Gay marriage, divorce, and the Gospels

By 8 Comments

Ted Cruz’s statement on Kim Davis, the Kentucky county clerk now in jail for defying a court order to do her job by issuing marriage licenses to same-sex couples, demonstrates once again that a high IQ and excellent meritocratic credentials are consistent with functional idiocy, and that functional idiocy is no bar to being treated as a “mainstream” Presidential candidate. (Walker, Jindal, Rand Paul, and of course Huckabee, all came out the same way.)

Of course Davis wasn’t arrested “for living according to her faith.” She was arrested for refusing to do what a judge, after a hearing, ordered her to do. She could have avoided jail by (1) doing the job she gets paid for; (2) allowing her clerks to issue the licenses she doesn’t want to sign; or (3) resigning. She chose to do none of these, and she’s in the clink. That’s life in the big city. When she gets out, she will no doubt spend several years collecting some kind of wingnut welfare.  To liken her to victims of genuine religious persecution is an insult to those victims.

On some level Cruz is plenty smart enough to understand all this, but he’s decided to make a career out of not understanding it.

There’s been some rather indecent glee among supporters of same-sex marriage about Davis’s own rather colorful marital history. There ought to be a strong presumption that a public official’s private life is off-limits in political debate, and Davis has on the face of it a reasonable case that behavior predating her religious conversion is irrelevant to her current beliefs.

But, as Lt. Colombo used to say, there’s just one more thing. Davis claims to be acting as a Bible Christian. Adultery violates one of the Ten Commandments. (Male/male sex violates a rule that’s on a list with eating shellfish, and female/female sex is never mentioned.) And Jesus of Nazareth – breaking with existing tradition in the interest of protecting women against being cast off by their husbands – says quite explicitly (Matt 5:32 and Luke 16:18) that marriage with a divorced woman (or marriage by a divorced man) constitutes adultery.

Therefore, by Biblical standards Ms. Davis’s sin is not in the past. Every time she has sex with her current husband, both of them are – according to the one they acknowledge as the Son of God – violating one of the Ten Commandments. The only way she could stop sinning would be to live as a celibate from now on (just like all those gay folks are supposed to do).

So, whatever religion Kim Davis is suffering for, it’s not the one preached in the Gospels.

This analysis suggests a question for Cruz and the other Republicans coming out in support of Davis:

If an elected county clerk who was an actual Bible Christian refused to issue licenses for the remarriage of divorced people with living spouses, on the grounds that his religion forbade him to connive at adultery, would that be legitimate exercise of individual conscience? And should divorcees in that county remain unable to marry?

Footnote There’s a general point here: Lots of the stuff that’s done in the name of “Christianity” has as little to do with the Bible as some of the stuff done in the name of “Islam” has to do with the Koran. In each case, local customs have been engrafted onto a larger religious tradition. As Don Marquis said, an idea isn’t responsible for the people who believe it. Especially, as he might have added, when they really don’t.

 

 

 

 

 

 

 

Weekend Film Recommendation: The Accused

By 1 Comment

This week’s movie recommendation continues last week’s theme of court-related drama. As the credits are still rolling, we watch a deeply distressed young woman named Sarah Tobias exit a roadside bar in an urgent search for help. Tobias has just been raped in full view of the bar’s patrons, and in this week’s movie recommendation, Jonathan Kaplan’s The Accused, she is looking for justice. Continue Reading…

Professors Not Retiring Reduces Faculty Diversity

By

Kirk Carapezza’s report on professors who don’t want to retire is worth
listening to (you can also read about it at our sister site Washington Monthly). But it frustrated me in covering an old white male college professor who sees no reason to retire without ever challenging him (or the audience) about how the lingering of a particular academic generation holds back the advancement of women and people of color in academia.

The critical demographic fact about professors who are now in their 60s, 70s and 80s is that in virtually every field, they are overwhelmingly white men. Meanwhile, the current generation of graduate and medical students who will soon be entering the academic job market has a much higher percentage of women and people of color. If you want to diversify your faculty, the time to go fishing is right now while the lake is stocked.

But you can’t bring in these exciting, diverse young people if most of your resources are tied up in old white guys with high salaries. The decision to get rid of the retirement age, whatever its virtues in other respects, was a decision to help older white male professors at the expense of younger women and minority would-be professors.

It may be unfashionable to say this, but the situation is also unfair to young white male would-be professors, whose generation is often expected to bear the entire burden of reducing the over-representation of white men in the academy. That’s a cost that should fall on the old boys who have enjoyed decades of privilege rather than some 27 year old who got his degree in a much more gender and racially balanced world

Suicide, assisted suicide, and physician-assisted suicide

By 10 Comments

Something like one million people each year in the United States try to kill themselves (with various levels of determination) and about four percent of them succeed. That makes suicide the 10th-leading cause of death: way ahead of homicide, and about on a par with auto accidents. About half of those attempts involve people with alcohol, tranquilizers, or opiates on board, raising the question of whether the person involved would make the same choice sober. (The answer might be “yes”: someone could decide in cold blood to kill himself and have a drink or three to steel himself to do it, or someone in chronic pain and taking opiates for it could decide that the pain is more than she wants to handle for years to come.)

In many cases, the impulse is transient; of those who survive suicide attempts, fewer than 10% eventually finish the job. Even people who, seemingly by chance, survive suicide attempts using methods that kill 95% or more of the people who try them (e.g. jumping from tall buildings or bridges, gunshots to the head) mostly don’t try it again. That suggests that most of those who succeed in taking themselves off were not acting on a steady, settled decision that life wasn’t worth living.

That being the case, preventing someone from committing suicide seems as straightforward a public-health objective and medical responsibility as preventing any other sort of sudden death.

Suicidal thoughts are even more widespread than suicide attempts. Physicians and other service providers know something – not as much as they would like, but something – about how to keep those thoughts from turning into attempts, and how to reduce the lethality of the attempts that are made. (Keeping guns out of the hands of those who might use them on themselves ranks high, since guns are especially effective means of ending one’s own life.)

Much of the burden of this work falls on psychiatrists. Those I know are proud of their many successes and intensely distressed by their occasional failures. So it doesn’t surprise me to find my friend Keith Humphreys, who teaches psychiatry, strongly opposed to having physicians – and psychiatrists above all – involved in helping people kill themselves. And published descriptions of Belgium’s legal Kevorkians are not encouraging in terms of how much care they use to avoid helping to end the lives of people who would, if they survived, be happy about it.

With all that said, I still think that people who have formed and held the view that their lives would be better shorter ought to be allowed to act on that view. The fact that much suicide is impulsive doesn’t mean that all suicide is impulsive. The fact that some people might change their minds later, either spontaneously or as the result of a medical breakthrough, doesn’t – in my view – justify the state in requiring someone who doesn’t want to go on living to do so anyway.

And the right to die ought logically to include the right to seek help in dying from a willing helper. There’s not much that can be done to prevent suicide by someone sufficiently determined and capable (physically and psychologically) of acting without help; but when someone asks for help that creates the opportunity, by surrounding the act of helping with appropriate rules, to try to screen out the cases where the intention is impulsive.

Where I agree with Keith is in thinking that the helper should not be a physician (with some exceptions I’ll get to). Physicians have the social role of protecting life and health; getting them involved in killing those who aren’t dying creates too much role tension, given that in the vast majority of cases the goal ought to be prevention.

But the real reason not to get docs involved in assisted suicide is that their professional knowledge and skill are almost completely irrelevant to the task. A physician can provide (probabilistic) information about the subject’s current and likely future health status, including mental health. “Is my depression going to get any better?” is a question a psychiatrist can try to answer. But “Would I be better off dead?” isn’t a medical question, and therefore a medical professional has no qualification for offering an opinion.

Nor is a physician needed to provide technical help, except where the laws get in the way. A breathing mask or plastic bag plus a tank of nitrogen will kill someone reliably and painlessly, and a plumber is more likely than a physician to be able to provide the requisite equipment and aid in its use. “Physician-assisted suicide” is an artifact of a world in which suicide is illegal, and some of its more reliable means (opiates and barbiturates, for example) available only with medical approval. In the special case of death by intravenous injection, skilled help is necessary simply because most of us don’t know how to mainline, even if we had the equipment and the nerve. That makes the physician the natural helper for someone who is already dying and in intense physical pain; a lethal dose of morphine or its equivalent can be given without anyone explicitly asking for a lethal dose when nothing less than a lethal dose will stop the pain.

But in the cases Keith addresses – physically healthy people who want to die because they can’t see any end to the suffering from their life situations or their somatic or mental illnesses – I’d want to keep the doctors far away. Someone in that situation ought to be allowed to register his or her decision to stop living, and – after some waiting period and approval by an actual “death panel” based on the panel’s conclusion (perhaps having taken psychiatric or other medical advice) that the subject’s intention is serious and not merely impulsive, is not made under pressure from others, and that the reasons the subject offers for the decision are not likely to materially change in the near future – be allowed access to carry out his or her intention without interference, and with help from willing helpers.

Of course this is personal. I’m now at an age where I’m going through the deaths of older relatives and friends, and every year my age gets closer to theirs. Some live well to the very end, but by no means all. I can think, without pausing, of five people close to me whose lives would have been improved by a fatal stoke months or years before the Man with the Sickle eventually showed up. I’ve spent enough endless hours in nursing homes to be absolutely certain I want to die before I land in one.

Yes, I’m worried that permission to die could evolve into social pressure to die. (See Tom Schelling’s “Strategic Relationships in Dying.”) And of course your mileage may vary. If your moral or religious principles forbid suicide, no one should try to change your mind, and you shouldn’t have to be involved in helping anyone else. But none of that seems to me an adequate reason to force continued life on those who are tired of it.

Footnote I note that Arthur Caplan, whose exquisite ethical sensibility requires that people who want to live die instead unless they can get replacement kidneys in ways that Caplan finds acceptable, also holds that people who want to die should be required to live until Caplan is satisfied there’s no “slippery slope” nearby. Seventeen people will die today in the United States waiting for kidneys, but Caplan and friends have made sure that potential living donors (you can get along just fine on one kidney) can’t be compensated for donating, so the waiting lists just keep getting longer.

In the good old days, the people who told you that innovations to alleviate human suffering (vaccination, anaesthetic-assisted childbirth, contraception, IVF) were e-e-e-e-villll and must be forbidden by law were called “bishops.” Now they’re called “bioethicists.” This represents dis-improvement in two important ways: (1) Bishops had more impressive costumes; (2) The separation of church and state doesn’t work to keep the bioethicists from imposing their professionally hyperactive consciences on the rest of us, whether we agree with them or not.

Putting Suicidal Psychiatric Patients to Death is not Compassionate

By

The current issue of the medical journal BMJ Open has a disturbing article on the euthanization of people who have mental illnesses. The authors are Belgian psychiatrists whose conception of what it means to be a mental health professional departs significantly from my own. Drs. Lieve Thienpont and Wim Distelmans have certified that suicidal people as young as 24 years old can ethically be put to death under the country’s euthanasia law because their psychiatric disorder (e.g., depression) causes “unbearable suffering”.

The argument for why this policy is compassionate runs as follows. Mental illnesses can make life extremely stressful, sad and challenging. Sometimes treatment helps only a little or not at all. If someone in such a situation wants to end it all, isn’t it therefore a kindness for the physician to step in and put the person to death painlessly and professionally rather than risk a suicide attempt that is painful or is botched?

Well, no, actually. Anyone who has treated people with psychiatric disorders knows that suicidal thoughts and impulses are nearly normative in the population. Many psychiatric patients say things like “I don’t see the point in living”, “I hate my life”, “I wish I had never born” etc., and they really mean it….right up to the point when they don’t. Every mental health professional knows people who have been miserable for years and are now doing well and very much want to be alive. Here is a concrete example, from John Colapinto’s recent New Yorker profile of my colleague Karl Deisseroth. Karl is treating a patient who is anonymized as “Sally”:

Sally, now in her sixties, had suffered since childhood from major depression, and had tried the standard treatments: counselling, medication, even electroconvulsive therapy. Nothing helped. She had spent much of her adult life in bed, and had twice attempted suicide. Seven years ago, she was referred to Deisseroth, who uses a combination of unusual medications and brain stimulation to treat autism and severe depression.

On Deisseroth’s advice, a surgeon implanted beneath Sally’s left collarbone a small, battery-powered device that regularly sends bursts of electricity into the vagus nerve, which carries the signal into a deep-brain structure that doctors think regulates mood. Originally developed for epilepsy, vagus-nerve stimulation has been approved by the Food and Drug Administration for use in the kind of treatment-resistant depression from which Sally suffers, but the exact reason for its effectiveness is not understood. Sally says that VNS has transformed her life, and that, apart from one period of “going pancake,” she has experienced just a few “dips.”

Drs. Thienpont and Distelmans might argue that this is an unfair example: A new treatment is being employed and there’s no way anyone could have predicted that Sally would be so helped by it. But that is precisely the point: It’s always very hard to predict the course of a person’s illness and even moreso the course of their life. No matter how sure Dr. Thienponts and Distelmans may subjectively feel that a psychiatric patient has a life of unending misery in front of them, they are going to be wrong at least some of the time.

A defender of the Belgium law might retort that safeguards are in place to ensure that the decision to euthanize isn’t just based on one psychiatrist’s opinion. Chuck Lane demolishes that rebuttal by pointing out that the committee which is charged with making sure that people like Dr. Distelmans do not engage in unethical euthanasia is co-chaired by…Dr. Distelmans.

An irony struck me as I re-read the Calapinto’s profile of Karl Deisseroth: “He accepts only patients for whom all other treatments have failed.” Drs. Thienpont and Distelmans say the same thing of themselves. If you or your loved one had a serious, hard to treat psychiatric disorder, which doctor would you want to see?

Must we put their names in lights (again)?

By 3 Comments

Some things never change. When I saw the coverage of the recent Virginia killings, I was reminded of this January 2011 post on related matters.

Must we put their names in lights?

I haven’t posted much on the Arizona killings. The enormity of the tragedy demands a respectful silence, unless one actually has something useful to say. Most everything constructive I would say has already been said by someone else with greater force than I would muster.

I would mention again the importance of long-term care and rehabilitative medicine. The typical 9mm bullet is quite adequate to lacerate human body parts, sometimes beyond repair. Every day, thousands of doctors, nurses, physical therapists, try to repair these lacerating wounds, and try to repair over months and years the human lives lacerated by such gun violence. Most of these men and women labor in relative obscurity. I happen to be away delivering a talk at a VA facility where some of these professionals do their work. Their faces rarely grace the front page of your local newspaper. There just isn’t the space to honor everyone who deserves it.

I’ll bet that your local newspaper found the space for this crazed mug shot of Jared Lee Loughner, the disturbed young man who apparently committed mass murder. He’s gotten his fifteen minutes, which I suspect is what he really wanted: to see his name and his picture in lights.

Can we not do that?

Much in our popular culture—from Silence of the Lambs, to Nancy Grace, ironically, to the death penalty itself—creates in some people an enticing motive for atrocity. Shoot someone famous, and you’ll end up an (anti) celebrity, on the cover of People or Newsweek. That’s a heck of a lot easier than finding the cure for AIDS, winning an NBA championship or “Dancing with the Stars,” not to mention accomplishing the intricate repair of brain tissue damaged by a 9mm round.

I wish there were a way to shun mass murderers the way we shun grimy child molesters. We should know who they are. The police, forensic experts, and the court system should do what they need to do. Yet I wish we lived in a world in which the rest of us gave this necessary work a little more distance and private space, in which it’s considered rather distasteful, even disgusting to publicize without some very good reason the little people who commit huge crimes.

I can’t prove what I believe. If we stopped rewarding these criminals with the massive publicity, we might have somewhat fewer of these atrocities.

O tempora! O Associated Press!

By 9 Comments

I haven’t been following the St. Paul’s School rape case. Apparently a senior boy told his buddies he’d had sex with a freshman girl when the girl was 15; seducing freshmen seems to have been considered a badge of honor among seniors. He was charged not only with sex with a minor but also with rape; the girl claimed he forced himself on her. He asserted that everything was consensual and stopped short of full intercourse.

The jury convicted him of sex with a minor (a misdemeanor) and using a computer to seduce a minor (weirdly, a felony) but acquitted him of rape.

Rather than lamenting the sexual mores of the rising generation, I want to lament its journalistic standards.

The Washington Post, which in my youth was a newspaper, with reporters and editors, where at least some of the reporters knew something about the topics they covered and at least some of the editors tried to keep obvious falsehoods out of the paper, ran an AP story that included the following sentence:

The jury by its verdict Friday signaled they didn’t believe Labrie’s assertions that he and the girl didn’t have intercourse but also didn’t believe her contention that it was against her will.

No, no, no, no, NO!

The jury “signaled” no such thing. Assuming that the jurors were following instructions, the verdict means that they were unanimously convinced beyond reasonable doubt that the accused penetrated a minor but were not convinced beyond reasonable doubt she had not consented. They could have all gone home saying “Yeah, seems way more likely than not that he forced her, but in a swearing contest it’s hard to be morally certain.” (Of course it’s also possible that the verdict was a compromise among conflicting jurors, which is against the rules but isn’t unknown.)

The more I think about this, the angrier I get. The victim, having been victimized once by the older boy and again by the criminal justice process, now suffers a gratuitous third victimization from the AP and the WaPo, which proclaim to the entire word, indelibly, that a jury found her to be a liar, when in fact it did not.

It seems implausible that there will be a retraction – not that it would do much good – and impossible that she can successfully sue for damages, since for this purpose she’s a “public figure” under the precedent in N.Y. Times v. Sullivan.. Why should reporters, editors, and publishers be allowed to negligently damage people by failing to do their job up to professional standards of competence, and escape scott-free? Note that this isn’t a matter of opinion; what the story says about the meaning of a “not guilty” verdict is simply wrong.

Apparently the strongest evidence against the accused was his own post-incident boasting to his classmates. He and his lawyer had to claim at trial that the boy was bragging about molesting an underage girl but hadn’t actually done so. Who knows? It might even be true. But it isn’t hard to see how the jury could dismiss that claim as far-fetched while remaining in some doubt on the consent question.  

The whole thing – more carefully described in this New York Times story – makes me wonder just how far New Hampshire law allows an eighteen-year-old to go with a fifteen-year old. And, as always, I wonder what a just sentence would look like for what the defendant was convicted of doing, rather than for the even worse thing he may well have actually done.

Weekend Film Recommendation: A Civil Action

By 9 Comments

The courtroom drama can be a pretty tired plot vehicle for many, perhaps justifiably so. It sometimes seems that the clichés are so well rehearsed that even the counter-clichés appear just as threadbare: people redeeming themselves through the law (e.g., see here and here) are about as compelling as people damning themselves because of it (e.g., see here and here). In this weekend’s film recommendation, Steven Zaillian’s A Civil Action, there’s no attempt to play around with or develop those clichés. Nonetheless, the true story from which this dramatization is lifted is more than enough to hold your attention.

John Travolta plays Jan Schlichtmann, a Boston-based personal injury lawyer. It doesn’t take long to develop an unflattering opinion of Schlichtmann: no sooner has he dismissed the charge of being a mere ‘ambulance chaser’ than he is distributing business cards to car crash victims as he passes by them on the street. There’s no question that Schlichtmann is in it for the money, as he’ll leap to consider the depths of his clients’ pockets—or those of his wretched opponents—far sooner than he will consider the probity of his legal arguments. He’s a money-grubbing lawyer of the scummiest kind.

Screen Shot 2015-08-26 at 22.52.03

Schlichtmann receives a phone call from the distressed mother of a recently deceased child. She entreats him to visit her and the parents of seven other recently deceased children—all taken by leukemia—in the nearby town of Woburn. Schlichtmann’s initial inclination is to decline because of the prospect of a paltry payout; it’s just not good business, as far as he’s concerned. But the suspicion of a huge payout from a big name corporation’s toxic dump upstream spurs him to take the case and pursue it feverishly.

After the initial premise is set, surprisingly little focus is then spent on the film’s original motivations, namely Schlichtmann’s efforts to uncover malfeasance and the thorny mismatch between his venality and his clients’ desire for no more than a formal apology.

Instead, the film’s pace and tone pivots to Schlichtmann’s sparring with the opposing counsel Jerry Facher, played by Robert Duvall. Duvall is as superb as expected, with an understated and unplaceably buffoonish villainy to his demeanor. Facher’s free time is spent lecturing at Harvard, where he delights in instructing his students on how to avoid the very traps in litigation that he has set for Schlichtmann. While Schlichtmann has flair and flourish, Facher has cunning and wile.

Screen Shot 2015-08-26 at 22.49.34

The conceit pitting these two lawyerly styles against one another doesn’t translate into the courtroom bombastics that might typically be expected from late-‘90s Hollywood. However, the juxtaposition of the two characters sets up a nicely developed theme, which recurs throughout the film, of the centrality of prestige and class in the law. It goes to show that it’s not so much the substance of the arguments, and in some instances it’s not even the skill of their delivery, that wins the day; sometimes, the gates remain closed simply because you’re just not cut from the right cloth to compete among the big boys (and boys is accurate—the supporting cast, though tremendous, is almost exclusively male). As Keith pointed out so well in his review of The Spy Who Came in from the Cold, even when at their most subtle these observations on class can be used to devastating effect: Facher has few scruples parading his old-money connections with the judge (a delightfully crabby John Lithgow) for all to see, just as Schlichtmann is evidently perturbed by his dull Cornell pedigree among the Harvard muckety-mucks.

Of course, all of this is merely a prelude to learning that the Woburn case isn’t really the film’s point at all. Rather, it’s Schlichtmann’s search for purpose and his journey toward redemption after his colossal abdication of moral sense at the film’s outset. That journey is troubled and arduous, and he has few compunctions with endangering the livelihoods of his partners in the process.

As mentioned, the supporting cast is a treat. It includes Sydney Pollack, Stephen Fry, William H. Macy, Kathleen Quinlan, Tony Shalhoub, Dan Hedaya, and James Gandolfini in a much more tender role than the macho kind for which he was traditionally associated (e.g., see my reviews of True Romance and In the Loop).