Are we euthanizing conscious patients?

Science, technology, and life.
Sept. 8 2006 9:53 AM

Buried Alive

Are we euthanizing conscious patients?

For the latest Human Nature columns on obesity, air conditioning, and genital mutilation, click here.

Brain scans suggest a woman diagnosed as "vegetative" is actually conscious. Evidence: "When asked to imagine playingtennis or moving around her home, the patient activated predictedcortical areas in a manner indistinguishable from that of healthyvolunteers." Pro-life spin: Terri Schiavo was murdered! Skeptical reactions: 1) This woman showed signs of minimal consciousness within a year; Schiavo suffered far worse brain damage and showed no consciousness for 15 years. 2) Nobody in a persistently vegetative state for two years has been shown to recover awareness. 3) Don't use this case to raise false hopes for families of PVS patients. Moderate reactions: 1) We'd better rethink our practice of judging people by their ability to communicate. 2) Give them all brain scans. (For Human Nature's takes on the Schiavo case, click here, here, and here.)

William Saletan William Saletan

Will Saletan writes about politics, science, technology, and other stuff for Slate. He’s the author of Bearing Right.

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A new drug delays premature ejaculation. The drug, an SSRI called dapoxetine, was tried on a sample of men who previously ejaculated, on average, less than one minute after vaginal penetration. A moderate dose delayed ejaculation to 2.78 minutes; a double dose delayed it to 3.32 minutes. Bonus finding: A placebo doubled average endurance to 1.75 minutes. Downside: "Side effects of the drug included nausea, diarrhea, headache and dizziness." Old medical spin: By preventing ejaculation, SSRI's emasculate men and harm sexual relationships. New spin: By preventing ejaculation, SSRI's empower men and improve sexual relationships. (For Human Nature's previous update on an anti-ejaculation cream, click here.)

Aging may be nature's way of preventing cancer. A gene that inhibits cancer appears to do so by preventing adult stem cells from multiplying. As you age and become more cancer-prone, the gene makes multiplication harder and harder. Result: Your body stops repairing itself, and you die. The good news: Aging isn't inevitable wear and tear. The bad news: Aging is programmed, and if we block the program, we'll get cancer. Optimistic spin: Maybe we can avoid both by learning to switch the program off and on. Political spin: Adult stem cells will never be as effective as embryonic stem cells. (For Human Nature's takes on the stem-cell debate, click here, here, here, and here.)

Midlife divorce increases heart disease for women but not men. Based on several thousand cases beginning at age 51, researchers calculated that by age 60, women who were divorced, remarried, or widowed were nearly 50 percent more likely to have cardiovascular disease than women who stayed married. "No such difference was seen for men. In fact, men who remarried were actually 19% less likely to develop heart disease than those who had stayed married to the same person." The authors conclude that "emotional distress and socioeconomic status" cause the harm to women. (Economics can't account for the whole effect, since "remarried women were more likely to have heart disease than continuously married women, although their financial circumstances were not substantially worse.") Feminist spin: Men have no hearts. Anti-feminist spin: We're just happier without you.

Caesarian sections may nearly triple the chance of infant death among low-risk U.S. women, according to a huge study. The death rate is 0.062 percent for vaginal births and 0.177 percent for C-sections. Speculated reasons: 1) Labor produces hormones that improve babies' lungs. 2) Labor squeezes dangerous fluid from their lungs. 3) C-sections may cause cuts and infections. 4) C-sections delay breastfeeding. Skeptical reactions: 1) The rest of the world would kill for a neonatal mortality rate under 0.2 percent. 2) The reason C-sections correlate with more deaths is that the riskiest women get C-sections. Authors' replies: 1) We restricted the study to low-risk women. 2) C-sections correlate with more deaths from multiple causes even after we adjusted the samples for medical factors and socioeconomic status. 3) C-sections are up nearly 50 percent in a decade; maybe we should stop this train. A second,  much smaller study suggests that the risk of maternal death is also three times higher in C-sections. (For Human Nature's previous update on births to women over 50, click here.)

Fat news: 1) More than 40 percent of kids in New York City's Head Start program are overweight. 2) Kids with baby fat often stay fat. 3) Heart disease is becoming more fatal to poor than rich people in some developing countries. 4) Stupid food subsidies are fattening and killing people. 5) Experts want a global ban on junk food ads to kids. 6) People underestimate calories in fast food. 7) Nine of the 10 fattest states are Southern. 8) Obesity causes male infertility. 9) The world's fattest man is preparing for weight-reduction surgery. (For Human Nature's take on global obesity, click here. For banning junk food, click here and here.)

Couples at U.S. fertility clinics are weeding out embryos with cancer genes. This mirrors Britain's decision to permit testing of IVF embryos (preimplantation genetic diagnosis) for the same purpose. PGD was previously used against genes nearly certain to strike and kill. Now it's being used against genes less likely to strike and often unlikely to kill. Pro-life spin: Here we go down the eugenic slope. Pro-choice spins: 1) It's my right to choose. 2) Let's get insurers to cover it so everyone can afford it. 3) I'm not just saving my kid; I'm saving all my descendants. 4) If we don't let people use PGD, they won't have families. 5) If we don't let them use PGD, they'll have abortions. 6) If we don't let them use PGD to weed out breast cancer genes, they'll get the same result by using it to weed out female embryos. (For Human Nature's take, click here.)

Older dads are more likely to produce autistic kids, according to a huge study. The risk is 0.06 percent if the child is born in your 20s; 0.09 percent if it's in your 30s; 0.32 percent in your 40s; and 0.52 percent in your 50s. The mom's age makes no difference. Feminist spin: Finally, we can blame dads instead of moms for causing a defect by delaying parenthood. Biological-clock spin: Did we mention that if you delay fatherhood, your kids are also likely to be dumber? Anti-dork spin: Maybe guys likely to have autistic kids tend not to become dads as early as other guys. (For Human Nature's previous update on the male biological clock, click here.)

Gene therapy helped beat cancer in two of 17 patients. Doctors used a virus to infect white blood cells with genetic instructions for targeting each patient's cancer. The other 15 patients are dead or dying. Happy spins: 1) Gene therapy can cure cancer! 2) We can fight cancer using your immune system instead of chemo and radiation. Skeptical reactions: 1) Saving two of 17 patients is not encouraging. 2) Make that one of 17, since the therapy didn't even wipe out all the cancer in one patient. 3) It's only been 18 months; if the cancers return, the result could be zero of 17. 4) Gene therapy's long-term batting average is even worse. 5) The white cells weren't even tested to make sure they caused the two recoveries.

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