I can’t hear you

by Ted on March 23, 2005

Kevin Drum recently wrote about the danger of the unceasing partisan war against the media:

If this continues, the eventual result will be an almost universal ability to ignore any news report you don’t like simply by claiming it’s the result of bias and therefore not to be trusted. This is unhealthy.

I’ve been noticing this for a while. It used to be limited to blog comment threads, more or less, but it’s been creeping up the food chain. Look at the way that popular right-wing bloggers talk about Seymour Hersh, for example. Nobel Prize-nominated blogger Tom Maguire from Just One Minute is one of the most intelligent, careful right-wing bloggers, but he’s not immune to it. See this uncharacteristic post.

Tom looks at a New York Times article about death by withdrawing a feeding tube. The Times spoke to:

* Dr. Linda Emanuel, the founder of the Education for Physicians in End-of-Life Care Project at Northwestern University,
* Dr. Sean Morrison, a professor of geriatrics and palliative care at Mount Sinai School of Medicine in New York, and
* Deborah Volker, an assistant professor of nursing at the University of Texas.

He might also have looked at this Chicago Tribune article which quotes:

* Dr. Michael Marschke, medical director for Horizon Hospice in Chicago
* Dr. Jeff Frank, a neurologist at the University of Chicago,
* Nancy Harte, a registered nurse and director of the Rainbow Hospice LIFE Institute for Learning in Park Ridge, and
* Susan Dolan, executive director of Des Plaines-based Seasons Hospice.

Among these experts, there is apparently unanimous agreement that this method of death is common and largely painless. The Tribune story also cites a 2003 survey of Oregon hospice nurses whose patients had chosen to speed death by refusing food or fluids, as published in the New England Journal of Medicine. According to the story, “Most of the deaths ‘were peaceful, with little suffering, although 8 percent of patients were thought to have had a relatively poor quality of death.'”

It certainly seems counterintutive to me, but I suspect that these people know what they’re talking about. Tom Maguire disagrees. Here’s the evidence that he’s marshalled for his side:

* his own intuition about what it’s like to be hungry and thirsty
* his boundless contempt for the New York Times, and
* another blogger’s take on the nursing protocol for Terry Schiavo’s end of life. It calls for such outrages as painkillers if they’re necessary, swabs of saliva substitute and care of cracked lips. How could the death be painless if these measures are called for, asks Rob, not realizing that he’s answering his own question.

On that evidence, Tom calls the New York Times a bunch of jokers. Sure, most of these people quoted have spent their adult lives working in end-of-life care. Some of them have seen hundreds or thousands of similar cases. But they had the poor taste to be quoted by the dread pirate MSM. Advantage: blogosphere, I suppose.

How do you reach someone who is absolutely convinced that a news story which doesn’t confirm his own beliefs can only be spin? You can’t, obviously.

UPDATE: Missed this Washington Post story, which quotes:

* William A. Knaus, who co-directed the intensive care unit at George Washington University Medical Center for 20 years,
* Porter Storey, a leader of the American Academy of Hospice and Palliative Medicine who was the medical director of a hospice in Houston for 18 years,
* Joanne Lynn, a researcher at Rand Corp. and an expert on care of the terminally ill.

According to the reporter, “experts are virtually unanimous in saying it does not appear to be painful.” Bias everywhere.

{ 25 comments }

1

Sebastian Holsclaw 03.23.05 at 1:57 pm

Is it painless because most of the people in question are not capable of experiencing pain?

2

asg 03.23.05 at 2:02 pm

This echoes discussions I often have with left-wing colleagues and acquaintances, who believe that any article or study producing conclusions with which they disagree must be “industry-funded” and therefore can be ignored without further thought. One colleague told me that the whole idea of Satan in the Bible was made up by modern Christians; that Satan doesn’t appear at all in the Old Testament. I fired up gospelcom and pointed him at the Book of Job. He promptly replied that as a “Christian” site, the texts thereon were not to be trusted, and therefore he stood by his view that, indeed, Satan does not appear in the Old Testament.

3

abb1 03.23.05 at 2:10 pm

…Tom Maguire from Just One Minute is one of the most intelligent, careful right-wing bloggers…
Are you serious? He is a nut. He was trying to block my IP under the lame excuse that I am not a ‘sensible lefty’ – can you imagine? If I am not sensible – who is?
And it’s not as if I used the word ‘fuck’ or something – which is how I got banned from Tacitus… These guys are nuts.

4

Urinated State of America 03.23.05 at 3:42 pm

“One colleague told me that the whole idea of Satan in the Bible was made up by modern Christians; that Satan doesn’t appear at all in the Old Testament.”
Yeah, but the Satan in the Book of Job is protrayed as one of God’s servants, literal translation “The Adversary”. It’s in the New Testament that it is referred to as the Devil. The idea of a cosmic war between the forces of light and the devil is an Essene influence on Christianity, as the Essenes projected the political split within Judaism on whether or not to collaborate with the Roman occupiers into a metaphysical struggle.
The current conception of Satan owes more to the Essenes, Dante (and other pre-Dante apocalyptic writes), Milton and the Malleus Maleficarum than to the Old Testament. What your colleague was conveying to you was a degenerate form of the argument made by Elaine Pagels in her book “The Origin of Satan”.

5

nick 03.23.05 at 3:58 pm

Put me in the ‘Maguire is a nut with a smiley-face mask’ camp here; and what’s worse about him is that unmasked nuts uncritically accept his every utterance.

6

Katherine 03.23.05 at 4:17 pm

It’s not uncharacteristic of Maguire. And you can’t reach them. This case has convinced me. THey’re beyond reason. We ought to stop trying, and think seriously about becoming a serious alternative media–“heighten the contradictions” with the shameless propaganda and noise machine that right-of-center weblogs have become.

7

praktike 03.23.05 at 4:36 pm

What’s interesting about all this is how unwilling normally areligious blogs on the right are to challenge The Party on this one. I think they’re scared. So they write about media bias, or like Glenn Reynolds, beg off. There are not very many real libertarians out there; just fake ones.

8

John Isbell 03.23.05 at 4:37 pm

Great post. FWIW, as to Job and the OT, Judaism does not believe in Heaven or Hell. The comment about the Xian source seems apt.

9

Katherine 03.23.05 at 4:53 pm

John Cole being the exception. But yeah–on OW, the smart conservatives don’t defend it, but for the most part they don’t comment at all.
A formerly-self-described libertarian at my law school has gone on hunger strike to protest this unjust judicial execution of the handicapped.
If the main test for believing something is whether you want it to be true, you’re no longer reachable.
I am not just bitching. This is a serious problem we need to think seriously about. I would like to think they’re overreaching and will be punished during the midterms, but given the Georgiamander and the many other mid-year redistrictings coming up and the generally uncompetetive nature of House races, and the underrepresentation of blue states in the Senate, we shouldn’t count on it. Nor can we count on “our long national nightmare” ending in 2008. Look at the behavior of Bill Frist and Jeb Bush in all this, to say nothing of Rick Santorum.

10

praktike 03.23.05 at 5:21 pm

Ah, yes. I commend John Cole, and, to a lesser extent, Henke.

11

Donald Johnson 03.23.05 at 7:25 pm

John Isbell, by the time you get to the time of Jesus, many Jews did believe in heaven and hell–the Pharisees in particular, but not the more conservative Sadducees. It’s a little hard to tell what people thought in the OT period–there’s apparently a belief in Sheol, the sort of shadowy afterlife you find in Homer.
Or that’s what I’ve been told and it’s the impression I get from the Bible.
As for Satan, Mr. Urine above is basically correct, I think, though my impression is that Satan goes back a little before the Essenes. it might be the Zoroasterian influence with a good God vs. an evil God.

12

Nell Lancaster 03.23.05 at 8:22 pm

praktike, who is Henke (or more to the point, what is the url of his(her? naah) blog)?
Jeanne at Body and Soul is collecting suggestions of good conservative blogs for a poli sci teacher friend of hers who asked.

13

Mill 03.23.05 at 8:40 pm

It’s not just painless because they can’t feel pain — it’s actually painless even if you’re fully conscious. It’s a weird and counterintuitive but well-known medical fact that if you go completely without food and water (but are well-cared-for in other ways), you enter an almost euphoric state. You die, of course, but it doesn’t hurt.

Refugees, victims of famines, etc. — the reason they suffer, and of course they do, is because they are desperate for food and water and will take whatever miniscule amounts they can get. This means that the euphoric shut-down mode can’t get started, so the body keeps calling for more fuel, which is extremely unpleasant when you don’t have enough. (And, of course, other conditions in a refugee camp or a famine-stricken country are generally much less comfortable than the comfort of your own home — and refugees/famine victims generally haven’t made a conscious decision to die, either, which doesn’t exactly do much for their peace of mind.)

In conclusion, starving to death on not enough food and water is hell. Starving to death voluntarily on absolutely nothing is not.

14

praktike 03.23.05 at 8:59 pm

nell-

Jon Henke of QandO.net

15

Tom T. 03.23.05 at 11:46 pm

Here’s a recent WaPo article on the physiology of starvation.

16

Tom Maguire 03.24.05 at 12:20 am

Darn, I had a compelling comment which both made my points and illustrated the theme of the post, and its gone.

Well, shorter – does anyone think the Times researched death by dehydration, concluded it was humane, and then relied on that to endorse the termination of Terri Schiavo?

No? Then why is it absurd to wonder if the piece might just be a little bit self-serving? Are we sure they would have run it if the story had developed differently?

17

Tom Maguire 03.24.05 at 12:24 am

[Continuing] / For example, Kate Adamson has a book describing her medical nightmare – stroke, coma, near death, feeding tube pulled, and… a miraculous revival! “Euphoric” is not her word choice for the dehydration phase; “agony” fits better. Yet the Times missed that.

18

Tom Maguire 03.24.05 at 12:29 am

And another thing – the Times story tells us that “Patients who are terminally ill and conscious and refuse food and drink at the end of life say that they do not generally experience pangs of hunger, since their bodies do not need much food.”

All plausible, but this chap says there is a major difference between the body shut-downs of the terminally ill, and dehydrating an otherwise “healthy” person like Terri S. He makes the argument that
physiologically, the two are quite different, and, in the case of the otherwise healthy, quite painful.

Is he right? Try a different question – why did the Times miss this angle? How hard did they look?

Now, I don’t want to spend too much time on the couch here, but I do want to respond to the notion that *”What’s interesting about all this is how unwilling normally areligious blogs on the right are to challenge The Party on this one. I think they’re scared.”*

Uhh, scared of what? Are there boogey men behind the terminal over in the reality based community? You can belive me, or not, but no one on the right would have cared if I ducked this (and I have certainly gotten my hands bloody enough at other times to have earned a pass on this tussle).

Or, just read my comments – half my conservative readers are killing me for being a fair-weather federalist. “Scared” might better describe the lib bloggers, none of whom have noticed that Tom Harkin is linking this to rights for the disabled (shameless self promotion).

In the course of helping your party reconnect with America, you might want to examine the dim, distant possibilty that some of the folks on my side on this case are sincere.

My wife, for example, is a moderate Dem, and a mom. She is apalled that Terri’s mom has to watch her child die at the decision of her, in effect, ex-husband. And somehow, when her well-meaning liberal friends explain the subtleties of the Florida court system to her, she does not seem to give a rat’s a**. Go figure.

Hmm, that was supposed to be the shorter response. Yikes.

Good conservative bloggers:

Fo Po: Gregory Djerejian

Econ: Andrew Samwick, Dead Parrots

Life, and everything in it: Pejman

True conservative, but too much for most folks here: Orrin Judd

19

Kieran Healy 03.24.05 at 12:46 am

Calm down, Tom. Your post was just in the moderation queue because it had so many links in it.

20

Tom Maguire 03.24.05 at 2:22 am

Calm? My tecno-frenzy is unabating!

Actually, I figured I was doing something wrong – an earlier coment did disappear after I didn’t preview it, or something.

What happened to the days of smoke signals and carrier pigeons?

21

JO'N 03.24.05 at 9:20 am

Tom Maguire said that we “might want to examine the dim, distant possibilty that some of the folks on my side on this case are sincere.” — I’m sure that some are. However, I would be far more likely to take that possibility more seriously, if only the Republican hysteria over removing feeding tubes from the children of hopeful parents extended to the more numerous cases where the tube is removed, against the parents’ wishes, by insurance companies unwilling to spend more money. The Texas law allowing this was passed in 1999, signed by George W. Bush. If the GOP were serious about the sanctity of all human life, it seems clear (at least to this commie bastard) that they would support a minimum guaranteed level of universal health care.

22

Ted 03.24.05 at 10:58 am

“Does anyone think the Times researched death by dehydration, concluded it was humane, and then relied on that to endorse the termination of Terri Schiavo?”

Um, I don’t know, Tom. This is not a particularly convincing argument to someone who isn’t convinced that the Times is Liberal Samizdat Central. Personally, I strongly, strongly suspect that the news editors would have been much more comfortable with a story with a headline like “Experts Disagree On Consequences of Removing Feeding Tube”. But our disagreement shows little more than Tom and Ted’s biases.

Furthermore, I don’t think that the editorial staff at the Times made their decision based on how painful they perceived this death to be. I think they made their decision based on their understanding of the separation of powers, the rule of law, and the arbitrary nature of this headline-grabbing seizure of the authority of the courts.

I don’t know anything about Kate Adamson, but I’ll bet cash money that the experts quoted by the Times and the Tribune do. And I’ll also bet that the people who devote their lives to end-of-life care are not ghouls. I just don’t believe that they’re trying to pull the wool over anyone’s eyes to conceal the painful nature of this sort of death. Why in the world would they?

I’m perfectly willing to assume that folks on the other side of the debate are sincere; your wife’s reaction is human and understandable. Can I ask for a little reciprocation? If we’re going to compare our hurt feelings, I could point to the copious Nazi analogies and the frequent accusations of murder that come from Team Save Terri. Peggy Noonan called people like me “red-fanged and ravenous” and said that the road leads from Terri Schiavo to Auschwitz. Hundreds of thousands of families will eventually face this sort of decision, and I’m rather sure that we don’t appreciate being called Nazis if they don’t extend life-sustaining treatment to the fullest possible extent.

23

Tom Maguire 03.24.05 at 1:07 pm

Well, Ms. Noonan is over the top – she seems to be describing a case that I speculated as being morally more challenging – what if the whole family wanted to terminate Terri, but right to lifers had adopted her as a symbol and were somehow holding up the procedure?

However, politically, that scenario gets a zero – what drives this case is that the family is so bitterly divided.

That said, I was not responding to every attack in the wide world – I was responding to a couple of comments in this very thread suggesting that I, personally, took up this issue because I was afraid of the party, or beyond reason.

So I am not sure that dragging Peggy Noonan into it, or holding me responsible for every statement made out there, is quite symmetrical.

As to your comments about the Times, what can I say – you don’t think they are biased, I tell you why I think so, and you say, well, I don’t think they are. Fine.

You don’t think they are biased; I mention Kate Adamson; you say (I guess), well, they would have noted her if it were important. How about, they would have noted her if they had wanted to present both sides?

Based on your “I am sure the experts knew” reasoning there is *NO* evidence I could present that would indicate bias. I could put a Harvard Medical School study on the table documenting extreme torment, and you would say, c’mon, the experts they cited have surely read that.

As to the end-of-life folks not being ghouls, of course not. But, for example, one person cited did mention “terminally ill” patients, for which there may be a physiological difference. SO maybe the Times talked tothe wrong experts.

Your argument is irrefutable, yet unconvincing.

24

Ted 03.24.05 at 2:30 pm

Tom,

First of all, you can’t be held responsible for Peggy Noonan. I don’t think that Peggy Noonan can be held responsible for Peggy Noonan. What I meant to respond to is the implication that it’s a losing issue for Democrats/ the left; you stated that we need to respect the other side to connect with America. I don’t think that that’s right; I think that the fury and dismissiveness of the right is much more self-damaging, and I think that polls back me up.

I don’t think that you’re reading me correctly. If you had presented a Harvard Medical School study, or anything remotely like it, you’d have a case. I’d be forced to admit that expert opinion is not uniform. (It certainly would have killed off this post at its inception. Your original post didn’t cite anything at all, just your intution that the Times must be wrong because they’re biased.)

What you’ve presented is an anti-euthanasia activist on the motivational speaker circuit (http://www.katesjourney.com/) and another anti-euthenasia activist on the lecture circuit (Wesley Smith is a lawyer whose books include “Culture of Death: The Assault on Medical Ethics in America” and “Forced Exit: the Slippery Slope from Assisted Suicide to Legalized Murder”). Smith’s only support is a quote from a neurologist saying that the feeding tube removal is painful to a conscious person who isn’t terminally ill. But Terri Schiavo isn’t conscious. Her cerebral cortex is gone.

My argument is not irrefutable. Point me at a couple of people who could reasonably be called experts, and I’m refuted. But we’re not looking at two equal sides where one side was ignored. You’ve got to admit that. If you were assigned this story as a reporter, what would you do? Wouldn’t you talk to doctors, professors, and experts in end-of-life care? What if they all agreed? Would you keep calling down the Rolodex until you got a motivational speaker to counter them, in the interest of balance?

Kate Adamson gives me pause, but I don’t know enough to talk about her. Maybe she’d be in the 8%. Maybe something else. Given the uniformity of expert opinion, I’m willing to give the reporters the benefit of the doubt. I maintain that an airy accusation of bias is inappropriate.

25

Uncle Kvetch 03.24.05 at 5:47 pm

what drives this case is that the family is so bitterly divided

No, that’s not true. In and of itself, the bitter division of the family is of no consequence, because the law holds that the husband, not the parents, has the right to make this decision. For whatever reason, large numbers people have decided that the law can be disregarded in this case.

Something else is “driving” this case.

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