Further Comments on Disabled Kids

 Posted by on 18 June 2013 at 10:00 am  Children, Disability, Ethics, Family
Jun 182013

On the May 19th episode of Philosophy in Action Radio, I answered a question on whether disabled kids should be kept out of the public eye. (My answer was, in essence, HELL NO.)

Shortly thereafter, I received this message in email:

It has been a while since I’ve checked in with you, but I wanted to reach out to tell you that I greatly appreciate your podcast segment on the visibility of disabled children. I have personal stakes in this — my younger brother has down syndrome, and my daughter was recently diagnosed with cerebral palsy — but I’d like to think that even without these intimate experiences, I would never had supported any idea that such people should be kept hidden, or out of the view of others. My brother and daughter have enriched the lives of many, and will continue to do so, for those people around them that are open enough to treat them as individuals. And I am grateful that you have taken the time to speak, in part, on their behalf.

Indeed — and thank you!

On the plane back from ATLOSCon, a young woman with Down’s Syndrome was on the train with me in the airport, then across the aisle from me in the plane. Not only was she not any kind of trouble, but I could tell that her family members enjoyed her company. At one point, I noticed that she seemed to be teaching sign language with the person next to her, and she was quite adept. As I watched her, I was so glad that her family didn’t think themselves obliged to cloister her; given her capacities, that would have been a loss for her and them.

So… if you’ve not yet heard that episode, you can listen to or download the relevant segment of the podcast here:

For more details, check out the question’s archive page. The full episode – where I also answered questions on individualism versus anti-social atomism, poor communication from the boss, arranged marriages, and more – is available as a podcast too.

How Doctors Die

 Posted by on 28 November 2012 at 9:50 am  Ethics, Family, Medicine
Nov 282012

In tonight’s Philosophy in Action Radio, I’ll interview University of Chicago geriatrician Dr. William Dale on end-of-life medical choices. One of the topics that we’ll discuss is how doctors talk to their patients about their options as they near the end of their lives — and how and why those doctors often fail to provide those patients with the full picture required to make decisions in accordance with their wishes.

That reminded me of an article titled “How Doctors Die” that I’d been meaning to read. I finally read it yesterday, and wow, it’s powerful and fascinating. It begins:

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds-from 5 percent to 15 percent-albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone. They’ve talked about this with their families. They want to be sure, when the time comes, that no heroic measures will happen-that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR (that’s what happens if CPR is done right).

Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it. Some medical personnel wear medallions stamped “NO CODE” to tell physicians not to perform CPR on them. I have even seen it as a tattoo.

Now, go read the whole thing, then join us tonight for the live broadcast of my interview with Dr. Dale or listen to the podcast later.

Questions on Family, Rational and Otherwise

 Posted by on 12 August 2011 at 9:00 am  Ethics, Family, Friendship
Aug 122011

In early September, I’ll be speaking at the MiniCon of the Chicago Objectivist Society on the proper egoistic approach to family, rational and otherwise. The conference is already sold out, but even if you’re not able to attend, the lecture likely will be available later for purchase.

To help me prepare, I’d like you to tell me what kinds of problems you’ve had with your family that you’d like me to discuss.

Basically, I’d like a series of case studies to analyze, and I hope that you’ll contribute them! If you have one, please post it in the comments. Please give some — but not too much — detail about the particulars, perhaps a paragraph or two.

Or, if you have some general topic regarding family relations that you’d like me to cover, feel free to post a question. Also, if you like someone else’s scenario or question, hit the “like” button.

Here’s the abstract for my talk:

Family, Rational and Otherwise

Many people struggle to maintain ties with destructive family members, often sacrificing their own values and interests in the process. As rational egoists, Objectivists reject that “family-first” moral ideal, instead seeking mutually beneficial relationships based on shared values, including with family. Such egoistic family ties are often an invaluable source of visibility and support. However, family relations are not always easy: many are fraught with difficult and persistent conflicts.

In this lecture, Diana Hsieh will discuss how to be consistently rational and selfish in your dealings with irrational, altruistic, and/or religious family members. She will answer questions such as:

  • When should you tolerate people you dislike or that you judge immoral?
  • How can you make those people more tolerable — or even acceptable?
  • When and how should you cut off relations with a destructive family member?

In short, this lecture will help you to better understand how to extract the most value from your family.

Now… comment away!

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