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SO NECESSARY
Re: Quin Hillyer's Why Revenge is Necessary:

That was the most brilliant article I have read in quite some time. God bless you!
-- Joe Mason DMD
Sapphire, North Carolina

THE ISSUE OF DEATH
Re: George Neumayr's The Future's Shadow:

Mr. Neumayr did a serious disservice to your readers with his recent article discussing the possibility of obtaining organs from patients who die in Emergency Rooms. I write this as a physician and critical care medical specialist. First, Mr. Neumayr begins with a criticism of Obama's health care policies and makes the point that that his policies promote abortion and use human embryos as fodder for lab experiments. These criticisms are both 100 percent on target. Based on these two facts alone Americans should be loathe to place the rest of the health care system in the hands of this Administration. The folly of doing so has been discussed eloquently by your many contributors. In fact as a physician I could outline probably hundreds of reasons Obama Care is a disaster and why this administration in general is a catastrophe.

Still the Department of HHS's move to obtain organs from those who die in Emergency Rooms is not one of them. Mr. Neumayr confuses the issue by stating that brain death and cardiac death are confusing terms and conflate the dying with the already dead. This is nonsense. It can be said only by someone who does not understand the terms. First what is "cardiac death" is simply a shorthand phrase that describes they way Physicians have pronounced death since as far as we know people have recognized death short of waiting for decomposition to set in. Traditionally people were declared dead when they were found to have no pulse or respirations, and were non-responsive, with fixed and dilated pupils. As it happens this is what is referred to as pronouncing death by "traditional" or cardiopulmonary criteria. It is what is meant by "Cardiac death". With the advent of modern intensive care it is possible to artificially maintain the pulse and respirations of people who have permanently lost all brain function. Such individuals will in some ways look exactly like those pronounced dead via traditional criteria. For example, they will be non-responsive with fixed and dilated pupils. Still they will have an artificially maintained pulse and if connected to a mechanical ventilator will have respirations. Eventually as the functions of the autonomic nervous system are lost, the ability to maintain a blood pressure artificially is lost and eventually regardless of interventions circulatory collapse (loss of heart beat and pulse) follows. Such individuals if they have blood flow to their brain measured even while they are being artificially maintained will often have no detectable blood flow to the brain, in effect they are physiologically decapitated. The situation is analogous medically to having someone have their head chopped off and taking the corpse and artificially maintaining a blood pressure and inflating the lungs with air. These individuals are not badly brain damaged, they are in fact dead. This was a state only possible to observe with the advent of modern intensive care. It became clear that such individuals only had artificial signs of life. In fact at autopsy such patients would often be found to have a liquefied intracranial contents ( the brain dissolved classically called "respirator brain in an older literature" ). This lead to the description and acceptance of brain death as a phenomena. In fact it is clear that all death is really "brain death". That is, you as a person are dead when you have sustained the irreversible loss of function of the entire brain. The only reason that someone can be pronounced "dead" when the have no heart beat or pulse is that without blood flow supplying oxygen and nutrients to the brain. Conversely, loss of pulse and respirations in and of themselves do not mean someone is dead so long as the brain is protected. This is amply demonstrated by multiple cases of individuals who "die" from a cold water drowning, and who are subsequently resuscitated. They are not brought back from the dead, but rather although "pulseless" the brain did not suffer irreversible damage because of the protection afforded by being cooled in cold water, as is the case with this type of accidental death.

All of this may appear rather technical. Perhaps Mr. Neumayr would concede that the Catholic Church, which opposes Euthanasia, would have a problem with the concept of "death." In fact, as he should know, the Catholic tradition has historically supported the concept. In fact, John Paul II (on his way to be canonized) declared in a talk to a group of Italian Transplant physicians:

Here it can be said that the criterion adopted in more recent times for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology. Therefore a health-worker professionally responsible for ascertaining death can use these criteria in each individual case as the basis for arriving at that degree of assurance in ethical judgement which moral teaching describes as "moral certainty". This moral certainty is considered the necessary and sufficient basis for an ethically correct course of action. Only where such certainty exists, and where informed consent has already been given by the donor or the donor's legitimate representatives, is it morally right to initiate the technical procedures required for the removal of organs for transplant.

The full text is available on the Vatican website.

In any case while I almost always agree with Mr. Neumayr, in this case he is confusing the issue. There are a lot of reasons to wish that the Obamanities were out of power, but this issue of the definition of death in not one of them.
-- Michael DePietro MD
Newark, Delaware

A CORRUPT BUNCH
Re: Jeffrey Lord's Specter Opens Door on White House Felonies:

Thank you for what looks like some good investigative journalism!  Regarding Robert Gibbs, Dick Armey said in response to a question about Tom Delay; "When you make a deal with the devil you become his junior partner." Robert Gibbs is culpable here. He comes across as the dumb puppet on the arm of the ventriloquist, but, I think he's 'dumb as a fox' and perhaps guilty as hell. I don't care if he is as lucky as Ron Z, he's playing the part at least of the loyal press secretary. If this is the case and he hasn't the integrity to resign he deserves like the rest of this "Chicago style" corrupt bunch to go down with that ship.

Keep up the good work!
-- Saxton Wiley
Ft. Collins, Colorado

A MOST OPPORTUNE TIME
Re: Mark Rotterman's Beware the Emboldened Left:

Marc Rotterman wisely points out that Barack Obama is a streetwise, tough politician. It's also well to remember that all politics is local, and in this case local means Chicago. On March 18 it was reported that the judge overseeing the corruption case of former Governor Rod Blagojevich denied a defense motion to delay the proceedings until November 2010. The former governor is charged with attempting to sell the Senate seat vacated by President Barack Obama.

Now the case will go ahead as scheduled on June 3, 2010. Blagojevich, who has vowed to testify, has demanded the playing of all recordings secretly made by investigators of his conversations in late 2008. The amount of soiled Illinois Democratic laundry to be aired could be immense and far-reaching. This perhaps, is yet another tough, streetwise reason to get the Health Care bill passed in March, 2010. The presidential trip to Asia can wait for a more opportune time.
-- Stan Welli
Aurora, Illinois