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Terminal Anorexia

Their primary concern is:

ANAD fears that this label could be used as a justification for providers to offer medical aid in dying and overlook the fact recovery remains possible even after decades of chronic illness.

This is a very reasonable/real concern. We need to remember that while it may not be true of all supporters of PAS, there are those who truly think at need to be facilitating the killing of people who are suffering…in ever-larger numbers.

If you or someone you know is suffering from an eating disorder, please seek help. ANDA has a helpline and treatment directory. It can also contact MyCatholicDoctor for help from Catholic therapists licensed in many States.

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Life-Limiting Prenatal Diagnoses and Beauty

While it is sad that this study was initiated with what seems to be an unquestioned assumption that it is, unusual, to “continue pregnancy after a life-limiting prenatal diagnosis”…we are very happy to see this result:

While we might choose a term like, “integral beauty” (the beauty of life is not some accident but rather is integral to life itself)…it is wonderful that this qualitative study included as an outcome, “…feelings of gratitude towards life…”

Hopefully this will picked up on by these and other researchers in the future!

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Transgender News from England – The Cass Review

The final report of the Cass Review (pdf)was recently submitted to NHS in England. This report provides an evaluation of the current state of the science with respect to so-called transgender medical and psychological interventions while also making various recommendations for current treatment protocols and future research.

A few Key Findings of note:
– “While a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.”
– “The rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown.”
– “Clinicians are unable to determine with any certainty which children and young people will go on to have an enduring trans identity.”

The bottom line is that, as we recently highlighted, there are no good data to support so-called transgender medicine, no matter what anyone claims. Indeed, the excruciating suffering experienced by those who feel their body does not match their experienced gender is only exacerbated by those who claim otherwise.

We appreciate that the Cass Review takes a clear-eyed view of the data. However, it should also be noted that the Review, not surprisingly, does not go as far as we would like, leaving the door open for continued treatment aimed at suppressing and changing secondary sex characteristics of those suffering from gender dysphoria.

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VSED…in the real world…

The topic of Voluntary Stopping Eating and Drinking (VSED) has been discussed in the medical world for a number of years. It is generally touted as a “natural” and/or “legal” way by which one can purposefully end one’s live without resorting to Physician Assisted Suicide (PAS)* or Euthanasia.

This came up recently at Strong Hospital while I was on the inpatient palliative care service. Ultimately, the questions that arose include:
1. What is the medical team’s responsibility to patients who are undertaking (or planning to undertake) VSED?
2. Should we treat hunger/thirst with opioids/benzos, or with offering food/water?
3. Can a patient use an advance directive document (e.g., living will) to direct that, when he becomes confused and asks for food/water that this be withheld and he be treated with opioids/benzos (or even sedation)?
4. Can a health care proxy enforce a patient’s explicitly-stated wish for VSED if the patient is asking for food/water.

These questions, and others, will be the topic of a panel discussion, which I will be part of, at Strong Hospital on April 17. See Upcoming Events for more info.

See also a related recent post and an article in the Linacre Quarterly by Dr. Cavanagh

– Tom Carroll

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* Often now referred to as Medical Aid in Dying (MAID)

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New Gender Study

This is the first study to look at all cause morality (and suicide-related mortality) as a function of transgender treatment while controlling for psychiatric disease.

The conclusion is that, given the same number of visits to a psychiatrist, those who were visited a transgender program in Finland were no more likely to die (all cause or by suicide) than those who had not visited such a center. Further, among those who did visit a transgender center, being treated for so-called gender reassignment did NOT lead to a lower likelihood of death.

While only one study, this is BIG!

We suspect this will prove to be only the first drop in an eventually very large sea of empiric evidence that attempting to change one’s body to match a feeling of gender is not the answer.

Given these data, it is only all the more important that we reach out to those suffering from gender dysphoria to offer loving support. The politicization of this issue has, as politicization always does, leaves individual human beings stuck in the middle.

St. Joseph, pray for us!

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Deep Sedation for “Psycho-Existential Suffering”… Euthanasia?

The issue of continuous deep (to-unconsciousness) sedation (CDS) to relieve suffering has been discussed in the literature and, indeed, used in clinical practice for a number of years. Two recent articles prompted this brief post…

First…

For our purposes, we should note that while a minority of all patients receiving continuous deep sedation (CDS) do so for psycho-existential suffering (8.5%), and only one for solely this type of suffering… the VAST majority of these patients (78.6%) also desired “hastened death.”

So, it seems that we have a patient who is suffering and wishes to end his/her life. Then, the doctor administers a medication (with the express purpose of inducing CDS) that renders that patient incapable of eating/drinking… until the patient dies. It is far from clear how one could claim that this is anything other than euthanasia.

Second…

We very much appreciate the balanced approach of Drs. Dalle Ave and Sulmasy. Finding a balance between the maintenance of consciousness and the relief of otherwise intractable (perhaps “non-beneficial”) suffering is often difficult…and always important.

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COVID Vaccine Redux – 2023-24 Season

As expected the FDA has now approved updated COVID vaccines, all of which are reformulated to target the newest COVID variant (XBB.1.5).

We are certainly in a different place now that we were in when we published our thoughts on COVID vaccines in the Fall of 2021 and Winter/Spring of 2022. The pandemic phase of COVID is officially over (as of May 11, 2023) and we are not, at the moment, talking about vaccine mandates.

However, we are not in a different place when it comes to the moral issue associated with COVID vaccine production and testing.

There are currently three FDA-approved vaccines, including from: Pfizer-BioNTech, Moderna, and (most recently) Novavax. While each of these have been updated to target the current COVID variant, their methods of production remain the same. Pfizer and Modera are still mRNA-based technology while Novavax is protein-based. All three have in common their viral target (the so-called “spike protein”).

USA Today has a good overview of these three vaccines. The bottom line is that they are likely to be equally effective and have similar side effect profiles.

From a moral compromise standpoint, the Charlotte Lozier Institute provides a good overview here (PDF). Based on their schema, they are all equal from moral standpoint. All three avoid the use of abortion-derived cell lines in the Design/Development and Production phases while using HEK293 cells in the Confirmatory Lab Testing phase.

On a related note, there was discussion in 2021 that Pfizer may produce an influenza and/or RSV vaccines using mRNA technology, though this has not yet come to be, though stay tuned. Keep in mind that some of the discomfort “out there” with the mRNA vaccines has to do with their newness (and so lack of long-term safety data), some with the use of HEK293 cells, and some from other considerations. If/When mRNA-based influenza and/or RSV (or other) vaccines come to market, their moral status will need to be considered one-by-one.

We should also keep in mind that vaccines are not the only places in which one finds abortion-derived fetal cells…

An additional, excellent, resource for vaccine-related ethical questions is the NCBC’s Vaccine Resources.