Archive for the ‘ OPINION ’ Category

Otto Warmbier and the Rule of Fear

The man in constant fear is every day condemned – Publilius Syrus c. 50BC

In March 2016, Otto Warmbier was tried and sentenced for allegedly stealing a North Korean political poster from his hotel in Pyongyang, a hostile act purportedly planned by the CIA. North Korean authorities arrested Warmbier at the airport just as he was leaving the country with his tour group. His trial lasted one hour and Warmbier was sentenced to 15 years hard labor.

Bill Richardson, diplomat and former governor of New Mexico met with North Korean officials in New York on behalf of Warmbier. Upon learning about Warmbier’s 15 year prison sentence, Richardson commented in an email to The New York Times that the prison sentence was, “An unfortunate development but a familiar pattern with American detainees . . . hopefully a prelude to negotiations that might lead to a release on humanitarian grounds.” After all, Warmbier was nothing more than a college student on holiday.

Richardson along with the Obama administration, American news media, international human rights organizations and most everybody else never guessed that Warmbier would soon be tortured into a coma, a condition not known to the public until Warmbier’s return to the United States last month.

Warmbier died this week. He died never waking from a coma, never seeing his family again, never returning to the University of Virginia, never completing his economics degree and never having an opportunity to develop his talents for the greater good. Instead, North Korean dictator Kim Jong-un and his communist thugs reduced Warmbier to an unlikely biological weapon that would eventually inflict fear upon the civilized world.

In the bad old days of the Cold War, an arrest like Warmbier’s was used as political propaganda against the West. Everyone would have understood that the crime was fabricated, the trial a sham and the sentencing designed to exert leverage in some classified spy game – a game played with the finesse found in an Ian Fleming or John le Carre’ story. Everyone also understood that a student like Warmbier would eventually be returned unharmed – an assumption made in 2016 by Richardson.

The Cold War was a battle of ideologies. The Soviet Union tried to win the hearts and minds of the West over to a nonexistent communist utopia. Kim Jong-un has no ideology other than fear and no purpose other than to destroy hearts and minds. He understands what Publilius Syrus meant about fear and the condemned person. He rules North Korea as the warden of a prison state.

To divert attention away from his brutalization of his own people, he shoots his prematurely exploding missiles at the civilized world while we mock his technological incompetence. We should not be so amused. Kim Jong-un may be unable to destroy America with his missiles but he managed to destroy Otto Warmbier, a single American citizen, in what has become a very public execution. Kim Jong-un adeptly projects fear where his missiles could not come.

My Sister’s Unvanquished Idealism and A Letter Praising Nixon

Some years after my mother’s passing, I went through a box of faded newspaper clippings, the kind that mothers keep of their children’s successes, no matter how minor. Mixed in with the wedding announcements and school awards was a letter written to the editor of The Greenville News. The letter, penned by my sister in early 1969 when she was a junior at Blue Ridge High School, praised incoming President Richard Nixon for having Rev. Billy Graham pray at his Inauguration and preach at the White House. She went on to encourage Nixon to keep Graham close by for counsel and prayer as our country went through difficult times. She closed by affirming her love of God and country.

My sister’s idealism was not typical of teenagers during the late 1960’s or at least not typical of the drug-fueled kind portrayed later as the Woodstock Generation. While talking with her about the letter, I discovered that her idealism was typical of her classmates at Blue Ridge. She described her lunch table where a student was free to sit only if the student was prepared to discuss the important issues of the day – issues like civil rights, Viet Nam, assassinations or other revolutions of the street. I later found a photo of her in a Blue Ridge High classroom from that same school year. She sat in front of a bulletin board boasting a picture of Hemingway and a list of the Ten Commandments as she talked to the class about some subject not noted on the photo’s proof label – maybe it was a lesson on Nixon and the Ten Commandments. She went on to become an excellent high school English teacher. A career choice that would carry her to teach my future 11th grade class.

Being fourteen years younger than her, my sister profoundly shaped my worldview. She did so by including me in her own interests. I remember watching her create the vivid geometric designs on her abstract paintings, hearing the quiet notes of Beethoven’s Fuer Elise from her piano, flipping through the many books lying about – Thomas Hardy and Jane Austen to name a few favorite writers – that she eventually taught me to read. Playing with the treasures brought back from her recent tour of Europe. A green colored glass dachshund with needle nose and tail, a chalet inspired Swiss music box and a sleek black Venetian gondola comes to mind. I don’t have a Swiss chalet or a gondola, but dachshunds have been my constant companions ever since. Her photos of Switzerland, France, Italy showed me that the Alps are a long way from the Blue Ridge. She opened my mind to vast possibilities.

Later on she would take me to see my first Shakespeare production (we discussed recently whether it was A Midsummer’s Night Dream or Much Ado About Nothing) and my first opera (Faust, we think). Later on I would study Kit Marlowe’s Dr. Faustus in a graduate school Renaissance drama class. Just last year my son had a part in his school’s production of A Midsummer’s Night Dream. With him, my sister’s influence became generational in my own very slender branch of the family tree.

If The Greenville News were to run her Nixon letter today, she would be ridiculed for her seeming naiveté. The online trolls would not understand that she knew Nixon had the same temptations of political greed and ambition common to all men. When my sister praised Nixon, she had already read Macbeth. She understood that the ideal must be stated if only to stand as a beacon when the electorate has to avert their eyes from the bloodstained chalk line of the latest fallen politician.

My sister has been my most stalwart encourager during my time in the South Carolina House. Her continued idealism, not just in politics, but in how to live and treat others frames my thoughts and my votes. Even today as she faces her life’s final battle, her idealism – Christian faith is a better description in this case – remains strong and her treatment of her family, friends, my son and myself filled with heaven bound loving-kindness.

Do Not Resuscitate Orders for Children – A Short Commentary on H3487

On March 28, 2017, the South Carolina House passed H3487 with little debate and only one dissenting vote. H3487 defines and expands how emergency medical personnel should interact with do-not-resuscitate (DNR) orders for minors. It also fundamentally changes both the spirit and letter of past advanced care directive legislation that until now excluded children from DNR orders. The bill specifically defines a child as anyone under age 18 and gives parents or guardians the right to issue DNR orders for that child if he is terminally ill.

Advanced directives regarding patients end of life healthcare have been controversial since the late 1960’s when were first proposed by the Euthanasia Society of America. Luis Kutner, the attorney for ESA who developed the first advance directive or “living will” proposed that since “a patient cannot be subjected to treatment without his consent,” he should have the right to formalize his wishes for health treatment or lack thereof should he become incapacitated.

Kutner’s “living will” legislation was debated state by state for the next twenty years. By 1986, forty-one states had adopted some type of advanced directive including South Carolina. Named the Death With Dignity Act, our law defines how advanced directives should be structured and when life-sustaining measures should be withheld. The General Assembly went on to pass the Adult Health Care Consent Act in 1990 and the Emergency Services Non-Resuscitation Order act in 1994. None of the bills applied to children and with good reason.

Terminally ill children are ethically unique as noted by Daniel S. Goldberg in his 2007 study The Ethics of DNR Orders As To Neonatal & Pediatric Patients: The Ethical Dimension of Communication. Several points in his study caught my eye in relation to H3487 allowing parents to issue DNR orders.

Goldberg notes that the last days, hours and minutes of a child’s life will stay in the parent’s memories forever. These memories will have a major impact on the future emotional health of those parents. His study shows a significant discrepancy between the physician’s prognosis and the parents understanding of what that prognosis truly means.

Parents are not doctors or emergency medical personnel. Parents are emotionally bound to the child and are not going to be rational during an emergency when DNR order questions will be raised.

After discussing the bill with it sponsors, I understand that the bill was offered with good intentions. However, given the complexity of medical procedures these days and the significance of any error made regarding a child’s DNR order, I encourage the Senate to dig for the unintended consequences that this H3487 will inflict.

Appendix – SC Code Cites

 SECTION 44-77-10. Short Title – Death With Dignity Act – 1986

SECTION 44-77-30. When life-sustaining procedures may be withheld.

If a person eighteen years of age or older adopts a declaration that is substantially in the form provided in Section 44-77-50, whether executed before or after an amendment is made to the form, and that on its face is duly executed, witnessed, and authenticated as provided in Section 44-77-40 or on its face is in compliance with the law of the state of the declarant’s domicile at the time that the declaration is adopted, if the declaration provided for by the law expresses an intent that is substantially the same as the intent of the declaration provided in Section 44-77-40, and the person’s present condition is certified to be terminal or to be in a state of permanent unconsciousness by two physicians who personally have examined the declarant, one of whom is the declarant’s attending physician, and the other of whom is a physician other than the attending physician, then life-sustaining procedures may be withheld or withdrawn upon the direction and under the supervision of the attending physician.

SECTION 44-66-10. Short Title – Adult Health Care Consent Act – 1990

Purpose – Confers authority on a health care surrogate to consent on the patient’s behalf to the provision or withholding of medical care and to make financial decisions obligating the patient to pay for the medical care provided.

SECTION 4466-20. Definitions.

Defines “Patient” as an individual sixteen years of age or older who presents or is presented to a health care provider for treatment.

Defines “Unable to Consent” as unable to appreciate the nature and implications of the patient’s condition and proposed health care, to make a reasoned decision concerning the proposed health care, or to communicate that decision in an unambiguous manner. This term does not apply to minors, and this chapter does not affect the delivery of health care to minors unless they are married or have been determined judicially to be emancipated.

SECTION 44-78-10. Short Title – Emergency Services Non-Resuscitation Order – 1994

 SECTION 44-78-25. Duties of EMS personnel when presented with “do not resuscitate order”.

 When called to render emergency medical services, EMS personnel must not use any resuscitative treatment if the patient has a “do not resuscitate order for emergency services” and the document is presented to the EMS personnel upon their arrival or if the patient is wearing a do not resuscitate bracelet. EMS personnel must provide that degree of palliative care called for under the circumstances which exist at the time treatment is rendered.

SECTION 44-78-50. Chapter not condonation of mercy killing; minors ineligible for “do not resuscitate orders”; compliance with article not suicide.

(A) Nothing in this chapter may be construed to condone, authorize, or approve mercy killing or euthanasia or to permit any affirmative action or deliberate act to end life other than to allow the natural process of dying.

(B) No person under the age of eighteen years may request or receive a “do not resuscitate order for emergency medical services” as provided for in this article.

(C) The withholding of resuscitative measures pursuant to this article does not constitute suicide for any purpose.

Miscellany

The Ultimate DNR order revocation – Genesis 22:9-12 –

And they came to the place which God had told him of; and Abraham built an altar there, and laid the wood in order, and bound Isaac his son, and laid him on the altar upon the wood. And Abraham stretched forth his hand, and took the knife to slay his son. And the angel of the LORD called unto him out of heaven, and said, Abraham, Abraham: and he said, Here am I. And he said, Lay not thine hand upon the lad, neither do thou any thing unto him: for now I know that thou fearest God, seeing thou hast not withheld thy son, thine only son from me.

For Abraham, the stay of being executioner to his own son came with the call of an angel. Upon hearing his name Abraham lowered his knife and ended the prospective nightmare of having Isaac cry out the same words that God himself would later hear from His only son, “My God, my God, why hast thou forsaken me?”

William Shakespeare’s son died in 1596. He was eleven. Shakespeare left so little evidence of his personal life that no direct reaction to his son’s death has been found. Yet in his play The Life And Death of King John, written just after the boy’s death, Shakespeare writes these words for Constance, the grieving mother of Arthur, the young Duke of Brittany, murdered because he was rightful heir to the throne.

The Life and Death of King John, Act III, Scene 4

 Constance:

 Grief fills the room up of my absent child,

Lies in his bed, walks up and down with me,

Puts on his pretty looks, repeats his words,

Remembers me of all his gracious parts,

Stuffs out his vacant garments with his form;

Then, have I reason to be fond of grief?

Fare you well: had you such a loss as I,

I could give better comfort than you do.

I will not keep this form upon my head,

When there is such disorder in my wit.

O Lord! my boy, my Arthur, my fair son!

My life, my joy, my food, my all the world!

My widow-comfort, and my sorrows’ cure!

 Shakespeare may not have expressed his own personal feelings of grief through sonnet or diary, but he infused Constance with grief’s total blackness that follows hard upon your child’s death.

Constance’s last three lines echo in W. H. Auden’s oft quoted poem about grief:

Stop All The Clocks

He was my North, my South, my East and West,

My working week and my Sunday rest,

My noon, my midnight, my talk, my song;

I thought that love would last for ever: I was wrong.

Auden was not writing about his son but grief cares not for blood relation, knows no societal boundaries, observes no funeral customs and expresses itself through the most unlikely sources. Still, the death of your son, your first-born son, the son that carries the dna of all that you were and the hopes of all that you could have been hits hard.

 A Father’s Love

I am convinced, that when a man tells a woman he loves her, he only means that he desires her; and that the only total love in this world is that of a father for his son. – Enzo Ferrari

Enzo Ferrari’s son, Dino, died in 1956 from Duchenne Multiple Dystrophy. He was 24.