita Brodderick. Hypocrisy? No, Bill Clinton “understood” women and women’s issues —his knowledge trumped his behavior, no matter how despicable.

There are many such similar examples, once you start looking for them. I recall a gay activist on NPR instructing his interviewer that the solution to “anti-gay intolerance” (i.e., anyone who had qualms about homosexuality, either in its morality or social agenda) was “education.” If we religious or socially conservative cretins were only properly “educated” —if and when we finally “got it” —then all of our concerns about homosexuality would melt away like an ice sculpture in August.

It is no accident that many of our most liberal intellectuals reside in the universities, in the rarefied atmosphere where ideas are everything and their practical application moot. We conservatives often marvel at the naivety of the peace movement, where World Peace can be achieved if only we “visualize” it. Like the magic formulas used by the Gnostics to dispel evil spirits and emanations, simply believing that peace can be achieved by “loving one another,” and mutual understanding is sufficient to transform those intent on evil, destruction, and domination. Human shields defend tyrannical monsters who would shred them in a heartbeat were they not so useful, in order to “put an end to war.” Judges implement rulings based on higher Sophia rather than the law, blissfully dismissing their profound impact on the Great Unknowing Masses beneath them.

The profound pessimism of the Gnostic world view is seen in contemporary liberalism as well. If ever there was a gentle giant in history–a nation overwhelmingly dominant yet benign in its use of power —it is the United States of the 20th and 21st century. Yet we are treated to an endless litany of tirades about our racist, sexist, imperialist ways, which will only end when the Left “takes America back” —ignoring that a nation so administered would cease to exist in short order. American liberalism was not always so. As recently as twenty years ago, it was optimistic, hopeful and other-oriented, albeit with misconceptions about human nature which proved the undoing of its policies and programs. Only at its farthest fringes did pessimism reign, but today this dark view is increasingly the dominant one.

Analogies have their limits, as does this one. Ancient Gnosticism was deeply religious, although pantheistic, whereas modern liberal thinking is profoundly secular and agnostic, for example. But even here similarities persist: how many New Age conservatives do you know? Modern secular liberalism is far more religion than political philosophy, and therefore largely resistant to confrontation or compromise based on logic and reason.

Gnosticism as a religious force collapsed of its own weight, crippled by its internal inconsistencies and the lack of power sufficient to transform and ennoble the human spirit. Yet failed ideas die hard, given the intransigence of human pride. How very odd that our predominant postmodern political philosophy is so ancient in origin.

The Law of Rules

Dr Bob

The Law of Rules

DaisiesIn contemporary political discourse, we often discuss the Rule of Law, especially in our postmodern culture where bad behavior is often justified (and excused) by situation, upbringing, or historical injustice. But no one ever talks about the Law of Rules.

Recently in the office I reviewed one of Medicare’s bulletins, clarifying (at least in intent, if not in practice) their regulations in some arcane area of reimbursement for surgical procedures. Few outside of the health care field have any idea of the complexity of regulations governing medicine. When last I checked some years ago, Medicare had about 150,000 pages of regulations in the Federal Register, approximately 3 times of the volume of the IRS tax code. American medicine is more highly regulated than Soviet state industry ever was, and getting more so by the day.

Without launching into a diatribe on the evils of government-funded and regulated medicine (perhaps another time), it strikes me that the explosive growth of rules, laws, and regulations in society as a whole is a reflection of an underlying shift in our culture, values, and individual moral integrity.

There are two ways to encourage good behavior in individuals and society: from within or from without. Human beings are morally flawed (a surprisingly controversial statement in our current, “values neutral” culture), and therefore in order to maintain a peaceful, stable, functioning society, laws – and the means to enforce them – are required. Laws exist not for the good in man, but rather for the evil, as a restraining force. If man were morally perfect, no laws would be necessary. Yet law cannot create morality, but serves only to protect the good in society from the evil. The more moral goodness exists in a society–restraint from harming one’s neighbor, acts of service, honesty, integrity — the fewer laws are needed and the better those laws already in place function. As individuals (and consequently the society they constitute) change from being other-oriented and self-restrained to self-centered and self-seeking, the more law-breaking occurs, the greater the enforcement required, and the more laws are required to manage and restrict human behavior. Hence the Law of Rules: Rules beget more rules.

We humans are intelligent, resourceful beings who are ever looking for new ways to achieve the goals and desires important to us. If our intent is to deceive, steal, or harm, there is almost always a way around existing law to accomplish our aims. The result of this is twofold: harsher enforcement of existing laws and more laws to cover the loopholes discovered by our innovative selves, as society seeks to protect itself. Hence the result of a deterioration in individual moral restraint is both more laws and harsher penalties. The logical end result of such a progression is something resembling totalitarianism: there are laws about everything, and brutal punishment for their violation — selectively applied, invariably.

We often hear totalitarian regimes such as China or the former Soviet Union boast of their low crime rates and the safety of their streets. And Islamic countries and cultures often proclaim their inherently higher moral status over us libertines in the West, cutting off the hands of robbers and the like. But while it is possible in large measure to restrict behavior through law and retribution, such measures do not make a society or its individuals moral as a consequence. In fact, the effect is quite the opposite. Laws intended to restrict evil behavior often have the unintended consequence of negatively impacting those intent on good. So, for example, the law designed to discourage fraud in Medicare by the few (a worthy goal) results in less time for patient care, restriction of access to care by the needy, and the exodus of good health care providers to other professions to escape their crushing burden — all bad outcomes affecting far more people than the few who would game the system. One need only look at the extreme effects of Islamic teaching on some of its more, , exemplary adherents, with the wanton murdering of women, children, unbelievers–and even other Muslims–to conclude that constrictive law-abiding society does not promote moral goodness as a consequence.

What’s the answer? Other than a fundamental reversal in individual moral virtue–an inside-out change–I fear there are few good alternatives. But I am not gloom-and-doom about the prospects for such change–I have seen and know of too many who have undergone such a change to be pessimistic, and am convinced of the existence of a God capable of implementing such change.