Footnote to a Debate on End-of-Life Care

Last night I reported on a debate on end-of-life care at the Press Club to be aired later on PBS. A trial attorney who represented former Governor Jeb Bush in the Terry Schiavo legislation ranted continually about nameless faceless bureaucrats in Washington making decisions. Others, a bioethicist and a palliative care physician, noted rationing occurs now, but is not as rational as it ought to be, and is inevitible. They wanted ethicists, theologians and doctors to develop guidelines. What is missing, in my opinion, is the need to emphasize that families and patients can choose hospice care. That requires conversations that people tend to avoid. Sarah Palin's turning the idea of requiring such conversations into "death squads" reveals that the solution cannot be via legislation. Perhaps through a private citizen campaign and public service announcements? Having personally used hospice at home when my husband died, but not when my mother died in a hospital, I strongly believe the hospice experience is more comforting to the patient.

Deception and Delusion

I have just completed The Land of Marvels by Barry Unsworth, a novel set in March, 1914 in the area that is now Iraq. Oil interests, Ottomans, German and British governments, and a monomaniacal archaeologist conspire for their interests. All but two of the characters engage in conscious deception and self-delusion, which is maintained by some deception of others as well. This leads me to muse whether self-delusion necessarily requires deception of others - pretense, exaggeration of accomplishments, concealment of truths dissonant with the delusion, or even just plain lies. Additionally, is the reverse true? Does habitual deception require some self-delusion to be maintained?

More or different college graduates?

Last Friday, I reported on a debate, moderated by PBS economics reporter Paul Salmon, at the National Press Club that will be aired on PBS. (Story at www.press.org/wire.article.cfm.id?=1934). The question was whether the United States needed more college graduates. The "pro" side (former education secretary Margaret Spellings and United Negro College fund CEO and president) argued that expanding college enrollments would assist minorities who are now under-represented among graduates. The con side, George Leef, of an education policy think tank, and Richard Vedder, Ohio State University economics professor, argued that the costs are too high, that quality has declined and many graduates take jobs that do not require college educations. (They don't deny the need for good colleges and universities and the need for doctors, lawyers, engineers, etc. to have education.) The issue is adding more to what we already have.

What I couldn't say in a news article is that the two sides are consistent provided one argues the politically unacceptable point that it is the composition of college graduates, not the number, that concern Spelling and Lomax. More minorities could graduate if fewer majority did. This gets to the conundrum affirmative action programs have reached in many contexts.

Is there an answer?