Bioethics and why I hope to live beyond age 75 attaining wisdom! — A rebuttal to Dr. Ezekiel Emanuel's 75 age limit

Journal/Website: 
Surgical Neurology International & HaciendaPublishing.com
Article Type: 
Editorial
Published Date: 
Wednesday, November 5, 2014
Source: 
http://surgicalneurologyint.com/surgicalint_articles/bioethics-and-why-i-hope-to-live-beyond-age-75-attaining-wisdom-a-rebuttal-to-dr-ezekiel-emanuels-75-age-limit/

For several decades, American bioethicists have been providing persuasive arguments for rationing medical care via the theory of the necessary "rational allocation of finite health care resources."(2) More recently, assisted by various sectors of organized medicine, they have developed multiple approaches to justify what they see as the necessary curtailment of services and specialized treatments deemed not medically necessary. The problem persists, though, and the need for rationing health services in increasingly socialized medical systems, including ObamaCare, requires more ingenious approaches, particularly in the U.S., where patients are accustomed to receiving the best medical care that third-party payers are willing to pay for, regardless of whether the payer is the insurance company or the government.(6)

Furthermore, government planners, supported by the ever-accommodating bioethicists, posit that with increasing longevity and augmentation of the population of American elderly, more drastic actions will be required to prevent the bankruptcy of the public financing of medical care. They believe therefore that outright government-imposed euthanasia, not only for the Bioethiciststerminally ill but also for the inconvenient infirm and the superfluous elderly, will become necessary.(1,4,8,10)

It is in this context that the individual-based, patient-oriented ethics of Hippocrates, including his fundamental dictum, "First Do No Harm," are seen as an obstacle by the bioethics movement. Obtrusive and in their way, time-honored medical ethics are being eroded and supplanted by the more convenient, collectivist, population-based ethics propounded by today bioethicists. As early as the 1980s, some bioethicists, including Daniel Callahan, then Director of the Hastings Center; Peter Singer, bioethics professor at Stanford University; and John Hardwick of East Tennessee State University, openly insisted that elderly patients who had lived a full life had a "duty to die" for the good of society and the proper utilization of societal health resources.(2) Dr. Callahan pointedly asserted, "Denial of nutrition, may, in the long run, become the only effective way to make certain that a large number of biologically tenacious patients actually die."(11) Likewise, Dr. Hardwick dropped all pretenses regarding their real intentions at about the time of the Clinton health care debate and the tentative formulation of HillaryCare, affirming a "duty to die" was necessary for those citizens whose lives had become not worth living because of chronic disease or advanced age.(7,10) Such openness was not well-received by the American people, and Hardwick's proposals were ignored, or like HillaryCare ostensibly discarded, thrown by the wayside. But appearances can be deceiving. Many proposals of the bioethics movement have quietly and gradually been implemented. Here is an insightful report by Pope Benedict XVI in his address to the Pontifical Academy for Life:

"Some ethicists warn that modern bioethics is in fact a new normative system of ethics that, based on principles of utilitarianism, can never be compatible with Natural Law principles. In the last few decades, bioethics has largely supplanted traditional, Natural Law-based medical ethics in hospitals and ethics boards in most western countries. Under traditional medical ethics, the guiding principle is 'do no harm.'  But contemporary bioethics abandons this…in an effort to find the utilitarian goal of the 'greatest good for the greatest number.'  Under these principles, preserving the life of the human patient is not considered paramount."(12) He is largely correct in his assessment. Moreover, the bioethics movement has recently received more impetus with President Barack Obama's creation of the Presidential Commission for the Study of Bioethical Issues.(9)

But their proposals have not all been fully implemented. To do so, today's bioethicists, although equally determined, are more subtle, and the foremost exponent of the new trend in bioethics is Dr. Ezekiel J. Emanuel.(3) Although 57 years of age and in good health, Dr. Emanuel says he hopes and wants to live to age 75 and die. He has lived a fulfilled and a good life and it is time to exit. After age 75, Emanuel claims life is a downhill spiral and not worth living. His family disagrees with him and says he is "crazy,"(3) yet the fact remains Dr. Emanuel is a respected bioethicist, the Director of the Clinical Bioethics Department at the U.S. National Institutes of Health, the recipient of numerous awards, but the danger here is he Creative Productivityencapsulates the views many bioethicists hold today. He insists that the productivity of creative people reach a peak at age 40 and plateau by age 60. In other words, after age 60, even productive people, create and produce little of value to society.(3) I beg to differ. In a recent conversation with my friend Dr. Russell Blaylock, who has also written on this subject,(1) he opined, "The reason very smart, creative people no longer produce earth-shattering discoveries later in life is because after their great accomplishments, they become department heads, drowning in administrative duties that prevent creative activities." I agree with Dr. Blaylock. Moreover, as we age and mellow and reach retirement, we also achieve satisfaction from a productive life well spent, and begin the contemplation and enjoyment of life that is only possible with the leisure that comes with retirement.

Dr. Emanuel, in stressing the relatively young age in which productive people reach the apex of their creativity, e.g., novelists, poets, and physicists, argues as if becoming poet laureates and Noble Prize winners were the universal aspirations of the average citizen. Most people do not aspire to reach those dizzying heights! The more realistic goals in life, instead, are more mundane, namely, fulfillment and contentment, qualities that are attained by being good citizens, and the satisfaction of leading good and productive lives; men and women performing their occupations and respective jobs, whether menial, artistic or intellectual, and doing them well — in short, being the best we can be in this transitory phase of our existence!Never too late to learn

In his article Dr. Emanuel writes that if we live longer than age 75, "we are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic."(3) And as far as suicide or euthanasia, Dr. Emmanuel claims he is against those options, although it escapes him logical reasoning will lead many people to pursue exactly those options when afflicted with depression, physical illness, or merely reaching that lethal age of 75 — or even worse. By which I refer to the State compulsorily implementing exactly those policies, purportedly as pragmatic and "sound" health care policies, when in fact they may be implemented for political expediency or budgetary considerations. This is particularly ominous when the State is involved in administering and funding medical care, as in socialized medicine or ObamaCare.(6,7)

In the same vein toward the end of his paper, Dr. Emanuel claims he is not advocating compulsory end of life at age 75 "in order to save resources, ration health care, or address public-policy issues," but that is exactly what he is inferring. In fact, in the next breath, he admits his proposals do have at least two policy implications and that these implications do refer to reducing life expectancy.(3)

Dr. Emanuel complains that Americans are obsessed with performing physical and mental exercises, undertaking diets, taking vitamins and supplements, "all in a valiant effort to cheat death and prolong life as long as possible."(3) In fact, leading healthy lifestyles and sticking to healthy diets are exactly what Americans should be doing, not only to prolong their lives, but even more importantly to improve the quality of their lives, while saving their own health care costs.

Mental Puzzles"Doing mental puzzles," which people have done to exercise brain function and which Dr. Emanuel derides,(3) may not exactly translate to the highest intellectual exercise. But not so other intellectual pursuits. I refer to reading and studying the classics of history and literature for their own sake; listening to good music in moments of contemplation for mere enjoyment; spending more leisure time with our families — in short enjoying all of those happy activities of leisure and exercising those fundamental virtues, which eluded us in our earlier, more active and hectic years of youth and adulthood. It is in our advancing years that we have the leisure to spend the time in just those intellectual activities that engage the mind and sooth the soul.

Others find happiness and satisfaction in doing what they have always done in life. This is particularly true of those who have answered a professional calling, who obtain intellectual rewards in continuing to practice their professions to the very end or until they are impaired by age or disability. That was the case with my father, a physician. It is the case, I suspect, with Dr. James I. Ausman, editor-in-chief of Surgical Neurology International, who at age 76 remains a scholar and an incorrigible multitasker and who seems to gather ever more speed in life as he gets older!

The key to meaningful longevity, then, is to remain active, exercising our intellectual faculties for their own sake, as well as for the preservation of brain plasticity. Dr. Emanuel admits the neural connections that are most utilized are reinforced and preserved, while those connections and synapses not used degenerate and atrophy. However, he is incorrect when he states that we cannot learn as we get older because no new neural connections and re-wirings are possible. Brain plasticity allows us to continue to learn well beyond age 75 for those who remain active, although it is true that in extremely advanced age, learning, creative thoughts, and memory retention become progressively more difficult as degeneration of neural connections and neuronal death take place.Plato and Aristotle

Thus, I am curious as well as perplexed. Has Dr. Emanuel ever had the interest or time to read Thucydides and Herodotus? I wonder if he ever read Plutarch, Livy, Virgil, or any of the poems of Sappho or Elizabeth Barrett Browning? I wonder if he ever read Plato, Aristotle, or understands the meaning of the Aristotelian good life, and the time and activities that are necessary for the attainment of real happiness and wisdom? The ultimate good life is not necessarily found in our hard-working, intensive, utilitarian, and productive years, but in our years of leisure and contemplation that in today's stressful and fast-moving society can be attained only in our advancing years. One can also spend those years continuing to fulfill the duties of citizenship, improving his/her communities, insisting on better government — e.g., preserving and increasing liberty — for one's children and grandchildren, hoping they live in a better world. In this sense, Dr. Emanuel's attitude reflects selfishness and lack of concern for the welfare of others around him or who may come after he's gone! Contrary to Dr. Emanuel's opinion about "faltering and declining" years past age 75, it is idleness, selfishness, and wasteful lives associated with diseases of the soul primarily that are the culprits for moral and intellectual decrepitude, rather than physical decline and reaching a certain capricious chronological age.

I'm not arguing here against individuals exercising their right to medical autonomy, especially those suffering from chronic disease and terminal illness. End-of-life decisions should be left to individual patients, their families, and their physicians. What I'm saying is that lives can be productive and fulfilling, worthy of living past age 75. I'm also cautioning bioethicists from propounding the utilitarian concept of "a duty to die" because a certain lethal age has been reached or chronic illness has become manifest. We cannot separate, nor does Dr. Emanuel distinguish, the process of aging from infirmity and illness. Certainly one leads to the other, and the duty to die at age 75 becomes the duty to die at any age, once a life is deemed not worth living. Death then is prescribed by the government planners and the doctors and bioethicists employed by the State, whether one reaches a certain age or is afflicted by illness.(1,4,8-11)

With the advances in medical care, life expectancy has been prolonged and the quality of life has been made immensely better. Yet, Dr. Emanuel argues: "Since 1960, however, increases in longevity have been achieved mainly by extending the lives of people over 60. Rather than saving more young people, we are stretching out old age." Furthermore, he asserts this is wrong because we are saving the life of older people with a myriad of medical problems and residual disabilities.(3) While, I admit this is partly true, many of these people can be returned to normal or near normal life with proper medical and nursing care. Moreover, medical and Judeo-Christian ethics, not to mention the lessons of history, have taught us that we should treat with compassion the sick and the most vulnerable segments of our society. Societies that do not do this descend into cruelty and barbarism. Once again, we must recollect the lessons of fairly recent history.  Dr. Leo Alexander at the Nuremburg TrialsDr. Leo Alexander, the leading psychiatrist and Chief U.S. Medical Consultant at the Nuremberg War Crimes Trials, in his classic 1949 New England Journal of Medicine article described how German physicians became willing accomplices with the Nazis in Ktenology, "the science of killing." This was done, we learn, for the good of German society and the improvement of "the health of the German nation." And in this light, Dr. Alexander asked the critical question: "If only those whose treatment is worthwhile in terms of prognosis are to be treated, what about the other ones? The doubtful patients are the ones whose recovery appears unlikely, but frequently if treated energetically, they surprise the best prognosticators." Once the rational allocation of scarce and finite resources enters the decision-making process in the doctor's role as physician, the next logical step is: "Is it worthwhile to do this or that for this type of patient," or for those who have reached a certain age?(5)

As much as Dr. Emanuel insists he is against euthanasia, his arguments lead inexorably to utilitarian ethics, the idea of lives deemed not worth living, and ultimately to euthanasia. Under the utilitarian ethics of the rational allocation of resources, productive lives whose only merit was considered benefit to society, Hitler issued his first order for active euthanasia in Germany on September 1, 1939. And yet it must be pointed out the road to euthanasia was paved before the Nazis came to power. German physicians in the social democracy of the Weimar Republic, as early as 1931, had openly held discussions about the sterilization of undesirables and euthanasia of the chronically mentally ill. So when the National Socialists (Nazis) came to power, "humanitarian" groups had already been set up, ostensibly for the promotion of health. These misguided groups with arguably "good intentions" had taken the first steps and were very useful serving as cover for the subsequent Nazi mass-killing program. And so it was that years before the onset of World War II and the Final Solution had been implemented, 275,000 non-Jewish citizens were put to death in Germany's "mercy-killing" program. From small beginnings and seemingly "well-intended" proposals, the values of the medical profession as well as an entire society were (and may be again) subverted by deliberately evil or misguided, well-intentioned men working in tandem with the State. Dr. Alexander was correct: "Corrosion begins in microscopic proportions."(5)

In conclusion, the resurgent bioethics movement — stressing "futility of care," conservation of resources, and "the duty to die,"  while rejecting Hippocrates' dictum of "First Do No Harm" and refusing to stand for what is in the best interest of the individual and the dignity of human life — is transmogrifying the time-honored, individual-based, patient-oriented medical ethics of Hippocrates into a collectivist, population-based ethic derived from the current thinking of the bioethics movement in the United Kingdom and most of Europe, as well as the United States. This resurgent ethic, presently propounded with subtle and dissimulating persuasion, is particularly well exemplified by Dr. Ezekiel Emanuel, today its foremost proponent. This bioethics "duty to die" movement is buttressed by a utilitarian, population-based ethic concerned primarily with the conservation of resources in the administration of socialized medicine by the State, rather than with the individual patient — and represents the first step down the slippery slope of determining who lives and who dies, rationing by death, and euthanasia. Doctors, patients, and the public at large must be made aware of the direction present society is headed.

References

1. Blaylock RL. National Health Insurance (Part II): Any Social Utility in the Elderly? HaciendaPublishing.com, September 26, 2009.

2. Callahan D. Setting Limits, Medical Goals in an Aging Society. New York: Simon and Schuster, 1988.

3. Emanuel EJ. Why I Hope to Die at 75: An argument that society and families — and you — will be better off if nature takes its course swiftly and promptly. The Atlantic, September 17, 2014. 

4. Faria MA. Bioethics — The Life and Death Issue. HaciendaPublishing.com, October 24, 2012.

5. Faria MA. Euthanasia, Medical Science, and the Road to Genocide. Medical Sentinel 1998;3(3):79-83

6. Faria MA. Getting US in line for ObamaCare and medical rationing. GOPUSA.com, March 18, 2010.

7. Faria MA. ObamaCare: Another step toward corporate socialized medicine in the U.S. Surg Neurol Int 2012;3:71.

8. Faria MA. Slouching Towards a Duty to Die. Medical Sentinel 1999;4(6):208-210. 

9. Faria MA. The road being paved to neuroethics: A path leading to bioethics or to neuroscience medical ethics? Surg Neurol Int 2014;5:146. Available from: http://www.haciendapub.com/articles/road-being-paved-neuroethics-path-leading-bioethics-or-neuroscience-medical-ethics [Last accessed on 2014 Oct 7].

10. Smith WJ. Culture of Death: The Assault on Medical Ethics in America. San Francisco, CA, Encounter Books, 2000.

11. Wickham ED. Repackaging Death as Life — The Third Path to Imposed Death. Presented at the Annual Life Conference Raleigh, North Carolina, October 23, 2010. Citing Bioethicist Daniel Callahan, 1983, "On Feeding the Dying," Hastings Center Report 13(5):22.

12. Wickham ED. Repackaging Death as Life — The Third Path to Imposed Death. Presented at the Annual Life Conference Raleigh, North Carolina, October 23, 2010. Citing Pope Benedict XVI's 2010 address to the Pontifical Academy for Life.

Written by Dr. Miguel A. Faria

Miguel A. Faria Jr., M.D. is Associate Editor in Chief and World Affairs Editor of Surgical Neurology International. He is a former Clinical Professor of Neurosurgery and Adjunct Professor of Medical History. Dr. Faria is the author of Cuba in Revolution — Escape From a Lost Paradise (2002). He has written numerous articles on the blessings of liberty and the venalities of totalitarianism, collectivism, and communism — all posted at his website: www.haciendapub.com & www.drmiguelfaria.com

This article can be cited as:  Faria MA. Bioethics and why I hope to live beyond age 75 attaining wisdom! — A rebuttal to Dr. Ezekiel Emanuel's 75 Age limit. HaciendaPublishing.com, November 5, 2014. Available from:  http://surgicalneurologyint.com/surgicalint_articles/bioethics-and-why-i-hope-to-live-beyond-age-75-attaining-wisdom-a-rebuttal-to-dr-ezekiel-emanuels-75-age-limit/ 

 Copyright ©2014-2016 Miguel A. Faria, Jr., M.D.

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Nevertheless, aging brains, dropping IQs...

Does IQ change over time? By Alex K. Chen

Yes, though there is considerable debate over the timing of the effects. Unfortunately, fluid intelligence tends to decrease with time, starting in either one's 20s or 30s. Average raw IQ scores decrease with age, though the average IQ at older ages stays at 100 because IQ tests are normalized for each age. Crystallized intelligence, however, is stable over time.

IQ change

There is disagreement over when the decline begins, however. Robert Epstein cites some declines that start in the mid-teens [1]. Timothy Salthouse says that the declines begin in the 20s, as shown by the figure below [2]. [3] says that the declines only begin in the 30s. There are some measures, like working memory, that can still improve in one's 20s [4]. It's entirely possible that some components of cognition can start to decline even before other components of cognition finally peak. After all, it's much harder for people to learn a new language after puberty - but that's well before the age when people's fluid intelligence finally becomes to decline.

There seems to be a general consensus that it's all downhill from the 30s, however.

What about physiological changes? Dendritic pruning in the brain still occurs during one's 20s [5]. But eventually,  the human brain shrinks over time [6]. After mid-age, the transcriptome of the brain also starts changing towards an older state. [7].

Bell CurveKeep in mind, though, that there is a significant amount of variability in the rate at which cognition declines (much of it probably due to lifestyle effects). Some older individuals have brains that are still as sharp as those who are several decades younger (Secrets of 'SuperAger' brains: Elderly superagers have brains that look and act decades younger than their age ). But that doesn't mean that they were as sharp as they were when they were in their 20s.

================

 Notes

[1] In the 1940s pioneering intelligence researchers J. C. Raven and David Wechsler, relying on radically different kinds of intelligence tests, each showed that raw scores on intelligence tests peak between ages 13 and 15 and decline after that throughout life. Although verbal expertise and some forms of judgment can remain strong throughout life, the extraordinary cognitive abilities of teens, and especially their ability to learn new things rapidly, is beyond question. And whereas brain size is not necessarily a good indication of processing ability, it is notable that recent scanning data collected by Eric Courchesne and his colleagues at the University of California, San Diego, show that brain volume peaks at about age 14. By the time we are 70 years old, our brain has shrunk to the size it had been when we were about three.

[2] The problem of conceptually regarding cognition as a unitary entity by claiming the early cognitive decline becomes obvious in the data Salthouse (2009) presents. The data depicted in Figure 2 do not reveal a coherent unitary picture. For spatial visualization, the decline seems to start early as stated by Salthouse, but it should be acknowledged that the decline seems to be limited to 20–35 years of age. The same holds true for reasoning, at least for two of the three reasoning measures. For memory, it should first be observed that the decline is surprisingly modest for all three measures. If anything, it seems to be a decline between 25 and 35 years of age, whereas for other ages, the decline is relatively meager. For speed, the decline is early and linear across later ages, but it is not as early as Salthouse wants it to be. It starts at 30 years rather than 20.

[3] Working memory, however, can increase even up to age 30 (and does not decline as quickly) Another key pattern is that there was a peak in working memory capacity in 30-year olds. Previous research only examined working memory growth up till 25 years and had indicated that working skills reached maximum capacity in the teenage years. The present study revealed that working memory continues developing even in our twenties, reaching peak performance in our thirties

[4] These distinctive patterns in the trajectory and decline of working memory skills suggest that while working memory and fluid intelligence may share neural substrates, they have dissociative cognitive profiles across the lifespan. Compared with IQ , the growth of working memory occurs more rapidly and the decline more slowly, with functioning in those in their sixties similar to those in their twenties

[5] Dendritic pruning happens up to one's 20s. We confirm that dendritic spine density in childhood exceeds adult values by two- to threefold and begins to decrease during puberty. However, we also obtained evidence that overproduction and developmental remodeling, including substantial elimination of synaptic spines, continues beyond adolescence and throughout the third decade of life before stabilizing at the adult level. Such an extraordinarily long phase of developmental reorganization of cortical neuronal circuitry has implications for understanding the effect of environmental impact on the development of human cognitive and emotional capacities as well as the late onset of human-specific neuropsychiatric disorders.

[6] Surprisingly, the chimpanzee brain is largely spared of these effects.

The team used MRI scanners to measure the sizes of a number of brain regions in both humans and chimps. The differences were striking: While chimps showed no significant age-related shrinkage in any of the regions measured, all of the human brain regions showed dramatic age effects, the team reports online this week in the Proceedings of the National Academy of Sciences. Some regions shrank as much as 25% by 80 years of age.

Moreover, the pattern was somewhat different for human gray matter, which contains the nerve cell bodies and their nuclei, along with auxiliary cells such as microglia, and human white matter, which consists of the long neural axons and which makes the connections between different brain regions.

For example, the gray matter of the human frontal lobe shrank an average of about 14% between the age of 30 and 80, and the gray matter of the hippocampus about 13% over the same period. But shrinkage of white matter was even more severe: The white matter of the frontal lobe shrank about 24%, similar to the white matter volume decrease in most other brain regions measured.

Moreover, unlike the gray matter, which showed a more gradual shrinkage over time, the decline in white matter was most precipitous between the ages of 70 and 80. So although the average decline in the frontal lobe was 24% at age 80, it was only about 6% at age 70. So why do chimpanzees make it through their entire normal life spans without significant brain shrinkage, whereas the human brain appears to wither with age?

Alex K. Chen is a Top Writer and Most Viewed Writer in Neuroscience (2013-2015) Quora.com (February, 2014)

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There is a definite correlationbetween SAT and GRE scores and IQs, at least an 80% correlation.---MAF

The Emanuel Brothers!

The interesting thing is that if Dr. Ezekiel Emanuel had proposed 85 years, as the age of voluntarily beginning to decline treatment, it would have been more difficult, if not impossible, to rebut given what we know about compression of morbidity.

But Dr. Emanuel seems to have been more interested in saving money for the government for the utilitarian success of ObamaCare, for which he is partially responsible, than in analyzing neurophysiology and morbidity and mortality valid data to make a more objective biological assessment. We also have to consider whether his "voluntarism" is genuine given the Democrats' penchant for compulsion as in ObamaCare.

Meanwhile, his brother Rahm, mayor of Chicago, the new crime capital of the United States, is insisting in turning Chicago into a Sanctuary City and attract even more crime!

Bioethics, Aging & the Future of Medicine

Bioethics, Aging & the Future of Medicine

from the SNI Newsletter, March 12, 2015

...In its ongoing effort to examine controversial subjects, Surgical Neurology International (SNI) explores a recent paper on limiting life to the age of 75 by Dr. Ezekiel Emanuel. Dr. Miguel Faria, an Associate Editor in Chief of SNI, in his Editorial, "Bioethics and why I hope to live beyond age 75 attaining wisdom!: A rebuttal to Dr. Ezekiel Emanuel's 75 age limit," provides a response to "the government planners, supported by the ever-accommodating bioethicists, who posit that with increasing longevity and augmentation of the population of American elderly, more drastic actions will be required to prevent the bankruptcy of the public financing of medical care. They believe, therefore, that outright government-imposed euthanasia, not only for the terminally ill but also for the inconvenient infirm and the superfluous elderly, will become necessary."

This subject is a very important one for physicians and neurosurgeons to understand, as it has major implications for the practice of medicine. Recently, Dr. Ezekiel Emanuel, whose paper was quoted by Faria, proposed this idea. Emanuel stated that people should not be allowed to live beyond the age of 75, as they are no longer productive for society, and consume resources needed by those younger. Emanuel is one of the architects of Obamacare...

James I. Ausman, MD, PhD,
Editor in Chief, Surgical Neurology International (SNI)

See the full editorial entitled "Bioethics, Aging & the Future of Medicine" by Dr. James Ausman under Articles

P/S. On March 1, SNI celebrated completion of its 5th year of publication. In that time, SNI and its publications have grown to reach 30,000 individual readers a month, in 223 countries and territories. SNI publishes nine supplements, on topics ranging from spine and stereotaxis to neuroscience nursing. It has the highest circulation of any journal in its field. Our thanks to you, our readers, for this success. — JIA 

My kudos to Dr. Jim Ausman for his fantastic achievement in presenting such an array of scientific articles month after month and the reflected and growing international readership of SNI by neurosurgeons, neuroscientists, and the informed general public. And for supporting my article in the Newsletter — MAF



Colombian Salsa!

"Dr Tim Wheeler: Hi old friend Miguel,

"I almost didn’t read your article because of the irresistible distraction posed by the video of the colombiana salsa dancer on the right side of the page. How is a man supposed to get anything done with that in front of him? My roommate in college was from Bogotá, and his friends were always trying to get me to dance at parties. It was a lost cause, because even though I am musically inclined, that sadly does not translate to anything like being able to dance. I do believe Colombian women, and maybe all south American women, have a natural talent for it.

"Anyway, I became aware of Rahm Emanuel's brother with his now-infamous article, the subject of your response. His denials of his own support for euthanasia and suicide ring hollow indeed. Your article is well thought out and well documented; as you write, this is a road that western civilization has been down before, with terrible results.

"You might be interested in the book review I wrote for the Claremont Review of Books some years ago, 'Unworthy Lives and Unalienable Rights'. It's a review of Wesley Smith's book "Culture of Death", which you cite as a source. It addresses many of the same issues..."

Dr. Miguel Faria replies: Dear Tim, That Fransini Giraldo is truly fantastic! Isn't she? With all the bad and disconcerting things in the world, as my grandfather used to say, "it is good to have a harmless consolation!"

Thank you for the words of encouragement and advice, as always. I used to subscribe, and did so for many years, to National Review. I even had a brief correspondence with Bill Buckley in his heyday, but with the years I lost track of the publication. I became dissatisfied with several stands taken by National Review. Finally with their attack on Thomas Jefferson written by Conor Cruise O'Brien (1917-2008; of UN Katanga infamy fame), I ceased subscribing. It was a fabulous publication and I still keep old issued spanning two decades.

It is ironic, that after reading dozens of tomes and biographies over the years, and becoming much more acquainted with intimate details of the Founding Fathers, I had to accept and admit that some of the criticisms of Jefferson in National Review (at least those by John O' Sullivan and Forrest McDonald) were factually correct and that I was wrong. I wrote a letter that was published (lost now), and if it ever resurfaces to the light of day, I will probably retract it!

Timothy W. Wheeler, M.D. is the Director Doctors for Responsible Gun Ownership — A Project of the Second Amendment Foundation
P.O. Box 1931
Upland, CA 91785-1931
web http://www.drgo.us

Miguel A. Faria, Jr., M.D. is the Director of Haciendapub.com

Anti-aging pill and a herd of sheep!

"There are over a thousand comments from readers of Dr. Ezekiel's column and I have read a few hundred of them. But few add anything significant to the discussion over whether the pursuit of living an extra 30 years is pointless or not.

"One thing that does stand out from all the comments Dr. Emanuel's article initiated is that there appears to be a collective mind about longevity; that humanity needs to march in lock-step together or not proceed at all; that since any anti-aging technology is likely to require public-pooled money, the decision to approve and offer anti-aging pills needs to be voted on by the population as a whole or least convince the public's representatives to vote for them...

"Those bioethicists dispatched by government, like Dr. Emanuel Ezekiel under the Obama regime and Dr. Leon Kass under the Bush II era, appear to be appealing to the public to die on time so government won't get caught short in delivering pension checks and paying for healthcare. Bioethicists writing from a purely moral/social viewpoint appeal to the unfair access and delivery of any anti-aging technology.
'
"It is ironic in this 'aging is optional' era that a health care planner like Dr. Ezekiel would propose voluntary "expiration dates" for humans. One wonders how he would accept an anti-aging pill. The first human study of an anti-aging pill that tabulates an accepted measure of mortality (red blood cell width) is underway with results due to be reported in late 2014. What then? - ©2014 Bill Sardi, ResveratrolNews.com

Bill Sardi, managing partner
Resveratrol Partners LLC, dba Longevinex

From "In an Era of Anti-Aging pill will the Next Generation of Humans Come with an Expiration Date." Resveratrol News, Sept. 24, 2014

Socrates on old age

This account comes from Plato's Republic, Book I, Dialogue in the house of Cephalus at the Peiraeus

"And this is a question which I should like to ask of you who have arrived at that time which the poets call the 'threshold of old age' — Is life harder towards the end, or what report do you give of it?

"I will tell you, Socrates, he said, what my own feeling is. Men of my age flock together; we are birds of a feather, as the old proverb says; and at our meetings the tale of my acquaintance commonly is — I cannot eat, I cannot drink; the pleasures of youth and love are fled away: there was a good time once, but now that is gone, and life is no longer life. Some complain of the slights which are put upon them by relations, and they will tell you sadly of how many evils their old age is the cause. But to me, Socrates, these complainers seem to blame that which is not really in fault. For if old age were the cause, I too being old, and every other old man, would have felt as they do. But this is not my own experience, nor that of others whom I have known. How well I remember the aged poet Sophocles, when in answer to the question, How does love suit with age, Sophocles, —are you still the man you were? Peace, he replied; most gladly have I escaped the thing of which you speak; I feel as if I had escaped from a mad and furious master. His words have often occurred to my mind since, and they seem as good to me now as at the time when he uttered them. For certainly old age has a great sense of calm and freedom; when the passions relax their hold, then, as Sophocles says, we are freed from the grasp not of one mad master only, but of many. The truth is, Socrates, that these regrets, and also the complaints about relations, are to be attributed to the same cause, which is not old age, but men's characters and tempers; for he who is of a calm and happy nature will hardly feel the pressure of age, but to him who is of an opposite disposition youth and age are equally a burden."

This is, like Book VII, Plato at his best, and as good a summation of real life as philosophy can describe by actual experience, rather than Plato's otherwise idealizations and development of his Ideal State conceptualized, for example, in Books II - VI of the Republic, the best governed State protected by his idealized, virtuous Guardians and ruled by his self-denying philosopher-kings — MAF



Diary of Dreams performs at the 2016 M’era Luna festival in Hildesheim, Germany. M’era Luna, “one of the biggest dark music events in Germany,” is held each year on the second weekend in August. Close to 25,000 people attend the festival annually to hear gothic, metal and industrial music performed on two large festival-style stages.