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saturday, march 26, 2005

The Tao of Process
"All the way to heaven is heaven." -- St. Teresa of Avila
David Brooks's latest column is wrong on so many levels I hardly know where to begin. I suppose, at the beginning.
So without further ado ...
The core belief that social conservatives bring to cases like Terri Schiavo's is that the value of each individual life is intrinsic. The value of a life doesn't depend upon what a person can physically do, experience or achieve. The life of a comatose person or a fetus has the same dignity and worth as the life of a fully functioning adult.
First, I had rather he said a "PVS [persistent vegetative state] patient" because the comatose can recover, and I understand that many comatose people really are aware of what's going on around them; they just can't respond. In other words, they are sentient. I have an enormous respect for sentience.
Social conservatives go on to say that if we make distinctions about the value of different lives, if we downgrade those who are physically alive but mentally incapacitated, if we say that some people can be more easily moved toward death than others, then the strong will prey upon the helpless, and the dignity of all our lives will be diminished.
Like I said, I have an enormous respect for sentience. Terri  is not mentally "incapacitated"; she is no longer sentient. Way different. There are many people with diminished mental capacity as a result of birth anomaly, disease, or accidents, yet they are sentient, and a compassionate society gives these people every opportunity for the best life they can have. 
Many conservatives, I've noticed, stubbornly refuse to see this distinction, so strong is their desire to present slippery-slope arguments. But to me it's quite clear.
Also, there are many ways to look at "individual life." If you don't mind indulging me for a moment, I'm going to present, very briefly, the Buddhist perspective. Please note I'm not trying to convert anybody, and if this really doesn't interest you, feel free to skip down to the other set of asterisks below.  
From a Buddhist perspective, an individual is to life what a wave is to ocean. The individual is a phenomenon of life, as a wave is a phenomenon of ocean. Although the wave is a distinct phenomenon, at no time is it separate from ocean. When it begins, nothing is gained; when it ends, nothing is lost. Thus, life itself, beingness itself, neither begins nor ends. It just ceaselessly manifests in myriad forms. Because life is infinitely wonderful and precious, all phenomena of life are wonderful and precious and worthy of respect.
The Buddha taught that an individual happens when five "aggregates" come together. These are the physical body, the senses, conception, volition, and consciousness. There are whole libraries of sutras and commentaries on sutras explaining all this; it's very complex. For purposes of this discussion, however, I will only point out that all of these aggregates, although they depend on physical form, are also all processes. As the guy who wrote this page explains,
Matter is organized into a physical organism and animated by consciousness. These two combine to form the body-mind substrate of the personality. The other three aggregates are forms of activity that arises in the interactions between the body and mind.
So, in Buddhism, an individual is not a thing, or an object, but a process, continually becoming, continually reaffirming itself, until the process has run its course. And since, from this perspective, the process that was Terri Schiavo has ceased, there is no moral reason to prevent the physical form from being reclaimed by the ocean of beingness. In fact, I suspect some sects of Buddhism would discourage keeping the body animated when it is no longer sustaining the process of personhood.
The rest of this post gets easier, I promise. Brooks continues,

The core belief that social liberals bring to cases like Ms. Schiavo's is that the quality of life is a fundamental human value. They don't emphasize the bright line between life and death; they describe a continuum between a fully lived life and a life that, by the sort of incapacity Terri Schiavo has suffered, is mere existence.

On one end of that continuum are those fortunate enough to be able to live fully - to decide and act, to experience the world and be free. On the other end are those who, tragically, can do none of these things, and who are merely existing.

I hate it when someone who doesn't understand what I think tries to explain what I think. I suppose I'm as much of a "social liberal" as anybody, but Brooks doesn't explain my POV at all. Although quality of life is important, that doesn't mean I think the life of someone with diminished capacity or a poor quality of life has less value. (And, anyway, it's all the same life.) My POV is that Terri Schiavo no longer exists. I suspect most "social liberals," including non-Buddhist ones, see the situation this way.
Brooks continues,

Social liberals warn against vitalism, the elevation of physical existence over other values.

I honestly don't know what he's talking about there.

They say it is up to each individual or family to draw their own line to define when life passes to mere existence.

Well, no, we think that it's up to medical science to determine when a life process has finished, or when the body is no longer sustaining the person we loved, or when the individual is no longer sentient, however you want to perceive it.

The central weakness of the liberal case is that it is morally thin. Once you say that it is up to individuals or families to draw their own lines separating life from existence, and reasonable people will differ, then you are taking a fundamental issue out of the realm of morality and into the realm of relativism and mere taste.

No, what we've saying is that, once the body is no longer sentient, it is up to families to decide if they want to maintain the body, or let it go. And it should be up to the families, because they're the ones who have to live with the consequences.
There is a story in today's Los Angeles Times about two mothers whose children were in a persistent vegetative state. One mother chose to bring her daughter home to care for, and the other mother chose to let her son go. My position is that these mothers had to work out for themselves what they could or could not live with; what they could or could not handle. Each mother did what she felt in her gut she should do, and so IMO both decisions were the correct decisions.
If some "moralistic" do-gooder had forced the first mother to let her daughter die, and the second mother to take her son home to care for him, those would have been the wrong decisions.
Families in these circumstances have to consider how they're going to cope with the consequences of the decision. Some families may not have the emotional or physical resources to maintain the loved one's body, and others might find some purpose or comfort in caring for the body. Some may perceive the person is really gone, but those who do not may need more time to process what's happened to their loved one. So, the right decision may not always be the same decision. There are a lot of variables to consider. That's why it's important for families to make these decisions, not the government.
People like Brooks who whine about "relativism" want morality to be something written in a rule book. I think that rule-book morality is what you fall back on when you don't understand morality.

You are saying, as liberals do say, that society should be neutral and allow people to make their own choices. You are saying, as liberals do say, that we should be tolerant and nonjudgmental toward people who make different choices.

Yep, as long as people don't break the law or scare the horses.

What begins as an appealing notion - that life and death are joined by a continuum - becomes vapid mush, because we are all invited to punt when it comes time to do the hard job of standing up for common principles, arguing right and wrong, and judging those who make bad decisions.

This makes me nuts. It's the rule-book moralists like Brooks who are not doing the hard work that compassion often demands. "Common principles" can cause suffering. There used to be a "common principle" that slavery was moral, for example. True morality demands that we close the rule books and set aside what we want, and instead look at the situation as-it-is and respond with selfless compassion.

If "principle" causes people to act in ways that are not honest and compassionate, then principle can hang.

The down side of honesty and compassion is it takes hard inner work to avoid the temptations of desire and ego. Nobody said morality was easy.

And what's this about "judging people who make bad decisions"? In how many different ways did Jesus teach his followers not to do that? The poor man-who-maybe-was-God practically stood on his head, waving a flag and whistling Dixie, to draw attention to the teaching do not judge one another.  See Matthew chapter 5, for example. But here's Brooks, thinking it's up to him to pass judgment on the rest of humanity.

If I ever meet Brooks, I will explain he is relieved of this duty.

There are laws, and courts, and courts must judge, but this isn't the work of morality. It's the work of civilization; it's something we humans need so we can stand to live with each other. But civilization doesn't depend on whether the family next door chooses to pull a feeding tube, or not.

You end up exactly where many liberals ended up this week, trying to shift arguments away from morality and on to process.

I've written before from time to time that process deserves respect. I've often noticed that conservatives these days seem to have no respect for process, only for the result. But the result is the process. This is something you have to learn for yourself through experience; I don't think I can explain it. But whenever you hear people say that the process doesn't matter, as long as we get to our result, expect the result to be bleeped up. And truthfully, in the grand scheme of things, there are no results. Everything is always in flux. It's all process. If you read the Buddhist section, you saw the argument that individual humans are processes.
And to me, morality is a process. It's a continual challenge of understanding who you are, how you relate to the rest of creation, how your actions impact others, how your actions come back and bite you, how to find the will to put aside what you want and instead do what is compassionate.
Though you may be following the Bill Bennet Golden Rule Book of Morality to the letter, if you have no understanding of these things -- of process, of beingness, of action and reaction, of the temptations of ego -- you will still screw up the morality thing.
And lo, Brooks provides an example:

If you surveyed the avalanche of TV and print commentary that descended upon us this week, you found social conservatives would start the discussion with a moral argument about the sanctity of life, and then social liberals would immediately start talking about jurisdictions, legalisms, politics and procedures. They were more comfortable talking about at what level the decision should be taken than what the decision should be.

Then, if social conservatives tried to push their moral claims, you'd find liberals accusing them of turning this country into a theocracy - which is an effort to cast all moral arguments beyond the realm of polite conversation.

He's so eager to make his argument about principles he forgets to be honest. Oopsie-doodle! This is the danger of denying the process of morality and relying on a static rule book instead. In order to maintain the integrity of his principles, he has to be dishonest -- in his column and with himself -- about the views of others.
Nobody says that people can't debate "moral arguments" in "polite conversation." What we're saying is that this is a nation of law, not a nation ruled by a mob, or subject to some popular consensus of what is or isn't "moral."
Many actions I consider immoral are not illegal, nor would I make them so. True morality cannot exist where all behavior is coerced. And once in a while someone does something illegal that is very moral. Rosa Parks comes to mind.
The point is that, as a nation of law, and not a theocracy, our laws must have a practical and secular purpose, such as maintaining traffic flow, respecting property rights, upholding contracts, and prohibiting murder -- not because murder is "immoral," but because civilization can't exist where people live in fear of each other.
I suspect Brooks knows this; he just lacks the moral courage to admit it.
Once moral argument is abandoned, there are no ethical checks, no universal standards, and everything is left to the convenience and sentiments of the individual survivors.
Since when were there "universal standards"? Ideas about what is and is not moral shift throughout space and time. What's upsetting Brooks is that there are people in the world who do not share his ideas of what is or isn't proper. And because he is a limited person, he must find some excuse to denigrate people who see things differently. Hard, heartbreaking choices are dismissed by Brooks as mere "convenience" and "sentiments."
This is, IMO, immoral.
Also: For another POV on why Brooks is being dishonest, see Armando at Daily Kos. And I agree with Armando that Matt Yglesias's post on "absolutism," although interesting, doesn't break through to the fundamental dishonesty of Brooks's position. But Matt is very young (compared to me, anyway) so I'm inclined to forgive him. See also Billmon on moral relativism and David Brooks.


3:54 pm | link

Big As Life, and Twice as Natural
Last night I was flipping channels and caught a snip of Larry King interviewing Pat Boone about Terri Schiavo.
freakshow2.jpgOh, please, make it stop ...
The evil "MSM" is covering Terri Schiavo the same way they covered last year's "swift boat" flap (and most anything else) -- by trotting out the usual clowns to present their uninformed "opinions." Ne'er a fact in sight. The cable networks aren't presenting news, they're presenting a freak show. The Daily Show's "Culture of Strife" segment pretty much says it all. 
One exception seems to be Dan Abrams of MSNBC. I caught a bit of his program a couple of days ago, and he was actually challenging a couple of Terri cultists to get their facts straight. It was a rare and beautiful thing to see. Abrams deserves at least an honorable mention for trying to be honorable.
Hunter at Daily Kos has a must-read rant about cable news called "Blood Sport."
There is a difference between bad coverage and willfully irresponsible coverage, and another line between willfully irresponsible coverage and dangerously irresponsible coverage. In the last three days, those lines have been crossed. Repeatedly. And it has been absolutely, definitively intentional. ...
... Now, there are times when the news media is simply sloppy; there are times when journalists simply get stories wrong, and there are times when, as in the trials of Michael Jackson, Kobe, O.J., Martha Stewart, etc., the news channels are simply swept away by their natural tendency towards low-cost voyeurism. But this isn't one of those times. This isn't petty irresponsibility or sloppiness, to be chalked up to the dwindling resources of corporate newsrooms.

This is a decision on the part of producers to willfully bend the lines in a manner that promotes sensationalism and potential violence, by intentionally tossing known-false information into a wire-taut public conflict to enhance the "ratings value".

I felt the same way last year about the swifties. Of course, there's an unholy alliance between cable news and the VRWC anyway, but I also believe the cable news whores saw the swiftie controversy as a ratings booster, and they exploited it. The cable newsies may be whores, but they're not stupid, and deep down most of the cable news show hosts must have known the swifties were full of it. And I believe that exploitation swayed a presidential election. We can rightfully gripe at Kerry for not responding sooner and more forcefully, but if the news business weren't such a freak show, he wouldn't have had to.

As I keyboard, basic news coverage seems to be breaking down. By now you've probably heard about the Miami Herald's report that Governor Bush sent state law enforcement agents to take custody of Terri Schiavo, but they were stopped by local police from doing so.  Here's the story as reported by Knight Ridder. Putting aside that this farce was almost certainly staged -- Jeb needs to appease the Fetus People, but he also needs the Schiavo controversy to go away and never come back -- Dr. Atrios says there appears to be a blackout of the story on CNN. I don't see anything about it on the web sites of MSNBC, the New York Times, or the Washington Post either, which makes me wonder if there's some question about the story's veracity. Or, maybe (dare I hope?) they're ignoring it because they know it was staged.

Nah, that can't be it.

But yesterday, I remember clearly, there were stories about somebody trying to steal a gun to kill Michael Schiavo, and somebody else putting a bounty on Michael Schiavo, but today those stories have nearly evaporated.

I'm starting to feel a tad nervous.

Billmon has a long rant up about blogging and life and the universe and everything, in which he says,

What I finally had to confront was the fact that truth alone is impotent in the face of modern propaganda techniques – as developed, field tested, refined and deployed by Madison Avenue, the Pentagon, the think tanks, the marketing departments of major corporations, the communications departments of major research universities, etc. To paraphrase Hannah Arendt, the peculiar vulnerability of historical truth (which means political truth) is that it isn’t inherently more plausible than outright lies, since the facts could always have been otherwise. And in a world where the airwaves are overloaded 24/7 with the mindless babbling of complete idiots, it isn’t very hard to make inconvenient facts disappear, or create new pseudofacts that reinforce whatever bias or cultural affinity you want to cultivate – particularly if the audience is already disposed to prefer your reassuring lies to discomforting truths told by strangers.

He's right, but if he's right, how can republican government survive?


8:32 am | link

friday, march 25, 2005

Stop Them Before They Nominate Again
I've seen two news articles this week that I interpret as evil omens for the Democrats. The first is in the current issue of Time:
It seemed as if the campaign had never ended. There was John Kerry standing on a chair in a blue neighborhood of Atlanta, in the Democrat-friendly tavern Manuel's, speaking to 100 folks, many of them wearing Kerry-Edwards T shirts. ... 
"It's been a long time since the Democratic Party gave somebody a second chance," says Grossman. "That's a big challenge to overcome." But it might not be the biggest. Kerry may find that there is little he or any other contender can do to get his party's nomination if Hillary Clinton decides to run. The New York Senator holds a commanding lead in every poll of Democratic voters, and some major party fund raisers are saying they expect her to have a huge financial advantage over her opponents. "She'll crush them all," says a lobbyist who plans to raise funds for 2008 candidates.
Discouraging. But Joan Venocchi writes in today's Boston Globe that Hillary Clinton is "carving up" Kerry's "political base" by seeking support from Massachusetts political activists and Democratic women, possibly to knock Kerry out of the running for the 2008 nomination..

As she slices up the traditional Democratic base, Clinton is also reaching out to the middle, seeking common ground on contentious issues from war to abortion. It is an early, but impressive show of political gamesmanship. And it is all happening while the rest of the Democratic pack of presidential possibilities train their arrows mainly at President Bush and Republicans in Congress.

Clinton's reaching out to women in Kerry's home state for her 2006 Senate race is smart politics for 2008. It points out how difficult it would be for both to run for president.

For liberal women, the lure of backing a female presidential candidate is powerful, one that would be difficult for Kerry or any male Democrat to neutralize. Moreover, if Clinton does run for the Democratic nomination, Kerry would also be fighting off another US senator from the Northeast.

Meanwhile, Delaware Senator Joseph Biden, who is also contemplating a presidential run, is also taking shots at Kerry, most recently in a New Yorker article, where he used the ''w'' word -- ''weak'' -- in connection with Kerry. Shoving Kerry out of the '08 contest makes it easier for Biden, who doesn't need another veteran male senator in the race, especially one who begins with the national constituency Kerry built as the last Democratic presidential nominee....

...Some conservative commentators are beginning to speculate that Clinton will not seek reelection to the US Senate in 2006. The theory, advanced by John Podhoretz in the New York Post, suggests that Clinton would not want to take votes in the Senate that could be used against her as a presidential candidate, which happened to Kerry during his presidential quest.

But at the moment, Clinton is concentrating on the base that lifted Kerry up, while letting others talk about the obstacles that blocked his path to the White House. Slice.

Makes me want to crawl into a corner and cry.

The Dems are not getting it. We don't want a candidate who moves right to find "common ground" with the wingnuts. We don't want a candidate who has ever provided butt cover for Bush. We don't want a candidate who voted for that abomination of a bankruptcy bill (Biden).

Dems are preparing to package Hillary into their idea of a marketable political product. Everything from her speeches to her hair style will be focused-grouped to death, and eventually she'll be made over into whatever some Beltway "consultants" decide is what people want, and off she'll march to the 2008 nomination. And then they'll wonder why sales are off.

I'm hoping the Blogosphere has a major impact on the 2006 mid-terms. Then the Washington powers that be would be given notice that they have to haul their heads out of their butts and pay attention to us.


Recommended: "All You Need to Know About the Schiavo Case" by Motherlode at No More Apples. "The Radical Right Tries Out Some New Fashions" at Steve Gilliard's News Blog.


11:28 am | link

White Father Blows It Again
Ceci Connolly writes in today's Washington Post:
Native Americans across the country -- including tribal leaders, academics and rank-and-file tribe members -- voiced anger and frustration Thursday that President Bush has responded to the second-deadliest school shooting in U.S. history with silence.

Three days after 16-year-old Jeff Weise killed nine members of his Red Lake tribe before taking his own life, grief-stricken American Indians complained that the White House has offered little in the way of sympathy for the tribe situated in the uppermost region of Minnesota.

 "From all over the world we are getting letters of condolence, the Red Cross has come, but the so-called Great White Father in Washington hasn't said or done a thing," said Clyde Bellecourt, a Chippewa Indian who is the founder and national director of the American Indian Movement here. "When people's children are murdered and others are in the hospital hanging on to life, he should be the first one to offer his condolences. . . . If this was a white community, I don't think he'd have any problem doing that."  

In fairness, I don't know that Bush would have been the first one to offer condolences had the shooting been in a white community. Bush has a history of being oblivious to this part of his job. As I wrote in December when Bush was criticized for his initial silence after the Tsunami disaster,
This, of course, is just part of a pattern. After September 11 The Brat had to hide out on Air Force One for several hours before he could pull himself together (or sober up?) and act like a president.  More than a year ago he had to be coaxed into addressing the nation after a particularly bloody day in Iraq (not as bloody as the days have been since, of course). And do you remember The Blackout of August 2003? I wrote at the time
It took him four hours to bring himself to speak to the nation after the Blackout began, and then he could do so only on tape. (Drunk or stupid? We report -- you decide.) After this week's bombing that killed at least 20 UN workers, Bush's keepers managed to get him off the golf course, into a suit and tie, and in front of cameras a bit faster. The keepers are learning, it seems.
Of course, he would have been a lot quicker if he'd been able to wear a quasi-military costume and prance around in front of a few thousand screaming groupies.
So if it's any consolation to Mr. Bellecourt, Bush doesn't give a shit about white people, either. That is, unless they're donors or present an opportunity to pander to donors.
The reaction to Bush's silence was particularly bitter given his high-profile, late-night intervention on behalf of Terri Schiavo, the brain-damaged Florida woman caught in a legal battle over whether her feeding tube should be reinserted.

"The fact that Bush preempted his vacation to say something about Ms. Schiavo and here you have 10 native people gunned down and he can't take time to speak is very telling," said David Wilkins, interim chairman of the Department of American Indian Studies at the University of Minnesota and a member of the North Carolina-based Lumbee tribe.  ...

 Even more alarming than Bush's silence, he said, is the president's proposal to cut $100 million from several Indian programs next year.

Bill Clinton addressed the nation within a few hours after Columbine. But the White House says Bush will say something about Red Lake in tomorrow's radio address. I'm sure the speechwriters are hard at work right now, making sure the President's words are sufficiently sincere.

Joan Smith writes in the Seattle Post-Intelligencer:

In Bush's America, where the political class has embarked on a mission to resuscitate the brain-dead, no one seems to have either the will or the power to intervene in the everyday existence of young people whose lives are going horribly awry. Whole sections of U.S. society grow up with guns and violent death, if not the internecine rivalries of gang culture, making the right-to-life debate currently being conducted in Congress and the Florida courts seem like a surreal joke.

I don't think this is an accident. Politicians enjoy occupying the high moral ground and it is easier to emote about the pain of Schiavo's parents, Bob and Mary Schindler, than to address the disfiguring inequalities of the richest nation on Earth -- especially when you are personally implicated, as the current president is, in making those inequalities worse.

But we knew that.

Also note: Wampum is accepting donations on behalf of the Red Lake Memorial Fund.


8:35 am | link

thursday, march 24, 2005

Why We Love Death
Peggy Noonan has a truly bizarre column in today's Wall Street Journal. Well, yeah, I know this is Noonan, but this is Out There even for Noonan. She's decided that those of us who are not willing to sacrifice federalism so that Terri Schiavo can continue to vegetate indefinitely must love death.
Rather than explain to Peggy why we lefties are so all-fired determine to see Terri Schiavo die, I'm just going to nudge her over to this Townhall Column by Neal Boortz. Writing from a Christian perspective, he responds to a question from Rush L., "Why do [you liberals] want Terri Schiavo to die?" I'll let you read his answer for yourself.
My answer is, I don't want her to die. I just recognize that it's probably her time.
There's a Zen story (Zennies have the best stories) about a monk who developed tuberculosis. So, as was the practice of the time, he was relieved of work duties and sent to live in a small house by himself outside the main monastery building. Every day the old teacher would come by to bring food, offer instruction, and see how the sick monk was doing.
The monk had a lot of worries, like who's going to keep the brass polished, and who's going to remember to feed the cat? And the teacher would always smile and say, not a problem. Don't worry about a thing. Somebody will take care of it.
Finally the monk asked, What if I die? And the teacher smiled and said, not a problem. If you find you need to die, just go ahead and die. Don't worry about a thing. We'll be sure you get a nice funeral.
Zen teachers tend to be big-picture guys. Anyway, I understand the monk got well after that.
Western culture and religion tend to have an antagonistic view of death (Oh death, where is thy sting? Oh grave, where is thy victory?). But the old teacher said, maybe dying is what your body needs to do. That's going to be true of all of us, sooner or later. It's painful to lose people we love, but not everything that's painful is evil, or wrong.  
Update: Nice analysis of the constitutional issues.
Right now it's pretty clear the Bushes (Prez and Guv) and Congresses (fed and FL), and all the courts, are closing their doors to the Schindlers. The GOP has been bitten hard by this little gambit, and they must realize there's no advantage to them if the tube is reinserted. They'd just have to go through the same farce again sometime in the future.
But did anyone notice how the Prez skipped out and let the Guv take the heat? And has the Prez made any statements about the Red Lake, Minnesota, tragedy? I hadn't heard.
And does anyone else think the Guv has his fingers crossed that Ms. Schiavo doesn't die on Good Friday? If she does, the Fetus People will go ballistic. I can already see the faded T-shirts showing a crucified Terri Schiavo being welcomed into heaven by Buddy Jesus.


2:27 pm | link

Holy Bleep
This reminds me of a course I took in college (awhile back; we held classes in caves; I think the dean was a brontosaurus) called "Life and Teachings of Jesus." The teacher taught about Jesus, etc., the same way a history professor would teach about any other historical personage. The course material was based on historical scholarship, not theology, and the teacher steadfastly refused to inject his own religious beliefs into the course. I honestly don't know if he was a believer or not.
We had one guy in the course who perpetually interrupted because the professor wasn't teaching the class that Jesus was God. The professor wasn't teaching the class Jesus wasn't God, mind you, and Jesus was treated very respectfully, just not worshipfully. The professor (who was a very good lecturer) kept trying to appease the heckler and get him to calm down so he could go on with the lecture. But the heckler was eating a lot of class time.
Then, one day, after a couple of weeks of this, the class turned on the heckler. I don't remember exactly how it started, but we rose up as one and told him to shut the bleep up, because we hadn't paid fees to listen to him.
As I remember, the heckler stormed out and dropped the class. A shame, because if he'd shut up and listened he might have learned something about Jesus.    


12:51 pm | link

Things Fall Apart
Very basically, there are two kinds of conservatives on today's American Right: social  conservatives and political conservatives. And although they have been fellow travelers and Bush supporters for some time, they really are two very different groups with very different philosophies.
Social conservatives want to use government to enforce their vision of morality and "normalcy." They want government to ban gay marriage, abortions, most divorce, and the teaching of evolution. They want government to indoctrinate conservative Christianity through prayers in public school classrooms and various "faith-based" programs.
But political conservatives lean toward libertarianism and don't like Big Gubmint, period. They've been Bush supporters because they like his tax cut plans -- they tend to be "starve the beast" proponents -- and they support the war in Iraq. They are mixed on whether they approve of gay marriage -- some do, possibly most do not. But they do not like people messing with the Constitution and are opposed to a gay marriage amendment. And they don't want America turned into a theocracy.
You may have noticed that whenever two Democrats, or two liberals, disagree with each other in public, rightie bloggers cheerfully announce that the Democratic Party is imploding, and that the Left is coming apart at the seams. By contrast, the American Right has been absolutely brilliant in maintaining uniformity of message. On any given day you can count on prominent Republicans and conservative activists to mouth the same scripted talking points verbatim. Democrats don't stay on message, mostly because they have too many diverse opinions about what the message ought to be.
But the fact is that the American Left isn't about to come apart; it came apart thirty years ago. As this Wikipedia article explains, what had been a "liberal consensus" eroded in the 1970s. The progressive/New Deal/pro-civil rights consensus was replaced by "identity politics," and the American Left broke up into a lot of issue advocacy groups competing with each other for attention and funds. Even the single-issue movements have lost cohesion. For example, there hasn't been a unified feminist movement since the Equal Right Amendment was defeated, some twenty-five years ago.
Further, since the ascension of Ronald Reagan, the Right has come to dominate national dialogue in mass media, and this in turn has kept the Left splintered. Mass media only allows for a one-way dialogue -- from the powerful to the masses -- and increasingly, lefties haven't been allowed to use mass media without having to shout over the righties. Gotta be fair and balanced, you know.
And in all these years, no leadership emerged to give the American Left a unified vision and direction. Those who might have (Mario Cuomo and Paul Wellstone come to mind) couldn't break through the mass media noise to communicate with us. Even Bill Clinton, for all his success and charm, did not pull us together. A great many liberals never felt he was one of us, anyway. He was just the best we could find under the circumstances.
The Right, on the other hand, had Reagan, and then they had mass media mega-stars like Rush and O'Reilly, and they had the many Clinton scandals, and now they have George W. Bush and the War on Terra. So, in spite of obvious ideological fissures, they've put on a cohesive front and marched in lock step lo these past several years. As I said, they're brilliant about it.
So today many Republican leaders must be stunned that much of the political Right isn't marching with the cultural/religious Right on the Terri Schiavo issue.
I've believed for a long time that the Republicans couldn't get away with the cohesion act forever. Eventually, the gap between small-government libertarian conservatism and authoritarian "values" conservatism would be wide enough that only the seriously deranged could be loyal to both sides. I didn't imagine the split would happen with what is, in the grand scheme of things, a minor issue. And maybe it really hasn't happened yet. But I think from here on out the GOP is going to step more carefully.
On reflection, it may be that a split was inevitable now that we're past the election and George W. Bush is a lame duck. Many on the Right had put their individual issues aside for the sake of getting a second term for Bush. Now, they want payback. But it's going to be darn near impossible for the Bushies to appease the cultural/religious Right and remain true to the libertarian ideals of the political Right.
About the only way the Right might be able to hold it together is if they can focus on a common enemy, like liberals or terrorists. Another terrorist attack on U.S. soil would probably do the trick for them. (Note: Stay out of tall buildings.) But the Dems seem to have adopted a rope-a-dope strategy, which is smart. And I don't think there's enough of Ward Churchill and Noam Chomsky to go around.
On the other hand, we on the Left no longer have to wait for mass media to give us a few crumbs of uninterrupted time, because now we have the Blogosphere. And in between sniffing out and informing each of the the latest Bushie outrage, we've been engaging (finally) in real dialogue about what liberalism and progressivism are, and what it is we really stand for.
First, I've come to believe (and I hope to write more at length on this in the future) that the bedrock foundation of liberalism is democratic self-government. Liberals believe that people are smart enough and decent enough to govern themselves, and don't need an aristocracy or oligarchy or plutocracy to boss us around. Conservatives may make speeches in that direction, but American conservative policies seem inevitably to end up serving a plutocracy over the people.
Second, I think the single most important message we need to promote is that the powers of government legitimately can be put to work to improve quality of life. Put another way (via Digby) we must put the lie to right-wing dogma that government can't be trusted to do any positive social good.
What was Reagan really saying when he said, "Government is not the solution to our problem; government is the problem"? In effect, wasn't he saying that democratic government doesn't really work? That government of the people, by the people, and for the people is a fantasy?
The Right for years has been telling people they can't expect government to do anything for them, and anyone who thinks otherwise should learn some self-reliance. That might have made some sense in the context of reducing social welfare expenditures in order to reduce the deficit. But now we've got a federal government that believes government cannot be used to help people in general, but somehow there is always plenty of money to throw at special interests and business cronies.
In other words, Washington is just one big patronage scam. As Bob Dylan said, you got to serve somebody.
Real democracy isn't about keeping political parties on-message. Real democracy is messy and chaotic and involves lots of arguing and contradiction and negotiation. But there's nothing wrong with that. When many people come to a table there will be that many different points of view, and rarely does any one point of view take in the whole picture. Generally when people come to a consensus, they find a middle way, not an extreme way, to work through a problem. But when ideologues take over and insist it's my way or the highway, representative government cannot function.
Democracy isn't about ideological purity. Democracy isn't about teaching party members to march in step and spew out talking points like parrots.
This is the time for liberals to rally around the ideal of progressive self-government. If the Right is about to break apart, this is the time to pull ourselves together and charge into the breach.


8:52 am | link

wednesday, march 23, 2005

(CBS/APCongressional leaders have insisted their only motivation in getting involved in the Terri Schiavo case was saving a life. But Americans aren’t buying that argument, a CBS News poll finds.

An overwhelming 82 percent of the public believes the Congress and President should stay out of the matter.

Just 13 percent of those
polled think Congress intervened in the case out of concern for Schiavo, while 74 percent think it was all about politics. Of those polled, 66 percent said the tube should not be inserted compared to 27 percent who want it restored. The issue has generated strong feelings, with 78 percent of those polled -- wheter for either side of the issue -- saying they have strong feelings.

Public approval of Congress has suffered as a result; at 34 percent, it is the lowest it has been since 1997, dropping from 41 percent last month. Now at 43 percent, President Bush’s approval rating is also lower than it was a month ago.
This is going to sound very cold, I realize, but it's the honest truth: I was reading the umpteenth news story quoting poor Mrs. Schindler pleading for somebody to step in and "save" her daughter, and a wave of pure, unadulterated annoyance swept over me. I suspect I am not alone.
The Schindlers have had the Florida governor and legislature at their disposal for the past several years, and now the United States Congress and the President have taken unprecedented steps to intervene in their little family drama. Today the Schindlers are shopping federal courts to find one that will give them what they want. I don't watch much television news, but I bet the Schindlers are on somewhere on cable nearly 24/7.
I don't know what percentage of Americans have watched a hospitalized love one die, or what percentage have dealt with heartbreaking questions about DNR orders, life support, organ transplants, etc. I suspect that a whopping majority of people over the age of 40 have been there and done that. And, nearly always, these decisions are made quietly and privately. It doesn't occur to most people to make a federal case out of their grief.
How many of these Americans are looking at the Schindlers and thinking, who the hell do you think you are? How many are thinking, I loved my baby, my child, my wife, my father just as much, but I could let them go without setting the whole country in an uproar.
Right now I think some people in the GOP must realize they've made a miscalculation and are secretly hoping Terri Schiavo hurries up and passes on. I think the longer this drama drags on, the bigger the backlash is going to be.
Update: Still feel sympathy for the Schindlers? Read this.
Update update: Billmon -- too funny.


7:00 pm | link

What's My Name?
Last Saturday this beautiful girl came home with me from a pet rescue adoption day. She's four or five years old and apparently was abandoned after being someone's pet.
The pet rescue people called her Marcia, but I don't think she's a Marcia. She doesn't answer to it, anyway.
I thought about naming her Lily, because it's almost Easter. Also, she's the color of a tiger lily, orange and black. But she's too assertive to be a Lily. She's already taken charge of the place and is ordering my son (home for spring break) and me around. No slacking around here, nosiree. She has an aggressive purr and a determined meow. If she were human she'd be running her own business.
On the other hand, she is very cuddly and enjoys hanging around people.
I haven't ruled out Lily, but I'm looking for options.
I thought of Alice or Lucy, because they are less wimpy names than Lily. I thought of Fionna because it's Celtic, I think. Maybe she's a Maggie.
Any thoughts on cat names?


1:30 pm | link

Eating Their Own

(Cross-posted at American Street)

Although there are more important matters going on, the Terri Schiavo case continues to fascinate because it’s so endlessly multifaceted. You can look at it as a moral issue, a legal issue, a political issue, or a human interest issue. And all these issues bleed together into something like media road kill. Yeah, it’s gross, but you want to look at it anyway.

And remarkably, the issue may be ripening in ways the GOP didn’t anticipate.

Left Blogosphere consensus says last weekend’s Big Top show–wherein the Congressional Clowns entered the center ring with their “let’s save Terri Schiavo” act, culminating with the Big Clown himself flying up from Crawford for the finale–was all about rallying the GOP’s Jesus base. And from this perspective it must’ve looked like a sure-fire way to reassert the GOP’s claim to be the Party of God–especially if Terri dies. The Fetus People will be given a martyr, and the Dems plus “judicial tyranny” can take the rap. And if, against all odds, the feeding tube is reinserted, the GOP can take credit for it. Win/win!

Or, maybe not.

Although a lot of us were irritated with the Dems for not resisting the GOP’s tampering with separation of powers, Steve Gilliard makes a persuasive case that congressional Dems avoided walking into a trap. DeLay, Frist, et al. expected the Dems to object, thereby accepting the role as villain in the morality play. And the Dems didn’t take the bait. Harry Reid says, you guys want to do this? Fine, go ahead. It’s your funeral.

One of these days the Republicans are going to be kicking themselves for going all out to defeat Tom Daschle. If they aren’t kicking themselves already.

VRWC mouthpieces like Rush Limbaugh have been dutifully whipping the Fetus People into a mouth-foaming frenzy over the “torture” of Terri Schiavo. But some parts of the mob may be getting out of the VRWC’s control. World o’ Crap reports that some of the Fetus People are turning their wrath on Jeb Bush.

Florida Fetus People want Governor Bush to use his police powers to rescue Terri. If she dies, they say, it will be on Jeb Bush’s head for not acting. Where are those jack-booted thugs when you need them? And if the Schindlers strike out in federal courts, why wouldn’t President Bush just issue an executive order to have the feeding tube reinserted? Why hasn’t he done that already? Why didn’t Congress just pass a special law ordering the feeding tube to be reinserted, instead of passing the hot potato to federal court in the name of fighting judicial tyranny?

Eventually, even the Fetus People may smell a rat. Terri Schiavo’s death would be another Waco to them, and if the Bushies aren’t careful, they’ll be cast in the role of Janet Reno.

And other parts of the GOP are getting mighty pissed off. See Joe in D.C. at AMERICAblog for details of GOP infighting. Plus, CNN notwithstanding, the overwhelming majority of Americans think the government should butt out.

(Bush may have been able to sell America on the Iraq War, because the overwhelming majority of Americans have never met a Muslim. But, by gawd, they do know about in-laws.)

If George Bush finds himself having to choose between placating the Fetus People (and reinserting the tube) or respecting the rest of the GOP and public opinion, I suspect he will choose the Fetus People. Whatever happens, by next year most of the country will have moved on to other issues. But if the passions of the Fetus People are not appeased, soon, their demands are going to become more extreme, and caving in to them may be politically costly.

(But … what’s this? According to WaPo, Bush is warning Dems they’d better not oppose his Social Security privatization scheme, or they’ll have to pay political consequences. Is he nuts? Dan Froomkin says, could be. Jacob Weisberg says, maybe, or maybe not. The point is that the Head Clown may have no clue what’s really going on.)


Having struck out twice in federal courts, Terri Schiavo’s parents are taking their case to the Supreme Court, one more time. Various legal experts say there’s little chance the SCOTUS will order the feeding tube reinserted. They may not even take the case.

There’s a fascinating article in today’s Chicago Tribune that calls the Schiavo affair by its correct name – family feud. According to reporter Patrick Kampert, Michael Schiavo and his in-laws got along just fine until Michael got a $1 million settlement in 1992. Of this settlement, $700,000 was for Terri’s care and $300,000 was for Michael Schiavo’s personal compensation.

Michael Schiavo claims Bob Schindler became indignant when he wouldn’t share the settlement with him. The Schindlers say their son-in-law’s personality changed and that he stopped all rehabilitation efforts after he got the money.

I still hear claims that Michael Schiavo just wants to keep the money. But if Terri’s care costs $80,000 a year, as I’ve read in several news reports, the $700,000 ran out a few years ago. And by now the $300,000 is probably in the pockets of lawyers.

Like I said, Americans may not know much about Muslims, but they do know in-laws.


11:04 am | link

tuesday, march 22, 2005

What If
We're still waiting to hear from the 11th District Court of Appeals on the Schiavo case, but I had a thought. What if at some point sooner or later the Schiavo parents have exhausted all appeals, and the feeding tube is either still out or has been ordered to be removed one more time? These people are not giving up.
Is it possible for a president to issue an executive order to ignore the courts and insert the tube? And if so would the Schiavo cultists turn their guns on Bush to pressure him to do so? And would he do it? (probably) Public opinion would be against it, but most people will put this episode out of their minds pretty quickly once it's out of the headlines.
World o' Crap looks at the storm-trooper tactics of the cultists to punish those who disagree with them. And the Crapster looks at this site that comes within a hair of advocating violent overthrow of the country if Schiavo dies.
That jolly crew at Free Republic rage against the judicial tyranny that began with Marbury v. Madison. Some of the commenters are calling for an overthrow of the judiciary. Here's a good'n:
To see the Left (LA Times) react to Congress giving the Federal Courts jurisdiction over Terri's case, was just amazing. They are hysterical with the notion that a coup d'etat had come to pass. Afterall, what business does Congress have in overseeing the almighty Courts.
The Freep are a little shaky on the separation of powers thing.
I would wonder how anyone who had read the Constitution, Federalist Papers, etc. could call what Congress did a "coup d'etat." Well, the Left hasn't read that stuff and has managed to convince many that the Courts have always been all powerful and nothing in the Constitution restrains that power.

I think the writer skipped Article 3. The Freep are a little shaky on the literacy thing.

The Left knows that its agenda can't be passed through the legislative process. Thus, the Courts are now in charge. Selecting willy nilly what is and is not the law. Who is and is not a citizen.

He's still pissed off about Dred Scott? That's actually kind of sweet.

Who is and is not entitled to seek redress in courts. Constitution?!!? What the hell is that. It is nothing more than a word to the Left and to too many Americans.

Yeah, who the hell do those judges think they are, ruling on laws and stuff? Bleepin' hell in a handbasket ...

Rude Pundit says conservatives are drowning in their own bile, but I think if that were possible the Freep would have done it by now.


9:51 pm | link

Silver Linings
If any good comes out of the Terri Schiavo tragedy, it will be that now there's a dim little light in what was a very dark corner of what we euphemistically call our "health care system." Mark Kleiman writes,

Moreover, the law allows for (even if in the Hudson and and Nikolouzos cases it did not actually involve) the termination of life-sustaining treatment for patients with "irreversible" conditions (i.e., conditions from which they will not recover and which leave them unable to care for themselves) even if their higher brain functions are completely normal. Indeed, the law contemplates that a fully competent patient may be served by his health-care provider with a 10-day notice to find another provider or have his plug pulled; it even provides that the patient has the right to attend the committee meeting at which his fate is to be decided. (Sec. 166.046) And the law provides no substantive guidance other than the provider's decision that the requested life-sustaining care would be "inappropriate."

So, if I read the Texas law correctly, it would allow for Terri Schiavo's feedling tube to be disconnected if her health care provider so decided, and if her family couldn't find another provider willing to take the case, even if her higher brain functions were entirely normal (rather than, as appears to be the case, entirely absent), even if she were awake and asking to be allowed to live.

And, remember, inability to pay for treatment is a criterion for allowing hospitals to refuse to take a case. Are we heading in the direction of refusing medical treatment for the poor with terminal illnesses? Are we already there? 
This is a difficult question, made more difficult by the inability of many Americans to face the reality that we are already rationing health care. Case in point: Jeff Jacoby, who writes in today's Boston Globe that those poor saps in Canada and Britain are often put on long waiting lists to receive care in a single-payer system.
As it happens, the real-world consequences of single-payer healthcare -- also known as socialized medicine or national health insurance -- are well-documented. Single-payer care exists in Canada, New Zealand, Great Britain, and much of Western Europe. And wherever it has been tried, writes John C. Goodman, president of the National Center for Policy Analysis, ''rationing by waiting is pervasive, putting patients at risk and keeping them in pain.''
... countries with nationalized systems invariably limit healthcare to control costs. The result, of course, is ever-lengthening wait lists.
What Jeff isn't facing is that those saps at least can get on a list. There's a growing number of low-income working people with no insurance benefits who are also ineligible for Medicaid. No lists for them. Instead, these good citizens usually wait until their conditions are life threatening, then they go to public hospital ERs.
Last year, the Henry J. Kaiser Family Foundation issued a report that argued that we could afford to provide health care for the uninsured, and it wouldn't cost all that much more than what we're paying now. As reported by Reuters:

The cost of providing health care for U.S. citizens who have no insurance will total $125 billion this year, with taxpayers and private entities footing most of the bill, a report issued on Monday said.

... "Leaving 44 million Americans uninsured exacts a substantial price on society as well as individuals, while covering the uninsured would improve their health care without generating large increases in overall health spending," said Diane Rowland, executive director, Kaiser Commission on Medicaid and the Uninsured.

The nation would have to spend an extra $48 billion to cover the so-called newly uninsured, the report said. But that would only increase health care spending's share of gross domestic product by 0.4 percent.

Partly because they lack insurance, an additional 18,000 adults die each year, the report estimated, citing figures from a branch of the National Academy of Sciences.

People who have no health insurance typically get less preventive care, are diagnosed with more advanced diseases, and "tend to receive less therapeutic care and have higher mortality rates," the report said.

The upside is, of course, that the working poor are not clogging up waiting lists, and Jeff Jacoby gets to see his doctor more quickly than he would if he were Canadian. 

It may be that, if you do have health insurance, you get better treatment in the U.S. than you would in a single-payer country. But if that's so, those poor people sure are messing up our national stats. According to this report (PDF file) from the University of Maine,  our health care system doesn't rank all that highly among those other other nations. As ranked by the World Health Organization (see Table One), the Unites States may be first in responsiveness, but it is thirty-seventh in overall performance. 

And (as I've ranted about in the past) our infant mortality rate compared to other industrialized nations is a disgrace. And don't get me started on medical bankruptcy.

But back to health care rationing and terminal illness. Right now people in their last year of life -- about 1 percent of the population -- use 30 percent of our nation's health care expenditures. We need to make some hard choices here, and let's hope those choices aren't made for us by the marketplace. Otherwise, someday we'll be putting our elderly poor adrift on ice floes while the bodies of long-insentient wealthy are maintained for years on end.

Mr. Kleiman links to a thoughtful post at Lean Left about "futile care." It used to be the case that medical facilities provided aggressive care even for the terminally ill until the patient was dead. Then we developed the notion that, maybe, some people would not want aggressive care, and so patients could refuse treatment or leave living wills. But now --

Some patients, or their families, wanted aggressive treatment up to the very end - which, in some cases, could be a very long time. Where the patient had at least minimal brain function, this made sense: though patients have the right to refuse treatment under those conditions, they also have the right to request it if they feel such a life would still be valuable or meaninful to them. (This raises severe problems when the patient’s ability to use up caregiving services exceeds their ability to pay for them, and the patient is receiving minimal benefit from them, but in practice most hospitals and nursing homes have tried not to refuse care in those circumstances because it leads to bad publicity. They suck up the cost and write it off.)

However, there is another conflict that sometimes arises: that in which a patient or patient’s family demands aggressive or intensive treatment that cannot benefit the patient in any significant degree. ...This may be a demand for an expensive treatment they’ve heard of that isn’t really appropriate for the patient, or a demand for an experimental treatment that shows no promise of working, or a demand for continued treatment for a patient who has no conscious experience at all.... In these cases, distraught or unrealistic family may demand continued treatment even when it is known that the treatment they are requesting cannot help the patient, or even, as in the case of higher-brain death, when no treatment can produce any difference in outcome.

In a perfect world I would still prefer to honor the wishes of the family rather than have laws written to say who gets treatment and who doesn't. But in a flawed world of finite resources I tend to agree with Matt Yglesias that the Texas futile care law has merits. But let's be clear that this law should be applied only in circumstances in which the patient is no longer sentient. Deal?


11:28 am | link

The Not Schiavo News
Late last night I heard about the school shooting in Minnesota. But when I cruised the news on the Web this morning, coverage of this tragedy seemed, well, subdued. Not at all like the coverage of Columbine. But then I realized the school in question is on the Red Lake Ojibwa Reservation, and the alleged shooter is Chippewa.
So I take it that most of the victims and their families are not blond and affluent. 
I assume television news is playing it up, or at least giving this story a few minutes between Terri Schiavo and the Michael Jackson trial, but now we know (don't we?) that national media won't be obssessing over every tiny detail à la Columbine. There's probably better background and more updates on this story at Wampum than in the papers.
A miracle has occurred. David Brooks wrote a good column. I'm serious. You should read it. Something this remarkable may not happen again in our lifetime.
George and Uncle Dick are out on the road again, trying to sell their Social Security privatization gimmick. They are not giving up. But Jacob Weisberg explains at Slate that, even though privatization is politically dead, Bush may yet score a political win.
Mark Steyn writes that "the liberal West" is heading for extinction because we liberals are not producing enough offspring. Hey, don't look at me. I had two kids, a boy and a girl. I did my bit for the species. However, if Steyn's column is representative of righties, one wonders how many of their offspring have measurable IQs. Quality over quantity, I say.

9:37 am | link

monday, march 21, 2005

Weenies of the Right

It was, famously, H.L. Mencken who defined Puritanism as “the haunting fear that someone, somewhere, may be happy.” The Puritans still exist, of course, but as Dobson showed in January, they’ve broadened their sights to include that someone, somewhere, who might disagree with them. [Keith Olbermann, Bloggerman]

I just got my new "silencing speech on campus" issue of The Nation, focusing on the current attempt to purge liberals from academia. Here's a bit from an article by Russell Jacoby called "The New PC: Crybaby Conservatives."

Today's accusations against subversive professors differ from those of the past in several respects. In a sign of the times, the test for disloyalty has shifted far toward the center. Once an unreliable professor meant an anarchist or communist; now it includes Democrats. Soon it will be anyone to the left of Attila the Hun. Second, the charges do not (so far) come from government committees investigating un-American activities but from conservative commentators and their student minions. A series of groups such as Campus Watch, Academic Bias and Students for Academic Freedom enlist students to monitor and publicize professorial conduct. Third, the new charges are advanced not against but in the name of academic freedom or a variant of it; and, in the final twist, the new conservative critics seem driven by an ethos that they have adopted from liberalism: affirmative action and a sense of victimhood, which they officially detest.

Except I never heard that the ethos of Affirmative Action was "winner takes all." And it isn't just academia. From a post at Alas, a Blog:

I run into variations on this “we conservatives are entitled to not be criticized” argument again and again. Although there were a handful of legitimate complaints having to do with overzelous “hate speech” laws, the majority of the complaints about “PC thought police” a few years back, consisted of conservatives saying it made them uncomfortable to be criticized when other students found their views misogynistic, heterocentrist or racist.

Did no one ever tell them that it’s not “thought police” when someone is criticized or made uncomfortable?

Amp at Alas provides examples, but I'm sure we've all seen this. Truly, the righties will not rest until they have sniffed out and eliminated every thought that dares stray from their orthodoxy.

Update: Kevin Drum, February 13:

Conservatives tend to thrive on a sense of besiegement, a belief that they're surrounded on all sides by enemies seen and unseen who must be destroyed. The politics of personal destruction, brought to a fever pitch during Bill Clinton's presidency, is tremendously helpful to their cause — and always has been.

OK, I Lied Department: Don't miss Dan Froomkin's comments on Schiavo. Especially this photo.  

3:54 pm | link

The Last Word

"There are an estimated 4,000 deaths each day where there's a conscious decision to limit treatment in some way," said Dr. Ron Cranford, professor of neurology at the University of Minnesota in Minneapolis.

"We have an estimated 14,000 to 35,000 adults and kids in a persistent vegetative state every year," he said. "It's a routine thing to discontinue treatment. These decisions are made behind the scenes."

Other estimates place the number of adult patients in PVS in the United States between 15,000 and 25,000. The annual cost of caring for these patients is estimated to be as high as $7 billion.

Cranford is among the neurologists who personally examined Terri Schiavo — in 2002 he confirmed the Florida woman was in PVS. "There's no doubt — not a shred of doubt," he said. Schiavo's feeding tube was removed Friday after a years-long legal battle between her husband and her parents.

Dr. Stephen S. Lefrak, professor of medicine at Washington University School of Medicine and chair of the ethics committee at Barnes-Jewish Hospital in St. Louis, confirmed that ending the care of a patient — also known as "terminal wean" — is a decision made daily in most hospitals.

And be sure to see Majikthise about the Schiavo blogstorm. Now, barring further developments, I hope to be able to go on to other issues.

7:22 am | link

Welcome to the Asylum
Congress meets on Palm Sunday; the President flies halfway across the country to sign a bill. For this. See also this
As Mary M. said, it's a shame Bush didn't show this much hustle when he got the August 6, 2001, memo titled "Bin Laden Determined to Strike in U.S."
See Majikthise about the Schiavo blogstorm.

11:11 pm | link

sunday, march 20, 2005

Birth of the Freep?
Or, stuff I found while looking for other stuff. This is from an old-fashioned, dead-tree book, and it's about public reaction to the Senate censure of Joe McCarthy in 1954:

According to Herbert Mack, the Senate Postmaster, the names and addresses on the envelopes were so frequently distorted— “To the Anti-Christ from Utah” or “Dear Commie Senator from Vermont”—that he often felt he could not deliver them, although he knew full well for whom they were intended. Senator Watkins found the contents “disturbing” and “peculiar.” So did Senator Fulbright, who read some of the letters into the Record.


Red Skunk. You are not fit to clean Senator McCarthy’s shoes. Hope you are struck by God.


You English Louse. Go back to England with your British wife.


I am an ex-marine who fought in the South Pacific, to open the gates of this Nation for the commie Jews that Hitler did not kill? You are one of the phony pinko punks connected with Lehman, Morse, Flanders and Bennett.


… Many [of the letters] were scribbled in pencil. The language was more abusive, more religious, more conspiratorial in tone. (“You have the Lord against you.” “I vomit at the mere sight of you.” “I put horns and a tail on you and you look like Satan.”)


[David Oshinsky, A Conspiracy So Immense: The World of Joe McCarthy (Free Press/Macmillan, 1983), pp. 486-487.]

Today they don't need pencils. Ain't progress grand?

4:00 pm | link

Life and Death in the Ownership Society
Schiavo resides at a nonprofit hospice that has assumed part of the cost of her care. Medicaid pays for the rest. According to this AP story, keeping her alive costs about $80,000 per year, and at least $350,000 of the malpractice settlement awarded to Schiavo and her husband in 1992 has been spent on her care. Florida Medicaid normally offers hospice coverage for those with a life expectancy of no more than six months, but Schiavo has received assistance from the state for the last two years. [Slate]
I touched on this yesterday, but it needs touching on some more. The Bush Administration and most Republicans in Congress wanted huge cuts in Medicaid funding as a "deficit reduction" measure. Meanwhile, all over America states are struggling with growing Medicaid deficits that are eating their budgets. And, as a result, people are being eliminated from the program.

Texas was the leader in making such drastic changes. It knocked nearly 200,000 people off the rolls last year. That state's physicians are now fighting a government plan to move more Medicaid patients into managed care. The proposal would turn over case management duties currently handled by doctors to HMOs.

The plan would offer the state more budget certainty, but it also would mean that the state is spending 11% to 15% in administrative costs that could be available for patient care, said John Holcomb, MD, chair of the Texas Medical Assn.'s ad hoc Committee on Medicaid.

At the end of last year, Tennessee Gov. Phil Bredesen put into motion a retraction of the TennCare program that would drop more than 300,000 enrollees. That has been held up by legal challenges by patient advocacy groups in the state.

Now Mississippi is facing a $268 million deficit that is threatening to shut down the program altogether. And West Virginia is more than $100 million short in state funding just a few months away from its new fiscal year -- a fact that will precipitate some "painful" cuts, according to state officials. [American Medical News, March 21, 2005]

During last years' presidential campaign, I heard President Bush say on several occaions that if John Kerry were president Americans would end up with rationed health care. And the lamebrain twits in the alleged "news media" didn't challenge Bush when he said this. I was furious then, and I'm furious now, because the fact is that we have rationed health care already. We've been rationing health care for a long time, and we're getting more and more stingy about it.
We need a list of politicians and commentators, including bloggers, who have been calling for cuts in Medicaid but who now have joined in the "save Terri Schiavo" cult. These people need to be challenged to take her off Medicaid and pay for her maintenance themselves. If you know of any such people, please add their names to the comments.
The righties are going to say, it's not about money, it's about principle. But the principle is that there are people right now who are not receiving health care that they need because they can't afford it, and their lives may be shortened as a result. But there is plenty of taxpayer money to keep Terri Schiavo alive, even though she has no hope of ever being conscious.
Why? Because she's politically useful, that's why. That's your "principle."
Families and physicians make decisions about resuscitation and intubation and feeding tubes, etc. etc.etc., all over America, every day. Google for "DNR orders feeding tubes" and you get a hodge-podge of opinions and policy papers from all the states discussing the many tangled legal and ethical questions surrounding these medical procedures. State laws differ, but my impression is that in general once a feeding tube is inserted it is legally difficult (but not impossible) to have it removed while the patient is still alive.
The downside of this is that every day many American families are put on the spot about choosing to insert a feeding tube. Some already are factoring in the difficulty of having the tube removed. I've talked to people who have said they worried they would regret having the tube inserted. 
This is especially difficult if the loved one is terminal but might have a few more days or weeks of reasonably pleasant life if he or she can survive a current crisis.  Let's say there's a very long shot that if the patient can survive in the hospital for a couple of weeks, the family can take the loved one home and enjoy his company for a brief time before the end. But the odds are that the patient's condition will deteriorate until no hope of consciousness remains. And then the family must make the decision to have support removed so that the loved one dies.
And let's say that making that decision from now on is going to be a big bleeping messy deal involving federal judges and politicians and activists that could stretch on for months or years. And you're standing there in the hospital corridor knowing this, and the doctor is standing there wanting you to say yes or no right now about inserting a feeding tube. What do you do?
Let's throw in another complication -- because of cuts in Medicaid, you're going to end up with at least part of the bill. And it will be a big bill.
Let's call up some Republicans and ask them what their principles are.

During a long drive today, while trying to find a basketball broadcast on the boombox that provides radio in my very old car, I happened upon the voice of Tom DeLay pontificating on the Schiavo case, and it made me physically ill. His claim was that what's happening to Schiavo would be illegal if it happened to a dog.

The cynicism and hypocrisy of that line of reasoning is breathtaking, even coming from Tom DeLay. Untold tens of thousands of American families face the same agonizing decision--whether or not to continue mechanical life-support in terminal cases--every year. My own family faced it a few years ago. And very often, the issue is the same as in the Schiavo case: taking out the feeding tube, or continuing it indefinitely.

The only unique thing about this case, of course, is the extended legal battle between Shiavo's husband and parents, and the media notoriety that has made it so ripe for political opportunism.

As George Bush returns to Washington so he can get his picture taken signing an emergency bill to "save" Terri Schiavo, some parents in Texas are preparing to bury their baby, whose life support was ended without their permission. (And Oliver Willis asks, "Where were the Republicans?")
When he was governor of Texas, George Bush signed the law that allows Texas hospitals to terminate life support against family wishes. One of the criteria for allowing the hospital to terminate the patient is the families' inability to pay the bills.
In other words, if you can show 'em the money you get to keep Grandpa. Otherwise ...
Update: A very recent ABC News/Washington Post poll says that an overwhelming majority of Americans -- 87% to 8% --  think it's time to let Terri Schiavo go. They think the husband and not the parents should be the one to make the call, 65% to 25%.
Steve M. of No More Mister Nice Blog makes the case that the real motivation behind the Cult of Schiavo is to influence judicial appointments. He documents that the righties are being whipped into hysteria over "judicial tyranny"; see also this Free Republic thread.
But the remedy Congress cooked up this weekend is, as I understand it, to take the matter out of state court and put it into federal court, which the righties seem to think will be more pliable to their will. But it's removing the decision even further away from the family.
So it's not "judicial tyranny" if the court sides with the Right? And what happened to "states' rights"?
Personally, I think the righties are proving you can be brain dead and ambulatory. Remarkable.
I think the Dems should be going to the American people and saying, look, these decisions should made by families and not by the government, whether state or federal, or whether the judicial, legislative, or executive branch. It seems the overwhelming majority of Americans see it this way, also. Most of us don't get too far into our adult years before being touched personally by hard medical decisions regarding a loved one. But when families disagree, the practice for many years has been to seek some kind of arbitration through state courts. Now the righties are saying such decisions should be made by federal courts. And they're complaining about tyranny?
Update update: The Bull Moose"Congressional Republicans are engaged in an orgy of grandstanding."  The Moose continues,
It is truly touching that the compassionate Republicans are so dedicated to ensuring that the vulnerable in our society receive the medical treatment they need. Golly gee, the Moose forgot that this crew just attempted to cut Medicaid benefits for the poor. At least the Catholic Church is consistent in its support for life.

I'm puzzled. I thought the President and GOPers didn't like activist judges and were for smaller government. It seems here they're moving this case to ensure activist judges handle it and are taking powers away from state courts and handing it over to the federal government. Do conservative principles matter, or are they only to be affirmed during election time?

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The War Prayer

I come from the Throne -- bearing a message from Almighty God!... He has heard the prayer of His servant, your shepherd, & will grant it if such shall be your desire after I His messenger shall have explained to you its import -- that is to say its full import. For it is like unto many of the prayers of men in that it asks for more than he who utters it is aware of -- except he pause & think.

"God's servant & yours has prayed his prayer. Has he paused & taken thought? Is it one prayer? No, it is two -- one uttered, the other not. Both have reached the ear of Him who heareth all supplications, the spoken & the unspoken....

"You have heard your servant's prayer -- the uttered part of it. I am commissioned of God to put into words the other part of it -- that part which the pastor -- and also you in your hearts -- fervently prayed, silently. And ignorantly & unthinkingly? God grant that it was so! You heard these words: 'Grant us the victory, O Lord our God!' That is sufficient. The whole of the uttered prayer is completed into those pregnant words.

"Upon the listening spirit of God the Father fell also the unspoken part of the prayer. He commandeth me to put it into words. Listen!

"O Lord our Father, our young patriots, idols of our hearts, go forth to battle -- be Thou near them! With them -- in spirit -- we also go forth from the sweet peace of our beloved firesides to smite the foe.

"O Lord our God, help us to tear their soldiers to bloody shreds with our shells; help us to cover their smiling fields with the pale forms of their patriot dead; help us to drown the thunder of the guns with the wounded, writhing in pain; help us to lay waste their humble homes with a hurricane of fire; help us to wring the hearts of their unoffending widows with unavailing grief; help us to turn them out roofless with their little children to wander unfriended through wastes of their desolated land in rags & hunger & thirst, sport of the sun-flames of summer & the icy winds of winter, broken in spirit, worn with travail, imploring Thee for the refuge of the grave & denied it -- for our sakes, who adore Thee, Lord, blast their hopes, blight their lives, protract their bitter pilgrimage, make heavy their steps, water their way with their tears, stain the white snow with the blood of their wounded feet! We ask of one who is the Spirit of love & who is the ever-faithful refuge & friend of all that are sore beset, & seek His aid with humble & contrite hearts. Grant our prayer, O Lord & Thine shall be the praise & honor & glory now & ever, Amen."

(After a pause.) "Ye have prayed it; if ye still desire it, speak! -- the messenger of the Most High waits."

·   ·   ·   ·   ·   ·

It was believed, afterward, that the man was a lunatic, because there was no sense in what he said.

[Mark Twain, 1905]

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