Mensa is an association of the best and the brightest, persons with an "IQ" so high that it places them in the top two percent of the population. In 1994, American Mensa Ltd. had 55,000 members, 2,000 of them in the Los Angeles area. At the end of that year, two remarkable articles appeared in Lament, the newsletter of Lost Angeles Mensa. The authors called for the extermination of "defective" people and the creation of a "master race."
Jason G. Brent, a lawyer, wrote that "society must face the concept that we kill off the old, weak, the stupid and the inefficient." Brent supported the creation of a "master race," and regretted that Adolf Hitler's actions prevent a rational discussion of this topic. (769) Answering journalists' questions, Brent said, "We cannot continue to have population explosion. We better face that we have to kill people. There are not unlimited amounts of resources." (770)
Another Mensa member, Jon Evans, called for liquidation of the homeless. "What good are they? The vast majority are too stupid, too lazy, too crazy, or too anti-social to earn a living. ... Granted, there are a few people who have fallen beneath the blow of circumstances and are unable to afford any place to live, but they are few and far between. The rest of the homeless should be humanely done away with, like abandoned kittens." (771)
The same, according to Evans, should be done with people who are mentally or bodily deficient: "A piece of meat in the shape of man but without a mind is not a human being whether the body be deathly ill, damaged by accident, mentally blank because of brain deficiency, or criminally insane." (772)
One could easily dismiss the articles by Brent and Evans as the excesses of some freaks. But these two gentlemen were not isolated in their opinions. The editor of Lament newsletter, Nikki Frey, was unapologetic, and surprised that anybody would be offended. "I wouldn't print anything I thought was truly harmful or offensive. I didn't think it was harmful. I don't think it's even that offensive--nobody wants to have a deformed child." (773) The chair of Mensa's Los Angeles chapter, Ms. Gowen, and the chapter's board supported Frey. (774) Ultimately, however, the editor of Lament had to resign from her post. There were many indignant reactions from other members of Mensa and from outsiders. (775) A member of American Mensa's national board condemned the publication of "hate material." (776) The director of British Mensa said that "one Adolf Hitler was enough for this century." (777)
For our own safety, we should not forget what ideas ferment in a certain faction of the West Coast's intellectual elite.
(1) For a detailed discussion of the subject, see Chapter XXVIII, on "The Oregon Law."
(2) East-West Bioethics Conference III, Prague, Czechoslovakia, Aug. 29-31, 1991.
(3) A. R. JONSEN, THE NEW MEDICINE AND THE OLD ETHICS 17-18 (1990).
(4) S. Alexander, They Decide Who Lives, Who Dies: Medical Miracle Puts a Burden on a Small Committee, LIFE, Nov. 9, 1962, at 102.
(5) J. E KILNER, WHO LIVES? WHO DIES? ETHICAL CRITERIA IN PATIENT SELECTION 27-74 (1-990).
(6) C. TAYLOR, SOURCES OF THE SELF: THE MAKING OF THE MODERN IDENTITY 4-8 (1989).
(7) This reasoning has interesting consequences since it leads to the conclusion that all medical actions and also all acts of helping a person in need are morally wrong.
(8) CASES IN BIOETHICS 96 (C. Levine & R. M. Veatch, eds., 1989).
(9) KILNER, supra note 5, at 72-74.
(10) R. D. Truog, Triage in the ICU, HASTINGS CENTER REP., 22:2, at 13-17 (1992); D. E. Singer et al., Rationing Intensive Care: Physician Responses to Resource Shortage, 309 NEW ENG. J. MED. 1155-60 (1983); P. J. Strauss et al., Rationing of Intensive Care: An Everyday Occurrence, 255 JAMA 1143-46 (1986).
(11) J J. D. Rothman, Rationing Life, N.Y. REV. or BOOKS, Mar. 5, 1992, at 33 (quoting D. Callahan, emphasis added).
(12) R T. MENZEL, STRONG MEDICINE: THE ETHICAL RATIONING IN HEALTH CARE (Oxford U. Press, 1991); Gross et al., Early Management and Decision Making for the Treatment of Meningomyelocele, 72 PEDIATRICS 450 (1983); Health Security Act, S. 1757 & H.R. 3600 (1990-91); Testimony of Hillary Clinton, 8:2 IAETF UPDATE, Mar.-Spr. 1994; E. Saltus, Silber Attacks Health System, BOSTON GLOBE, Apr. 30, 1991; D. Callahan, Symbols, Rationality, and Justice, 18 AM. J. L. & MED. 1 (1992).
(13) W. Slater, Latest Lamm Remark Angers the Elderly, ARIZ. DAILY STAR, Mar. 29, 1984, at 1; J. Paterson, Something Needs to be Done About the Quality of Dying, INT'L HERALD TRIB., Jan. 15, 1988; Saltus, supra note 12; D. CALLAHAN, SETTING LIMITS: MEDICAL GOALS IN AN AGING SOCIETY (1987); D. CALLAHAN, WHAT KIND OF LIFE: THE LIMITS OF MEDICAL PROGRESS (1990). Contra, R. Fenigsen, Most of Them Would Rather Live, INT'L HERALD TRIB., Jan. 29, 1988.
(14) See Chapter VI, infra at 128.
(15) See Chapter III, infra at 110.
(16) American bioethicists are attempting to stir up the anti-medical rebellion in countries where this conflict does not exist. Eastern Europe is still one such happy region: in Polish opinion polls of the 1990s, much the same as in the 1960s and 1970s, eighty percent of respondents named the physician as the most respected profession. But in recent decades the American bioethic think tank, the Hastings Center, organized a number of "East-West Bioethics Conferences" at which they have acquainted the Eastern Europeans with the American criticism of medicine and distrust of doctors. At the August, 1991, Prague conference which 1 attended, the pronouncements of American bioethicists caused a good deal of bewilderment among the East German, Polish, Czech, Bulgarian, and Rumanian delegates.
(17) Saltus, supra note 12 (quoting J. Silber).
(18) Bij eigen schuld gaat andere patient voor [trans.: When the patient (himself) is to blame (for his condition), another patient will have precedence], BRABANTS DAGBLAD, NOV. 2, 1990 (interview with professor Helen Dupuis).
(19) The subject of medical ethics is further touched on in Chapter VI and discussed in Chapter XVI.
(20) P. SINGER, PRACTICAL ETHICS 13, 90-91, 102-05, 172-73 (2nd ed. 1993).
(21) L. WITTGENSTEIN, NOTEBOOKS 1914-1918 (2nd ed. 1979) (entry for July 30, 1916); see also TRACTATUS 6.421.
(22) INTERNATIONAL CODE OF MEDICAL ETHICS (1983) (adopted at the Third Assembly of the World Medical Association, London, Oct. 1949; amended at the Twenty-Second Assembly, Sydney, Aug. 1968, and the Thirty-Fifth Assembly, Venice, Oct. 1983).
(23) E.g., as a buyer of health insurance, as an employee whose work was valuable enough for the employer to pay for a health plan, as a life-long taxpayer or dependent of one, and even as an indigent helped by fellow Americans out of human solidarity.
(24) R.J. LIETON, THE NAZI DOCTORS: MEDICAL KILLING AND THE PSYCHOLOGY OF GENOCIDE 30 (1986).
(25) See, e.g., Editorial, A New Ethic for Medicine and Society, 113 CAL. MED. 67-68 (1970) (official journal of the California Medical Association).
(26) LEO TOLSTOY, 9 SMYERT' IVANA ILYICHA [The Death of Ivan llyich] 102 (Sobranye Khudozhestvennykh Proizvedeniy, Moscow: Prawda Pub. House, 1948).
(27) IVAN ILLICH, THE MEDICAL NEMESIS: THE EXPROPRIATION OF HEALTH (1976); and IVAN ILLICH, TOWARD A HISTORY OF NEEDS (1980).
(28) See Ch. I, supra.
(29) This subject will be discussed in Chapters VI, Speaking the Truth, XI, On Therapy, XII, The Lost Shills, The Bad Habits, and XV, Is Medicine Still for the Patient's Benefit?
(30) R. FENIGSEN, OSLUCHIWANIE SERCA [Auscultation of the Heart] (PZWL Pubs., Warsaw, Polland 1968). During my visit to Polland in 1997, I was pleased to see that this textbook was still being used for the training of Polish cardiologists.
(31) S. A. LEVINE & W. P. HARVEY, CLINICAL AUSCULTATION OF THE HEARX (2nd ed. 1959).
(32) E A. ONGLEY ET AL., HEART SOUNDS AND MURMURS: A CLINICAL AND PHONOCARDIOGRAPHIC STUDY (1960).
(33) M A. MCKUSICK, CARDIOVASCULAR SOUND IN HEALTH AND DISEASE (1958).
(34) J. W. Hurst & R. C. Schlant, Introduction and Principles of Auscultation, in THE HEART, ARTERIES AND VEINS 219-38 (J. W. Hurst & R. B. Logue, eds. 1970).
(35) FENIGSEN, supra note 30, at 20.
(36) R. PORTER, THE GREATEST BENEFIT TO MANKIND: A MEDICAL HISTORY OF HUMANITY 370 (1998).
(37) B. LOWN, THE LOST ART OF HEALING 191-95 (1996).
(38) E. Chetkowska, E. Spolinska, K. Ballandowicz, Q' R. Fenigsen, 145 napadow czestoskurcu kornomwego [145 attacks of ventricular tachycardia], 8 KARDIOLOGIA POLSKA 69 (1968).
(39) R. Fenigsen, K. Ballandowicz, W. Chrust, & E. Spolinska, Kardiowersja w czestoskurcu komorowym [Cardioversion in ventricular tachycardia], 8 KaRDIOLOGIA POLSKA 209 (1966).
(40) I fully support the (recently proclaimed) right of patients to sue their HMOs for failure to provide due care. It is not this right that is the subject of the present paragraph, but the rights purported to protect patients from being wronged by their doctors. Promoted by the so-called patient's rights movement, these "rights" have become an important argument in the fight against medical paternalism.
(41) EJ. Ingelfinger, Arrogance, 303 NEW ENG. J. MED. 1507 (1980).
(42) s. John et al., Closed Mitral Valvotomy: Early Results and Long-term Follow-up of 3724 Consecutive Patients, 68 CIRCULATION 891 (1983).
(43) B.H. Lorell & E. Braunwald, Pericardial Disease, in HEART DISEASE 1522 (E. Braunwald, ed., 3rd ed., 1988).
(44) K.H. Olesen, The Natural History of 271 Patients With Mitral Stenosis Under Medical Treatment, 24 BRIT. HEART J. 439 (1962).
(45) J. KATZ, THE SILENT WORLD OF DOCTOR AND PATIENT 219 (1984).
(46) A. Solomon, A Death of One's Own, NEW YORKER, May 22, 1995, at 68.
(47) Clots that originate in the veins and travel through the heart to the main lung artery or its branches.
(48) M. Edelman, To, co dobre, jest slabe [The weakness of the good], TYGODNIK POWSZECHNY (Cracow), Dec. 4, 1994 (No. 49).
(49) B. GOLDSTEIN, THE STARS BEAR WITNESS 160-61 (1949).
(50) G.S. SEAGRAVE, BURMA SURGEON...