Topic: Government and Politics

Legal Trends in Bioethics

Starting with the fall issue of The Journal of Clinical Ethics, my “Legal Trends in Bioethics” column will be available on the Cato website at time of publication instead of only several months later. That means the information provided will be more up-to-date and relevant for anyone interested in tracking legal issues in bioethics.

For those not familiar with the column, it tracks bioethics related issue through all stages of litigation, legislation, and regulation at both the federal and state levels, as well as occasionally mentioning exceptional legal developments in other countries. The topics covered are not always exactly the same, but usually there are sections on informed consent, abortion, children’s rights, vaccines, organ procurement, HIV, mental illness, medical privacy, unconventional treatment, right-to-die, stem-cell research and other new technologies, among other topics depending on what bioethics topics are of legal concern in the U.S.

The column tries to be comprehensive as far as reporting the most relevant developments at each level of government and in each topic area. It is a very useful tool for doing exactly what its name implies – tracking the “Legal Trends in Bioethics.” The following is the introduction to the fall column which will be published in The Journal Clinical Ethics and simultaneously become available on the Cato website next month:

The most troubling development in this quarter is the extent to which legislators continue to intervene in the patient/physician relationship by trying to regulate the relationship down to the smallest specifics of what is said and done. These developments are a great threat to both physician and patient autonomy, but while there have been many attempts to pass such invasive legislation, at this point, few of such bills have actually made it into law. It will be important to watch the next two issues of Legal Trends if someone is interested in seeing how many of such bills actually do end up as laws.

The issue of medical tourism is not new to bioethics, but it is on the brink of attracting more attention in U.S. courts and legislatures. There is no separate heading in “Legal Trends” for “medical tourism,” but it is important for anyone interested in the subject to regularly check the “Legal Trends’ subheading dealing with interesting developments in other countries. In this issue, for example, some Canadians are seeking a police investigation into an assisted suicide in Switzerland. Physician assisted suicide is legal in Switzerland, but illegal in Canada. At issue is whether Canadians have a legal right under Canadian law to travel to Switzerland to avail themselves of a practice that is illegal in their own country. In the United States there is a constitutional right to travel which would make it legal for the patient seeking physician assisted suicide to go to Switzerland (there is no case directly on point but the basic principle is well-established in U.S. constitutional jurisprudence), but even in the U.S., as in Canada, it may be possible to prosecute someone who assists that person in getting to Switzerland. This could be considered aiding and abetting a suicide. The Canadian suit has not even been filed yet, and no such case exists in the U.S., but it is an interesting issue to watch. It may come up as it did in Canada with respect to traveling to Switzerland where it is legal for physicians to assist foreigners in committing suicide (this is not true in the Netherlands); it is also likely to come up in connection with people suffering from kidney disease traveling to Iran, the only country where it is legal to purchase kidneys, and in other situations where the legality of the activity is not the issue but the price of medical treatment.

The “Legal Trends” from earlier this year are available on the Cato website or directly from The Journal of Clinical Ethics.

Pelosi’s World

House Speaker Nancy Pelosi’s understanding of government’s role in a liberal democracy (and of the veto power) may be worse than I thought. A reporter sends a transcript of a press conference that Pelosi held yesterday, where she made the following remarks:

Oh, [President Bush] used the veto pen to veto the stem cell research bill.  That was a major disappointment… . I remember that veto very well because he was saying, “I forbid science to proceed to improve the health of the American people.”

Regarding Bush’s threatened veto of the Democrats’ expansion of the State Children’s Health Insurance Program:

The President is saying, “I forbid 10 million children in America to have health care.” You know from your Latin that is what “veto” means.

Pelosi should know that there is a difference between the government not funding something and forbidding it. 

My colleague Sigrid-Fry Revere documents that stem-cell research proceeds even — or especially? — in the absence of government funding. Anyone with passing familiarity with SCHIP knows the program covers millions of children who would have health insurance anyway — and even more children who would still get health care if the program disappeared tomorrow. Yet Pelosi thinks that vetoing SCHIP expansion is the equivalent of stormtroopers kicking in clinic doors to stop a well-baby visit.

Notably, no one from the press challenged either comment.

Refereeing the Cheney-Greenspan Debate

In today’s Wall Street Journal, Vice President Cheney presents a friendly rejoinder to Alan Greenspan’s recent comments about the fiscal profligacy of the George W. Bush years. In it, Cheney notes:

On the spending side of the ledger, I can’t dispute Alan’s general notion that the federal government is too big and spends too much money–we’ve agreed on that point since we both worked in the Ford administration more than 30 years ago. President Bush feels the same way, and that’s why he has steadily reduced the annual rate of growth in non-security discretionary spending.

The key here is to notice that Cheney is only referring to “non-security discretionary spending.” What Cheney wrote isn’t necessarily wrong. But to make it true, you need to ignore all spending on entitlements (like Medicare and Social Security), everything the Pentagon does, and interest payments on the national debt.

What you’re left with is a very small slice of the budget. About 13%, actually. Asking Greenspan to grade the president using only this very narrow criterion is like asking your college to re-compute your graduation-day GPA using only four of the classes you took.

Why ignore the rest of the budget? After all, the Bush administration did have a hand in expanding many parts of it – the Medicare drug benefit is Exhibit A. Nor is everything the Pentagon does related to the operations in Iraq and Afghanistan. And the rising costs of the national debt are a result of the GOP’s unwillingness to cut spending in the face of deficits.

So, what if we put everything back into the mix except the money spent on the Department of Homeland Security, the security-related functions of other federal agencies, and the operations in Iraq and Afghanistan? (The last of these has been estimated by the Congressional Budget Office as recently as January of this year.)

Doing that, you’ll notice the growth rate has not declined steadily. In fact, as you can see in the chart below, the rate has jumped all over the place. It never went below 3% and, thanks to election-year spending sprees, sometimes went as high as 9%. The average annual growth rate since 2001 was 5.8% – faster than the average annual growth of GDP during that period (4.5%) and almost twice inflation (3%).

Looks to me like Alan Greenspan is on the right side of this fight.

Fred Thompson’s Questionable Views on U.S.-China Trade

Fred Thompson’s relatively late entry into the presidential race has left people scrambling to discern his views on a range of topics from social issues to trade with China. I’ll leave it to others of probe his position on the former, but I came across something this week on the latter that is not encouraging for those of us who support free trade.

Two years ago, the former Tennessee senator was one of 11 commissioners to approve and sign the “2005 Report to Congress of the U.S.-China Economic and Security Review Commission.” The commission was established by Congress in 2000 to hold hearings and write reports on the implications of America’s growing trade with China.

Americans are right to cast a sober eye toward China’s foreign policy intentions and human rights record, but the commission also dabbles in the worst sort of economic populism toward U.S.-China trade. Among the questionable assertions in its 2005 report:

China’s “active participation in the global economy … is resulting in the movement of jobs, especially manufacturing jobs but increasingly service jobs as well, from the United States to China and other countries offering higher rates of return on capital” (p.3).

“U.S. producers of advanced technology products are also subject to the growing pressures posed by China. In 2004, the U.S. trade deficit in advanced technology products with China grew to $36.3 billion” (p. 4).

“The opening of the Chinese, Indian, and former Soviet bloc economies has led to more than a doubling of the global market’s work force and likely will put downward pressure on U.S. wages for workers at all levels, including higher levels of the wage scale. Mobile capital and technology flows accelerate this trend” (p. 5).

“Congress should consider imposing an immediate, across-the-board tariff on China’s imports at the level determined necessary to gain prompt action by China to strengthen significantly the value of the RMB [its currency]. The United States can justify such an action under WTO Article XXI, which allows members to take necessary actions to protect their national security. China’s undervalued currency has contributed to a loss of U.S. manufacturing, which is a national security concern for the United States” (p. 14).

Cato’s Center for Trade Policy Studies has systematically addressed economic concerns about U.S.-China trade at our web site, but here’s the crib sheet:

U.S. job losses from trade with China have been small and have been more than offset by jobs created in sectors that do not compete directly with China. The U.S. economy has added a net 16.5 million jobs in the past decade of expanding trade and the national unemployment rate is a low 4.6 percent.

Trade with China and other emerging economies has helped to boost living standards in the United States by reducing prices for consumer goods that make our lives better everyday. Average real hourly compensation (wages and benefits) paid to American workers is up 22 percent in the past decade. Tariffs on imports from China would reduce the well being of tens of millions of American households.

Real manufacturing output in the United States is up 31 percent compared to a decade ago. As my colleague Dan Ikenson shows in a new study for Cato, U.S. manufacturers enjoyed record output, sales, profits, and returns on investment in 2006. The “advanced technology products” that the commission worries about are overwhelmingly laptop computers and other consumer electronics. A WTO panel would rightly laugh at the claim that imports from China have somehow endangered America’s “national security.”

Which brings us back to Fred Thompson. Does he really believe the many questionable assertions in the 2005 report of the U.S.-China Economic and Security Review Commission that he approved? Or was he not really paying much attention? Or has he revised his views since 2005? An enterprising economics and business reporter should ask him.

Hillary Hates Freedom

Maybe that’s a bit strong. Let’s just say, Sen. Hillary Rodham Clinton operates with reckless disregard for individual freedom and the limited government that protects and sustains it.

In her latest salvo, she dismisses the great promises of the Declaration of Independence, the founding principles of the United States, as rhetorical flourishes, mere garnishes on the real stuff of life. “We can talk all we want about freedom and opportunity, about life, liberty, and the pursuit of happiness, but what does all that mean to a mother or father who can’t take a sick child to the doctor?” she asked.

In her senatorial activities and her presidential campaign, Clinton has tended to propose modest, moderate programs. Even her new health care proposal is being hailed as more modest than her 1993 plan (though it would in fact impose a new government mandate on every person in the United States). But at her core, Hillary Clinton rejects the fundamental values of liberalism, values like individual autonomy, individual rights, pluralism, choice, and yes, life, liberty, and the pursuit of happiness. She seems to see no area of life that should be free from the heavy hand of government. And to her the world of free people seems a vast nothingness. When a few Republicans proposed to eliminate the National Endowment for the Arts, which spends about $125 million of the $63 billion spent on arts in the United States, she declaimed that such a move “not only threatens irrevocable damage to our cultural institutions but also to our sense of ourselves and what we stand for as a people.”

After her first attempt at nationalizing and bureaucratizing American health care, she told the New York Times that her next project would be “redefining who we are as human beings in the post-modern age.” I’d say 300 million Americans can do that for themselves.

Her hostility to freedom is not just a left-wing attitude. In the Senate, she’s been adding the paternalistic agenda of the religious right to her old-fashioned liberal paternalism. Clinton has called for federal legislation to prohibit the sale of “inappropriate” video games to children and teens. She’s introduced a bill to study the impact of media on children, a likely prelude to restrictions on television content, and she touts the V-Chip regulation that President Bill Clinton signed. She supports federal legislation to outlaw flag desecration (though not a constitutional amendment).

In her book It Takes a Village, she insisted that 300 million free people could somehow come to “a consensus of values and a common vision of what we can do today, individually and collectively, to build strong families and communities.” She told Newsweek, “There is no such thing as other people’s children,” a claim that ought to frighten any parent. She promised to inflict on free citizens government videos running constantly in every gathering place, telling people “how to burp an infant, what to do when soap gets in his eyes, how to make a baby with an earache comfortable”—all the things that no one knew how to do until the federal government came along.

Hillary Clinton is no socialist. But when she makes her rejection of liberal values as explicit as she did on Monday – dismissing “freedom and opportunity [and] life, liberty, and the pursuit of happiness” as irrelevant to people’s real lives–she is far too reminiscent of some of the most authoritarian figures of the 20th century. Lenin, for instance, wrote, “Bourgeois democracy is democracy of pompous phrases, solemn words, exuberant promises and the high-sounding slogans of freedom and equality.”

And maybe it’s no surprise that Clinton cosponsored her videogame ban with Sen. Rick Santorum, who is also an articulate and determined opponent of individualism. In his book It Takes a Family and in various media appearances, he denounced “this whole idea of personal autonomy.” At least once he rejected “the pursuit of happiness” explicitly, saying, “This is the mantra of the left: I have a right to do what I want to do” and “We have a whole culture that is focused on immediate gratification and the pursuit of happiness … and it is harming America.” Not the mantra of the Hillary Clinton left, obviously.

We know that societies that reject bourgeois freedom – the freedom of individualism, civil society, the rule of law, and yes, you guessed it, life, liberty, and the pursuit of happiness – in favor of collectivism and economic goods end up with neither freedom nor prosperity. The United States has the most advanced medical care in the world – The rate of death from heart disease in the U.S. was cut in half between 1980 and 2000, for instance – because we have a mostly free and capitalist economy. Mandates and regulations make medical care more costly than it needs to be, and Hillary Clinton now proposes to pile on yet more mandates and regulations. But the really scary prospect of another Clinton presidency is not what she would do to our medical care but what she would do to the “life, liberty, and the pursuit of happiness” that is the foundation of our free society.

Solutions Day!

Newt Gingrich has always been an irrepressible, gushing font of ideas and information: ”My name, Newt, actually comes from the Danish Knut, and there’s been a major crisis in Germany over a polar bear named Knut,” he told the crowd that had come to hear him debate global warming with Sen. John Kerry back in April. 

But now he’s seeking your input. In just two weeks, Gingrich’s group American Solutions will be hosting an online extravaganza called “Solutions Day.” You may not be interested in Solutions Day, but Solutions Day is interested in you:

On September 27, the anniversary of the Contract with America, we will have the first annual “Solutions Day.”

Solutions Day will be a day of citizen activism. It will be devoted entirely to positive solutions based on positive principles to enable us to transform government and public policy so America can win the future.

Solutions Day will feature an online workshop available to every American.

Since September 27 is a Thursday, we will repeat Solutions Day via the Internet on Saturday, September 29, so people who have to work can be involved.

Which is a smart move, lest we end up with a bunch of solutions heavily skewed toward retirees, stay-at-home moms, the unemployed, and day traders. After all, real change requires input from a broader cross-section of Americans. Real change requires the involvement of informed citizens. Real change requires…, er, real change. That’s the slogan of Gingrich’s effort: “Real Change Requires Real Change.” And it has the virtue of being true both backwards and forwards.

Solutions Day will also feature a series of workshops, like “The End of Government… As We Know It” and “Space — The Race to the Endless Frontier.” And if you miss it both times around, don’t fret: ”All events will be made available on-demand on the Internet.”

Newt being Newt though, he’s full of Big Ideas even now, two weeks before Solutions Day. He unveiled some of those ideas Monday in a war-on-terror speech at AEI.  

This isn’t your typical right-wing stemwinder. It’s classic Gingrich, chock full of chunky idea-nuggets, like peanut brittle for the mind. Here’s Gingrich framing the debate fairly:

America is currently trapped between those who advocate “staying the course” and those who would legislate surrender and defeat for America.

Here he is making clear that the debate should proceed in sober, rational terms, without hysterical fearmongering:

 We need a calm, reasoned dialogue about the genuine possibility of a second Holocaust….   

and here he is taking a long view of the threats we face: 

The Iranian dictatorship had been at war with America for 22 years before 9/11.

That last point may confuse you. For instance, the first thing I thought was: that must be embarassing for them. At war with us for over two decades and we barely notice? Then I thought, wait: if Iran’s at war with us, then why did we just topple their major regional enemy and clear the way for a country dominated by Iran’s close allies? But that just shows I’m not a foreign policy expert, let alone a genius. These things are complicated. Real change requires real change. 

And this is a speech about real change. As in those alternate-history novels he’s famous for, Gingrich presents a bold vision of “An Alternative History of the War since 9/11.” The former Speaker’s biggest ideas for ending terrorism center around continuously warning Americans that we may all be killed; among other things, he’d have us run ”highly publicized simulations of two nuclear and one biological attack each year.” 

Another key idea for Gingrich is that the U.S. should think seriously about launching wars with up to three additional countries. Risky? Sure. But as Newt puts it, “we must adopt a spirit that it is better to make mistakes of commission and then fix them than it is to avoid achievement by avoiding failure.” Just imagine how different things could have been if the Bush administration had been animated by that spirit these last six years.     

Obama and Original Sin

After the 1992 election, the philosopher Jean Bethke Elshtain wrote:

Those who assert that the cultural questions somehow got put behind us in 1992 because economic matters were first and foremost the issues and themes of the presidential election are pushing an illusory hope. The cultural questions — abortion, family values, drugs, and race relations — were all joined in 1992, often in language that underscored just how much people of all political persuasions still look to government as the remedy for every ill, personal and political.

The problem with such reliance is this: democratic politics can reasonably offer hope, but it cannot promise deliverance. Yet deliverance, a dramatic and rapturous sea change to bring in the new and sweep out the old and corrupt, is what loud voices and dominant groups on both the left and the right seek.

The very gridlock that the two major parties and Ross Perot’s angry, antiparty protesters all decried is generated by their own actions in promising deliverance and in deepening cultural cleavages rather than alleviating them by removing some questions from government’s purview, or at least from government’s control as the final arbiter.

One might wonder why the government can offer hope if it cannot provide deliverance. But some things never change.

Among the presidential candidates on offer, Barack Obama most clearly offers deliverance as well as hope. His mixing of religion and politics was clearly on view in a recent debate when he called money “the original sin of politics.”

Should he be elected, Obama will not provide “a dramatic and rapturous sea change to bring in the new and sweep out the old and corrupt.” That is, he will not provide deliverance because doing so is beyond the power of the government or at least beyond the ambit of a constitutionally limited government. Should Obama succeed in ridding politics of “money” (that is, of private financing of campaigns), we will live in a world where the government and its officials control all financing of political struggle. Some would find therein deliverance. Most would not.

In Obama’s defense, you can say that he no doubt truly believes he can bring deliverance to “the people.” And some voters no doubt are demanding deliverance through public financing and other, more coercive forms of the Lord’s work. But Obama is a thoughtful man, and I wonder why he does not realize that his promise of deliverance will frustrate his larger hope to restore faith in government.

As Elshtain suggests, Obama’s inevitable failure to provide deliverance will foster more distrust in the federal government. And rightly so. Such distrust is warranted at any time, not least because promises of deliverance through coercion inevitably violate individual rights. Still, it is puzzling why a thoughtful man like Obama does not conclude with Elshtain that “removing some questions from government’s purview” might be a better way to offer hope,  if not deliverance.