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Biblical Reflections on Modern Medicine

Vol. 11, No. 2 (62) 


More on Feeding Tubes and Letting Die


Discerning Principles That Apply to the Situation

Note: My article on feeding tubes in last month's issue prompted the following letter to which I respond here.

I appreciated your last Reflections. As a surgical oncologist, I deal continuously with the issues of feeding tube placement. In residency, I was taught that it was "immoral" to keep someone alive on the tube, so we would refuse to put them into our advanced head and neck cancer patients, who you knew would not be surviving their cancer. 

Private practice seems to dictate matters differently. I occasionally have them placed (or do it myself), if I anticipate feeding to be only a temporary hurdle. As an example, most esophageal cancers (85-90 percent) will respond nicely to chemotherapy preoperatively, but are generally malnutritioned. Thus, it is easy to justify nutritional support via a jejunostomy (part of the small intestine just below the stomach) tube, until completion of chemotherapy. Of course, if the chemotherapy does not work, we stop the tube feeding, and we do not operate. It would not improve their prognosis at all.

There is a state home in close vicinity to our hospital which cares for the advanced and profoundly retarded person, who is generally abandoned by the family or develops "overwhelming" care for a family to provide. They stay at Ranier school for the remaining 50-60 years of their lives. Often, their state-appointed guardians demand feeding tubes to keep them alive, or to allow feeding without aspiration. These guardians are sometimes well-meaning Christians. They decide that either personal, state, or God-given obligation is to provide virtually everything possible to maintain every breath of life possible for these poor people.

I have serious misgivings about being aggressive with tube placement in these settings. As pro-life as I am, my personal moral obligations are not well defined about these people. I would like to hear more from you on this subject. What are our obligations to the profoundly retarded? How do we, as Christians, decide which interventions are legitimate, and which are not? Are personal circumstances influential, such as personal family support?

For example, Dr. _______ _______ has a profoundly retarded adopted daughter, constantly requiring medical care, paid for by the state because he is in the military. Is this situation any different?

Ed's Answer

First, feeding tubes should rarely be placed in anyone unless it is a temporary measure; for example, as the oncologist has chosen to do for patients with esophageal cancer.

Second, the applicable principle is that food, water, and air by natural routes should never be denied to anyone. 

Third, the moral imperative for any procedure, medicine, or surgery is the probability that the patient's medical condition will be improved. Surely, no one would argue for some medical thing that does not or only minimally improve(s) the patient's health status. 

Fourth, medical care should prolong life for well-defined reasons, not as an end in itself. For example, there may be legal proceedings that need to be carried out that would simplify estate concerns for the family.

Wrong Situations

A recurring theme on these pages is that "There are no right answers for wrong situations." Were it not for the state sponsorship of medical care, most feeding tube issues would be resolved on an economic basis alone -- few could afford them. "Ah!" I hear the cry. "What a heartless person you are to let people die simply because they cannot afford it."

Well, I suppose that I will just have to stand with the Apostle Paul and His God. "If anyone will not work, neither will he eat" (II Thessalonians 3:10). Food is a far more basic need of life than medical care!

In conjunction with this principle, the state has no business in welfare and medical care. The state does have a limited role in public health, but there is nothing in the Bible that can be construed as state provision of these "needs." Charity is the role of the individual, society, and the Church. (By "society," I mean organizations that are organized specifically to provide such needs to people.)

What About the "Profoundly Retarded"?

The above principles apply here, as well. The family and the church are primarily responsible for the invalid and infirm, whatever the age. Has not the Church recognized this ministry throughout the centuries -- until the advent of the modern welfare state?

The physician above who is in the military is in a specific situation where the government has included, as part of his contract for military service, the provision of medical care for himself and his family. He is "working," and therefore, his family may "eat." That one member is "profoundly retarded" is not relevant.

These principles cover all the issues raised by the oncologist. However, can we say anything about the placement of tubes in the state home, even though it is a "wrong situation?"

Perhaps, we should modify Dr. Terrell's statement to "There is no right answer to many (most?) wrong situations." The above principles can answer the problem of feeding tubes in spite of the wrong situation of a state-run home. A feeding tube is an "unnatural route" and does not change the health status of the patient. Further, it only prolongs the inevitable.

I trust that I have covered all the issues brought forth by the oncologist. But, he and other readers may have further questions, as this subject has its own complexity.

Proceed with Caution

"A young man developed a sore throat. He went to his physician who prescribed penicillin for the inflammation. The sore throat promptly disappeared. Three days later, however, he developed itching and hives all over his body. A physician correctly diagnosed penicillin reaction and prescribed antihistamines. The hives went away.

"The antihistamines caused the patient to be drowsy so that he cut his hand while at work. He went to his company's nurse who put some anti-bacterial salve on the injury. The salve contained penicillin and caused the hives to return.

"Recognizing a possible serious anaphylactic reaction for the second time, his physician then prescribed corticosteroids (a form of cortisone). The hives again disappeared.

"Unfortunately, the patient developed abdominal pains and noticed blood in his stools. The correct diagnosis was the made of a bleeding peptic ulcer, brought on by the cortisone. The patient failed to respond to standard measures to correct the hemorrhage, so the next course of action was a partial gastrectomy. The surgery was successful. The stomach pains diminished and the bleeding stopped.

"The patient lost so much blood due to hemorrhage and the stomach surgery that a transfusion was indicated. He was administered two pints of blood and promptly contracted hepatitis, as a result of the transfusion.

"Being young and vital, he recovered from the hepatitis. However, at the point of insertion of the transfusion needle, painful red swelling appeared, indicating a possible infection.

"Having had previous bad experience with penicillin, the drug of choice for this infection became tetracycline. The infection promptly subsided. 

Disruption of the intestinal bacteria by the tetracycline caused painful abdominal spasms and severe diarrhea. The patient was then administered an anti-spasmodic drug, and the diarrhea and spasms subsided.

"Unfortunately, this drug was bella donna, or muscle-relaxant group of drugs which relaxed the smooth muscles all over his body. From this action on the muscles of the iris of the eyes, it impaired the patient's vision. He drove his car into a tree and was killed instantly. This is a true story!" (From the Nassau County Nursing Society magazine, a reprint of an article by Dr. Tushkin (sp?) in The Myth of Modern Medicine. Found on a page stamped with Vaccine Research, Northbrook, IL.)

Ed's comment: I have my doubts that this story is true. If it is, it is from more than 35 years ago, when penicillin and tetracycline comprised most of the antibiotics available. Nevertheless, it illustrates colorfully how "treatments" are often disease-causing agents of harm and destruction. And, it all started with one of my pet peeves, an antibiotic for a sore throat!

Terrell's Treatises

Plowing Up Medicine One Furrow at a Time

Hilton P. Terrell, Ph.D., M.D.

Ed's note. The following was originally published in the Agrarian Steward, January 1998. Slight modifications have been made for differences in readership. It is published with the permission of the editor of the Steward, David Rockett, and the author.

It seems unlikely to me that there would be any readers of the Agrarian Steward who are less knowledgeable of agrarianism than I am. At first, my fascination was morbid -- are these people Luddites? Do they not believe in taking dominion over creation, under God, as Genesis 1:28-30 and Psalm 8:3-8 indicate? Are they captive to the pantheistic environmentalism rooted in the land?

Reflection with some friends interested in and knowledgeable of agriculture, economics, and civil government has dispelled much of the morbidity of my fascination. The efficiency of many modern specializations is attenuated with a broader view of their costs. Many monetary costs and liberty interests are omitted. I have never seen included in agricultural costs the price of maintaining an intimidating standing military to dissuade upstarts from depredations, even among themselves.

We may not send gunboats up Chinese rivers today, but we send Desert Storm to Arab principalities. Also, I never see inclusion of costs of the oppressive and expensive regulatory apparatus which measures the diameter of peaches lest they be called peaches when they are too small. (Do they then become pecans?) The Japanese have been reported to measure the gap around the doors of imported cars, rejecting those with too great a variance. Clearly, Japanese buyers are as stupid as American, requiring a bureaucrat to examine car doors. Perhaps, the bureaucrats slam the doors and kung fu kick the tires for them, also.

An example of the human cost of some efficiencies is the use of machines to do labor that humans could, and would, were they not priced out of the labor market by minimum wage, child labor, "safety," and other laws which are designed to accomplish just that exclusion. Overarching everything is the manipulated world fiat money system, which imposes an immense cost upon agricultural and other efficiencies and pressures toward environmental damage.

A babe in such matters, I have noted nonetheless that they seem to resonate with matters in my own vocational calling - medicine. About 30 years ago, American medicine was lamented as a "cottage industry." One was encouraged in the image of unkempt peons carding wool with a brush in dingy cabins, lit with smudge pots. Who would want medicine like that? The centrists were doing the necessary verbal engineering to clear the way for an industrialization of medicine, which is now well advanced.

While I remain guarded about agrarianism at its agricultural center, I believe that medicine should be the quintessential cottage industry. Centralization and standardization of medicine are a disaster. Health is ineluctably subjective. Determination of the success of a treatment is idiosyncratic. If the patient is not satisfied with the outcome, no "objective" measure can veto his dissatisfaction. 

A core concept in modern medicine is that disease is caused by an objectively observable derangement in some aspect of the body's machinery. It has been a powerful concept, but its reach has exceeded its grasp. Witness the persistent popularity of various "syndromes" (e.g., irritable bowel and chronic fatigue syndrome) which collect the substantial residue of people who feel ill yet without demonstrable objective pathology. Witness the nearly half billion annual visits by adults in the U.S.A. to providers of non-standard medical care - a $12 billion enterprise. These practitioners and their patients often risk real penalties from the mainstream monopoly.

Rather than a physician and a patient having a conversation, a shared understanding of what the problem is and how it is to be approached, a common cultural background, and a mutually satisfactory business aspect, we have hordes of watchers deciding what they thought the problem was and how it should, and should not, have been solved. They never see the patient; most have no vocational calling whatsoever directly in healing. 

They do not know the patient's aspirations, hopes, or fears. They make the decisions by algorithms, by phone, from air-conditioned comfort, and from nine to five, holidays excepted. They sent box-checkers out to peruse written records. They follow the holy rule that if something was not written down, it did not happen. (I have often been tempted to ask those who make that asinine assertion what they do about their constipation, since I seriously doubt that they keep a stool record!)

How does a nurse capture in words the haggard look of a sleep-deprived mother with three sick children. From her observations, she discerns that the mother could only absorb the most elemental of instructions. Yet, the box-checker dings the nurse for failing to write down that she warned the mother about common side effects. No matter that the mother knows them already from previous encounters and common sense. If the nurse attends to the documentation rather that to the patient, actual care suffers, while the record looks more impressive.

The enslavement characteristics of Medicare almost beg description. Medicare has to be notified even if the treatment is one that Medicare has already said it will deny. "Sell" the patient a treatment that Medicare believes is worthless and risk prosecution. Every diagnosis has to be transformed into a numerical code from a book (on which the American Medical Association makes an enormous profit) containing thousands of such codes, presuming thereby the whole medical model. Errors are not merely errors; they are potential felonies. The patients are the cattle and the medical "professionals" are the cowboys. The state is the owner. "Git along, little doggie"!

It seems to me that the agrarian viewpoint supports return to a cottage industry of medicine. The medical industry will go down swinging, but it seems to me to be wobbling on its feet already. Those in the medical industry will have to release their grip on the money and power that has flowed from their handlers. That is becoming easier since the handlers have had to become more niggardly in their distributions. Having promised extravagant medical goodies to voting blocs, they have trouble supplying them.

Underlying the "shortage" is the error of complete objectification of medicine. In an objective sense, we have never had more medical care than we have in the nation at this time. Yet, patients are more dissatisfied, perhaps, than ever. Unseen at the bottom of this black water river of dissatisfaction is the failure to see the individuality, the personality, and the particularity of the context of each medical encounter.

Those who can, objectify look at the river at an angle that allows no penetration. Those who look straight down in the water can see the human being with a name, a family, a calling, a history that extends way beyond the typical medical history. No I.D. number.

That desire of the sick to connect with his healer is quite powerful enough to overrule all the medical industrialists. I will live to see the cottage industry revive, God willing!

Of Vaccines, Viruses, and (Scientific) Vanity*

A fascinating story, well told, appeared in the February 2000, Atlantic Monthly (pp. 68-80). (See brief note on same article in January 2000 Reflections). Forty years ago, the live poliovirus vaccine was discovered to contain in nearly every dose a contaminant virus from monkey kidney, known as SV40. Ninety-eight million Americans received the contaminated vaccine during the 8 years that it was distributed, including this writer.

Hasty studies done quietly decided that the virus was innocuous, as many such viruses are thought to be. Existing stocks of contaminated vaccine were used up for two years, lest the public be shaken in its confidence in that vaccine by a withdrawal. Once the contaminated lots were consumed and clean lots available, the matter, it seemed, was closed. In recent years, however, the wound has reopened, as suspicions have arisen that the virus is not innocent.

Using new techniques, some researchers have found SV40 virus actively present in rare cancers of the lining on the outside of the lung, one form of bone cancer, and some childhood brain cancers. Some of these cancers, though still quite rare, have been noted to have increased in their frequency. The virus has been found to have some peculiarly efficient capacities in degrading a cell's natural cancer-fighting ability. It also may now be passing from mother to child and from person to person among those who received the contaminated vaccine.

Aside from the molecular biology, the story offers a believable view of how a supposedly objective scientific establishment actually works, with very human disputes over what should be published and who funds what. In particular, a defensive palisade tends to form around any information which would threaten the infectious disease cartel. (A cartel more dangerous than the "drug cartel"?) It would not work to have a public become fearful of the idea of mass, mandatory vaccinations. 

Therefore, the standards for what is scientifically true at this point are raised exceedingly high, which is the present hurdle for the connection between SV40 and cancer. For items which benefit the cartel, the standards can be as low as need be. As example, zanimivir, an inhaled drug to treat influenza, has been approved by the Food and Drug Administration (FDA), despite the fact that symptom improvement was not statistically different from placebo (from the package insert for the drug, RelenzaTM).

* Consider yourself an astute reader, if you immediately connected "vanity" with the Preacher of Ecclesiastes! In modern times, he would be preaching about science, as the foremost vanity of our day.

Truth in (Christian) Advertising

Ben Kinchlow and Madeline Balletta are advertising nutritional products apparently connected with honeybees (World [Magazine], February 26, 2000). The advertisement is vague and testimonial in nature, probably due in part to the oppressive rules of the FDA. Scripture is quoted (Psalm 139:14), and God is credited with providing a "super food" which is not specifically named. Coffee and chocolate are criticized as "artificial" and "not healthy."

Odd, coffee and chocolate both come from natural beans. This new product, whatever it is, comes in capsules, which seems "unnatural." The advertisement reminded me of a promotional campaign around 1960 which advertised a lipstick containing "royal jelly of the queen bee." The actual content of "royal jelly" was about 0.04 percent. Something about bees must make a business buzz (pun intended!).

God constrains us to be truthful witnesses of both His revelational truth, as well as what we observe. We need to be careful with our claims regarding observations, since our perceptive faculties are sometimes faulty. One wonders on what observational basis these professing Christians offer "dramatic" changes in vitality, energy, illness, and mental alertness. No one can gainsay the testimony of another's subjective sensations.

Yet, more than one's own experience would be required to imply that other people will also respond that way. While there is no valid excuse for the heavy regulatory hand of the FDA, as the filter of all truth, Christians need to practice discernment and self-governance in making and accepting claims unless they have some appropriate observational substantiation. While a political freedom to sell snake oil is desirable, snake oil is still snake oil. Caveat emptor. Don't get stung. Caveat vendor. Don't sting one another.

On Not Choosing Life: An Ethic of the Past

The American Life League, tireless and intelligent opponents of abortion, have distributed a letter containing an excerpt from Pope Pius XII's 1951 "Allocution to Italian Midwives." The Pope's statement clearly condemns the preservation of the life of a woman delivering a baby by the means of Killing the baby. While this conflict is extremely rare in modern American obstetrics, the citation allows no exit to choose one life over another, setting up the potential for two lives to be lost.

The anti-abortion slogan, "Choose Life," takes a hit through this papal directive. In such a rare dreadful circumstance, one is enjoined to make no choice at all. One suspects that 50 years ago in post-war Italy, the conflict between the life of a mother and a baby being born would not have been quite so rare, which may also be the case in less-advanced nations today. The papal statement also may cover some rare cases in which Siamese twins are both going to die if not separated, but for which only one vital, indivisible structure exists.

Stream of Consciousness in an Unconscious Nation

Room full of physicians, many young ones, some still in residency training. Wonder what the personal debt load is for the room? Most of it education loans. Bet it tops two million for the 30 people present. The presenter is a head-honcho type of fraud investigator. Has a degree in criminal justice, among other accomplishments. Going to explain to us about Medicare fraud. Professionally done handout packet, projects animated slides from his computer, very nice suit, uses a laser pointer. There's money in this Medicare policing business! Explains the Medicare system. Uses familiar branched tree organizational chart. Top box contains "President and Congress." Interesting! The electorate is not there above it. True enough. Dumbed down in public schools, they are now reduced to a herd. Our presenter is a sheepdog. Bark, bark, nip, nip. Move those "providers" along. Also, not in the chart is the Constitution. The Tenth Amendment alone is sufficient to disemploy this presenter and all that he represents.

Morning paper reports Vice President Gore describing the Constitution as a "living document." Means, of course, that it doesn't mean what it says, but only what he wants it to say. Constitution is an historical curiosity. Above the absent Constitution and electorate in his diagram, there is no God. 

Here is fundamental misunderstanding. We can make a nation, a profession, we think, without Him and in disregard of His Word. We are still digesting the fruit from the tree of the knowledge of good and evil. That tree was not the Tree of Life. Gnosticism is with us yet. If we know enough, we will live. Need special knowledge. Only the anointed understand it. Algorithms. Rules. Data enough to gag a mainframe!

Penalties are reviewed. Tens of thousands of dollars for a $2 item. The usual blandishments that they are only after real frauds. Truly government by terrorism. Except that God says the ruler is to be a terror to evildoers, not to a physician who would prefer to spend time with a patient than looking up the right number. 

Questioner: "Are we responsible for all the 100,000+ regulations?" "Know the current provider manual and quarterly updates." Slick. Didn't answer the question. The herd in the room doesn't notice. The answer offered is nonfunctional, as well as deceptive. Manual is 200 pages. Quarterly updates -- 40 pages. Blinding detail. Pages of 5-digit code numbers. Contingencies and exclusions. Don't apply to me, but have to read to know that. 

Coding gives false impression of precision. Can code same problem or service accurately various ways. Which one is "right?" Which one is "fraud?" Read also all the private insurance rules. All the formularies. Hospital protocols. Forms for nursing homes. Forms for commode seat arms. Forms for 0.3 cent lancets for Mrs. DuBose. If not "medically necessary," you are culpable. No time for patients. This man is concerned only with his slice. Assures us he is reasonable. Only after the bad guys. A government of men, not laws. Not reassuring.

That voice again in my head. Opt out. Get out of Medicare. Sign off. Trap! If your "UPIN" number is not on your request for labs, Medicare patient pays the whole freight, not just your fee. Lab costs patient more than you do. Can be a big deal. No UPIN number, you cannot admit to hospital. Hospital bill needs your number. Soon, prescription drugs will be added. Medicare requires that no payer pays less than it does. Disaster for the uninsured. Hospital and labs jack up rates and can give no discounts to self-pay. Trapped into having insurance. Trapped by insurance once you have it. Diabolical.

System cannot be reformed. Will have to collapse. Who is fined or goes to jail in the meanwhile? Whomever they want! Can't know, let alone, obey all the rules. Frauds and honest mixed together. Wheat and tares. Caesar yanks up whichever he pleases. The goal of terror is served either way.

Who Really Has High Blood Pressure?

Scientific studies are necessarily dependent upon the pre-suppositions which underlie the design. Change the assumptions, and the outcome is radically altered. A venerable long-time study involving heart disease is the "Framingham" study, which has spawned innumerable publications and valuable data. One of the clinical practices which Framingham, among other studies, supported was an aggressive approach to diagnosing and treating hypertension.

Using the Framingham data, but with different presuppositions, a now-oppressive consensus on the lower limit of hypertension (high blood pressure) has been challenged (The Lancet, January 14, 2000, pp. 175-180). Framingham and allied studies use a linear logistic regression model for the data on the relationship between blood pressure and death from all causes. 

By using a different presupposition -- a very different conclusion is reached. That is, that there is no increase in mortality as blood pressure rises until one's blood pressure exceeds the 70th or 80th percentile for one's gender and age group. After that, the risk of death rises rather dramatically.

The significance of the difference is striking. By the standard model now holding sway, as much as half the population has too high a blood pressure. By the different assumption, only about a fifth of the population would be at risk. Since the treatment of hypertension is expensive and fraught with side effects, such as passing out, impotence, cough, weakness, asthma, and frequent urination, it would be helpful to confine treatment only to those truly at increased risk and to leave the remainder alone.

Practicing physicians have for years been more tolerant of elevated blood pressures as patients age, though this practice has come under pressure (no pun intended) by "consensus" groups of experts. Management by expert-from-afar carries its own hazards.

Ed's Comments

This study is a major bombshell for both the treatment of hypertension and innumerable other studies. Except for HIV/AIDS possibly, hypertension has been studied more than any other disease process. Unlike, HIV/AIDS, high blood pressure is the most prevalent disease in the United States. As Dr. Terrell has indicated, as much as one-half of the population is potentially affected by this study.

I have been suspicious of "linear" graphs for almost 30 years. Researchers show a chart with dots all over the place, and somehow, "statistically," draw a straight or smoothly curving line through all those dots. On the one hand, we are taught (even in elementary school) that there are no perfect lines (a circle, for example) in nature. On the other hand, scientific analysis in general, and medical science in particular, are always giving us these "lines" of linear relationship.

This Lancet study blows those smooth lines into the fragments that they were before the artificial line was drawn. Properly applied, this type of analysis would virtually destroy most of the modern medical enterprise. (But, there is too much at risk. Not the health of patients, you understand, but the monetary enterprise of modern medicine.)

I find myself moving to the position that no patients should be treated unless there is a objectively identifiable, immediate medical problem. I understand that extremes are usually to be avoided, but I would be interested in what readers would propose as diseases that can be effectively "prevented." 

One of my fears of this newsletter in particular, and my writing in general, is that I become so repetitious on some points that I turn readers off. With that risk in mind, however, I will make this statement once again.

Christians, of all people, should stop worshiping at the shrine of modern medicine. Individuals, churches, and even denominations have faced bankruptcy chasing after magical "cure" and prevention. It is not that the emperor has no clothes; his body is only a vague, barely discernible wisp of dust.

Make no mistake. When my body is broken and bleeding from an accident, I want all the resources of modern medicine available to me immediately. Beyond that, I would rather they approach by the slowest ox cart available.

On the Organic Origin of Sin

A friend, with whom I dialogue occasionally, wrote and asked: "Is it possible to make this distinction: a) that an inclination toward homosexual behavior (e.g.), if not a 'disease,' might be organically related. For such inclinations, we are not morally responsible, but that b) our response to any stimulus, organic or otherwise, is that for which God holds us responsible. Am I being overly complex here?"

Ed's Answer

I would prefer "temptation," rather than "inclination." I find that by placing issues in Biblical terms, we are more likely to understand what the Bible says about them. The question, then, is can (does) temptation come from the organic (material) side of man?

Let's see. When I am extremely tired or hungry, I am more irritable and more likely to sin against others. That's an inclination (temptation). A person who is hyperthyroid is more irritable and likely to sin against others. A woman in her premenstrual phase is similar. These are examples of organically induced "inclinations" or temptations.

Paul said that it is better to satisfy sexual temptation in marriage than to sin (I Corinthians 7:9). But, we run into a "complexity" here. Is the origin of sexual temptation materially or immaterially induced?

And, even in our organic states above, the personality and spirituality of the person has a profound effect on reactions that are sinful.

The point is that the origins of inclinations (temptations) toward sin is difficult, if not impossible, to separate from its spiritual component.

Orthodox (as in Christian tradition, not Greek Orthodox) theology has held that the material world (which would include the material body) is not sinful in itself. But, by definition, temptation that does not progress in thought or action is not sin. So, then, organically induced temptation would be allowable within this orthodox position.

The more important point, however, is that no sin can be blamed on an organic etiology. Nowhere does the Bible excuse sin, but requires its forgiveness. Further, the spiritual state of the person at the time of the temptation profoundly affects one's reaction to it. Paul said that he was content in whatever state that he found himself, and many of those "states" were extremely difficult for his body to endure and his mind to respond to spiritually, e.g., singing in prison after being whipped.

Whether "an inclination (temptation) toward homosexual behavior might be organically related," I do not know. However, I am doubtful. To date, there is no evidence for such a relationship. That certain changes have been found in the brains of homosexuals at autopsy does not rule out effect, rather than cause. More likely, their temptation arises in their souls. But, I will allow for the possibility of an organic stimulus.

Second, brain states that we know are organically induced cause momentary responses, not planned actions. For example, a person whose brain is damaged by trauma may react differently to other people and to his environment, but the damage does not cause sequential steps of reaction and avoidance, such as screaming, going to one's room, locking the door, and turning on the television. The initial reaction is organically induced, but the pattern of behavior thereafter is learned.

Even biochemically induced states are reactionary, not logically sequential, and they are highly influenced by one's prior choices. LSD, for example, does not "cause" people to react wildly and jump off buildings. It alters their perception of reality, and their behaviors correspond to that perception. But, it is well known that LSD does not affect everyone the same. And, there is an environmental influence. Certainly, the reaction of a person to LSD in a dark, quiet room would be quite different from LSD at wild party where the senses are overloaded already. 

In Conclusion

So, I would essentially agree with the writer. "Our response to any stimulus, organic, or otherwise, is that for which God holds us responsible." But, I would add that you cannot ignore the rest of the substrate of the person's soul. On what does he constantly feed his mind? Is he growing spiritually? With what friends does he hang out? 

When hunger for food is excessively gratified, obesity results. When sexual appetite (homo- or heterosexual) is fed, it will also grow proportionally. In allowing temptation, let us not allow thoughts and behaviors that will cause the temptation to exceed greatly what it would otherwise be. Is that not the progression of James 1:14-15?

America's Christian Roots

Herb Titus, is a constitutional lawyer with a solid Biblical foundation. He is offering for a small donation two pamphlets that he has written. The titles are The Declaration of Independence: The Christian Legacy and The United States Constitution: A Christian Document. The requested donation is $25.00. Write Forecast Foundation, P. O. Box 16448, Chesapeake, VA 23328-6448.

Brief Reports with Ed's Comments

More on Gulf War Syndrome

More reports continue on the Gulf War Syndrome. These reports are covered in the news media with considerable bias. For example, an early-December study of brain damage in Gulf War Veterans had "flocks" of reporters covering it. The report "showed a link between ill Gulf War Veterans and brain damage." However, it "was neither reviewed nor published in a scholarly journal and had a very small sample."

"The second study, published in the American Journal of Epidemiology, was mostly ignored. Researchers used non-government hospital records to compare the health of veterans deployed in the Gulf War to that of non-deployed, finding very little difference. In other words, a major peer-reviewed study found no evidence of Gulf War Veterans being sicker than other veterans."

Only two sources (San Diego Union-Tribune, January 1, 2000, and Bridge News, January 18, 2000) reported this later study.

"With a myriad of symptoms from the commonplace to the bizarre, Gulf War illnesses have confounded the media for years. This most recent chapter in the long-running debate might have been better served by more that just a headline-grabbing but scientifically weak argument."

(Quotes and information are from Vital Stats: The Numbers Behind the News, February 2000, p. 5.)

Ed's Comments: I continue to stand on record that the Gulf War Syndrome does not exist, at least as consistent and objectifiable medical findings in Gulf War veterans. It does seem to exist in the minds of the majority of the news media, many physicians and researchers, some politicians, and a minority of Gulf War Veterans.

Psychotic Children, Ages 2-4 Years!

Prescription of psychotropic medications in the 5- through 14-year-old age groups has "increased significantly" in the last few decades, particularly in the last 15 years. However, little has been known about the use of these medications in children under the age of 5 years. A recent study in The Journal of the American Medical Association (February 23, 2000, pp. 1025-1030) looked at this age group.

Specifically, two Medicaid and one HMO populations were reviewed for the period of 1991-1995. Of 1000 children, 12.3 (number, not percent) were found to be on "stimulants," that is, traditional treatment for Attention Deficit Hyperactive Disorder (ADHD); 3.2 were on antidepressants (for "clinical" depression); 2.3 on clonidine (an anti-hypertensive being tried for treatment of ADHD); and 0.9 were on neuroleptics (formerly called "anti-psychotic drugs"). The authors concluded that "Psychotropic medications prescribed for pre-schoolers increased dramatically between 1991 and 1995."

We have to be a little careful of overreacting here. In the largest group, only 1.2 percent of children in this age category were on a particular medication. In raw numbers, this number is not large. Also, the baseline for an "3-fold increase" would be only 0.4 percent. So, while the numbers are not large, the lack of medical indications and the trend is quite alarming, but not unexpected. In fact, what else can be expected within a worldview in which humans are no more than biochemicals.

For four decades, adults have attempted to drown their worries and despair in an increasing variety of psychotropic medications. Also, during this time, more and more school-age children were "discovered," first, to be hyperactive, and then to have depression and other psychotropic disturbances commonly diagnosed in adults. So, the progression is now complete: cradle to grave coverage of psychotropic medications.

It is interesting that this extension to young children is neither supported by the medical literature nor by psychiatrists. The interest of the investigators was to shed light on this trend, and they hoped, to slow or even reverse it. An accompanying editorial (pp. 1059-1060) demonstrates that among "experts" in child psychiatry, these medications are rarely used. And, there is virtually no literature to support their use in this age group.

So, what we have here is no different from my ranting and railing against antibiotics for colds. Even those who worship at the throne of (medical) scientific research, do not have a case. The best science does not support such practice, but condemns it. What gives?

The modern medical enterprise is really no longer about "scientific medicine," but about the beliefs of the modern age. Although I have skirted the edges, this observation seems to have a new focus. As we have passed into the "post-modern" age, have we correspondingly passed into the "post-research" age of modern medicine? I think so.

The best scientific medicine might support 0.1 percent of what modern medicine does. Reasonable scientific medicine might support 5-20 percent of modern medicine. I am guessing numbers, but we need look no further than recent, massive trends in medicine that have become "standards of care."

Virtually every male over the age of 50 years should be on fat-lowering drugs to prevent heart disease and strokes. The levels for high blood pressure have been recently lowered to include one-half of the population. Every post-menopausal woman should be on some hormone and bone-strengthening agents. These trends have no support in "scientific medicine," yet they are supported by more than 90 percent of the medical practitioners.

One could blame the American enterprise system. Drug and device manufacturers are spending billions to advance their products and brain-wash physicians and the public. But, is there a more "bottom-line?"

I think so. At the root of all trends is a spiritual reason. As I commented above, man is only a mixture of biochemicals. There is not room for development of character or responsibility. Only answers in pills (biochemicals).

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