WYSONG HEALTH LETTER
Dr. R. L. Wysong
April 1991

Less Fat In, Less Fat On
 
    A study out of Cornell University measured the effect of low-fat diets, with unrestricted consumption of food, on weight loss.
    Thirteen females were randomly assigned either a low-fat diet, consisting of 20-25 percent of calories as fat, or a control diet, consisting of 35-40 percent of calories as fat, for an eleven-week period.   After this study period they were allowed a seven-week washout time, and then the conditions were reversed for another eleven weeks.  In other words, it was a crossover study.  Menus were designed so that no matter what the subjects ordered, they received the percentage of fat assigned to their group.  Those in the low-fat group only calorically compensated by 35% by the end of the 11-week period, which resulted in 2.5kilograms of weight loss during that 11-week period, which was twice the amount of weight lost by those on the control, higher-fat diet.
    The significance of the study is that it demonstrates that by simply lowering the amount of fat consumed, weight can be lost.      As we discussed in some detail in previous issues of the Review, the body likes to convert fat consumed into fat deposited.  It only takes three percent of the calories of fat consumed for the thermic assimilation of the calories in the fat.  On the other hand, as you may recall, it requires23 percent of the calories within carbohydrates to make them available for energy 40 be used by the body.  Thus, fats are assimilated efficiently, and the body treats them Os a precious reserve of fuel, due to their containing almost three times the net caloric value of other food products.  Therefore, the more carbohydrate and protein that is eaten, the more the body must use its energy resources simply to me4abolize these products, and thus, there results less net energy consumed.
    This emphasizes what we have stated before, and that is if you want less fat on your body, consume less fat.  If you wish to consume less fat, de-emphasize animal products in your diet.
    Reference:         
        Kendall, Anne, Ft. Al., American Journal of Clinical Nutrition, volume 53, Number 5, May 1991, pp.1124-1129.
 
Natural vs Unnatural Fish Oil
    Natural is a tired word that is being worked over relentlessly by both proponents and opponents of the natural foods movement.
    Absolutes, upon close examination, often become neither black nor white, but varying shades of gray.   “Natural” is a word that cannot be defined in absolute terms.  It is a term that signifies degree of relationship to the pristine, pre-industrial, natural world.  This is probably the most common perception.
    However, argument could be made that all of the activities of humans, including their industrial, and consuming, polluting ways, could also be called natural, since humans are natural, and therefore, their acts are natural.  And of course, ”natural” fruit juice can be argued to be natural, even if it only contains 5% real fruit juice.
    The argument could be continued to include so called natural nutrients, and supplements.  In other words, canon extract from a natural plant, such as vitamin F tocopherols is truly considered natural after they have been removed from that natural context.       Similarly, can vitamins, which are synthesized in a laboratory to duplicate the chemical structure of vitamins extracted from plants, be truly considered natural out of their context?  Nutrients are never found isolated in nature, they are, therefore, not natural if taken as single, isolated nutrients.
    We have taken the position in the Reviews that the more whole, and unaltered the food is, the more likely we will be to derive benefit from it.  We have cited different examples demonstrating this, including a reference this month to the better value of choline as a part of lecithin, than as an isolated ingredient.  We have mentioned vitamin C as a component of citrus extract being superior to pure ascorbic acid, and natural vitamin E being superior to synthetic vitamin E. There are many other examples, but even these do not fully demonstrate the validity of our synorgonic theme, since in some cases, comparisons are simply being made between an extract and synthetic, or an extract made of a conglomerate of nutrients, as opposed to one isolated part of that extract.
    In any case, evidence seems to slowly be accumulating in the literature to demonstrate that, as a matter of degree, the closer we get to the more natural, complete, unextracted raw source of the nutrient the better that would go something like this:
    1.    Natural, whole, raw ... the best
    2.    Whole, natural, concentrates or extracts
    3.    Single, natural, components extracted from #2
    4.    Synthetic duplicates of natural nutrients
    5.    New, synthetic compounds not found within nature ... the worst.
    We have talked many times about the functions of omega-3 fatty acid in the diet.  This is now a popular health theme, and has gained credibility by a plethora of scientific studies demonstrating the value of increased omega-3 to omega-6 fatty acids in the diet.  The assumption has been made that consuming isolated omega-3 fatty acids derived from fish would fulfill the benefits of this nutrient.  Recent studies have shown that if whole fish is eaten, that the omega-3s are both absorbed better than the extracted oil and exert a more beneficial effect on the blood lipid profile than the isolated oils.  This simply is another example of how there are elements within the matrix of whole natural foods that complement out systems to exert a more healthful benefit.
    Focusing on isolated nutrients treats the body as if it is comprised of parts, rather than a synorgonic whole as a part of synorgon itseIf.  Food is a complex, a matrix, we are a complex and a matrix, our world is a complex and a matrix.  Therefore, eating and living as If we are an integral part of this matrix, and not simply a component made from other components requiring the consumption of components, is the best course to achieve and maintain heath.
    Reference:
        The American Journal of Clinical Nutrition, volume 53, Number5, May, 1991 pp.1210-1216.
 
Natural vs Synthetic Choline
    We have continued to emphasize the rationality of whole, natural foods 95 sources of dietary constituents.  The prevailing opinion, however, is that a nutrient is a nutrient, regardless of its source, either from a chemist’s bench or directly from the vine.       Conventional nutritional thinking freely puts down those who would argue that naturally complexed nutrients are superior to isolated, synthetic forms.  We have mentioned some controlled studies previously in the Review regarding ascorbic acid and beta-carotene, for example, which demonstrate the superiority of natural sources of these particular nutrients.
    I want to mention here some studies which have shown the superiority of lecithin, as it is a part of natural foods, such as egg yolk, soy, and many other foods as a source of choline, as compared to choline chloride as a synthetically derived isolated nutrient.
    Lecithin, as you may recall from our sections on lipid nutrition, is phosphatidyl choline.  The three-carbon glycerol is occupied by two fatty acids in the numbers 1 and 2 positions, and a phosphate in the number 3 position, which is, in turn, attached to choline.  Such phosphatides are common components of cellular membranes, as you may recall.  Choline is a precursor to acetylcholine.  The brain is unable to synthesize choline, and thus is dependent upon blood levels for the synthesis of acetylcholine to occur through the action of the enzyme choline acetyltransferase, which converts the choline to acetylcholine.
    Studies of the relative availability of choline from ingested lecithin as compared to isolated choline were undertaken to determine the effectiveness of choline in tardive dyskinesia.  This central nervous system disorder is believed to reflect increased dopaminergic activity, to the expense of cholinergic tone.  Choline is a component of cholinergic neural transmitters, and is known to ameliorate certain cholinergic deficiency states, such as tardive dyskinesia
    In a couple of studies we have reviewed, both choline and lecithin were able to raise blood levels of choline, but lecithin did so much more effectively.  It also was virtually without side effects, whereas choline showed side effects, such as a fishy body odor, gastrointestinal Irritation, poor palatability, and the aggravation of Parkinsonian signs.  It might be mentioned here, also, that lecithin has been given to patients at levels of 100 grams daily, for over four months, with no adverse ill effects noted.
    So, this becomes another useful piece of evidence for those needing controlled studies to show the merit of naturally complexed nutrients.  It is also good to remember that the relative paucity of such comparative studies between natural complexes and synthetic isolates should not be taken 40 mean there is scanty evidence for our synorgonic contention.
    Studies must be funded and who is going to fund, for example, a controlled expensive study showing nutrients in whole foods are better than their synthetic copies?  Does a vitamin C manufacturer want to do this?  Hardly, for obvious reasons.  Does an apple or orange farmer want to do this, when the hundreds of thousands it would take to create a study to satisfy poor reviewers would boost the business of every other fruit and vegetable grower in the World?   Few would be so optimistic.
    The lack of data in our commercialized world may mean nothing more than the unprofitability of a particular discovery.  Scientific inquiry and knowledge, much more than we would like to believe, comes out of a cash register.
    References:
        Gelenberg, Alan J., M.D. et. al., American Journal of Psychiatry, Volume 136, Number 6, June, 1979, pp.772-776.
        Wurtman, Richard J., Ft. Al., The Lancet July 9, 1977,  p. 68-69.
 
More Problems With Meat-Eating
    You will all no doubt remember, from your American Literature coursework, Henry David Thoreau, the remarkable individualist who so independently lived on Walden Pond for a little over two years, in a small cabin which he had built by hand himself - furnished with his three chairs as he described them: one for solitude, two for company, three for society. Thoreau is famous for simple, beautiful philosophies, including defining what he termed the necessaries of life - Food, Shelter, Clothing, and Fuel but he got really wound up when he could talk about how we have gotten to the point of having too much of each of the necessaries. In his day, that is, he considered already that civilized man was using too much food, had shelters which were far too extravagant, owned far too much, had overly ornate clothing, and consumed fuel far beyond the truly necessary. He saw the people of his era as overdressed gluttons who were cooking themselves with fires kept far too warm. As he wrote, “The luxuriously rich are not simply kept comfortably warm, but unnaturally hot; they are cooked a la mode. On the necessity of clothing he wrote: “We don garment after garment, as if we grew like exogenous plants by addition without... Only they who go to soirees and legislative halls must have new coats, coats to change as often as the man changes in them. I say, beware of all enterprises that require new clothes... The principal object is, not that mankind may be well and honestly clad, but, unquestionably, that the clothing corporations may be enriched.”- Recall, he lived and wrote at Walden Pond during the 1840’s.
    To our topic; which is meat-eating, I’m sure you’re wondering why I’m beginning with Thoreau. You’ll understand when you hear what he wrote more than one hundred and fifty years ago. I quote him: “One farmer says to me, ‘You cannot live on vegetable food solely, for it furnishes nothing to make bones with;’ and so he religiously devotes a part of his day to supplying his system with the raw material of bones; walking all the while he talks behind his oxen ,which, with vegetable-made bones, jerk him and his lumbering plow along in spite of every obstacle.”
    So as Thoreau saw it 150 years ago, we’re killing ourselves seeking more and more of what is not necessary and may even be harmful. The farmer works every day, a slave to the land, to gain meat he does not need, to build a bigger home, to buy more clothing and fuel. Meanwhile, his vegetarian oxen are healthiest, strongest, and perhaps happiest.
    This is a subject we have touched upon before, but I want to return for another brief look at what meat-eating is doing to us all. For our own health’s sake and for the sake of the environment at large, each of us needs to seriously consider eating most of our food from much lower on the food chain. The United States is the only country which structures its agriculture the way we do, yet other countries, as they gain wealth, are beginning to follow suit and devote much of their resources to raising animals for meat. Before we started this trend, it was different: most livestock were raised as a sideline to crops. People ate the plants primarily, and turned the plants that they could not eat info fodder for animals which they could eat. Only in the United States has livestock stood at the center of agriculture, absorbing much of our crop harvest along with a hust percent of the energy and water spent on agriculture, rather than as a sideline.
    Although we have begun slowly to decline in beef consumption, we have gone far up in chicken. Egg consumption has declined, but turkey has risen. We’ve simply been jumping away from some animal products to others. In 1955 per capita consumption of beef and chicken combined was about 137 pounds; today it is 178 pounds. Less beef, perhaps, and more chicken - but far more all together nonetheless.
    An average family of four eats half a steer, a whole pig, and a hundred chickens a year. That is a tremendous demand for meat for agri-industries to keep up with, so the farm has become a factory. Only cattle spend most of their lives in daylight or actually go outdoors. Gigantic, darkened sheds keep broiler chickens indoors their entire lives, with conveyer belts feeding them precise grain rations, often laced with growth hormones and antibiotics which make their way into the meat of the chicken and into us. These food additives are necessary because of the unhealthy lifestyle of the chickens. Egg production is similar to that, but with two conveyer belts - one for grain to feed, one to toke away the eggs. These animals never see the light of day. Pork comes from warehouse-sized sheds often built over sewage canals which sluice away the manure. The only animals who graze outdoors are the cattle and dairy cows, but their grazing in such huge numbers which are required by our appetites’ demands is ruining the land and polluting the air.
    More than 70 percent of our country’s grain production is fed to livestock. Last year, according to the USDA, 162 million tons of grain, mostly corn but also sorghum barley, oats, and wheat were eaten by livestock Millions of tons of protein-rich soybean meal rounded out their diets. No other country In the world can afford to feed so much grain to animals. The last months of beef cattles’ lives are spent in outdoor feed lots where they are encouraged to gorge on rich rations of corn, sorghum and soybean meal to fatten them for slaughter. An Iowa-based nonprofit research group, the Council for Agricultural Science and Technology, indicates that all that grain, if it were instead consumed directly by humans, could nourish five times as many people as it does after it has been converted into meat, milk and eggs.
    While agricultural energy use varies from food product to food product, it is overall very high. Pork production is the worst offender, taking 14,000 kilocalories for just one pound; and while dairy farms use only a fraction of that to produce a pound of milk, producing vegetation for humans to eat overall requires one-third less energy on the farm than supplying meat for humans.      The worst, the production of pork, involves more than 15 times as much energy as fresh fruits and vegetables, but milk is not so bad, using almost as little         energy as plant foods.
    Water is a great problem, too. In California, where water is rationed, nearly a third of irrigation water goes to livestock agriculture. No other area of agriculture requiring irrigation gets such a large fraction. In the animal sciences departments at the University of California, Davis, it has been estimated that it takes about 430 gallons of water to produce a pound of pork, 390 gallons for a pound of beef, and 375 gallons per pound of chicken. The water used to supply each American with just their daily average of meat totals about 190 gallons per day, which is two times what typical Americans use at home for all other purposes.
    And what does all this eating and drinking result in? You guessed it: a lot of animal doo-doo. After it’s dried, it amounts to 158 million tons a year. That’s 7,900,000 typical semi truckloads of animal waste. The range cattle of course produce much of this waste, which is naturally left on the ground to allow normal decomposition. But it is the penned, caged kept animals which produce waste which won’t just decompose and go away. Disposing of this is a huge problem; it must be moved, stored, and spread without allowing it in the water supplies.
    One last problem with all this meat; one we’ve more thoroughly covered before in past Reviews, but I’ll just toss out a reminder about foreign beef, the relatively inexpensive type being bought up for fast food use. Producing a single Costa Rican hamburger involves the destruction of 55 square feet of rain forest. Now, this may only be a small area, but it typically contains one good sized tree, 50 saplings and seedlings, up to 20 to 30 species, small animals and birds ,thousands of insects from hundreds of different species, and an incredible amount and variety of mosses; fungi, and microorganisms. For one burger. eaten in minutes.
    While I could go on with incredible statistics, I have no wish to be overly dramatic here and we’re all hearing plenty of statistics on our society and the environment as it is. Let me be more subtle, let me end, as I began, with a bit of Thoreau: “I see young men, my townsmen, whose misfortune it is to have inherited farms, houses, barns, cattle and farming tools; for these are more easily acquired than got rid of.... Who made them serfs of the soil? Why should they begin digging their graves as soon as they are born? They have got to live a man’s life. pushing all these things before them; and get on as well as they can. How many a poor immortal soul have I met well-nigh crushed and smothered under its load, creeping down the road of life, pushing before it a barn seventy-five feet by forty, its stables never cleansed, and one hundred acres of land, tillage, mowing, pasture, and wood-lot... The portionless, who struggle with no such unnecessary inherited encumbrances, find it labor enough to subdue and cultivate a few cubic feet of flesh... The farmer is endeavoring to solve the problem of a livelihood by a formula more complicated than the problem itself. To get his shoestrings the speculates in herds of cattle.
    Reference:
        World-Watch, May/June 1991
       
Alternative Therapy Dangers
    Alternatives to conventional medicine are often positioned in such a way as to present the opinion to the health care consumer that these alternate therapies are without danger. Although wholism and naturalism have their virtue, and  by their very nature are usually less invasive and manipulative, and   thus less dangerous ,this is not to say that people should tacitly accept the notion that such treatment approaches can bring only benefit, or no result at all.
    A report in the Western Journal of Medicine, for example, demonstrated a danger with acupuncture. Acupuncture is increasingly being used as an adjunct to treatment for the prevention of nausea after general anesthesia, and chemotherapy, and for preventing recurrence of alcoholism and any other uses are applied outside of conventional circles.
    A woman with a history of childhood asthma was experiencing the recurrence of symptoms during her second pregnancy. She had been receiving immunotherapy for multiple pollen allergies, but decided to try acupuncture when pregnant the third time. Needles were-inserted into her upper back, but this elicited immediate, severe pleuritic chest pain. A few hours later she became dyspnoeic, and found conversation increasingly difficult. She presented to an emergency department, and showed radiographically bilaterally tension pneumothoraces. Thoracostomy tubes, and asthma treatment relieved her symptoms, and she was later discharged.
    There have been four reported cases of bilateral pneumothoraces after acupuncture; one proved fatal.
    The point being here not that acupuncture may not be highly useful in certain circumstances, only that it, as well as any other form of treatment, has potential dangers, and should always be undertaken with as much awareness as possible.
    References:
        Wright, R.S.., Et. Al., Bilateral tension pneumothoraces after acupuncture, Western Journal of Medicine, 1991; No. 154; pp.102-103.
        “Pop Goes the Needle, The Lancet, Vol.337; Feb. 9, 1991, pp. 355-356.
 
Male Breast Cancer
    An epidemiological study of male breast cancer in telephone workers demonstrated a significant increase in workers exposed to very low frequency electric and magnetic fields.
    In telephone switching offices the rapid on-off switching of machinery produces complex field environments which can even make compasses, placed nearby, spin.  It’s theorized that these exposures may result in increased susceptibilities of men to breast cancer. The mechanism is believed to, perhaps, work through a suppression of melatonin rhythms, resulting in increased prolactin and estrogen, which can lead to increased estrogen receptor positive breast cancer rates.
    As we continue to surround ourselves with a variety of unnatural electromagnetic fields, it will be likely that increasing numbers of health problems will be related to this aberration in our environment. Because it can not be seen, smelled, or felt, most feel such forces are like likely innocuous. This is the same mentality that lead to many health care workers burning off fingers and developing a variety of radiation related illnesses and cancers when the x-ray machine was first introduced.
    This also demonstrates the need to look at our work environment, and be suspicious of any exposure over a prolonged time to unnatural circumstances. Our body is tuned to a natural synorgonic world. When those balances change, we can expect the balances within our body to change as well. A body out of balance is a diseased body.
    Reference: 
        Motanoski, Genevieve M., Et. Al., The Lancet, Vol.337, No.8743, March23, 1991 , page 737.
 
Lipids and Abortion
    If you might recall from our previous discussions on prostaglandins, the thromboxane forms are pro-inflammatory, and pro-blood platelet aggregatory. On the other hand , the prostacyclins are vasodilatory, and prevent platelet aggregation. The balance of these two end products of a cascade of certain lipids can profoundly effect health. We’ve talked before about how the thromboxane levels can increase with increased consumption of omego-6 fatty acids common in many emphasized modern grains such as corn and wheat, and with arachidonic acid as found in meats. This, then, tips the balance and can lead to inflammatory and aggregatory problems.
    A report out of Finland recently reported that habitual abortion in some women is linked to thromboxane dominance. The authors conclude that a deficiency in vasodilatory prostacyclines may be a factor in habitual abortion. They state further, as we have emphasized before, and I quote, “It is the balance between prostacyclin and TXA2, or thromboxane, which may be more significant for the outcome of pregnancy, than the concentration of either component alone.”
    Since the relative amounts of these two prostanoids is ultimately dependent on dietary intake, it becomes clear that the conversion of the diet to high levels of omega-6, particularly arachidonic acid from meat sources, may predispose to a variety of health problems. By converting the diet to emphasize to a greater degree natural, whole, varied vegetable products, the ratio between omega-6 and omega-3 will be decreased, and thus, prostanoid balance can be restored, and health regained.
    Another testimony to the value of whole, fresh, raw, natural foods, and the respect we must keep in mind for synorgonic balance.
    Reference:
        Tulppala, M., Et. al., The Lancet, Vol.337, No. 8746, April 13, 1991, pp. 879-881.
 
Cancer – Quality of Life
    A controlled study recently reported in The New England Journal of Medicine purports to compare the quality of life, and survival of similarly grouped cancer patients being treated by conventional therapy, as opposed to alternate cancer therapies.
    The conventional therapy involves surgery, radiation, and chemotherapy, whereas the group receiving the nonconventional therapy was supported nutritionally, given coffee enemas, the use of an autogenous immune enhancing vaccine, and perhaps other therapies.
    The report indicates that both conventional and unorthodox treatments produced similar results.
    The significance of this study is that it addresses the question of the relative merits of the two forms of treatment in a rational, controlled way. Unconventional therapies are often supported by anecdotal testimonials, and conventional therapy is supported by the shear authority of the technological, medical community. But it is interesting that this study, per-formed by conventional medical practitioners and reported in a mainstream medical journal,. showed no superiority of one form over the other. The authors state , and I quote, “We hypothesized that survival time would not differ between the two groups, on the basis of the assumption that the unproved remedy would be no more effective in patients with end-stage disease than conventional care, itself largely ineffective.” Thus, we have the explicit admission that conventional therapies are not of superior value to so called unproven, nonconventional therapies. There is also this last admission that conventional therapies are, as they state, largely ineffective.
    These authors argue that the study proves that unproved therapies, as they call these alternate therapies, (although in the same article they admit that their therapies are unproved also,) do not enhance the quality of life.
    It is also interesting in this study that the majority of people who elect alternate nonconventional cancer therapies are more highly educated than those who simply accede to conventional forms.
    I think the high interest in alternate therapies, and the increasing suspicion about conventional modes of therapy is simply an indication that the war on cancer is not being won, and people are electing to not simply bow to medical opinion, but seek more control over their own destiny.
    This trend, an inclination toward self-determination, is a step, certainly, in the right direction and from it, hopefully, new forms of therapy and better education about preventive measures will emerge.
    Reference:
        Cassileth, B.R., Et. Al. The New England Journal of Medicine, Vol..324,No. 17, April 25,1991, pp. 1180-1185.
 
Death and Dying
    It has been said that death and taxes might both always be around, but that at least death isn’t getting any worse Indeed, some are trying to make death better. Death - even though it’s certainly nothing new - is suddenly a hot issue, with everyone wanting to express their view as to how dying should be done the right way. Death has become almost more of a moral issue than a physical one. Some are predicting that the pros and cons of doctor-assisted deaths will soon replace the abortion issue as the most debated issue of our times. Dying with dignity was something everyone used to do; it was the only way. But now that there are options, what is a dignified death? The way we die is becoming increasingly optional and we may soon be faced with choosing from among Dying Plan A, Plan B, etc.
    At the risk of becoming morbid, permit me to share some of the dying styles we have recently looked at. After all, this is something we all can count on experiencing, and even though most of us vacillate between feeling smug or flip about death and feeling abject terror.  It is increasingly becoming something we can think of rationally. It may become similar to the way we would choose a car, a house, a birthing method, a type of wedding ceremony, or any life choice. Let’s take a look at some of the extreme opinions and some which fall in-between.
    At one extreme is Dr. Jack Kevorkian of Michigan, who designed the now-infamous suicide machine which permitted his 54-year-old patient, Janice Adkins, an Alzheimer’s victim, to self administer a fatal dose of drugs. You may recall that they accomplished this more or less together, on a pre-determined day chosen by Mrs. Adkins. She was able to push the button, so to speak, while he stood by and gave support as she died. This case was widely publicized and surrounded by heated debate - ranging from full support and sympathy for what Dr. Kevorkian did, and for the bravery of his patient, Mrs. Adkins, to astonished outrage that they had both broken legal and moral laws. Because Michigan has no laws against assisted suicide, the initial charges of first-degree murder which were brought against Dr. Kevorkian were dismissed. But now civil suits are being brought by prosecutors to prevent Kevorkian from ever again using the machine or building another one. Kevorkian feels so strongly that people should have their lives and deaths so firmly and literally in their own hands that he had once said he would like to establish clinics at which doctors would help terminally ill people kill themselves. He has been stopped, but perhaps only temporarily. He is certainly not the only one who believes that a dignified death is a very personal production - to be both acted and directed by the dying person. If Dr. Kevorkian had his way, we could all choose our day to die, we could go before we became a burden., problem or embarrassment to our families, we could go before too much suffering had filled ours and our families’ last days together. But is this too orchestrated? Too calculating? Does it spare us some final test, perhaps, which we are each of us supposed to undergo for some unknown cosmic reason? Does it fly In the face of a belief system held by many that only their god can choose their day? And the way? And how much suffering?
    Well, one strong opinion at the opposite extreme from Dr. Kevorkian is Julie Grimstad, who is the executive director of the Center for the Rights of the Terminally Ill. Permit me to quote her so that her stand is fairly represented: “I am not opposed to a person dying a natural death at the time of God’s choosing. I am not opposed to a person refusing heroic medical measures or extremely burdensome treatment when death is near and unavoidable. I am opposed to doing anything’ either by omission or commission, to deliberately cause or hasten the death of a human being in order that all suffering may in this way be ended, or to relieve society, families, or medical personnel of the burden of caring for our ‘least brethren’.” She further states that living wills and doctor-assisted deaths take the matter of life and death out of God’s hands and put it into the hands of those - and I quote her here - “who have no interest in our souls and are not concerned about a Christian death.” Now, I am not going to be presumptuous enough to assume I fully understand what she means here by a Christian death, but I am guessing that it is one which comes with the full spectrum of suffering, pain, and grief that may accompany it, as, presumably, a final test from God. I am sure many Christians would not fully agree or may even disagree, I do not mean to imply here that her view is the one most widely held by Christians, but rather that she seems to be on the opposite side from Dr. Kevorkian.
    Now, going back to the other extreme we hear from Joseph Fletcher, who is president emeritus of the Society for the Right to Die, formerly the Euthanasia Society of America, who has said, “What has taken place in birth control is equally important in death control. It is ridiculous to give ethical approval to the positive ending of subhuman life in utero but to refuse to approve of positively ending subhuman life In extremis.”
    It can be argued that if we can choose to receive or not receive modern dramatic life-support measures, if we can choose to donate or not donate our physical organs, why can we not choose to receive or not receive a bit of help along the way toward death, particularly if it is a difficult death for the patient and those who love him or her?’
    One answer to that comes from Dr. James Goodwin of Milwaukee, Wisconsin, who questions the concept that mercy killing, truly arises from a concern for the patient’s well being. In an article entitled “Mercy Killing: Mercy for Whom? (JAMA 1-91),     Dr. Goodwin suggests that since in nature there is no evidence that sick animals want to die - in fact social animals will sometimes sacrifice themselves to save their offspring or for the good of the herd, but not just to spare themselves suffering in a hopeless situation. Given a situation where they could choose death - presumably by jumping off a cliff or into water, or permitting themselves to be caught by a predator - or could choose chronic suffering and misery, he believes most of the cases would find the animal hanging on to the very end. Similarly, he says that very, very few people kill themselves, no matter how sick or crippled they become. I quote him here: “Instead, the experience of every physician is of individuals clinging to life, fighting, as it were, to the last breath. How many patients with chronic obstructive pulmonary disease, with cancer, with congestive heart failure actually kill themselves?” He wants to know, if so few people who suffer such great pain actually do kill themselves, why all this talk about mercy killing? He is especially trying to champion the cause of the Alzheimer’s patient who is considered so vulnerable by many as to be a new type of victim, After Dr. Kevorkian and Mrs Adkins ended her Alzheimer’s suffering, and citing mercy killings by relatives in California and Florida he wrote:
    “Once again we must ask: Whose suffering is being relieved? In my years of care for such patients {Alzheimer’s), I have known few who were chronically miserable... But the families suffer terribly. There can be few agonies as great as witnessing the mental deterioration of a loved one... Add to this the physical burdens of caregiving for a demented relative, and it should be very clear who is suffering. It should also be clear who are the recipients of mercy in the mercy killing of an Alzheimer’s patient.     What do we hear over and over from the interview, the docu-dramas, the analyses?  “I couldn’t stand to see her suffer. Mercy killing...like all killing, is the ultimate. selfish act.”
    Supporting Dr. Goodwin, an attorney who did not wish to be identified carried this opinion out further by pointing out, and I quote here, “You know, it’s always men who say they want to kill their wives out of mercy. It never seems to be the other way around - women wanting to do away with their husbands. The women just nurse the men along until they die, but men aren’t going to do all that caretaking. And when they bring about their wives’ deaths, they can say they did it out of love.
    Since the Society for the Right to Die takes so much heat from the other side, we decided to take a closer look at some of their literature. The living will is suggested strongly in one mailing we received from the Society for the Right to Die, because, according to them, it is the best way to avoid spending your final days attached to life-support machines which are part.of some fruitless medical treatment. They cite the cases of Nancy Cruzan, perhaps the most widely publicized case, who was kept alive for seven years in a persistent vegetative state until the Supreme Court finally gave her parents the power to get her unplugged from artificial feeding and other life-support measures, thus allowing her body to die. Another similar case is Paul Brophy, a 45-year-old fireman who lay permanently unconscious in a hospital bed for three and a half years with no hope of recovery, until his wife won a long battle in the courts which finally released him from futile treatment. Another case is Daniel Deho, persistently vegetative as a result of negligence during routine surgery at age 33, whose useless treatment stretched out over more than a year. Finally his wife and mother together fought and finally won the right to terminate treatment and let him die.
    A member of the Washington Post Writers Group, Jane Bryant Quinn  is sympathetic toward the living will. She says that death isn’t just a personal matter any more, but goes further throughout the patient’s family and even into public policy. She writes: “Thousands of terminallly ill or permanently unconscious patients are living on costly life-support systems in hospitals and nursing homes In the United States. This, while Congress is cutting Medicaid and Medicare programs for patients who have a chance to recover.” Further hitting on the issue .of costs, John McCabe, who is the legislative director of the lawyers committee that wrote the Uniform Rights of the Terminally Ill Act, in use now in at least five states, says “a gut-level under-current to this issue is whether it’s right to permit the maintenance of a comatose individual to ruin a family’s finances.”
    Part of the problem stems from the confused political picture from state to state. Some state laws say that life-support systems can be withheld only when death is “imminent”; this could be interpreted to mean within a matter of hours, or it could clearly apply to someone whose death is inevitable and probably coming soon, but who could conceivably survive up to a year.      Just what is “imminent”? Why would they even have used language like that? States also differ as to whether someone in a permanent coma can be removed from life-support systems, and whether removing a feeding tube is legally and ethically different from removing a respirator. In twenty-two states, courts have ruled that family members or a legal guardian can “stand in the patient’s shoes” to make the life-and-death decisions that they believe the patient would most likely make, if he or she were awake and coherent enough to do so. Many other states allow this also, but don’t have actual court rulings. However, two exceptions are Maine and New York; where no surrogate decision can be accepted, unless there is clear evidence that the patient, while still functioning, expressed a wish not to be kept alive artificially. Additionally, of course, enter the children, who often are heard to say, “I know Dad would want us to unplug him, but I just can’t do it.”
    How to avoid all this legal and medical hassle is the subject of a most interesting book which we have begun to carry in the Wysong Library listing: Coming HomeA Guide to Dying at Home With Dignity; by Deborah Duda. Now this book is almost 400 pages, so I cannot begin to do it justice here, but it deals with practical and everyday aspects – as well as many things you’ve never thought about - surrounding dying. As Ms. Duda says in the introduction, the book is an outgrowth of her watching and working with her father as he died at home, helping two close friends die at home, working with terminally ill patients in hospitals, and with some others who chose to die at home. Her first experiences with actually observing daily and participating in the evolution of a death were like uncovered territory for her - as they would be for most of us. In general, our society denies the fullness of life because of fear and embarrassment and tucks away the last part of life -death - behind hospital doors. We go, often as children, to our grandparents funerals, but we don’t see how they got that way. People die around us throughout our lives, but because we don’t want to see it we pay the medical community to allow them to do it away from us  we even pay “cheerful” visits to the hospital and painstakingly avoid talking about the most important thing happening in the patient’s life - their dying I The author believes, and it does seem to make sense -wouldn’t it be better for all concerned if we said, “Come home and I will do my best to help you through this.”
    The book covers the practical information needed to help alleviate our hesitations and fears about such an undertaking; the what-to-do and how-to-do-it of physical care, pain control, mental, emotional and spiritual support, physical therapies, and much more. According to Duda, supporting a home-dying is a wonderful opportunity for the family and so much better for the dying person. What to do about family morale, pacing yourself, giving injections, and more is covered.
    Duda, who has worked and studied with Mother Theresa and done much personal spiritual searching, considers not that life and death are opposites, but rather that birth and death are the opposites. One describes entering into form, and the other simply describes leaving form. As she says, “Accepting death is a process of surrender, of letting go and accepting life as it is rather than how we think it should be. Exquisite beauty and meaning can be present in dying when we and the dying person accept in our hearts that life is following its natural course, and when we cooperate with life instead of fighting against it.” Further, she states, “Focusing on life as a process instead of as a goal has helped me accept death.” Instead of being afraid and putting someone in the hospital right away, we can consider that dying, like living, can be done in many different ways. It is possible, within your own home, to make the dying experience a peaceful and beautiful one for everyone involved. And so much more personal: there will be time, between smoothing bedsheets, changing the bedpan, bringing meals, and so forth, to simply hold hands and talk of what may come, to talk about the shared past, to begin a gradual adjustment to earthly life without this person, and to give the dying person an intensified, heavy-duty dose of what we all want while living - love, compassion, patience, humor, serenity.
    It’s a personal choice, but this certainly does sound better than lying in a hospital, being taken care of by strangers, while the doctors and your  relatives quibble about your care - or the cessation of it. By to king responsibility for dying we reclaim responsibility for living and regain the personal power we’d given away. One way to take responsibility is to stop playing victim to our culture’s pressure to go away quietly and die in the sterility of a nursing home or hospital. Who wants to be seen as a forthcoming vacancy! We can die right here amidst the people and things we love, the kids, the dog , the garden, our favorite chair,” she says.
    Dying is not an easy issue. It is one we usually simply ignore, try to prevent, prolong, or repudiate by focusing a hoped for existence on the other side. It does indeed seem that dying should be addressed squarely and every effort made to place choices in our hands and to sensitively and compassionately support and assist directly those we love as they-and as each one of us will one day-experience the final process of life. Perhaps even it can occur more healthily.