Monday, March 28, 2005

Response to Comments: The Schiavo Case

Instead of responding below comments to my post Morality vs. Legality, I decided to create a new post to provide detailed answers.
Moebius Stripper says:
For those who believe that people can choose not to be kept alive, but that Terri Schiavo's feeding tubes should be re-inserted, the only remaining moral position I can see is that the patient alone can make this choice and it must be recorded in writing (in the form of a "living will", presumably).

Where do you get this? I personally think that people can choose not to be kept alive, but that her feeding tube should be reinserted. This isn't based on a belief that only a patient can make the decision to die (like you, I'd have trouble committing to something ahead of time) - it's based on a belief that no one should die by being starved to death over a two-week period. I think that the most disturbing aspect of this case is that it's basically taken for granted that shooting Terri Shiavo in the heart or giving her a lethal injection that would kill her in seconds is murder, but that starvation over a two-week period constitutes death with dignity.

This is a good point; my original post was flawed. I presume you'd agree with what I wrote if we were discussing a similar case which didn't involve a protracted death? For completeness, when writing about the Schiavo case, I should have discussed this argument as well. If it's any comfort, MS, it hasn't been completely neglected; several websites and talk-shows have dwelt on the starvation issue and why it's cruel. Still, I don't think it makes much difference, because it doesn't seem like a tenable position, either.

The claim I've seen advanced most often is that removing the feeding tubes will cause Terri Schiavo to suffer terribly for two weeks or so. The problem is that the word starvation is loaded: our visceral reaction is to imagine patients in severe anguish for a long time. This is inaccurate; it is generally accepted that death by complete starvation/dehydration in a hospital is not particularly painful. Here are three different articles quoting several neurologists who believe that Terri Schiavo will not experience severe thirst or hunger. I'm quoting rather extensively from the best of these, an L.A. Times article devoted to this issue:
[M]edical experts say going without food and water in the last days and weeks of life is as natural as death itself. The body is equipped with its own resources to adjust to death, they say.
...
"What my patients have told me over the last 25 years is that when they stop eating and drinking, there's nothing unpleasant about it -- in fact it can be quite blissful and euphoric," said Dr. Perry G. Fine, vice president of medical affairs at the National Hospice and Palliative Care Organization in Arlington, Va. "It's a very smooth, graceful and elegant way to go."
...
"The cessation of eating and drinking is the dominant way that mammals die," said Dr. Ira Byock, director of palliative medicine at Dartmouth Hitchcock Medical Center in New Hampshire. "It is a very gentle way that nature has provided for animals to leave this life."

In a 2003 study published in the New England Journal of Medicine, 102 hospice nurses caring for terminally ill patients who refused food and drink described their patients' final days as peaceful, with less pain and suffering than those who had elected to die through physician-assisted suicide.

The average rating given by the nurses for the patients' quality of death was an 8 on a scale where 9 represented a "very good death" and 0 was a "very bad death."
...
[The] pain of hunger is only felt by those who subsist on small amounts of food and water -- victims of famine, for instance, or concentration-camp inmates. They become ravenous as their bodies crave more fuel, said Sullivan, a senior fellow at Duke's Center for the Study of Aging.

After 24 hours without any food, "the body goes into a different mode and you're not hungry anymore," he said. "Total starvation is not painful or uncomfortable at all.
...
The weakening brain releases a surge of feel-good hormones called endorphins.

Doctors also have a host of treatments to ameliorate acute problems, such as sprays and swabs to moisten dry mouths and creams to moisturize flaky skin. They can also administer morphine or other powerful painkillers.
There's also some anecdotal evidence in a comment thread at DailyKos, but you might want to take that with a grain of salt. Given that this kind of death is fairly painless, I think it's reasonable to prefer it to lethal injections or the like. (And if the nurses in that study were right, dehydration is actually the less painful alternative.)

RL's comment was longer:
I would want my family to make the best decision they could based on medical advice and the probability that I would recover.

The courts have established that it is probable that she would not have wanted to be kept alive; even if this is discounted, her husband wishes it, and if anyone has a moral right to decide, it is her spouse.


Your above two statements are very disturbing as they lead to things very very dangerous. We are living in times of Harold Shipman. I don't think civilization has reached a decisive stage where even terminal patients themselves can be given the power to decide if or not to pull the plug - leave alone a third person - however he/she be close to him/her. It is not everyday that Bush comes up with sosmething like this - but it definitely makes a lot of sense to "err on the side of life"

If that be the question - I shudder to think of the debataes that will follow. Can severely depressed men and women allowed to take their lives? What about penuriously bakrupt people? What about people in lunatic asylums? What about people imprisoned for life without a chance for parole? What about people who cannot afford to keep their loved ones on life support - though they may have a good probability of recovery in the long term?

And when you ask proponents for legislation to define that "life is sacred, and that we may never choose to let it end" - I shudder to think of the consequences. Do you think law can ever be complete ? Do we need to define everyday activities in black and white laws? We will enter a Godel's world where there will always crop cases which cannot and should not be for the courts to decide.

Life is something we havent cracked - and we cannot ever make a decision for anybody. I am a leftist liberal, but I cannot bear to bring myself to defend for everything branded as "liberal" - just for the heck of it. I believe in the sanctity of life - and I hold that above any judiciary.
He raises several issues, and I'll try to address them one by one.

To begin with, when I said, "Adherents to [the belief that we can never choose to let life end] would do well, in my opinion, to petition for legislation in their favour.", I was making a serious suggestion. This is a viewpoint I respect, and I thought (and still think) that a law would be the simplest and quickest way to ensure that it is complied with. We certainly cannot pass laws to cover every situation, but if you believe in the sanctity of life and that patients can never choose to die, legislation to that effect could easily be drafted. In the absence of legal guidelines, there will always be disputes.

As regards the liberal/conservative issue, I actually think I'm less leftist than you, RL. I'm generally liberal on social issues, but moderate to conservative on fiscal issues. Like you, I can't defend every 'liberal' cause: In fact, it's morally unacceptable to me to support any party on an issue if I disagree with their position.

And finally, while I agree that "erring on the side of life" is desirable (I don't think anyone objects to this principle), this is distinct from insisting that no-one be permitted to choose to die. My position is that people in a persistent vegetative state, with no hope of recovery, should be allowed to die if they so wish (or rather, if they had indicated this wish while still able to). In the absence of such a wish, the next-of-kin can decide. Yours, I presume, is that this decision can never be made. I think that would actually be more complicated: for one thing, the government would have to financially support such patients. On this, then, we appear to disagree.

Many of the problems you describe are not directly related to this issue. As an example, I'll pick one, the case of people who cannot afford to keep loved ones on life support even if it is likely they will recover. Consider the following problem: a member of your family will die if he/she does not undergo complex, expensive surgery. The surgery will probably succeed, but you cannot afford to pay for it. Wouldn't you agree that this is essentially the same as the previous problem? The solution has nothing to do with life-support: it would be reasonable (from a logical point of view) for the state to pay for both or neither. From an ethical perspective, I - again, like you - would rather the state paid for both. But these are issues best discussed in a separate post.

Sunday, March 27, 2005

Another break

I suspect that blogging will be sporadic, at best, in the near future: My roommates have given me the first three volumes of Gibbon's The Decline and Fall of the Roman Empire! I've wanted to read it for the longest time, so I'm eternally grateful. God bless them both!

And if anyone's reading this today, Happy Easter!

Saturday, March 26, 2005

More blogroll updates

I just noticed that Dilip D'Souza and Bharati have blogs:Death Ends Fun and Lest I Forget, respectively. I also noticed that I've somehow neglected adding QuestionableTaktix to the blogroll. Remiss of me, and I apologise to Sanky, Nair, and Rahul.

Morality vs. Legality

After my last post on the Schiavo case, I spent some time thinking about the moral and legal issues involved, and how liberals and conservatives differ in their basic approaches to the problem. Today, David Brooks has a column on the subject in the Times. His thesis is that social conservatives believe that " ... the life of a comatose person or a fetus has the same dignity and worth as the life of a fully functioning adult", that life is sacred, and hence, presumably, that removal of feeding tubes is akin to murder. Social liberals, on the other hand, believe that there is "... a continuum between a fully lived life and a life that, by the sort of incapacity Terri Schiavo has suffered, is mere existence" and that "... it is up to each individual or family to draw their own line to define when life passes to mere existence." Brooks claims that there are flaws with both of these: the conservative viewpoint is not pragmatic, and the liberal argument lacks moral force.

I disagree with the last statement, as do Matthew Yglesias and others. The liberal argument is rooted in moral principles, just not those which Brooks considers. The principle is that faced with such problems, individuals should be free to choose; in the event of dispute, the courts can decide. Belief in freedom and respect for the law are surely good principles to hold dear.

I want to think about the principles held by those demanding Terri Schiavo be kept alive. Either they believe that people do not possess the right to choose to be 'allowed to die' in such situations, or that the right does not apply in this case. If the latter, why not? Terri Schiavo is in a Persistent Vegetative State (PVS); electro-encephalogram results show no brain activity, even though most people in PVS have about 5% of normal activity. The courts have established that it is probable that she would not have wanted to be kept alive; even if this is discounted, her husband wishes it, and if anyone has a moral right to decide, it is her spouse. The fact that Michael Schiavo may benefit from her death should not be considered; it is routine for relatives who decide to withhold care from a patient to be named as beneficiaries in the patient's will.

For those who believe that people can choose not to be kept alive, but that Terri Schiavo's feeding tubes should be re-inserted, the only remaining moral position I can see is that the patient alone can make this choice and it must be recorded in writing (in the form of a "living will", presumably). If not for the written requirement, there would always be disagreement. This is not a very attractive position, because not everyone would write such a document, and we cannot foresee all circumstances. I, for one, would be uncomfortable to commit either way in advance of an incapacitating accident. I would want my family to make the best decision they could based on medical advice and the probability that I would recover.

With those who believe that life is sacred, and that we may never choose to let it end, I can only disagree; I (sincerely) respect that belief, but it is one I do not share. Adherents to it would do well, in my opinion, to petition for legislation in their favour. It seems to me, though, that only a minority of the demonstrators against removal of the feeding tubes share this viewpoint. What, then, is the moral position of the majority of those demanding that Terri Schiavo be kept alive? I'm genuinely curious; I'd love comments.

Friday, March 25, 2005

Day Tripping

Photos from my trip to Chicago last Saturday have been uploaded.
To head off criticism from family and friends:
a) The only reason there aren't more is that I forgot to charge the batteries.
b) I know I'm not in any of the snaps, but this time it's not my fault. Amul took photographs with his camera, and I'm in those. When he sends them to me, they'll be added to the collection.

More Bits and Pieces

First of all, thanks to madmrid for all the comments. They're a very large part of what makes blogging worthwhile. :-)

Second, I went to Chicago last weekend, and I promised to post photographs here. They'll be up tomorrow. There aren't many of them; idiot that I am, I forgot to charge the camera batteries.

Three, Moebius Stripper is conducting a multi-player pre-calculus bingo contest. Give it a shot! (Full details and history on her site.)

Thursday, March 24, 2005

A Right to Life?

The Terri Schiavo case has been dominating the local news for several days now: every American news website I've checked has it as the number-one story today.

I'm not going to comment on the case itself; pretty much every reasonable position (and almost every unreasonable one) has been presented and argued over in thousands of fora, from TV debates to blog comment threads. The issue has become incredibly politicized: it seems farcical that Republicans brought the issue to federal courts, or even got the government involved in the first place. And subpoenaing her so that she would have to be kept alive was downright stupid. I honestly don't see what all the hoop-la is about. There seem to be only three options:
1) Let the courts decide, and abide by this decision. If the decision is not the one you want, you'll just have to accept it.
2) Pass a law which would deprive Mr. Schiavo of the power to stop the feeding of his wife. This could be specific enough to apply only to the Schiavos (but that would be ridiculous, and probably unconstitutional), broad enough to apply to all spouses of patients in a Persistent Vegetative State (but then who else could make the decision? Who could be closer than a spouse?), or somewhere in between.
3) Amend the constitution in one of a hundred ways that could keep Terri Schiavo alive.

The third option is nonsense, and the second probably wouldn't work. That leaves only the first, but too many people seem to find it unpalatable. Even worse, they resort to legal irrelevancies like ad-hominem attacks on Michael Schiavo. (Some of the comments may be morally relevant, but that's a whole different ball game, which I'll come to in a later post.) In the absence of a "living will", the law says that the spouse decides, and Michael Schiavo wants the feeding discontinued. That should be all there is to it, and conservative talk-show host Neal Boortz explains why Christians should be willing to let Terri go to heaven after 15 years of suffering. Of course, if there is a reasonable doubt about the facts of the case, we should definitely "err on the side of life", as President Bush put it. Bill Frist's remote diagnosis doesn't cut it, though.

As an aside, Andrew Sullivan and Dahlia Lithwick point out another inconsistency in the Republican position: if marriage (even civil marriage) is a 'unique and special legal bond' between two people (one which must be protected from corruption by gay couples), then Michael Schiavo is the only person whose opinion matters in the slightest. (For someone who wasn't going to comment, you managed a fair bit - ed.)

Unfortunately, while the nation's attention is focussed on the circus that the Schiavo case has become, more serious issues are not being addressed. Cuts in funding for Medicaid and Medicare will result in many more lives lost over the next few years, but we don't have special Sunday sessions of Congress to consider that. E. J. Dionne Jr. has a good column on what being 'pro-life' really means. Sadly, I doubt we'll ever have thousands of people demonstrating in favour of Medicaid reform. Elizabeth Barrett Browning's lines in Aurora Leigh come irresistibly to mind:
A red-haired child
Sick in a fever, if you touch him once,
Though but so little as with a finger-tip,
Will set you weeping! but a million sick ...
You could as soon weep for the rule of three,
Or compound fractions.

Tuesday, March 15, 2005

Tidbits

The Harvard faculty passed a no-confidence vote against their president, Lawrence Summers. This isn't the end of the world for Mr. Summers, who is responsible to a governing board that supports to him. Still, it can't have been a pleasant experience.

The Times is carrying a good editorial on why reform should begin in primary school, not high school. This is obvious, and it's bothered me that more people weren't saying it all along.

When I visited the Washington Post website today, the headline "Poll: Iraqis Better Off But War Not Worth Fighting" screamed at me. The obvious assumption is that the poll was conducted among Iraqis; in much smaller type below, we read "Majority of Americans feel...". In all fairness to the Post journalists, the headline of the actual article is "Americans Believe Iraqis Better Off Today", but the way it's presented on the home page is misleading, to say the least.

Staying with the Post, Richard Cohen provides a good example of how media organizations striving for 'balance' in coverage can go too far. C-SPAN wants to balance an upcoming Holocaust lecture at Harvard with David Irving, a Holocaust denier who has been ruled "anti-Semitic and racist" by a court in a lawsuit he filed.

The best news of the last couple of days was the huge demonstration in Lebanon yesterday against Syrian intervention in their country. Most of the American media outlets I've looked at have only vague figures on the total crowd size, but organizers claim over a million participants and the Associated Press put the total at 'well over 800,000'. For some perspective, the total population of Lebanon is 3.5 million. That is, one in every four Lebanese was at the protest!

I have a Complexity exam tomorrow, so thoughts on these and other issues will have to wait until that's over.

Monday, March 14, 2005

Books of the Month: March 2005

In a email exchange yesterday, I wrote "I grew up in a small town in India where it was often very difficult to find books. It sometimes took years for me to get my hands on books I wanted, and I hated the waiting." One of my favourite things about America is that every book I really want is available from one of:
a) the Urbana Free Library
b) Campus Libraries (UIUC apparently has the third-largest academic library system in North America, after Harvard and Yale.)
c) the Illini Union Bookstore
d) Amazon or eBay.

In the last six months, I've read books ranging from Clausewitz' On War to E. B. White's The Trumpet of the Swan, books by Mark Twain and Stephen Donaldson, books of science fiction and on the science of Economics. I've found so many treasures that I've decided to pick (at least) two of my favourites every month and describe them here.

March's books are Manalive (Warning: The Amazon review contains spoilers!) by G. K. Chesterton and The Good Companions, by J. B. Priestley. They're both superb, absolutely; the only other thing I'll say about them is that you should get your hands on them at once, at once. If that last sentence seems awkward, you really need to read The Good Companions at once :-)

I discovered the books only because they were highly recommended by Deepak and Lakshmi, respectively. Readers are invited to list in the comments any outstanding books they've read in the recent past; I (and possibly some of the other commenters) would love to try them.

Monday, March 07, 2005

More on Software Patents

There were several things I wanted to blog about, including several good editorials in yesterday's Post, and one from today which begins:
Remember the gag about "the three biggest lies"? They were: "The check is in the mail," "Of course I'll respect you in the morning" and -- the punch line -- "I'm from the government, and I'm here to help you."

Maybe it's time to add a fourth: "We're from the private sector, so naturally we'll do it better."
William Raspberry explains why Private Doesn't Mean Better.

Worthy as all these subjects undoubtedly are, today's post is on everyone's favourite topic: Software Patents. The European Council approved a directive on Software Patents today in spite of opposition from Poland, Denmark and Portugal, and a demand by the European Parliament to re-write the directive. The directive now goes to the parliament again, but a larger majority is needed to reject or amend the directive. The Foundation for a Free Information Infrastructure (FFII) - the best resource I've found for information on the status of Software Patents in Europe - has some good coverage, along with a 'Horror Gallery' of European Software Patents (including a patent by Sun Microsystems on converting Windows 95 filenames to the Windows NT format, allegedly taken for the sake of annoying Microsoft).

I really did intend to write a serious post about why patenting Software is Evil (TM), but this is just so funny I had to change direction slightly. Pat-rights, a Hong Kong-based company, is threatening to sue Apple for infringing on their patent on 'Internet User Identity Verification' - somewhat ridiculously titled 'Protection of software again [sic] against unauthorized use' - United States Patent number 6,665,797.

I spent half an hour trying to figure out what, exactly, the patent covers, but am not much nearer to any conclusions than I was when I began. It appears to apply to any software-based system for authenticating users attempting to access any server to obtain 'service(s) or software product(s) or alike' (which isn't even good grammar), particularly when secure operations must be performed when payment is involved. The date on the patent is December 16, 2003; the decades of prior art seem to be irrelevant. (Granted, e-commerce hasn't been around for decades, but software-based user authentication certainly has.) The patent application says:
Conventionally, software protection methods for protecting commercial software products such as programs, multimedia software, distributed through a communication network, such as a telephone system, require a user computer to have a piece of hardware comprising decryption keys and system be installed therein, for to be authenticated by a software program running on the computer.
Are we to believe that every system prior to 2003 distributed hardware to permit access to its servers? The application also states that the invention provides a method to to discourage rightful users of the software from copying it 'to [sic] someone else' by means of a 'psychological barrier.'

Pat-rights' business model (openly stated) is to file patents, and collect 'staggering' license fees from infringers. So far, they have a grand total of 3 patents in their portfolio - one described above, one on Mobile commerce, and the third covering 'Vehicle Smart Window Safety Control.' This last is absolutely hilarious: a smart window (for the ignorant, like me) is "a window whose transmissivity / transparency can be changed electronically, i.e., by depression of a button, for stopping excessive incoming sunlight or for providing privacy, etc." The patent does not cover technology for building smart windows because Pat-rights does not have any such technology. This didn't stop them; they came to the stunning conclusion that any smart window must have a method for the user to control the transparency. Further, if the window is insufficiently transparent, this would make driving the vehicle dangerous. Therfore, the geniuses at Pat-right have patented "preventing an occupant of a moving vehicle from inadvertently touching the manual switch and causing the transmissivity / transparency of a smart window [sic] to a level dangerous for forward driving." In the 'Commercial value' section of the patent description, they proudly proclaim "While betting on a particular smart window technology may be risky, our vehicle patent provides a more secure investment opportunity, because it will always be indispensable, as long as there will be a success [sic] smart window technology in the future!"

While I'm laughing helplessly now, I'm depressed that people would consider this a viable business model. What's worse, I'm horrified that many of these patents are actually being granted by governments world-wide. The entire patent system is in urgent need of an overhaul, but no-one seems interested.

More information on the Pat-rights claim of Apple's infringement (and another affecting the iPod) are available here and here.
Hat tip: Slashdot.

Wednesday, March 02, 2005

The Jedi Mind Trick

From Learning Curves, via Ernie's 3D Pancakes.
I wonder if this semester is going to see a significant improvement in student evaluations of Math/CS teachers. :-)

No More Executing Juvenile Offenders

The Supreme Court narrowly (5-4) ruled that executing people for crimes they committed as minors was 'cruel and unusual punishment'. Interestingly enough, the court believes that a "national consensus" determines what constitutes 'cruel and unusual punishment'. Even the four Justices who dissented appear to concede this point; Justice Antonin Scalia objected on the grounds that such a consensus did not exist. This is not a new point of law, merely one of which I was ignorant: it apparently dates back to a 1958 ruling which states that as society matures, its standards of decency evolve. What is new, though, is that international opinion appears to have influenced the decision. The five judges who formed the majority and Justice Sandra Day O'Connor believe that international trends help define the meaning of 'cruel and unusual punishment.' The United States was - until today - one of the few countries to permit the execution of those under the age of 18, and the majority opinion holds that the views of the rest of the world confirm their conclusions.

My feelings on the whole issue are decidedly mixed. To begin with, I'm against the death penalty entirely. Gandalf sums up my feelings perfectly in this conversation - about Gollum - with Frodo: "Deserves [death]? I dare say he does! Many that live deserve death. And some that die deserve life. Can you give it to them? Then do not be so eager to deal out death in judgement."

On the other hand, a previous ruling had already prevented the execution of children aged 15 and younger at the time they committed the crime. The new ruling affects 16- and 17 year-olds, and was partially based on evidence that they are too immature to be held completely accountable for their crimes. This leaves me feeling uncomfortable: Is 16 too young to realize that murder is wrong? And the death penalty is usually reserved for juvenile crimes that are particularly brutal, or for serial offenders. In my opinion, 16 year-old criminals probably know enough to be responsible for the consequences of their actions, but I'm willing to concede I may be wrong; I don't know much about the typical American teenager convicted of such crimes. Still, one would think that if you can't be held accountable at 17 years and 6 months, half a year more won't make much difference. To be fair, though, the same could be said of any artificial boundary, and I presume juries make appropriate allowances.

Surely a cleaner solution would be to abolish the death penalty altogether? The Supreme Court probably won't have a role to play, because the Constitution (via the Fifth Amendment) allows for the existence of a death penalty. Either the Constitution could be amended again (which is unlikely), or the 38 states that allow capital punishment could ban the practice. It'll be an uphill battle, but with luck, we'll get there eventually.

So here's what I think:
1. The death penalty should be abolished.
2. I'm glad the Supreme Court abolished the execution of minors, but I feel that the reason advanced (that 17 year-olds are too immature to be held completely accountable) was somewhat specious.
3. The way to get rid of capital punishment isn't via the judiciary; instead, the various state legislatures should outlaw it.

Tuesday, March 01, 2005

It feels good to be back!

I've been busy for the last two weeks, and so haven't had time to blog at all. I actually experienced mild withdrawal symptoms; after the first few days with no posts, I began to feel an urge to blog again! Unfortunately, assignments and mid-terms for the courses I'm taking - and grading for CS 225 (which I'm TAing) - kept me from writing. The horror that hit me one morning when I realized I hadn't read the previous day's newspapers is still fresh in my mind. :-) (Ok, so I'm a news junkie. Deal with it.) I still have most of an assignment for Computational Complexity left undone and over 150 papers to grade, but they'll just have to wait.

Quick updates for everyone who asked:
1. Mid-terms were ok. Not good, but that's the best I can say about them.
2. The Complexity course (CS 579, for the curious) hasn't become any easier. The only thing that consoles me is that everyone else is finding it incredibly difficult too. A friend commented that it takes a special kind of masochism to register for a course where collectively, the whole class can solve less than half the homework. Still, it's a lot of fun. More than that, it's beautiful.
3. The Socratic method worked with my CS 225 sections. More precisely, I used a modified version, to account for the fact that the students were familiar with some of the material from lectures. Participation in class has increased drastically, and they've even done well on the mid-term! (The fact that the exam was easier than usual has nothing to do with it, I'm sure. - ed.)

UPDATE: My apologies to Dilip Hiro, whom I quoted last night. For some reason, I read 'Iran' as 'Iraq', and so found a perfectly reasonable sentence hilarious.
I didn't even realize my error after reading the sentence several times! I haven't felt this stupid in a long time. Many thanks to Suresh for pointing this out.