Reflections: Why I love animals but am not a vegan.

I am an animal lover. As you know if you are following this blog, I have one cat. I also hope to get another cat soon, in part for the wellbeing of my existing cat; when I get my second cat it will be a shelter kitty. I don't eat pork since I found out that pigs, a favourite animal of mine, are often factory farmed in small crates, despite their intelligence and social nature. A couple of years ago I gave up eating any red meat for health reasons, and I will never go back to it, even if I can. I buy free range eggs, and (where available) poultry, and I eat at least three vegetarian main meals a week.

Nonetheless, there are people who would tell you that because I eat eggs, honey, dairy, poultry and fish I am inhumane. Maybe they are right, maybe I can't justify my position, but here is the argument I will use to try:

I need more protein and less fibre than the average bear because of my health situation. I try to eat beans and nuts as much as possible, but they are risky kinds of fibre for me; dairy, eggs, lean poultry and fish are much safer in terms of retaining my health. If my health goes downhill, I am almost certain to require medical treatment that has been tested on animals, and in some cases made out of animals. Peta would probably argue that I should be a vegan and refuse this treatment, but if I were to do so I would die of malnutrition and bowel perforation almost for sure. Is it unethical to eat humanely treated animals and their products to I continue to live?

Rant: Responsible research

I was home, visiting my folks recently, and as well as a much needed holiday, it meant I got to do a lot of the things I really like doing -- including watching the news, which I am always far too busy to do at home. Anyways, while I was there I heard about some very promising research into how to expand the human lifespan...something to do with worms, I believe.

Now, I'm sure to many of you this sounds like a grand idea, but to me even doing this research sounds plain irresponsible. Why, you might ask would I think a strange thing like that? Well, there are two reasons. The first reason is the gross overpopulation of the world already, and the second is the waste of resources that have gone into this work. Yes, it is highly commercialisable work, yes, the people who figure it out are going to make a fortune, but is it really responsible?

There are a few reasons, to my mind, why this work is irresponsible. There is the problem of the aging population. There is the disparity in life expectancies around the world. And then there is the quality of life issue. In the end, of course, these things all come down to the same thing -- the almighty dollar.

So, in more detail, the developed wold already has an aging population. This causes all sorts of social problems (and no, not just with the grannies on the mobility scooters who all seem to have a deathwish). In a nutshell, aging is an expensive business; when the elderly retire at 60 or 65, in many countries they may expect to receive a state funded pension. On top of that elderly people require and consume more medical care than other sectors of the population (no surprises there, right?) and potentially also consume more social services such as meals on wheels. In an aging population, ever more people are drawing on these services, and ever fewer are working to pay for them. Unless we accept a later retirement age and are healthier when we retire (unlikely, in an age where obesity is causing more problems at a younger age than ever before), having people live even longer than they already do can only exacerbate these problems.

Not only does the deleoped world world have an aging population, but there is a massive disparity between the life expectancies of people here, and people in third wolrd countries. In fact, as life expectancies in the west increase, they are falling in Africa. A child born this year in Norway may expect to to live to nearly 80, and a child born in Japan to over eighty. On the other hand a child born in India this year will live to approximately 64, a Vietnamese child will live to nearly 70, and a child from Bostwana will live only 40 years, a number which has fallen from nealy 65 fifteen years ago, and is set to fall further in the next ten years. There are any number of causes for this, AIDS being one of the more touted ones, but thereare other problems in the third world two (war, poverty and hunger, according to the ads I keep seeing on TV) which seem to me as though they must play a part. For the purposes of this rant, though, the causes do not matter, what does matter is the ethical side of the question, specifically is it ethical to be doing research to keep wealthy westerners alive longer when third world populations are dying in droves?

And now to the quality of life question, the one closest ot my own heart. If someone offered me a drug that would keep me alive twenty years longer in similar health to my present state, I would decline it -- even if it had no side effects and it was free. You might think I am too youg to know that I would do this for certain, and you might think I am just plain mad. I would say no, to both -- I have a chronic illness that for a long time I believed would kill me, and this gives me a different perspective on life. I do not want to live longer unless my (currently incurable) disease is cured -- not put into long-term remission by a drug with side effects, as it is now, but once-and-for-all cured. Now, as mentioned already, many elderly people become sick as they age -- and none of the sicknesses sound very pleasant. I would rather have a shorter, pleasanter life, than a longer, less pleasant one (and if the money wasted spent on this research is not to be spent or sorting out the third world's problems, it would be nice if was spent on debilitating lifelong illnesses, or things that affect kids, or whatever, rather than reversing a natural process).

The only responsible purpose I can see for this research is to help those with premature aging (not just a few lines earlier than they would like, but kids who get old and die by the time they're 18 like in that movie...you know, the one with Robin Williams). Otherwise it is just pandering to the western obsession with Peter Pan; we never want to grow old, and we sure don't want to die (for heavens sake, people are willing to undergo life-threatening surgery to look artifical -- and suppsoedly younger). I would ask that we all learn to age with dignity. And if you are a fellow researcher, I implore you to think about the wider implications of your research, and what costs it may have to society as a whole weighed against the benefits.

Rant: Why 'House' is a bad show, and doctors have bad attitudes (even if they save your life)

I have a chronic illness. What's more, it's not a trendy chronic illness like cystic fibrosis or MS, it's not pretty... in fact, it is largely an unspeakable disease. People don't like talking about the symptoms, or the diagnostic procedures (one of my friends, a so-called medical professional, has said "eeeeeeuuuuuwwwww" about one of the procedures I have had to have, despite the fact he invades women's private parts everyday, because "you get a better picture that way". Um... Yeah). And this disease occurs in an area of the body that is hard to see or indeed visualize in any way. Because the disease is not trendy(and that is another rant all in and of itself), there is not a whole lot of research funding in it, so the unpleasant diagnostic procedures are still used.

What, you may ask, does this have to do with 'House'? Well, the lead character, the eponymous House, epitomizes all that is wrong with the medical profession. He is willing to treat without adequately diagnosing, and he is willing to subject patients to unpleasant tests on a hunch or a whim. However, the thing that is the most wrong about House is that he gives nary a damn for the patient; all he is concerned with is the diseases the patients carry. It is under the illusion that you can treat the disease without taking the patient's humanity into the equation that can allow him to make the callous and often ego-driven decisions portrayed on the show. The real danger of this is not that the show will inspire medical professionals to behave like House (many of them already do), but that the show will lead patients to believe that this is an acceptable way for doctors to treat them.

It is this disconnection of the patient from decision-making capabilities, feelings, or dignity that allows medical professionals to do things like order an enterolcysis (an xray where a tube is passed via the patient's nose into their duodenum while thy are still awake, and their already-damaged bowel is filled to maximum with contrast -- all this without sedation or pain relief) or do a transvaginal scan (saying objection to this is "sentimental") in the name of getting "better pictures". Is it worth entirely sacrificing a patient's comfort, dignity, modesty and privacy so a miniscule amount of further understanding may be gained about their condition? Is it ethical to refuse to do things any other way? Is pain (and it's deliberate infliction by medical professionals) a legitimate diagnostic tool?

As a professional patient I say no to all the questions I have just asked. For non-surgical procedures, I believe no doctor or medical professional should be allowed to perform a diagnostic procedure without first undergoing it. If they do not have the requisite anatomy, they should not perform it at all (what is with all these weirdo male gynecologists? I mean, how does that ever seem like a good idea?). I believe that for many patients, particularly the ones who are long term patients and need to make decisions about their health every day, informed consent includes offering a selection of different tests and explaining the risks and benefits of each (we, in particular, struggle to maintain dignity and identity as patients). I believe that uncomfortable tests are not legitimated by their lesser cost (than tests equally as accurate, but more expensive).

I understand where the doctors and medical professionals are coming from. To think of every patient as an individual suffering from something unpleasant would be mind-bogglingly difficult, and would result in burnt out professionals very, very quickly. However, treating each patient as a being with dignity, pain and feelings should be considered part of the job. It can be hard when dealing with uneducated patients to explain their options, and it may even be more humane not to explain all the options in every case as decision making can be agonizing for those who are not well informed prior to the appointment (and to educate everyone prior to an appointment would be prohibitively costly). However, medical professionals should be charged with the responsibility of making humane decisions, and in a case where a patient clearly knows what they are dealing with, including them in the decision making process.

Most of all, I believe everyone, doctors, nurses, diagnostic professionals, other healthcare professionals, and patients alike have a responsibility to ensure that 'House' is not what we expect of a medical professional, nor even acceptable.