Tuesday, July 11, 2017

The Lesson of the Charlie Gard Affair

The Charlie Gard case is exciting conservatives from the US to the Vatican, because of what it says about government programs.

Charlie Gard is a baby in the UK with a severe genetic condition that has resulted in irreversible brain and organ damage. But there is an experimental treatment called "nucleoside therapy" and a US hospital has agreed to offer Charlie the treatment.

The BBC has a helpful article "Charlie Gard case explained" to help the perplexed.

If you read the BBC story it takes the line that science has decided the case and
courts ruled that the original [hospital] decision should stand and that it would be in Charlie's best interests to be allowed to die with dignity.
Notice the passive voice. What is more,
The therapy is a treatment, not a cure. And it is highly experimental.
All very good. And perfectly logical and in accordance with science and expert opinion. But this was not a passive decision as implied by the BBC's passive voice. What happened is that the British government decided not to spend the money to keep Charlie Gard alive.

Naturally the BBC is perplexed that folks like the Pope and Donald Trump have intervened. Thus
The president of the Royal College of Paediatrics and Child Health, however, says such interventions from high-profile figures, no matter how well-intended, are "unhelpful".
Of course he did.

Now I want to make two points here. The first is that the BBC and the British National Health Service all believe in the supremacy of the administrative state and its scientific world view: that expert opinion, based on settled science, administered through government programs, should be dispositive.

The second is that most people are perfectly happy with this, because it removes them from responsibility.

On the first point, the only problem is: what if the experts are wrong? We have the example of climate change where the ruling class, prompted by international bureaucrat Maurice Strong, decided that carbon dioxide was a problem and then set up an ideological system on the assumption that carbon-based energy equals more CO2 equals runaway global temperature equals the end of the world, therefore the ruling class should control the production and use of energy. OK, but what if they are wrong? How would we know? How could we correct the mistake?

Because that is the question of first interest in any system or culture or any situation in life. What happens when things go wrong?

On the second point, of comprehensive government programs, specifically "single payer" health care, the system takes away the right of individual action against the system. The system, here including the Great Ormond Street Hospital and the court system of the UK, decided that it is "in Charlie's best interests to be allowed to die with dignity." Even though Charlie's parents had found the money to  pay for Charlie's treatment outside the NHS system they were forbidden to remove Charlie from intensive care in Great Ormond Street Hospital to seek this treatment. In other words, the state has primary custodial rights over the children of the UK, not the parents. The parent has no right to dissent from the state's custodial supremacy.

It is my belief  that most  people are quite happy with this, for a simple reason. When the state has supreme rights over you and your children, it relieves you of the responsibility of making tough decisions. If you are the subordinate subject of a national health system and the system says you are too old to get a hip replacement, well, that's it. You complain about the system and about its injustice, but you don't do anything about it. You don't have to, because the system decides for you.

In reality, if you have a ageing mother that needs a hip-replacement or an expensive experimental cancer treatment, you could pay for it yourself. You could mortgage your house, draw down your IRA, whatever, to save mom's life. And if you decide not to then, if you are a woman, you will feel guilty about it for the rest of your life.

See the benefit of the government program system? If anything goes wrong, you can just sit back and blame the system, or the insurance companies, or the drug companies, because they did nothing to help your mother. You can see that this plays beautifully into what I call the woman's Culture of Complaint.

If you think that, then according to my reductive Three Peoples theory, you are a Person of the Subordinate Self. OK, no problem, the world has always been full of workers and peasants.

But if you are a Person of the Responsible Self you rebel against the notion that the government gets to decide whether to pull the plug on your child, or that the government gets to decide whether you are too old to get a hip replacement. You are the kind of person that agrees to take responsibility for your actions, even when you make the wrong decision. You are the kind of person that is willing to live with the guilt of being wrong. You are willing to live with the knowledge of your own selfishness when you decide not to empty out your life savings to save your child's life.

Now right now I am involved in an end-of-life situation with Lady Marjorie's mother. About a month ago we put her into hospice mode. That means that she can't be kicked out of her retirement community. Hospice care is free under Medicare, but you don't get to go to the ER when you have a medical emergency. Instead you get palliative care.

So, at some point last week the hospice people advised not to use antibiotics to fight a possible infection, under which Marjorie's mother was in extreme distress with coughing and liquid in the respiratory system. Instead they applied palliative care. Which basically means applying pain medication and other measures until the patient expires.

Do you see what is going on here? The system is getting to decide what to do about the end of life of an ageing Medicare recipient. And the system has a rather obvious interest, that of limiting heroic methods and the associated expense to save a life. And being a system, it does not make moral and ethic decisions. It makes technical decisions, like the decision about Charlie Gard, that "it would be in Charlie's best interests to be allowed to die with dignity."

But as I say, System is Domination. When  the system decides whether you live or die, it is not science or law or morals or ethics. It is Domination.

And that is something that our liberal friends do not understand.

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