Susan Jacoby
Author and reporter

Susan Jacoby

Susan Jacoby is the author of nine books, most recently "The Age of American Unreason" and "Alger Hiss And The Battle for History."

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On the avoidance of death in life

Q: Does end-of-life care prolong life or does it prolong suffering? Should it be a part of health-care reform?

In the United States today, 80 percent of Americans die in hospitals or nursing homes, and only 20 percent die at home. More than 90 percent, however, say that they would prefer to die at home. The reason for this gap is that most people are so reluctant to openly confront the facts of life, illness, and death while they are in good health that they provide no legally binding, written guidance for their relatives or their doctors. The proposal that Medicare pay for one doctor-patient consultation every five years, in which Americans and their doctors--who are just as skittish about death as everyone else--would discuss the patient's wishes concerning end-of-life care was a timid step in the right direction. Of course end-of-life care, like all medical care, should be a part of health care reform. A third of the entire Medicare budget is spent on care in the last year of life, and a 2009 study by the Dana-Farber Cancer Institute found that an astonishing third of that total is spent in hospital intensive care units in the last week of life, on pointless high-tech maintenance for people who have no hope of recovery. Is that how you want to die?

The whole "death panels" nonsense isn't even worth discussing. It is simply a right-wing tactic designed to scare old people. In our society, there are basically three approaches to end-of life care, any of which may be adopted by individuals. The first is the "do everything possible" approach. The second, and by far the most common, is "do everything possible unless I have no hope of resuming a normal life." The third, and by far the least common, is a desire to control one's death through the option of suicide or physician-assisted suicide. The real problem, because people are so reluctant to plan ahead, is that "do everything possible" has become the default position of the medical system, and people who have not explicitly made their wishes known in advance are likely to end their lives in intensive care units in a setting that they would never have chosen. In spite of all of the publicity about living wills and the need to appoint a health care proxy to make medical decisions if an individual cannot speak for himself, only 30 per cent of Americans have prepared such documents. And the vast majority of people with living wills have not informed their doctors of their wishes. (This is a huge gap that consultations paid for by Medicare could close.)

From a secularist point of view, the only moral issue is an individual's right to determine, insofar as that is possible, the conditions of his or her own dying and death. For many of us, that won't be possible because we will not be mentally competent at the end--and that's why it is so important to make our wishes known and delegate decision-making power to a trusted relative or friend. The reason why this issue has become another attack point for the religious right is not, as conservatives contend, fear of government control. It is, rather, the belief that only God has the power of life and death. That's one reason why the right regards assisted suicide with horror. There is also a profoundly conservative religious belief that suffering has some sort of intrinsic exemplary value. I reject that belief (as do many liberal religious believers).

Leon Kass, the conservative bioethicist who served as chairman of the President's Commission on Bioethics under George W. Bush, provided an excellent example of this thinking in a forum in the May 2001 issue of First Things: A Journal of Religion and Public LIfe." Kass even opposes living wills because "it's preposterous to think that we can have the kind of foreknowledge to cover the myriad circumstances in which we may find ourselves. Nor can you accurately pass judgment on how you're going to feel about your life in a different circumstance...No kind of legal approach and no kind of medical approach are going to take the place of a loving, prudent caregiver on the spot." What if you don't have a loving, prudent caregiver on the spot? Do you want your fate to be determined by peope who may not share your values? I certainly trust my imperfect judgment, based on more than 60 years of living and on what I have learned from the deaths of those I loved, more than I do anyone else's judgment.

Kass goes on to find value in "senility, crippling arthritis, the need for hearing aids and dentures, and the degrading dependencies of old age." Without them, he argues, "we could no longer comfort the widow by pointing out that her husband was delivered from his suffering." What a shocking ethical position! People ought to suffer before death so that their survivors can be comforted by the end of the loved person's suffering.

The warriors of the religious right are worried not only or even primarily about the government "pulling the plug" but about individual human beings who want to influence the course of their final illness and death. They don't want people to talk to their doctors about this subject because want to leave everything up to God. I don't.

By Susan Jacoby  |  November 3, 2009; 9:18 AM ET
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compchiro,
i would have to agree. it seems like jewish people are the least anti-science of the three branches.

Posted by: walter-in-fallschurch | November 10, 2009 4:44 PM
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Walter,

"i've often wondered how judeochrislamics would "deal with" the discovery of alien life."

I can't speak for Christians or Muslims but when I was religiously Jewish I remember many Rabbis saying that they were fairly sure that we are not the only ones in the universe. And that if "aliens" arrived, that they would invite them over for a nice dinner (assuming human food was not poisonous to them) and offer their hand in friendship.

I find it funny "defending or explaining" the religous views of a religion I no longer adhere to. In the over 40 years that I was part of teh that religous community I never heard a Rabbi or scholar deny that evolution is valid or claim that humans are the only ones out there. In fact most rabbis would that the 6 days of creation were no anything like 6 days in time that we now know. Most of them would say that creation story is pure analogy.

Posted by: compchiro | November 10, 2009 4:25 PM
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oops...pardon me, meant to write:

i've often wondered how judeochrislamics would "deal with" the discovery of alien life.

Posted by: walter-in-fallschurch | November 10, 2009 2:12 PM
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schaum,
those are beautiful pics.

certain spots in the universe sure are pretty.... i've often wondered how judeochristians would "deal with" the discovery of alien life.

Posted by: walter-in-fallschurch | November 10, 2009 2:09 PM
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Even stranger than one might have thought...

http://www.boston.com/bigpicture/2009/11/martian_landscapes.html

Posted by: Schaum | November 9, 2009 4:29 PM
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Daniel12:

Mere constant repetition of your assorted lunacies does not bring them closer to truth.

You are seriously disturbed. You need professional help, as well as an education.

Posted by: Schaum | November 9, 2009 8:18 AM
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Part one.

The concept of atheism would not have arisen at all if not for the logical problems of the religious view. If the religious view of the world had been consistent no one would have questioned it. The belief in God would have reigned supreme.

Disbelief in God arises because belief has not satisfactorily explained things. There are inconsistencies, contradictions in the religious view. Just one of them is the problem of God somehow being good when he created the world and evil is in it.

One does not become an atheist by saying there is no proof of God as if there are no inconsistencies in the religious view and one just wants to say there is no proof of God. Inconsistency, illogic, contradiction in the religious view is why one becomes atheistic. If the religious view was logically solid one would not say there is no proof of God.

As for the atheistic view being logically solid, it is not. Saying there is nothing behind existence results in the problem of how intelligence arose not to mention why it should be valued. Saying there is a designer but that he is not God has problems as well. This designer WITHIN the universe? Then we have the problem of who created the designer. The designer OUT of the universe, being an alpha point? Then the designer is liable to exactly the same questioning addressed to the word God. How can this designer be good if evil exists which has been created by it?

Posted by: daniel12 | November 9, 2009 5:52 AM
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Part two.

This designer considered evil, that is the way out of the logical impasse? Then the consequence is that life is futile, because the designer himself is evil and there is no escape.

Whenever one wants to address the beginning and ending of things one enters contradiction and other problems of logic. The value of the atheistic view is not that it is any more logical than the religious view but that it clears the ground of religion and allows INTERMEDIATE ideas to be born, such as evolution and relativity to which religion had been hostile.

The intermediate--that between beginning and ending--has been much fleshed out by science and will continue to be fleshed out, but so far as we can tell when it comes to the big questions such as evil, intelligence behind things, creation etc. we are stuck in contradictions and other logic impasses. That is just basic philosophy. Read a book.

And do not call me a liar. I most definitely try my best to be honest, clear and rigorous. I play no games with people when it comes to words--in fact I do my best to play no games at all. The evidence of my speaking the truth is right before your eyes. All one has to do is take my words to a philosophy teacher or really anyone interested in science, philosophy and religion.

Posted by: daniel12 | November 9, 2009 5:51 AM
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One has to ask whether there is anything to be gained by giving medicines to a man who is already dead.

Posted by: Schaum | November 8, 2009 6:30 PM
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Daniel12,

"As for atheists ssying there is no proof that God exists--that that is the reason they disbelieve--they say so precisely because they are marshalling proof of this non-existence such as if God exists then why is there evil."

That is a lie. Again you are making a claim about what ALL AThesits belive and you have no standing (and I would argue no intelligence) to make such a specious claim. Very few atheists that I know equate evil to proof of no deity. Ergo, your assertion is a lie and false.

"ATHEISTS HAVE REASONS FOR THEIR DISBELIEF."

Yes. It is becuase there is no proof that god does exist. It really is that simple. Just because you are not capable of understandig that does nto change the fact. There is no proof. Period.


"If problems such as evil existing in a world created by a good God did not exist then atheists would not have a foundation for disbelief."

Read above to see how that is garbage.

"Disbelief would simply not arise if there were no problems, no contradictions in the religious view."
Disbeleif would still arise in the minds of intelliugent people who do not simply buy religious ideas without proof. Without proof ther is a very valid reason to not believe.

"Saying there is no proof of God is identical to living in a world in which one sees no evidence of God, and this non-evidence is born by such observations that evil exists and that this conflicts with religious assertions that God is good."
Again, stop focusing on evil as the reason. It is not.ince that seems to be you sole point you are ignorable.


"As for atheists believing there is possibly a designer but no God, here we have an impossible argument because admitting a designer is identical to saying God, for this designer must have been at the beginning and is the ultimate at the end or the designer would be merely an entity within the universe."

Not at all. There being a desinger does NOt in any way shape or form require God. Educated people see that.

Posted by: compchiro | November 8, 2009 10:29 AM
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Daniel12:

"As for atheists believing there is possibly a designer but no God, here we have an impossible argument because admitting a designer is identical to saying God"

Only in your extraordinarily limited mind. You make yourself more ridiculous with each posting.

Posted by: Schaum | November 7, 2009 9:45 PM
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Part one.

"Existence does NOT require or even point to a deity. As I stated in a prior post, it MAY point to a design process and/or designer(s), but not a deity."

Existence may point to a design process or designer but not a deity...First of all we have no deity admitted here. And we have the possible admission there is a designer. But the bulk of the emphasis is on nothing behind existence. And that results in contradictions such as intelligence rising with nothing behind it, etc.

As for atheists ssying there is no proof that God exists--that that is the reason they disbelieve--they say so precisely because they are marshalling proof of this non-existence such as if God exists then why is there evil. ATHEISTS HAVE REASONS FOR THEIR DISBELIEF. They are not saying they disbelieve for nothing. If problems such as evil existing in a world created by a good God did not exist then atheists would not have a foundation for disbelief. Disbelief would simply not arise if there were no problems, no contradictions in the religious view. Saying there is no proof of God is identical to living in a world in which one sees no evidence of God, and this non-evidence is born by such observations that evil exists and that this conflicts with religious assertions that God is good.

As for atheists believing there is possibly a designer but no God, here we have an impossible argument because admitting a designer is identical to saying God, for this designer must have been at the beginning and is the ultimate at the end or the designer would be merely an entity within the universe. If atheists say the designer is within the universe, then we still have the problem of what created the designer, and if nothing, then atheists are still stuck in the argument of why intelligence is so important when all creation arose by no intelligence at all. And if atheists say the designer is at the beginning, that is saying the same thing as God because then all the questions concerning God are placed on the designer, such as how the designer can be good if evil exists. And if the designer is evil, then we have existence futile because always thwarted and so on--a senseless existence.

Posted by: daniel12 | November 7, 2009 8:34 PM
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Part two.

Every which we way we turn contradiction exists as to the big questions. No one has managed to solve the contradictions at the heart of existence, and for an atheist not to recognize even the contradictions is just to be without even basic knowledge of life.

Again, this conversation is silly because the basic equipment of the well-rounded mind includes knowledge that existence is a mystery, which means fundamentally contradictory whenever we try to solve the big questions. If there were no contradiction there--if the atheistic view has no contradiction at all--one would not have to progress further in science at all because one would be living in a logically consistent world, ONE WHICH IS SOLVED. All one has to do is question a mathematician about this. Any worthwhile mathematician will tell you that despite all the rationality, logic, consistency of math it is still surrounded on all sides by contradictory math statements.

More obvious contradictory statements appear in such sciences as physics, what with Einstein saying if we increase speed toward lightspeed time slows down and everything else outside one moving at this speed accelerates in time. And Quantum theory has it that one can measure the trajectory of a particle or its absolute position but not both at the same time.

Basic knowledge of science and life.

Posted by: daniel12 | November 7, 2009 8:33 PM
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Daniel12,

"Atheists somehow think that they have managed to solve the contradiction of existence, for existence is a contradiction when one gets to the big questions and has never been solved by anyone--and this is the grand goal of existence above discovering this or that scientific theory. There is no grand theory of everything unless it solves the contradictions of existence to satisfaction."

That makes no sense whatsoever.

"But apparently atheists are so wise as to have solved the contradictions of existence."

So far you have shown no contradictions of existence. Existence does NOT require or even point to a deity. As I stated in a prior post, it MAY point to a design process and/or designer(s), but not to a deity.

"Atheists say God cannot exist because there is evil in the world"
Maybe a few do but the ovewhelming majority say that god does not exists (outside of the human imagination) because there has NEVER been anything close to irrefutable peoof of said existence.

"and also say there is no intelligence behind things."
Again you are making generalizations about ALL Atheists, which is invalid.

"And how silly I have to point this out. So much for the superior intelligence and integrity of atheists. This is definitely one of silliest discussions here."

It is only sily because you seem incapable of understanding things. That is your weakness, not ours.

Posted by: compchiro | November 7, 2009 4:50 PM
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"do not tell me you cannot see my point, for I will be starting with religion and speaking as best as possible your very language."

You have no point. You speak only in and out of ignorance. You know nothing about atheists or atheism. You make up vast pronouncements about what atheists "believe" that merely highlight your ignorance and make it visible to the entire world.

"Atheists say God cannot exist because there is evil in the world and also say there is no intelligence behind things."

Atheists say no such thing. You are, again, making things up to support whatever it is you are trying to prove. You are simply stupid, Daniel. You have chosen to be ignorant and you assume that is the condition in which everyone else lives. You do not think: you are incapable of reflection, research, logic. You do not think, you react! And your reactions are the product of sheer uninterrupted stupidity. Everyone else who posts here can think -- and WRITE -- circles around you. You are a beacon of darkness.

"and do not tell me you cannot see my point,"

You have no point, Daniel. You are meaningless. Your thinking is meaningless. Your writing is meaningless trash. Your existence is without purpose or even form. You are a waste. You are a failed man.

Who, in your undeveloped, uneducated, unintelligent little mind do you think you are?

Posted by: Schaum | November 7, 2009 8:33 AM
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Daniel12:

"there is no compelling reason to celebrate intelligence over ignorance--in fact one can state knowing nothing at all is preferable to intelligence"

This is, obviously a great truth for you. Fortunately, it is a truth ONLY for you.

Posted by: Schaum | November 7, 2009 8:25 AM
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If everything arose--even intelligence itself--without the slightest bit of intelligence behind it, then how can intelligence be even closely as important as the sheer blindness of universal drive? If there is no intelligence behind things--not even intelligence behind the creation of intelligence--there is no compelling reason to celebrate intelligence over ignorance--in fact one can state knowing nothing at all is preferable to intelligence, more likely to result in something created, even intelligence.--For the universe arose with no intelligence at all. How difficult to see that we have a contradiction here? But no, atheists have solved the contradictions of existence.

Posted by: daniel12 | November 7, 2009 2:48 AM
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Part one.

To all atheists. I am going to try one more time--and do not tell me you cannot see my point, for I will be starting with religion and speaking as best as possible your very language.

Everyone knows--even the religious--that the religious view of the world never makes perfect sense, never fulfills logical explanation. In fact examined carefully it is contradictory. A good example is if God is so good why is there evil in the world, how can it be God created everything but had no hand in evil. Other examples of this kind can be made. The religious say when confronted with such problems "God moves in mysterious ways, etc." And of course the religious emphasize faith against problems such as these. Atheists I know will have no problem bringing up other examples.

But despite all these observations and the entire history of metaphysics--philosopher after philosopher attempting to solve this difficulty--atheists somehow think that they have managed to solve the contradiction of existence, for existence is a contradiction when one gets to the big questions and has never been solved by anyone--and this is the grand goal of existence above discovering this or that scientific theory. There is no grand theory of everything unless it solves the contradictions of existence to satisfaction.

Posted by: daniel12 | November 7, 2009 2:35 AM
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Part two.

So far as we know existence is a contradiction at its heart. If it helps any, every attempt I have made to really put things in logical form has failed because so far as we know when the big problems are approached--and I make quite a few attempts at such--they defeat human intelligence. The very piece I first wrote here is still contradictory even though I tried to straddle the problem.

But apparently atheists are so wise as to have solved the contradictions of existence. When anyone points out a contradiction in their thought, no there is no contradiction there. What arrogance. Arrogance no different from the more fundamentalist religious people who think their view of the world too is without contradiction.

And what makes it all so silly is that it is not at all difficult to observe that all concerning human thought is tentative, makeshift, hypothetical, provisionary. Atheists say God cannot exist because there is evil in the world and also say there is no intelligence behind things. But apparently they feel it is no contradiction to value human intelligence when the entire universe arose without any intelligence and even created human intelligence. How important can intelligence be when not only everything other than it but it itself arose without intelligence? But no, no contradiction there...Again, what arrogance.

And how silly I have to point this out. So much for the superior intelligence and integrity of atheists. This is definitely one of silliest discussions here.

Posted by: daniel12 | November 7, 2009 2:33 AM
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Pamsm:

I read that to mean "don't try to confuse my mind (with facts)."

Posted by: Schaum | November 7, 2009 12:20 AM
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Daniel 12 says:
"...but do not try to confuse my mind..."

Oh, no need for that. It couldn't possibly be more confused.

Posted by: Pamsm | November 6, 2009 11:46 PM
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daniel12,
i said,
"It's like lamenting that humans exalt chocolate, when the universe arose without the slightest bit of chocolate."

and you said,
"Good grief Walter, that is a ridiculous analogy."

of course it's a ridiculous analogy - but it's apt. it is ridiculous to say humans can't value intelligence if we didn't "arise from" intelligence.

you said,
"Anyone can observe that chocolate is a product of a single plant in a vast universe and is in no way a causative agent of everything around us."

anyone can observe that human intelligence (chocolate) is the product of a single species evolving over billions of years and is in no way the causative agent of everything around us.

you said,
"However intelligence is the default causative agent which has long been recognized..."

yes, like demonic possession "has long been recognized" as the causative agent of leprosy.

etc, etc...

Posted by: walter-in-fallschurch | November 6, 2009 9:31 PM
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"It's like lamenting that humans exalt chocolate, when the universe arose without the slightest bit of chocolate."

Good grief Walter, that is a ridiculous analogy. Anyone can observe that chocolate is a product of a single plant in a vast universe and is in no way a causative agent of everything around us. However intelligence is the default causative agent which has long been recognized because nothing can be imagined superior to the operation of intelligence. This is why we call God omniscient. And to eliminate the concept that intelligence is behind the creation of the universe is to leave no causative agent behind the universe--precisely because nothing else can fit the bill. Your analogy does not at all hold.

It is a stone cold contradiction to say the universe arose by no intelligence at all then to celebrate intelligence inordinately as atheists do. If the universe arose without the slightest bit of intelligence then obviously and quite logically intelligence is not that important--in fact arguably ignorance is superior, for the universe arose without the slightest knowledge concerning itself and its actions.

You need a lesson in intellectual integrity. As for those of you whining, yes whining, about my opinions on end of life care, what I have obviously done is set a standard of courage which you are incapable of recognizing. Repellent how everyone accepts this athlete is superior to that, this musician superior to that, but when it comes to intellectual matters no one at all is willing to recognize standards, level of quality. Everyone when it comes to intellectual matters takes himself for a world class athlete or something. It is clearly setting a standard when I say that arguably we should celebrate those who have lived so fully that their actions resulted in their premature death rather than those people who never dare and just drag out their lives. Take Evel Knievel. He dared much and busted up his body. He preferred to really live rather than drag out life. A standard set. If everyone here does not want to recognize that, then do not recognize it, but do not try to confuse my mind and pretend that your objections are in no way a lower standard and that I have no idea what I am talking about. What I am talking about is common knowledge capable of being explicated by many examples.

Posted by: daniel12 | November 6, 2009 8:49 PM
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"I understand that His presence is manifest, etc., but when, for example, can we expect Him in Brooklyn?"

AFTER the Yankees have 30 straight years of losing seasons. LOL!!!

Posted by: compchiro | November 6, 2009 6:08 PM
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farnaz,
"I understand that His presence is manifest, etc., but when, for example, can we expect Him in Brooklyn?"

ha! that's funny... ;-)

Posted by: walter-in-fallschurch | November 6, 2009 12:34 PM
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In David's psalms, he lamented the absence of direct contact with the deity as there was in the time of Moses. It's been awhile since Moses. I lament, as well.

I wonder if D12 can give us an idea of when we might expect Him to stop by. I understand that His presence is manifest, etc., but when, for example, can we expect Him in Brooklyn?

Posted by: Farnaz1Mansouri1 | November 6, 2009 9:54 AM
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Daniel12,

"But the atheists eliminate any intelligence from being behind the universe while simultaneously calling for the use of intelligence against the ignorant. In other word, they celebrate intelligence when the universe according to them arose without the slightest bit of intelligence."

That is in no way a contradiction. Additionally you are making a generalization statement about Atheists which is a foolish thing to do. Not all atheists reject the notion that there may have been some form of design process. What they reject is that there is any proof that god or a deity was part fo it or that such an entity even exists. A careful reading of the ORIGINAL concept of Intelligent Design (not the worthless garbage put forth by some religious folks) in no way shape or form requires (or even insinuates) that the design process or producers be god or deities. Nor does it in any way justify worshipping them or insinuate that they (the designers) are still around or were ever omnicient. It does not prove the validity of god or religion. The two are completely separate.

"But the atheists are left emphasizing only intelligence--human intelligence--in a universe which supposedly has no intelligence behind it, according to them."

Not at all.

Lastly, human intelligence is part of teh evolutionary process. There really does nto need to be intelligence behind the formation of the galaxy for human intelligence to have devloped.

Posted by: compchiro | November 6, 2009 9:05 AM
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daniel12,
why the "fixation" on this "intelligence" thing?

grant for the sake of discussion that the universe/life/humans arose without an "intelligence" behind it. how does that exclude "intelligence" from being a good thing?

there's a flaw in your "logic". i'm sure you think it's some kind of paradox (your intelligence has divined), but it's not.

intelligence is why humans have tools and cities and agriculture and computers. in this sense we ARE the products of "intelligence" - our own intelligence.

Posted by: walter-in-fallschurch | November 6, 2009 8:53 AM
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"But the atheists eliminate any intelligence from being behind the universe while simultaneously calling for the use of intelligence against the ignorant."

Forgive me. I forgot to mention that you are also unutterably stupid.

Posted by: Schaum | November 6, 2009 8:25 AM
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Daniel12:

"I only gave my opinion Schaum and Lion's Den. "

We are very well aware that they are YOU opinions -- few other people would lay claim to them. That they are YOUR opinions does not make them less repugnant, less distorted, less socially destructive, nor you less repulsive and disturbed.

Posted by: Schaum | November 6, 2009 8:23 AM
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daniel12, you said,
"In other word, they celebrate intelligence when the universe according to them arose without the slightest bit of intelligence."

jeez...this again...

there's no contradiction. it's not a paradox. there's no connection. it's like lamenting that humans exalt chocolate, when the universe arose without the slightest bit of chocolate.

Posted by: walter-in-fallschurch | November 6, 2009 7:01 AM
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I only gave my opinion Schaum and Lion's Den. If you would have paid closer attention you would have seen that I wrote that it is only my opinion. Furthermore I wrote that a person should not be expected to slavishly follow a religion or scientific theory for that matter. Furthermore I wrote that concerning intelligence precisely all is not settled. I wrote all is ahead of us--intelligence is to be had, not assumed that one already knows it. I meant no imposition on anyone, I merely wrote what I would prefer. And yes, I admit that I might change my mind in those dire circumstances. I know myself not to be particularly courageous. Not a coward, but not a hero either. Hope that makes things more clear.

As for selfishness, I think the atheists take the cake for that. They call the religious narrow and anthropocentric for believing the universe is backed by a God which cares for them. But the atheists eliminate any intelligence from being behind the universe while simultaneously calling for the use of intelligence against the ignorant. In other word, they celebrate intelligence when the universe according to them arose without the slightest bit of intelligence. This is vastly more anthropocentric than any religious person before the Copernican view of the world. Vastly more anthropocentric precisely because the religious at least acknowledge a relationship--one between them and God. But the atheists are left emphasizing only intelligence--human intelligence--in a universe which supposedly has no intelligence behind it, according to them. Talk about self-absorbed. This is not to say the religious are not anthropocentric, but to set the record straight: self-absorption seems a great human talent. Would that we would have other talents.

Posted by: daniel12 | November 6, 2009 5:39 AM
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Schaum,

Clearly, Sebastian is suffering from post-pup depression syndrome, following the departure of Leah and puppies. I agree with Pamsm about the park.

First you need to have a heart to heart with him. Explain that, in life, both puppies and people come and go; however, you will not go. (Ergo, he shouldn't chew your stuff.) In between times when we have close inter-canine-or-personal relationships, we must make do with more casual company.

Having thus pronounced, bring lots of dog toys to the park so that Sebastian can attract other puppies.

I have no knowledge of dogs, except that I love them. Still, a heart-to-heart with the sometimes sad Sebastian and a trip to the park could help, I think.

Otherwise, seriously, you might have to consult a pup shrink. (I'd use that as a last resort, though.)

Posted by: Farnaz1Mansouri1 | November 6, 2009 1:14 AM
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Pamsm:

I didn't have any of these problems with him before the pups and his mate all left. Now its just him and me...and a house full of dog toys.

Its almost as though he is suffering some kind of post-pups depression. If I'm not giving him direct attention/play, he sits in the floor and stares at me as though he's forlorn and neglected. He DOES know how to work me, I'll give him that.

Posted by: Schaum | November 6, 2009 12:24 AM
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"Or is itjust excessive energy?"

Yes. He's a terrier.

There was a time when people who owned anything other than toy dogs kept them outdoors, with doghouses for shelter. Now we keep them in our houses. They love this, socially - they're with their human "pack" and that makes them happy; but they're getting far less exercise. Especially those that don't have fenced yards and only get to go out on lead.

If he's good with other dogs (most terriers aren't, particularly entire males) find a dog park where he can play with them. Or buy him a companion and give them lots of off-lead outdoor time. Play "fetch" with him until your arm gives out. Buy him a treadmill. Wear him out.

Also make sure he has "legal" things to chew - dogs like chewing. If necessary, crate him when you can't be watching him.

Posted by: Pamsm | November 6, 2009 12:02 AM
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And I think you are right...but WHAT? I spend enormous amounts of time with him...indoors and out. Its certainly not a question of his being ignored or needing attention he's not getting. Is he jealous of ANY amount of time I'm not with him? Or is itjust excessive energy? Maybe I should take him to a specialist. I know he's missed the pups and his girlfriend... Is he angry? I can't figure it out.

Posted by: Schaum | November 5, 2009 11:36 PM
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Sebastian is in disgrace at the moment. He chewed up one of my volumes of the complete organ works of Bach. I am really pissed.
---------------
Hmmm....Let's see. He's chewed your glasses, the vacuum cleaner plug, and, now, Bach. Ny inexpert guess is that he is trying to communicate something. :[

Posted by: Farnaz1Mansouri1 | November 5, 2009 11:33 PM
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Sebastian is in disgrace at the moment. He chewed up one of my volumes of the complete organ works of Bach. I am really pissed.

Posted by: Schaum | November 5, 2009 11:15 PM
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Hi Schaum,

"Yes, I said as much that Mills would not accept what I was saying as he was a libertarian. But libertarianism does not automatically follow from utilitarianism."

I must agree with you there. Wonder what Sebastian thinks? :]

Posted by: Farnaz1Mansouri1 | November 5, 2009 10:36 PM
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Yes, I said as much that Mills would not accept what I was saying as he was a libertarian. But libertarianism does not automatically follow from utilitarianism.

Posted by: DaveL2 | November 5, 2009 10:16 PM
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In the "automatic signature" feature on my email system, I have this quote, which pretty much sums it up for me:

"“The only purpose for which power can be rightfully exercised over any member of the community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.”
-- John Stuart Mills"

Posted by: Schaum | November 5, 2009 8:56 PM
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"Is it to be assumed that I am in any way obligated to agree as to that "greatest good and happiness" if it unnecessarily burdens me?"

If one is a very strict utilitarian, then yes. But I should add that you'd be better talking to a utilitarian about this. I'm not a utilitarian. All I was suggesting is that there are some secular grounds, if one is a utilitarian, for supposing that autonomy is not the only factor in the decision to end one's life.

Looking back over your previous post, however, where you stated, "I hasten to add that I would personally find a single parent who chose to commit suicide while leaving underage dependents behind to be morally reprehensible," I think we are in agreement about this. I should add that I was making no claims about legality, just morality. My only point has been that, morally speaking, one can have grounds for looking beyond one's own autonomy when making decisions about ending one's life.

Posted by: DaveL2 | November 5, 2009 8:50 PM
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walter-in-fallschurch

I did not "want" to die. I was experiencing a great deal of physical and emotional suffering. And I did not think there was any hope that I could ever recover.

And I saw my mother and father's lives gradually being dragged down and ruined because of me. So, at some point, you just give up. And that is what I did.

But they didn't. That is a good lesson that I learned, not to give up too soon.

I am sorry that I said such mean things to Daniel12. I think he may be a little fragile. Yet, I just cannot let him sneak such ugly remarks into the thread, without some kind of comment.

Posted by: DanielintheLionsDen | November 5, 2009 6:29 PM
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"served the purposes " should read "served the perceived purposes"

Posted by: Schaum | November 5, 2009 5:42 PM
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DaveL2:

""But 'utilitarian' is an individual choice, not a moral imperative."

That again depends on one's philosophical intuitions."

Greatest good and greatest happiness for the greatest number of people? Is it to be assumed that I am in any way obligated to agree as to that "greatest good and happiness" if it unnecessarily burdens me?

The "greater" number of people in Maine decided to deny equal rights to a smaller segment of the population yesterday...in effect, they voted for oppression. Am I to agree with that simply because it served the purposes of the greater number of people? It is my individual choice not to be "utilitarian" in this (among other) instances.

Posted by: Schaum | November 5, 2009 5:34 PM
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"But 'utilitarian' is an individual choice, not a moral imperative."

That again depends on one's philosophical intuitions.

Posted by: DaveL2 | November 5, 2009 5:09 PM
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DaveL1:

" I think if one is a utilitarian, then there could be grounds for other considerations as well."

And I agree. But 'utilitarian' is an individual choice, not a moral imperative.

Posted by: Schaum | November 5, 2009 5:01 PM
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"I wasn't engaging in conversation with Schaum, so I fail to see how that is relevant. My comment was directed at the author of the article. Susan Jacoby did address suicide, which is why I brought it up. If that does not go in line with the conversation other people have had following her post, frankly I could care less. "
Because Susan Jacoby is not likely to respond, but those of us on this board ARE the responders so our views ARE.

Posted by: compchiro | November 5, 2009 4:47 PM
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"I am an existentialist, in many ways. I believe that life, in and of itself, has no objective meaning."

Fair enough. I can respect that we do not share the same philosophical intuitions. The point of my initial post, however, was that a secular view of morality need not only take into account personal autonomy. I think if one is a utilitarian, then there could be grounds for other considerations as well.

Posted by: DaveL2 | November 5, 2009 4:38 PM
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I hasten to add that I would personally find a single parent who chose to commit suicide while leaving underage dependents behind to be morally reprehensible.

However, I think he definitely DOES have the right to be morally reprehensible. He is in no way obligated to live his life according to my values.

I am an existentialist, in many ways. I believe that life, in and of itself, has no objective meaning. What subjective meaning it may have/does have is a result of what we INDIVIDUALLY determine our lives/values to be. That/those are our rightful decisions. We do not have the right to impose our values on each other.

Posted by: Schaum | November 5, 2009 4:26 PM
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Davel2:

"So if a single mother or father decides one day to commit suicide,..."

I presume, considering the way you ask this question, that you consider the actions it describes to be bad/evil/wrong/destructive.

My answer is YES, everyone has the right to determine his behavior. Everyone has the right to be wrong. We are, ultimately, responsible for ourselves.

Posted by: Schaum | November 5, 2009 4:00 PM
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"I do. I get to make that decision for myself. Just as you get to make it for yourself."

So if a single mother or father decides one day to commit suicide, regardless of the situation this will leave for the children, it's OK because she or he performed the action autonomously?

Posted by: DaveL2 | November 5, 2009 3:52 PM
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Davel2:

"Again, no argument is given for this claim. It is arbitrary and I don't know why I should accept it."

Then don't. I don't imagine that many people will lose sleep over your opinions.

Posted by: Schaum | November 5, 2009 3:09 PM
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Davel2:

"But why? Who says personal autonomy is the only consideration?"

I do. I get to make that decision for myself. Just as you get to make it for yourself.

Posted by: Schaum | November 5, 2009 3:08 PM
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"I would say yes."

But why? Who says personal autonomy is the only consideration? This isn't obviously true and needs further argument.

"We are not talking about suicide as Schaum has defined it "

I wasn't engaging in conversation with Schaum, so I fail to see how that is relevant. My comment was directed at the author of the article. Susan Jacoby did address suicide, which is why I brought it up. If that does not go in line with the conversation other people have had following her post, frankly I could care less.

"That principle is irrelevant in end-of-life issues."

Again, no argument is given for this claim. It is arbitrary and I don't know why I should accept it.

Posted by: DaveL2 | November 5, 2009 2:44 PM
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DanielintheLionsDen,
omg! you really wanted to die? there was a moment where, if left up to you, you would have refused further treatment and died?

well, glad you lived.

Posted by: walter-in-fallschurch | November 5, 2009 1:22 PM
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Dear Daniel 12

You said:

"It seems so selfish and craven to go on hanging on, driving up medical bills, and teaching to one's relatives--and friends, acquaintances, doctors and nurses--that death is so terrible, that a person just cannot face it, and that the correct procedure is to head in the direction of more and more medicine, for pain physical and otherwise--not to mention medicine which is supposed to...what? Cure one?"

I now see you as a weirdly eccentric, possilby disturbed person.

The sick, elderly, injured are selfish and craven? I have never heard anyone say such a thing.

I was terribly injured. I was one of those craven and selfish people. I suffered unendurable pain. I wanted to die. I thought it would be better that way, and my family would grieve for awhile, but it would be better for them, without me dragging them down.

But they would not let go of me. They did not see it that way. They wanted everything to be done that could be done. I didn't want it. I knew I would die no matter what we did.

But I didn't die. I got better. So I am a little conflicted on this question. I don't think that people should be kep alive by machines when all hope is lost. But just when is all hope lost? It is hard to tell.

I think that you are very self-absorbed, with little empathy for others. You think and say atrocious things, without seeming to realize just how offensive you are.

The "purpose" of medicine as a science is to relieve suffering and to cure disease. I think the only question here is when is the effort to relieve suffering not yielding any good result, and maybe even making things worse?

It certainly is not about the craven and selfish sick, crippled, injured, and elderly people for whom all of medical science exists to aid.

You don't seem to like anyone but white people. You don't seem to like atheists. You don't seem to like the sick and the elderly. What's left, for crying out loud?

All you love is yourself. That is your problem.

I guess I accidentally slipped into "ad hominem."

By the way, I found you first few paragraphs so terribly shocking that I was not able to read ALL THE REST of your thoughts.

Why don't you take up writing fiction? Why don't you write a nove? Maybe you would be better at that.

Posted by: DanielintheLionsDen | November 5, 2009 12:51 PM
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Daniel12:

"A person should not try to live beyond the point any sensible person can see is the last remaining point between worthwhile life and just suffering and helplessness. "

A person should try to live for exactly as long as HE determines, it being nobody else's place to judge when his life is no longer "worthwhile". You'd have approved of Hitler's euthanasia programs, I can see.

You are completely certifiable.

Posted by: Schaum | November 5, 2009 11:23 AM
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Part one.

Should a person go on trying to live--by medical means of course--after it is quite obvious that quality of life has declined to the point that really there is no life left to live there?

My answer to this is unequivocal: No. A person should not try to live beyond the point any sensible person can see is the last remaining point between worthwhile life and just suffering and helplessness. A person should have a certain self-respect. It seems so selfish and craven to go on hanging on, driving up medical bills, and teaching to one's relatives--and friends, acquaintances, doctors and nurses--that death is so terrible, that a person just cannot face it, and that the correct procedure is to head in the direction of more and more medicine, for pain physical and otherwise--not to mention medicine which is supposed to...what? Cure one?

Posted by: daniel12 | November 5, 2009 9:10 AM
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Part two.

In fact it is arguable that we should routinely celebrate those who have made the most of their lives, even if the life they led resulted in premature death. But if this is going too far, still, every person should be taught to make the most of his or her life and that trying to hang on and drag out life is no substitute for a life well lived. But this could very well be only my opinion because I feel I am becoming reconciled to my death. In fact I have thought about it to where I hold a position concerning such (and life as well) which is neither religious in the traditional sense nor atheistic.

I believe there is intelligence and morality behind the creation of the universe but that such is always a project for the human race to understand and that commands from God or even current scientific evidence is no substitute for continuing to learn about the universe. This intelligence and morality I believe in is always ahead of us, we are never equal to it, and it is a gross error to think we understand such to the point of erecting a religion which all must follow--and a gross error as well to set up scientific evidence as if it is absolute, never to be superceded. Everything is always ahead of us. We never know more than "something" or a "little" now. No use in trying to pound into people's heads one's pet religion or pet scientific evidence.

Posted by: daniel12 | November 5, 2009 9:09 AM
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Part three.

I have come to this conclusion after studying both the positions of the religious and the atheists. The monotheistic religions of Judaism, Islam and Christianity allow for little modification in understanding the origin and meaning and morality of the universe if any modification at all. Here it is agreed morality and intelligence is behind the creation of the universe but concerning such all is supposedly settled! God forbid anyone would have any other interpretation of the intelligence and morality behind the universe than that which we are supposed to believe in and follow! And Hinduism and Buddhism are really no better what with hypotheticals such as reincarnation and the possibility of escaping rebirth and the notion of reaching a position called "nibbana" which is suspiciously like believing one can become God. All religions approach things as if all is settled and that one must only follow. There has never been a religion it seems which says merely that all remains to be discovered. Hopefully the latter is something of the project of science.

I really have no problem with science. In fact I love it. But I reject the more dogmatic scientific minds. It would not surprise me a bit if so much of what we know now is incorrect by future standards. And I have a problem with scientific views when they are enveloped by the atheistic view. I have a big problem with the atheistic view. Atheists of course are not given to religion--not even Buddhism although some try to distinguish Buddhism from religion and call it a philosophy compatible with the atheistic view. Compatible with the atheistic view when one is supposedly constantly reborn (and there is no evidence of that) and that one can never escape this until one reaches perfect enlightenment by which rebirth is extinguished? Perhaps no overt belief in God here, but certainly something of the belief that one can become God what with enlightenment and all.

Posted by: daniel12 | November 5, 2009 9:09 AM
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Part four.

But to get to the point about my problem with atheists, they are perfectly correct to be against the settled positions of the religious, perfectly correct to be against all which arrests the pursuit of knowledge, but they get themselves into an obvious contradiction when in eliminating God they go to such an extreme they say there is exactly nothing behind the creation of the universe and life. No God, no intelligence, no morality. They get into an obvious contradiction because in saying such things as everything blindly self-organized they undercut their constant call for an increase of intelligence--an increase of science especially--over ignorance, especially the ignorance of the religious.

In other words, if everything arose without the slightest bit of intelligence behind it why should we particularly care about intelligence as the atheists constantly ask us to do? If all arose from nothing then human intelligence is at best a petty conceit, a piece of local self-flattery in a vast universe. With nothing behind the creation of the universe there is no reason at all to pursue intelligence. The universe apparently does quite well for itself without intelligence--in fact it has done virtually everything!--so why should we pursue intelligence, what makes it so important? In fact we should arguably work toward becoming more ignorant, for that would be more in tune with the universe that has nothing behind it--more in tune with the blind drives which have created the universe and life.

Posted by: daniel12 | November 5, 2009 9:08 AM
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Part five.

Certainly with nothing behind the universe intelligence is at least an anomaly and probably an aberration. Something to be removed rather than admired. In other words the atheists go to the opposite extreme of the religious. The religious treat everything as definitively understood, that all one must do is follow. The religious do hold that there is intelligence behind the universe but they also hold that concerning such all is settled--we have our commands and must obey them. The atheists understandably recoiling against this eliminate intelligence behind the universe completely--but then they also lose their rationale for asking us to become more intelligent and overcome ignorance. My solution is that there is indeed intelligence behind the universe--morality as well--but that the bulk of the knowledge concerning such is always ahead of us, nothing is really settled.

There is no compelling reason to make people slavish followers of a religion or a particular scientific theory for that matter. All is ahead of us. And this is why I am reconciled to my death. I believe in the intelligence behind things. This does not necessarily mean life after death but that one can learn and enjoy--there is so much to be known. One can live a full life. And at the end of the day tell everyone to keep pursuing--to never give up. And supposing people always do such and keep succeeding, then there will always be life after death.--THIS life, which we should never try to prolong if it falls below a certain level of quality. In fact we should never try to make acceptable a lower quality of life but always try to increase the quality. And this we can call life after death.

Posted by: daniel12 | November 5, 2009 9:07 AM
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rubyteusday,

Reevee and Morrie made their own choices. That was their right. No one here is saying that they should have made another choice. But both Reeves and Morrie also recognized that their choices were not the only choices and that others who choose to end thier lives had as much right to do so as they had the right to fight to the end.

I have a living will and a Durable health care agent form filled out. My doctors, family and friends all knowa bout it. My moths is currently in the end stages of her life and if it were not against the law I would gladly accede to her continually expressed wishes to end her life. Unfortunately my state legislature is a bunch of worthless cowards who have not yet followed Oregon's and Washington state's intelligent example and allowed physician assisted suicide. Otherwise my mothers slow decline and her misery would be over.

Posted by: compchiro | November 5, 2009 9:01 AM
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edbryonadams,

"Virtually everyone suffers the vagaries of old age, sickness and death. It is part of life."

The issue is not whether everyone endure some amount of "suffering" as one ages or gets sick (not all death results in extended suffering and some death occurs very quickly, but that tends to be unintended death such as accidents and the like).

The issue is whether people have a right to decide when to end their own lives or die with as much dignity as possible. Long lingering death or illness is NOT a required part of life.

Posted by: compchiro | November 5, 2009 8:49 AM
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Davel2,

"Is it true, though, to say the *only* moral issue is the individual's right to determine?"

I would say yes.

"that the suffering of others which would arise from the chosen action ought also to be considered?"
We are not talking about suicide as Schaum has defined it (the result of treatable depression or mental illness) where the emotional suffering of family and friends MIGHT be a valid part of the equation (I am not sure that even then if it really matters what others think or feel). We are talking about end-of-life decisions where there is no treatment to stop the impending death or where the quality of one's life is not going to get any better and one will continue a slow often painfull and/or undignified end. Any family member or friend who is worth anything would agree that the patient's wishes are all that matters.


"Given the utilitarian principle to take the course of action that either promotes the most happiness or promotes the least unhappiness, the individual's autonomy, while certainly one of the most important factors, is not the only consideration in this moral issue."

That principle is irrelevant in end-of-life issues.

Posted by: compchiro | November 5, 2009 8:45 AM
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RubyTues63:

"Life is not an exercise in avoiding pain."

Thomas Jefferson disagrees with you: "The art of life is the art of avoiding pain; and he is the best pilot, who steers clearest of the rocks and shoals with which it is beset."

Posted by: Schaum | November 5, 2009 1:28 AM
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Life is not an exercise in avoiding pain.

Once upon a time a handsome, but otherwise unremarkable actor named Christopher Reeve broke his neck when he was thrown from his horse. The accident left him paralyzed and unable to breathe on his own.

At first Christopher could imagine no meaning to his life. At first he saw only the things he could not do. At first Christopher Reeve wanted to die. But he didn’t. He found new purpose and became an inspiration greater than the characters he played on the big screen. After the accident, Christopher Reeve stopped acting and became Superman.

Tuesdays With Morrie is the story of a student who reunites once a week with his dying teacher, who uses his last few months to teach his pupil about life. Morrie had Lou Gehrig’s disease, a progressive, fatal neurodegenerative disease. Morrie knew his life would become more and more difficult, more and more painful, that eventually he would not even be able to control his bowels or breathe on his own.

Morrie used his Tuesday visits with the author, Mitch Albom, to teach Mitch about life and love and everything important. Through his book, Mitch shared Morrie’s life lessons with millions.

What would the world be like if Christopher Reeve quit? He certainly had every right. No one expected anything of him after the accident. What would the world be like if Morrie had taken the easy route? Certainly no one could begrudge him an easy death.

I’d like to believe that everybody has a little of Christopher and Morrie in them. I’d like to believe that every life lost is a tragedy. I’d like to believe we are more than the broken shells we inhabit.

Posted by: rubytues63 | November 4, 2009 11:03 PM
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This is Quinn and Meacham's favorite atheist. They are piling a lot of hopes on her to help them get O-care passed" There, there, old people, now don't be scared. Hush, hush sweet old people, there is othing to fear. You know you have to die; our only purpose is to help you."

Posted by: chatard | November 4, 2009 8:51 PM
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Old joke:

Q: What's the punishment for suicide?

A: Life imprisonment.

Q: What's the punishment for attempted suicide?

A: Hanging.

Posted by: norriehoyt | November 4, 2009 6:38 PM
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Old joke:

Q: What's the punishment for suicide?

A: Life imprisonment.

Q: What's the punishment for attempted suicide?

A: Hanging.

Posted by: norriehoyt | November 4, 2009 6:37 PM
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"Enjoy Today (in Sikness or in Health), and don't worry about tomorrow, if ye can; nor hurry tomorrow for it surely will come [Justly in a FLASH as it had in the Past]"

O' DEATH! The patience that ye hath; the Friend of [i] friend; O' my Loyal friend; Why hath ye been unjustifiably given such an ugly name of sorts for such a beautifull THING or feat?! O' i-deal dear Death, WE [i] know that Ye art not a Beast, Yet i [WE] intuitively know that ye art a good care-taker , No-Matter. O' Death, such a smart but Loyal Worker; We, The-FEARLESS, not the-Jealous folk are your Soldiers!

From Caterpillar NOW [THIS] we are, To Butterfly [NEXT] each goes... according to TiME] Our Holy-i Cosmic Eternal Miracle(s) in Motion: Coming & Going according to "IT"s [Natural] unreversable-Laws (No Error). Note: ""IT"" ['G-D' by manymanymany names, not 99 or 1,000 names; does make, not many, mistakes (i.e., placing a Female in a Mans Body; vis viz, etc..) ; but IT is impossible for IT to reverse IT's own Existance! Hark;

LiFE [LOVE] is a Miracle [not written in Sin or in Curse story's] And Sex, or coochy-poochy is surely not Love!

Pssssst, Death is an inverse phenomona-of-OFF, and Birth is the inverse phenomona-of-ON; This happens because "IT" loves LIFE "iTSELF" and "IT" in-turn needs to rely-On DEATH; or else there is No Such thing as "ETERNITY AVOiDING LONLiNESS" (includes MATH, like in; INFiNITY & FiNITY) through each and every 1-of-US ANNiMATE(s), aka PHOTON Essences; appearing Justly for a 'time' (in manmade clocks & Religion system) via Real 'TiME' (our appearing now then disappearing again & again via "IT"s own given TEMPERATURE & Frequency (Cosmic Heartbeat) , for US, thereFrom & thereTo.

iMAGINE, another Future bound "ESHATOLOGICAL POSSIBILITiES OF ONEs (Immortal MEMEtic) SELF"!? includes All In-Animates through "IT"s own stuff & THiNGS; hence OUR Holyi Cosmic immortal Motion, 'Avoiding Lonliness' for LOVE [Life's] sake!"

"People Need People" WHEREFORE: "iT too needs IT" for support in the holy [Eternal Heartbeat in Warmth] PALINDROME sweeping IT's things & Stuffs round & around.... for "iTSELF", only to be again!And that includes ANY-[Unique]-1!

Vote, YES! TO Help ease those whom have No family to take care of them during each Carbon-based n Biofinite-Deaths great momentuum, aka "END OF [ANOTHER] TIME(s)" moment.

Hint: H-O-P-E via "IT" is our Best-Friend! Note: NO-Hope; no Future. Therefore: WE [i] was never Created, nor can i [WE] ever be destroyed!!! Includes The-GOOD or the-BAD "Photon Essences" in "Photon-Mist forms!" So How can anyone "Immortal" BEGONE from our midst?!

SECRET: Your Current Parents (Humanly-Planed Ye, US, i, or not) art not the only real Parents you've ever Had. And in the Future, again, Ye will have different parents (Conscious or not!)

Posted by: eschatological-man | November 4, 2009 6:32 PM
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I think the following is exactly right and corresponds to my own thinking about this subject, except that I've got 21 years on Susan Jacoby -- I'm 81.

"I certainly trust my imperfect judgment, based on more than 60 years of living and on what I have learned from the deaths of those I loved, more than I do anyone else's judgment."

If my wife were able to make a decision in this kind of situation, that would be fine, but she has been severely damaged by a disastrously failed brain operation. And our children all live pretty far away, anywhere from North Florida to New Hampshire to Oregon. They're all wonderful, but a living will is the best insurance I have that I won't become an expensive basket case.

Posted by: dicesare1 | November 4, 2009 6:21 PM
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'Kass even opposes living wills because "it's preposterous to think that we can have the kind of foreknowledge to cover the myriad circumstances in which we may find ourselves. Nor can you accurately pass judgment on how you're going to feel about your life in a different circumstance...No kind of legal approach and no kind of medical approach are going to take the place of a loving, prudent caregiver on the spot.'

Baloney.

There wasn't a living will or an advance directive in the Terri Schiavo case and look what that led to.

Posted by: norriehoyt | November 4, 2009 6:15 PM
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Schaum,

I"m altogether agreed with your points on self determination on life and death issues. Morality is self determined as well, after all. Outside of that we live in societies that put some value on them, and governors on what people "have the right to choose".

Their own deaths should not be included in that pot. The life of an individual is not owned by the master any more, or the state, or the church. Although there may be some argument for partial ownership, (like a lien?), by vested interests. Those are usually clearer if they are purely financial.

Hard to put a 'value' on emotional investment, especially in a society that ascribes $'s and euros and yen to any value...

So maybe it all comes down to the banks! :-) The new Rome!

Posted by: justillthennow | November 4, 2009 5:36 PM
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JTTN

Rereading it, I agree: I could have been clearer that my remarks were about Zen Buddhists and the samauri suicide traditions. The point I was most interested in making was outlining the requirements that the court stated as making euthanasia in Japan acceptable.

My own point of view is that suicide is an individual right/decision, under any circumstances. I will even allow for the possibility that suicide is "wrong"; it is, nevertheless, my life to do with as I please. And even if it is wrong, I do have the right to be wrong. I will not endure a painful death merely to please someone else's sense of "morality" or "aesthetics". And there is no reason I can find why anyone should.

Posted by: Schaum | November 4, 2009 5:26 PM
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Schaum,

Fair enough. I took the title of your post and flavor of commentary as a statement of how Buddhism in general views euthanasia, using Japanese Zen Buddhism as an example. It was not clear that you were speaking of Zen Buddhism specifically.

Posted by: justillthennow | November 4, 2009 5:08 PM
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JTTN

" I do not find that there is a broad condoning of euthanasia, "

Thats because there isn't. I was writing about Japanese Zen Buddhists; their point of view has found some favor with the western Zen community. Others (Tibetan, Chinese for instance) are adamantly opposed to euthanasia. But they practice Buddhism as a religion. I know only a handful of Zens who do so. Certainly I don't.

Posted by: Schaum | November 4, 2009 4:57 PM
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Hello Schaum,

I liked your post on Buddhism and Euthanasia. I do not find that there is a broad condoning of euthanasia, and no clear set of prerequisites that bring majority agreement with the practice. One of the fundamental intentions of course is the maintenance of healthy mind and thought. It is a crucial point of departure for the different camps.

I have known Buddhist teachers and masters as well as Swamis and Vedantic teachers and masters that have mostly fallen (do they fall?) on the side that disagree with euthanasia in most cases. A couple were adamant that it brought about long term suffering and spiritual reparations to the soul that departed, before being able to reincarnate.

On my first point, and knowing you love them, here are a couple of links:

www.urbandharma.org/udharma/suicide.html
www.bbc.co.uk/.../buddhism/buddhistethics/euthanasiasuicide.shtml -
www.westernbuddhistreview.com/.../suicide_as_a_response_to_suffering.html -

Posted by: justillthennow | November 4, 2009 4:54 PM
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wmarkw wrote:

"...But in how many of those cases was it known in advance that it was the last week of their life?"

In most cases you cannot be sure if it is the last week or the last few months, but there is absolutely no doubt when an elderly, sick patient is dying. I have seen enough people die to know that. It makes no difference whether you save someone in that condition for 1 extra week or 2 months. No sane person in that state would want to be saved.

The notion that people are likely to change their minds at the last minute and demand full-scale intensive care is ridiculous. On two occasions, people who were dying with their minds intact told me and others in no uncertain terms that they wanted no extreme intervention.

Dying in many cases is easier than people realize. The patient does not mind as much as the surviving friends and family. People who put their relatives on intensive care are really acting on their own behalf, not the patient's. They do not want to face the inevitability of their own death, so they torture their relatives. It is a cowardly and inhuman thing to do.

Posted by: jedrothwell1 | November 4, 2009 4:36 PM
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1.

Buddhism and Euthanasia

In the teaching of Buddhism, all of us will pass away eventually as a part in the natural process of birth, old-age and death and that we should always keep in mind the impermanence of the life that most of us cherish and wish to hold on to indefinitely.

In Buddhism, however, death is not the end of life -- it is merely the end of the body we inhabit in this life. Among the Japanese warrior elite, who usually followed Zen Buddhism, suicide was considered an honorable alternative to being killed by others OR continuing a life in shame or misery. Many samurai suicides were in fact the moral equivalent of euthanasia. The reasons for a samurai's suicide were either (1) to avoid an inevitable death at the hands of others, or (2) to escape a longer period of unbearable pain or psychological misery, without being an active, fruitful member of society. These are exactly the sorts of situations when euthanasia is desired today: (1) to avoid an inevitable death at the hands of others (including disease, cancer, or bacteria), (2) to escape a longer period of pain or misery without being a fruitful, active member of society.

Posted by: Schaum | November 4, 2009 2:06 PM
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2.

Of course there need to be safeguards in such situations, and those safeguards have already been spelled out by the decision of the Japanese Nagoya High Court. In a case of euthanasia, the Nagoya High Court (1962) defined certain conditions under which euthanasia could be considered acceptable:

(1) The disease is considered terminal and incurable by present medicine.
(2) The pain is unbearable--both for the patient and those around him.
(3) The death is for the purpose of his peaceful passing.
(4) The person himself has requested the death, while conscious and sane.
(5) The killing is done by a doctor.
(6) The method of killing is humane.

If these safeguards are followed, it seems there is no moral reason that Japanese Buddhists should oppose euthanasia.

Physicians who automatically oppose the shortening of a person's life would prefer to prolong the material life-processes, regardless of the mental quality of that life. This is where Buddhists disagree with materialistic Western medicine. But there need be no conflict between Buddhism and medicine: there is no reason to assign the physician the "responsibility" for the death of the patient. Following the guidelines of the Nagoya court, patients potentially eligible for euthanasia are going to die soon anyway, so that is not the fault of the physician. And the patient has the right to determine his own death. The fact that he is too weak to cut short his own life is not morally significant. If his mind is clear, calm, and ready for death, then the one who understands and compassionately assists that person is also following Buddhist morality. In summary, the important issue for Buddhists here is whether or not the person will be allowed responsibility for his own life and fate. The entire Buddhist tradition argues that personal choice in time and manner of death is of extreme importance, and anything done by others to dim the mind or deprive the dying person of such choice is a violation of Buddhist principles.

Posted by: Schaum | November 4, 2009 2:06 PM
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"... that comes out of the religious beliefs that suffering is ennobling, and that only God has the right to end suffering. (I can't say such people believe only God has the right to end life, as they are almost always supporters of both the death penalty and warfare.)"

Then too, God would end life much sooner in many cases without the intervention of modern medicine. If we're to leave it all to God, we should eschew the use of vaccines and medical treatment of all kinds, shouldn't we?

The positions of the religious right on medical life-preservation, warfare, abortion, assisted suicide, death penalty, faith healing, and end-of-life counseling are such a tortuous mass of contradictions that I'm surprised that even they attempt to defend them.

Posted by: Pamsm | November 4, 2009 1:09 PM
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"And, if someone else, upon recieving a fatal diagnosis, decides not to wait on the inevitable, but to take matters into their own hands and choose their own ending, that's their right as well."

Actually, it isn't. But it should be.

Posted by: Pamsm | November 4, 2009 12:55 PM
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"...But in how many of those cases was it known in advance that it was the last week of their life? I suspect paramedics put more work into the patients who die en route to the hospital than on those who live."
Posted by wmarkw

wmarkw, that's why I believe the will of the individual must reign supreme in these end-of-life matters. If you want everything that can be done to be done, and never mind the pain or cost, that's your right. If I am willing to accept that my desire to escape suffering means I may give up "too soon" when there is a faint possibility that I might recover, that's my right. And, if someone else, upon recieving a fatal diagnosis, decides not to wait on the inevitable, but to take matters into their own hands and choose their own ending, that's their right as well.

Susan's point is that many religious people, and conservative religious people in particular, seem to believe that those of us who wouldn't make the "do everything" choice shouldn't be allowed to choose. She assumes that comes out of the religious beliefs that suffering is ennobling, and that only God has the right to end suffering. (I can't say such people believe only God has the right to end life, as they are almost always supporters of both the death penalty and warfare.)

Is she right? Is the religious rejection of assisted suicide, end-of-life consoling and such ideas based on these beliefs? If so, how can one justify forcing those who don't share these beliefs to live and die by them? If she's incorrect, what is the basis of the objection to such ideas?

Posted by: gimpi | November 4, 2009 11:39 AM
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"People ought to suffer before death so that their survivors can be comforted by the end of the loved person's suffering."

Virtually everyone suffers the vagaries of old age, sickness and death. It is part of life.

Posted by: edbyronadams | November 4, 2009 7:49 AM
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Off Topic -
For those interested in Human evolution, PBS is airing a 3-part series on Nova called "Becoming Human."

Part one aired a few hours ago, parts 2 & 3 will air on the next two Tuesdays.

You can watch part one on their new Evolution site: http://www.pbs.org/wgbh/nova/beta/evolution/

Some really good stuff on the site, including an interesting section on Evo Devo. Explore. Enjoy.

Posted by: Pamsm | November 4, 2009 12:13 AM
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"From a secularist point of view, the only moral issue is an individual's right to determine, insofar as that is possible, the conditions of his or her own dying and death."

Is it true, though, to say the *only* moral issue is the individual's right to determine? Could one not argue from a utilitarian point of view, though perhaps not the utilitarianism of J.S. Mill, that the suffering of others which would arise from the chosen action ought also to be considered? For instance, in the case of suicide, the action does not only affect the individual carrying it out. Others may well undergo severe emotional, psychological, and, for his or her dependents, financial distress if the action is carried out. Given the utilitarian principle to take the course of action that either promotes the most happiness or promotes the least unhappiness, the individual's autonomy, while certainly one of the most important factors, is not the only consideration in this moral issue. As I said, given that John Mill was quite libertarian in his views, he would not agree with this, but his is not the only form of utilitarianism open to the secularist, if one is a utilitarian at all.

Cheers,
Dave

Posted by: DaveL2 | November 3, 2009 11:14 PM
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farnaz,
i think those principles are in the UDHR and any "freedom of religion" document. the problem is...well...religious people tend to bring their religion everywhere. religions purport to be life-guiding constructs, so for the religious, the idea of "checking your religion at the door" is nonsense.

the ideas of an islamic (any religion)republic and "freedom of religion" are not logically compatible.

we're still at least 100 yrs away from "freedom from religion". we may never get there, though, because people seem to just love having religion.

Posted by: walter-in-fallschurch | November 3, 2009 11:11 PM
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and article 18 says, in part,
"Everyone has the right to freedom of thought, conscience and religion;"

i know you know this, so are you saying they need to say freedom FROM religion?

with this idea in mind, would you "outlaw" designations like "islamic republic of iran"?
----------------------
WalterIFC,

If humankind could have the right to freedom from religion, we could outlaw ALL religious states, all state religions. England, of course, has a national religion!

Folks who wish to pray (not prey) could do so off their own bucks, in their own houses of worship, homes, etc.

I'm not saying outlaw religion although I'd like to; I'm saying give the rest of us freedom to be without it, unexposed to it, untortured and nonkilled by it.

Posted by: Farnaz1Mansouri1 | November 3, 2009 10:20 PM
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farnaz, you said,
"Again, I urge all and sundry to consider whether humans have the fundamental right to be free of religion. If so, should this not be taken up at the United Nations?"

the UDHR in its preamble imagines
"...the advent of a world in which human beings shall enjoy freedom of speech and belief and freedom from fear and want has been proclaimed as the highest aspiration of the common people..."

and article 18 says, in part,
"Everyone has the right to freedom of thought, conscience and religion;"

i know you know this, so are you saying they need to say freedom FROM religion?

with this idea in mind, would you "outlaw" designations like "islamic republic of iran"?

Posted by: walter-in-fallschurch | November 3, 2009 10:17 PM
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Schaum,

"Is freedom from religion and religionists a human rights issue?"

Purely gut-level response: of course.
----------
Frankly, I can't understand why liberals can't see this. In the name of religion, people want to control women's wombs, commit female genital mutilation, throw acid in women's faces, terrorize gays, deprive them of their civil rights, cut off people's heads, enslave them, and blow folks up.

Is there a more dangerous force? I'm not joking. They need to be stopped, the religionists, before they kill us all.

PS. MOre on JMR last night, early morning. Blogged with him a bit. He is definitively not an idiot, I'm partly relieved to say, since his previous essays suggested otherwise. I checked his cv, surveyed his publications--impressive, very. His blogging here in no way jibed with what I discovered on the web.

So now one finds he is lucid, learned, intelligent, very funny. Also, in dead earnest in his religious views, religionism, conservatism.

He is where things would get especially scary if he were not primarily an ambitious academic.

Posted by: Farnaz1Mansouri1 | November 3, 2009 10:10 PM
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Farnaz:

"Is freedom from religion and religionists a human rights issue?"

Purely gut-level response: of course.

Posted by: Schaum | November 3, 2009 7:54 PM
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The “end of life choice” is not euthanasia, and it is not suicide, regardless of the shrill and emotivemotive denunciations which the “religious” right have used to confuse and blur the issue. christers have, deliberately, obscured what the movement for dignified assisted dying is all about. The choice of assisted dying for the terminally ill, within strict safeguards, is neither suicide nor euthanasia, and it is certainly not an encouragement to anyone to throw himself off the roof of a tall building.. It is merely the choice of assistance in die for those who are suffering, who are competent to make the decision -- and who are already dying. Assisting suicide is distinctly different from assisting death, and this distinction needs to be clarified in law.

Suicide is often motivated by despair, hopelessness, mental health problems or other concerns that could be treated or resolved. Assisted dying is a rational decision made by a dying person who knows that his condition is terminal and for him there is no resolution. It is clearly and undoubtedly wrong to encourage someone's suicide. It is also clear that helping someone, at his request, to take control of his impending death when he believes that his suffering is unbearable is not wrong and should not come with the risk of many years in prison.

Suicide is illegal in most states – if your attempt fails, you will probably end up in a mental institution for a “period” of observation (which means until someone decides you are no longer a danger to yourself), and saddled with a suspended sentence for a felony. The incidence of people traveling abroad to die is increasing; the terminally ill continue to want choice and control over the time and manner of their deaths; and there has never been a more important time for a sensible debate about assisted dying. We can't regulate foreign assisted suicide clinics, but we can clarify our own laws so that those who choose an assisted death abroad, within safeguards, don't have to do so alone. This is a private end-of-life choice.

Posted by: Schaum | November 3, 2009 7:53 PM
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"A third of the entire Medicare budget is spent on care in the last year of life, and a 2009 study by the Dana-Farber Cancer Institute found that an astonishing third of that total is spent in hospital intensive care units in the last week of life, on pointless high-tech maintenance for people who have no hope of recovery."

But in how many of those cases was it known in advance that it was the last week of their life? I suspect paramedics put more work into the patients who die en route to the hospital than on those who live.

Posted by: WmarkW | November 3, 2009 6:52 PM
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There is also a profoundly conservative religious belief that suffering has some sort of intrinsic exemplary value.
-------------------
Again, I urge all and sundry to consider whether humans have the fundamental right to be free of religion. If so, should this not be taken up at the United Nations?

Kass's position is reminiscent of that of the Mother Theresa, the Duvalier-loving saint, she who inflicted needless suffering on countless dying Indians (she did worse).

If you ever wonder who these people really are, you will gain tremendous insight from Christopher Hitchens' "Mommie Dearest." Since I'm not a fan of Hitchens and knew from Indian friends the truth of Mother Theresa, I resisted reading this book until they insisted. And I went further. I sought and found authentication for every miserable claim he made about the Sainted Demon.

Is freedom from religion and religionists a human rights issue?

Posted by: Farnaz1Mansouri1 | November 3, 2009 6:37 PM
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LEPIDOPTERYX:

"every time I have any sort of hospital procedure done, I have a copy placed in my file"

Smart. Very smart.

Posted by: Schaum | November 3, 2009 5:19 PM
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I have a living will that spells out in a fair amount of detail what measures I will and won't consent to.
My parents, my husband, and my daughter each have a copy, and every time I have any sort of hospital procedure done, I have a copy placed in my file.

Posted by: lepidopteryx | November 3, 2009 4:56 PM
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susan noted,
"Kass goes on to find value in "senility, crippling arthritis, the need for hearing aids and dentures, and the degrading dependencies of old age." Without them, he argues, "we could no longer comfort the widow by pointing out that her husband was delivered from his suffering." "

kass is a highly-skilled rationalizer - i.e. he thinks god is good. probably sees value in people starving in africa...

Posted by: walter-in-fallschurch | November 3, 2009 4:56 PM
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For anyone who does not want to risk interference from god, or any of his representatives or enthusiasts, with the execution of his/her final wishes in the 'course of their final illness and death', I strongly recommend having his notarized signature on an Advance Directive, executed and copies left with lawyers and next of kin, as well as personal physician. One can be found at

http://www.ewtn.com/expert/answers/Directive.pdf

Its also a good idea to appoint a TRUSTED friend to have Power of Attorney in Health Matters, a standard form for which can be gotten at stationers, again executed before a notary public -- the trusted friend of course being one who is fully aware of, and willing to be faithful to, your final wishes.

Posted by: Schaum | November 3, 2009 4:46 PM
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