Seymour Siegel - Human Experimentation and Informed Consent

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Rabbi Seymour Siegel, professor of ethics at the Jewish Theological Seminary in New York, speaking at a forum on biomedical ethics organized by the Minnesota Inter-religious Committee for Biomedical Ethics, and sponsored by a grant from the Minnesota Humanities Commission in cooperation with the National Endowment for the Humanities. Siegel’s speech was entitled, "Human Experimentation and Informed Consent". To what lengths should researchers go to gather data using humans as subjects? How much should a potential human subject be told about the experiment he or she is to take part in? These and related questions were topics of speech.

Read the Text Transcription of the Audio.

Before I arrived in the Twin Cities, I was in Washington DC and I had occasion. To speak to a high percentage in the Senate not from this state and I told him that I was coming here. To speak about the informed consent human experimentation and issues, which might be controversial. And he told me a story about one of his constituents who told him a story about a politician some years ago. Who's walking down the street before election time and man came over to him and said, what is your opinion about the dog bill? the candidate was in a quandary since he had not heard about the dog Bill and more importantly he didn't know which side his questioner was so it didn't know what answer to give so he said Some of my friends are for the dog bill. And some of my friends are against the dog bill and I always stand with my friends. I mentioned this before I start talking this is not to be. taken from my time, so that you So that you will know that the where I stand on many of these issues before I start. In 1932 one day in 1932. a man by the name of Charles Wesley Pollard turned up for the first in a series of injections that he would continue to receive during the next 25 years. Pollard together with some 400 other black men in Alabama was told that his blood was tested because he had quote Bad Blood. At the completion of their treatment each of the men received $25 and a certificate which read as follows the United States Public Health Service. This certificate is awarded in grateful recognition of 25 years of participation. in the Tuskegee medical research study as it turned out later on. Pollard and the 400 had been unknowing subjects of a ghastly experiment. where treatment had not been treatment but a morbidly prolonged observation. Of the overall effects of untreated syphilis on physical and mental health In the report it was confirmed that 84% of the untreated were ill in some way compared to only 39% in the treatment group. It was these four hundred men at all contracted syphilis. Some of them were treated with Penicillin and the others were treated was placebos, which looked like medicine, but which were only sugar or water. And the experiment has been designed to monitor the effects of syphilis and the ravages it caused in the body of those who are unfortunate enough to have it the experiment continued. for 25 years until the 1966 wear a public health advisor wrote to the chief of the venereal disease program of the national communicable disease Center complaining about this procedure. He never received an answer and it wasn't until 1972 that is series of articles in the Associated Press made public the real character of the Tuskegee syphilis study. A specific drug had been available, but it was not used in the service of research. It was also shown that little information was really gain by this study since what was new was already know. In a report that appeared right after World War II. an indictment of the United States of America Representing of the four governments that the Allies who had won World War II and had gathered together in Nuremberg to charge the war criminals and to see that their Justice was meted out. reported that a certain prominent physician And experimenter by the name of Carl Brandt. Had conducted experiments summer, which I will very briefly read to you. From about March 1942 to about August 1942 experiments were conducted at the Dachau concentration camp for the benefit of the German air force to investigate the limits of human endurance and existence at extremely high altitudes. The experimental subjects were placed in a low pressure chamber and thereafter. The simulated altitude there in was raised many victims died as a result of these experiments and other suffered grave injury torture and ill-treatment. From August 1942 to May 1943 experiments were conducted at the Dachau Concentration Camp primarily for the benefit of the German air force to investigate the most effective means of treating persons who had been severely chilled or Frozen in one series of experiments. The subjects were forced to remain in the tank of ice water for periods up to 3 hours in another series of experiments. The subjects were kept naked outdoors for many hours at temperatures below freezing. I will not continue the indictment the lasted ran over several pages and describe the horrors that had been visited upon the unfortunate inmates of the concentration camps for the sake of scientific progress and to gain knowledge useful to the military forces of Nazi Germany in a much less mournful and painful method Dimension the following editorial. I read now excerpts from the following at it from an editorial which appeared in this morning's New York Times. It does if you don't read the New York Times, it is supposed to be the greatest newspaper in the world. That is the people who own it say so the State University of New York at Albany admitted last week that some of its psychology teachers had conducted potentially dangerous experiments on students without informing them of the risks in one experiment women were given electric shocks by machine that the State Health Department considered unsafe and another a student was burned on the face by a malfunctioning lamp. None of the experiments cause secret injury, but the episode reveal the most casual attitude towards state and federal regulations designed to protect human guinea pigs in scientific experiments earlier this year another group of researchers at the University of California. San Francisco campus broke the federal guidelines for recombinant DNA research And so on they say in some of these Laboratories and I quote. It is almost Chic not to know the rules. It is clear. That these kinds of experiments. I should be banned and those who in the past those who had conducted them should be punished in indeed in the case of the Nazi war criminals those who had conducted it did receive a severe punishment though the of those who designed the Tuskegee experiment are still functioning as far as I know. As a matter of fact both the Tuskegee the Auschwitz and the world-famous Willowbrook experiments in which children who were confined to the Willowbrook school on Staten Island, New York City who are mentally retarded. And who very frequently contract hepatitis though some entering children who had not yet had hepatitis were infected with it. So that the doctors could see how it affected them and to see whether they could find us some way to prevent the hepatitis from spreading. It was all so clear and Willowbrook as it later emerged that parents were told that if they didn't consent to these experiments, they would be difficult to admit them into this school or Hospital. It is clear. As I said that this kind of experiment should be banned as a matter of fact the Auschwitz Willowbrook and Tuskegee Horrors. Stimulated and brought into being various procedures institutions and guidelines which now are part of the experimental life in this country at least right after the Nuremberg trials a series of guidelines were accepted as to how to guide human experimentation later to be repeated and refined at Helsinki and the Willowbrook and Tuskegee experiences gave rise to a special commission at the National Institutes of Health to set guidelines for experiments on human beings in various stages of their life. It would be wrong, of course to assume. That all experiments that are conducted with human subjects have the same horror Dimensions as the ones that I have mentioned. And that the caricature of the mad scientist who goes ahead with his experiments regardless of the consequences is just that a cruel bitter and untrue caricature. but nevertheless as our chairman mentioned in introducing this evenings discussion with the great progress of Technology, especially in the areas of biology and Medicine. New and unprecedented problems arise which call up our deepest ethical and moral commitments and our the necessity for us to actively pursue a policy which would set guidelines and protection for those who are the subjects of human of experimenters who use human beings as their subjects. As the cunning of History has shown us so often. The very Solutions which we find two agonizing problems turn out to be problems with which we have to find new Solutions now in regard to human experimentation. There that is experimentation on humans and I will use the two phrases interchangeably that there is a conventional disk a conventional distinction which is useful and important for us as we contemplate the problematics in this area. There are those kinds of experiments first of all in which the intention of the experimenter is the welfare of the subject. A typical case of course would be a patient. Who is in a hospital suffering from a disease for which there a cure or some other kind of medication has not yet been fully proven to be effective and the physician or the experimenter tells the patient or those who stand for his interests that he will try this or that drug. Perhaps it might help. his main intention Is the therapy possible cure? of the subject of the experiment A result which is concomitant with this is greater knowledge which might be used in other occasions in which a similar situation exists. There isn't much moral and ethical problem with this kind of therapeutic experimentation for it is an accepted ethical principle in all systems of Ethics by which we are guided whether religious or secular that it is not only permissible but it is even obligatory for the physician to use whatever means he has to bring about a cure or an amelioration of the situation of the patient even though there may be some risk There is however a Twist in this which is come up frequently in the present in the practice of medicine. And in research namely what if the patient or his representative patient here more usually refuses the therapy. A case which became famous in Florida concerned the lady named Martinez who was suffering from a particularly painful cancer and that the Physicians had prescribed a procedure which was causing her agonizing pain for which there was a slight chance of at least a cure or remission, but most likely this was a terminal situation after several months of Agony. Mrs. Martinez. Set to her doctor enough. I'll take my chances without the medication. The Physician and the hospital involved being extremely conscientious then took mrs. Martinez to court to try to force her to undergo this therapy in a landmark decision the judge in the Florida Court said that Mrs Martinez and all those like her had the right privilege To say no to therapy, which they themselves did not consider to be useful or that the painted it failed was not sufficient was was so so terrible that there was no other end. That would be that would be great enough in order at to endure this kind of Agony. I misses Martinez speak is a rather heroic women in many ways. She's now course no longer among us, but she and others established the principle that even for therapeutic experiments or therapeutic a medication and Surgical and other kinds of procedures are autonomy as human being. Extends also to the possibility of saying no, especially in situations where there is no hope for a cure or even an amelioration for a significant amount of time. An equally famous case entailed a person who refuse therapy not because she could not endure the pain but because of religious Scruples famous case concerning the Jehovah's Witnesses who who according to their religion or refuse blood transfusions on the grounds that it is a transgression of the levitical prohibition against eating blood. Hear both ethics and the law have been divided as to what is the morality of allowing persons to refuse blood transfusions at which the without which the person with infected and all cases where they did refuse it. Or at least the cases that we have on record. the consensus seems to be that if a child is involved a minor child and it is the parents who are refusing for him or her the blood transfusion which will bring a cure or at least surcease to the illness from which the child is suffering. Then the child becomes a ward of the state and is taken away from the possession of or the supervision of the parents in order to save its life if the person is an adult Then the Martinez and other presidents are enforced and conscience which prevents consent is enough to allow the refusal of treatment in a case, which happen at Georgetown University middle-ground was reached in which a woman who was a Jehovah's Witness came into the hospital and she refused a transfusion but it was found that she had two small children and the president and the board of directors of Georgetown University brought her to court to force her to get a blood transfusion and indeed she did. And was saved from her illness. This is known as the famous Georgetown case. Have you been in Georgetown last year? I tried unsuccessfully to trace this woman to see whether the decision of the cart turned out to be had happy one. I think it probably did since she is alive. Now in there for is therapeutic experiments or experiments which have is their aim the therapy of an individual even though a side effect would be or a side. The advantage would be the gaining of knowledge which could be used to evaluate drugs or surgical procedures are for the most part moral and licit. In fact even not only desirable but even mandatory except where the individual himself for good and proper reasons refuses to accept the therapy and to suffer whatever consequences in Co the Problem, of course is where the experiment with the drug surgical procedure is not designed for the benefit of the subject who is receiving the drug or the surgical procedure but is designed to gain knowledge. Of the processes which and seal and even for beneficent ends to trace the illness in its development or to test the effectiveness of a drug. In these cases of which there are many. as a matter of fact as as I discussed it with our colleagues on the panel just before our meeting this evening a good part of Medical Practice, of course is experimental hear the principle of Ethics seems to me to be Sovereign and that is the Dignity of man, which we religionist phrase as the quality of the human being created in the image of God, or as Immanuel Kant in a famous dictum a summing up the ethics are ethical obligations toward each other said never view any person as a means, but only as an end or as the great Jewish philosopher of the 20th century phrased it in his own inimitable language treat all other individuals as Not as it's the Dignity of man. Who is after all not an animal? the man that any invasion of a person's privacy or officially of his person. Be done only at his or with his consent if that is possible. Call Ramsey one of the most important writers on medical ethics today professor of religion at Princeton University phrased it or explained it using another important biblical concept the concept of Covenant of Britt that all of us when we are born into the world are born with obligations, which can be summed up as covenants agreements of mutual concern mutual love and mutual respect. You have covenants with ourselves with our families with our city with our congregation. And of course with God himself farting to the biblical assertion the a covenant Covenant loyalty which in Hebrew means test is Hesed. requires that a relationship between an experimenter and the vet upon whom an experiment that he upon whom an experiment is being performed. The one of Integrity mutual respect which entails the consent of the individual being experimented upon this consent of course has to be informed consent. It has to be at consent based not only on faith in the other two, but also a consent which is based on knowledge of what is being done to him why it is being done to him. And what are the foreseeable consequences of what is being done to him? So that consent and especially informed consent is a Corollary. is a an outcome of our basic view about our own life in the world and our self evaluation assessment of ourselves as beings who have touched the Hem of sanctity of Holiness and therefore to be treated as a n as a not as a a means, but as an n That is why all of the the codes of that. Regulate experimentations on humans have as their centerpiece the hinge upon which the whole door turns the notion of informed consent. Let me outline a few more problems for as I understand it from your distinguished organizers part of my task is not to give answers but to raise questions instructed as I am by the wisdom of the Ancients who said that asking the right question is already half the answer. First of all, is it possible to have complete informed consent? the evidence shows that if I install by various investigators That is a matter of cold calculation. That most people even when they give their consent do so without being informed even when the information is presented to them in 1970 doctors Carl fellner and John Marshall study the consent issue as it applied to kidney donors. that is people who are called upon to give one of their kidneys either to a sibling or to someone who was compatible chemically with them both anticipated that the decisions regarding kidney donation would be long and anguishing once marked by ambivalence and prolong soul-searching instead much to their surprise the decision for or against donating a kidney was made at the time of the first contact with the kidney transplant team often via a telephone conversation and long before the detailed information needed for informed consent was even provided That is to say hardly anybody very few. Not even statistically significant few change their minds about donating a vital organ or at least an important organ in their body after they got all the information that is they had already made the decision on the basis either of emotion or love or trust and faith. How much information has to be given in order that informed consent requirements would be satisfied. There are teams of investigators not working on this very problem. And as far as I know have reach know very definite conclusion. Do you have to tell the prospective patient or prospective subject everything that might conceivably happen if he takes this pill or gets this injection or our experiences the surgical procedure as a matter of fact, it is true in medicine as my medical colleagues have confirmed to meet this evening and in other occasions that literally anything can and sometimes does happen. How much then How much information has to be given in order that informed consent be satisfied? How does the language of inform of the information affect the giving or the not giving of the consent? There are now teams working in Washington as you know, there are many teams working in Washington at the moment some for our benefit most of them for our detriment trying to find out. I don't give away my politics here, but I think you all guess it by now. It's find out. how to phrase The possibilities for example, if I tell you that point 5% of the population who took this drug developed paralysis. And that's a completely different way of saying it that one out of a hundred million did. And some people would prefer the first or so, it would mean more to them to have the first formulation and others with the second. What do you do with people in this country? For example, who don't speak English? And therefore you have to inform them in foreign languages where some of the overtones are not the same as in English. So that the notion of informed consent is itself itself a kind of ideal. Which we try to approximate. in our Interpersonal relations, especially in regard to experimentation but like all ideals are not completely realizable. Secondly who should be the subjects. Of human experiments or experiments made upon humans the answer you say our is volunteers. However, it turns out that in most hospitals most of the people who are the subjects of the experiments are in the charity wards. And very few people who are in private rooms seem to be given the opportunity to become volunteers. Secondly many of the volunteers for human experimentation happen to be incarcerated in prisons. And if you are an experimenter and you're trying to find out what is the effect of drug addicts and you come to a man who has 10 years to serve in in sing sing and say look here if you take this pill for a week 5 years disappear from your sentence. What's going to happen to me? And you go down the list. I've been told by people who have had such experiences that the only thing the prisoner here is is the five years. The rest of it goes out of one ear goes in one ear and goes out the other this could be extremely. Well. This could be a case of extremely well-informed subjects even with formal consent. signed sealed and delivered but it isn't really consent. under these conditions the very distinguished and perhaps the most profound writer on medical ethics in America today Professor Hans Jonas of the new school for social research in New York City suggested that since human experimentation is an adventure a voyage into the unknown that the best subjects would be the experimenters themselves. or people who are the feelings of curiosity or higher and more laudable motives feel themselves forced to or willingly board this ship of experimentation and sail out into the Uncharted Seas. Hoping to find Shangri-La or some other great and valuable destination. No one says Jonas has the right to choose Martyrs for science. Furthermore even a more agonizing question assuming that we could settle the question of who should be the subjects. I imagine there are at let me decide because I've been personally been involved in it to imagine. There are college students here and who find it difficult to pay the high tuitions that even the State University's now charged not to speak of Ivy League colleges and who see a sign on the bulletin board healthy young man wanted for experimentation $5 an hour who readily give their consent. Is it a free and unencumbered consent? Possibly? Yes, but possibly know what about situation where consent cannot be gotten by the nature of the experiment itself. Here we enter a very very murky area. Which is usually confined to problems in sociology. I'm sure we have all heard about the famous experiment which was conducted by Professor Stanley Milgram at Yale University in which he recruited a group of subjects from New Haven. Where Yale is Oh where Yale is located. He says he did not want to get Yale students because they were they may be too smart to and see through it and I'm sure you've heard the experiment when something like this. the students were told that what are being the subjects were told that they that the topic of the experiment was to see how much pain people could and you're and they were given a a mechanism which they were told was an electric shock. and and they were told by the experimenter Milgram to give escalating amounts of electric shock to what with who they thought were the subjects who is sitting on the other side of a 2-8 a one-way screen. Which was not soundproofed. This supposed subjects to whom the real subjects were giving electric current where actors. Who win the electric and electric shock of course was not an electric shock. It wasn't connected to anywhere. But when the dials were turned the actors rise in pain scream hollered and even fainted one even feigned death itself and Milgram was interested to see how far would the real subjects who thought they were the experimenters go in following the orders of the scientists inflict pain upon others for just in obedience to whom they thought was a and authority figure and of course you read that the it was shockingly high incidence of the amount of electricity or supposed electricity, which people were willing to inflict on others in response to orders here not from a political figure. But from a scientific authority figure milgram's experiment is almost become classic. It has been replicated in different places and different countries. But it seemed to me and to many others, of course that it violated the very canons of Ethics that we have presented here this evening. In the nature of things there could be no informed consent for those who were the subjects of the experiment even though of course they sign papers. At the Kennedy Institute one of these subjects came and reported to us that his life was ruined. He said although I look pretty well-preserved to me there by having participated in this experiment. He had nightmares. He had doubts about himself about his own rectitude and morality and most of all his wife was taunting him continually and saying you are a knifeman. can Such experiments be conducted. Ethically when the very essence of the experiment is a deception of the subjects of the experiment. I would venture to say no regardless of the sacrifice that we would have to make in this area of sociological information. I've more agonizing question. What about children? serving as subjects of experiments which are risky and which do not have as their primary aim the therapy of the subjects, but the gaining of knowledge valuable as it might be Children, we assume certainly under a certain age and I'm not sure what that age is. It depends on the religion and the culture who by nature of things cannot give consent anyting I'll parents know that they very hard to get consent even from small children. And even when they do give consent it is not considered by law or morality as being real and sent. Here in this area. There are there is what we do is call him a cloak and a difference of opinion which is now been carried on in pages of journals and books between two very distinguished Ephesus one of whom I have already mentioned Professor Paul Ramsey of Princeton University who has written very significant volumes and articles in the subject of medical ethics. So when I saw him last he told me that it has been so wrenching experience that he's no no longer going to ride in medical ethics and it's turning to the cheerful sermons of Jonathan Edwards. And the other is my very very distinguished colleague at the Kennedy Institute. Perhaps the leading Catholic ethicist in the United States Professor Richard McCormick. Ramsey claims that since children in the nature of things cannot give consent. Therefore there is no way in which experiments that are non therapeutic and which are risky can be carried on with children as subjects regardless of the value of the results or the importance of the outcome. That is something which society he said will have to sacrifice in order to preserve its ethical Purity or at least it's a aspirations towards ethical purity. The car make on the other hand says that a person like a child who has Buy in the nature of things not reached. The age of consent can be included in experiments if those who are responsible for him usually his parents or Guardians consent for the child if he were grown-up aunt, to consent to these experiments and probably would Consent to these experiments especially if they were of Great Value since part of McCormick everyone in a society has some obligation to contribute to the welfare of that Society. And the Ramsay of course counters and says that is treating a child like a grown-up that is against all reason and Common Sense and we cannot know what he would do where he a grown up since he is not a grown up. And therefore a no experiments on children can be carried up. Personally, if you're interested in my personal point of view racing at my opinion on a famous Tom music dick them, which is Zac Henley Adam Shalom enough means that if you're doing a favor for someone you can do it to for him even without his consent that if indeed it is a favor for someone to participate in the scientific experiment and in any scientific Adventure, then if the parents who are responsible for the outcomes agree and children under certain circumstances can be used as experimental subjects. Then of course the same question arises arises in regard to people who are medically unable. To give their consent they are in a coma. They are insane. They are as one of my colleagues said and it will bring it up. So depressed that they willingly very willingly. Enter into situations in which harm is possible and even probable. Can consent be gotten for them by their guardians or not personally again, I think in invoking the principle that I mentioned perhaps yes, however, the most agonizing question about which there is the greatest amount of controversy and about which I had planned to speak on at some length, but I will not since the sands of time are running out. How is about what about not children who are actually human beings according to all definition of human beings? What about fetuses that have not yet been born? consider for example the following situation a mother comes into a doctor position and not at her pregnant that she's about to be a mother pregnant. And said that she has decided to abort the fetus. the physician Himself or calling in one of his colleagues says now we have it. Would you mind? Dear lady that before we do the abortion. We inject you with drug addicts. and we've cuz we want to see what effect drug X has on children in Europe and when will you board your Child fetus and then we can test and kill it at first then we can test and see whether it has absorbed the drug into its system and what effect it has had if and even if it's going to have a bad effect your lady. What do you care? You have decided upon an abortion in any case. what would be your Reaction, assuming you were unfortunate enough to be this mother or little bit more fortunate to be an observer. This question has been has been taken up by ethicist Morales lawyers. And even the government itself. That is the United States government and Her Majesty's government in Great Britain. the governmental authorities in issuing guidelines for fetal research which you can buy a very big stick book published by the national suicide by the National Institutes of Health and health education and Welfare Department of refuse to permit such kinds of experiment their reasoning it runs into one of two directions sometimes in both directions with cuz they're not mutually exclusive cuz sometimes the government even the government is rational not always are the main consideration here is that if you allow such an experiment you effectively remove the option from the mother. I was going to say the mother and father but as you know, according to the some of the latest decisions of the Supreme Court concerning abortion father's don't have any say in whether the abortion should or should not be performed. But let's assume we have a pre Supreme Court or in between Supreme Court Family options have not been to change their minds about the abortion has now been closed off. Because its likelihood that the fetus will be flawed and incomplete that is one consideration. The other consideration is by those who believe that the fetus is either the same as a foreign child or at least is more than which is my personal belief much more than just a part of the woman's body but a much more significant part of the woman's body than any other part because it is Destin if it is not interfered with to become a human a full human being or it's now human being on the way and on the principle that we cannot. Undertake any procedure which is potentially harmful to the child. Or to a human or someone who has human life in it unless it's for its benefit certainly not for its harm are there by would not agree to such a procedure. And in this case of the both governments who have expressed himself have agreed to that observation. There are more sticky problems, which I would just mention for the length of time. They only what about experiments done at the moment of abortion, especially when the abortion is performed as a cesarean section. And therefore you have the child still attached to its mother but in front of you and can experiments be done here here the two governments agree that it can be done. Although I think it's a good argument could be made against at 2. No, these are some of the tricky questions that come up in regard to informed consent though. We all of us. I think agree that it is indispensable to invoke the principle of informed consent in order to guide and to guard the Integrity humanity and even sanctity of the human being it is a much more complicated problem, then it seems to be at first glance. There is just one other kind of human experiment or experiment on human which raises questions which are even more serious and more complicated and thereby not the amitabul to quick and easy answers. What about experiments? Which have as their goal? the very modification of human life itself We are promised. Why are scientists? and Brilliant imaginative and ball that we will have in our hands not too long in the future. Procedures and methods by which the very nature of the human being could be modified. We might be able to repair before birth defective genes. We might be able in fact, I'm told by people who know indeed. We are almost able to do so now to order the sex. Of the child whom we are fathering or mothering depending on your role. As a matter of fact, we are promised that they won't make a difference who the mother and the father is because we will find ways to produce human beings outside the mud the womb of the mother and even without the direct implantation of by the father. Are there indeed any limits to the types of human experimentation that we undertake even with all of the informed consent in the world? All of the guidelines that will be manufactured and spun out by the many bureaus institutes and commissions that perform that service for us. Or are we in danger of repeating the adventure might I say the misadventure of a famous Jewish hero. Whose story was then adapted by the wife of one of our greatest English poets. Rabbi the great Rabbi love of Prague seeing the Jewish Community endangered by its enemies using the science of his date, which was kabbalistic secrets. Created a Golem. A being made of clay, but into whom he had given the spirit of life. You remember the story of the color. D&D does save the Jewish community of Prague from destruction, but having begun the process propelled by the momentum with the implantation of the Divine name had begun even in his inert clay being turns finally upon his creators after having vanquished the addresses. It is a story of Frankenstein which misses Shelley had created and is one of the most moving and important myths of our civilization. Will we succeed dear friends in doing away? Not only with sickness? Not only with pain. Not only with inconvenience, but with death itself. will we be able to enjoy your immortality or is mortality itself. As God has seemingly planted. So intrinsic a part of our very Humanity that in removing, even the threat of our mortality for we are beings born in unto death removes from us and essential element of Our Own humanness. I don't know. I don't know the answer, but I do know. That we cannot whether we are experimenters professors Club at public tax payers or government officials. Remove our concern from this area and allow things to take their course and the famous dictum of Hillary. Why did you climb Mount Everest because it was there. To be part of our Promethean culture. Thank you very much.

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