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Slandering oxygen
Oxygen study frauds  
Alleged study results
Later deaths
Futility and harm
Fluorescent ROP lamps
Damaging irradiance
Preemie vulnerabilities
Studies of light and ROP
Frauds in LIGHT-ROP
Coverup stonewalling

 

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Sixty-year-old Crypto-Eugenic Euthanasia Program
continues to kill babies to protect them from blindness   
  
posted January 3, 2015

 

© 2015 Peter Aleff, prevent@retinopathyofprematurity.org

You have permission to republish this article under a Creative Commons BY
Share Alike license, with attribution, and with a link back to this page.
 

 
 

 

Preemie on ventilator

Photo by the author: Preemie on Ventilator.jpg

A recent article in the ethics-oriented newsletter Mercatornet by Alex Schadenberg, the Executive Director and International Chair of the Euthanasia Prevention Coalition, reported that a co-editor of the leading academic journal Bioethics advocated that physicians and parents should have the right to decide to end the lives of newborns with disabilities if they deemed them “not worth living” [1]. Similarly, Xavier Symons, a writer for Mercatornet’s sister publication BioEdge, proposed not long ago that eugenics has hibernated for 60 years and is coming back, with medical ethicists arguing that parents have an “obligation to choose a healthier child” based on a moral imperative to avoid creating situations of “harm” [2].  


The only thing new in these bioethicists’ proposals is that they are now again made openly. Euthanasia for newborns at risk for harm has long been a tacit routine practice in the U.S. and many other countries, a hidden legacy from the original eugenics movement that has never disappeared. Like a river that seems frozen solid but flows freely below its thin crust of surface ice, the old eugenics has gone underground but continues to kill those caught in its current. It still drives the longest-running and most widely practiced euthanasia program ever devised to “prevent children from having to live with harm” which really means “prevent them from living”. That program has been running unseen but continuously for sixty years against prematurely born “defective” children, and it killed 150,000 of these in just its first two decades, according to official medical estimates[3]. Numbers for the toll in later decades have not been published, and this continuing atrocity has never been investigated.

The eugenic tradition of ending the lives of babies to prevent a non-fatal disability still causes doctors today to withhold the badly needed oxygen breathing help from premature babies, killing many of them by asphyxiation to avoid their being harmed by baby-blinding retinopathy of prematurity (ROP). Most nursery doctors are now no longer aware of the real reason behind their doctrine of restricting the life-saving oxygen for these defenseless victims, but this often fatal practice was introduced based on the belief of eugenicist doctors in the 1940s and 50s that the blinding was caused by “defective germ plasm”. Their solution to stop the then new epidemic of baby-blinding was to secretly suffocate the preemies most at risk and to thereby reduce the embarrassingly high rate of blind survivors while eliminating the carriers of this alleged defect from the gene pool[4]. The current death toll may be a little lower than at the beginning of this ruthless practice because this initial mass killing appears to have shocked even some nursery doctors and led them to slightly relax the oxygen restrictions, but the relief is at best partial.

1.) The start of the euthanasia program

The first babies ever to suffer from ROP were born in 1940. By then, nursery doctors had administered oxygen supplements to premature babies routinely and generously for many decades without ever blinding anyone[5]. Although some current writers on ROP try to contrive scenarios of a change in oxygen practices at that time, these are transparent ad hoc fabrications to retroactively explain the blaming of oxygen. There neither was nor is any rational reason to link the then new and quickly spreading epidemic form of blinding to this long established and consistently life-saving treatment, and all attempts to confirm this allegation have remained inconclusive.

However, blindness had been a favorite target of U.S. eugenicists[6]. Their pseudo-science dominated medical thinking during the first half of the 20th century to the point that 31 U.S. states enacted medically inspired sterilization laws to keep “undesirables” from contaminating the gene pool. And some of the most influential American ophthalmologists at the time believed that ROP was caused by “defective germ plasm”.

One of them was Dr. Algernon B. Reese, President of the American Academy of Ophthalmology and Otolaryngology and editor of its “Transactions” journal. He came from the Harvard Medical School which was a bastion of the eugenics movement and had been a major driver for the eugenic sterilization laws in the U.S. That School had also supplied some of the architects for the eugenics program in Nazi Germany as well as highly publicized “scientific” support for Hitler’s racial policies[7]. In 1928, the Harvard Medical School founded the Howe Laboratory of Ophthalmology as a joint venture with Mass Eye and Ear to promote ophthalmic research and education with a major emphasis on ophthalmic genetics. It was named after Dr. Lucien Howe who was a celebrated ophthalmologist and president of the American Ophthalmologic Society as well as the president of the Eugenics Research Association. This ardent eugenicist had made blindness his major target as a model case for the eugenic sterilization laws he zealously promoted, and he was determined to "hunt down" anyone with vision problems as well as their relatives and to imprison them as "protection against future defectives"[8].

Primed by this background at his highly regarded Alma Mater, Reese wrote several learned-looking papers about the new eye damage to assert its allegedly prenatal origin caused by “defective germ plasm”. He presented the latest of these at the June 23, 1948, meeting of the American Medical Association’s Section on Ophthalmology where he and his like-minded colleagues recommended that the best way to deal with the epidemic was to “not be so zealous in preserving defective persons, of which the world has a sufficient quantity already”.[9]

The most effective way to preserve the lives of premature babies was and is to help their still immature lungs with supplemental oxygen. As mentioned above, oxygen had by then been given routinely and generously to premature babies for several decades and was highly acclaimed as a “life-saver”, without ever having caused any eye damage.

Letting supposedly “impaired” babies die without life-saving treatment had long been a tacitly accepted and at times even openly promoted custom since the beginning of the century[10]. Even the Bishop of Baltimore had supported this practice in the Catholic Review of November 19, 1915[11]. However, in those postwar years of Reese’s presentation, the American public had newly learned about the horrors the Nazis had committed in the name of eugenics, including their brutal mass euthanasia programs against disabled people as “useless eaters”. Given this reversal in the reputation of eugenics, there was no way any American doctors could openly carry out a similar action against “preserving defective persons” by withholding their oxygen breathing help. However, they could and did disguise that agenda.  

Accordingly, this group of doctors and some of their British colleagues began a smear campaign against oxygen as an “undeserved subsidy” that stifled the infants’ “private enterprise” of breathing on their own[12]. They also ran some small-scale experiments to discredit its benefits but conspicuously omitted to report the critical mortality rates. Then the group around Reese launched in 1953 the multi-hospital Cooperative Study of Retrolental Fibroplasia (as ROP was then called) to more convincingly blame ROP on that oxygen breathing help[13].

That Study was an overt research fraud. Its designers had never changed their conviction that the damage was a prenatal genetic “defect” and could therefore not be caused by anything done to the babies after their birth. Yet, they withheld the oxygen from virtually all babies for the first two days and then only enrolled the survivors of this merciless weeding in their study. By that time, 45 percent of the babies had died[14], as compared, for instance, with 32 percent of similar babies who had died in the first seven days in one of the study hospitals during the immediately preceding two years[15].

However, the designers of this Cooperative Study concealed this better-dead-than-blind carnage and deceptively claimed that they had practically wiped out the blinding without affecting the survival rate. Instead, they had covertly killed the babies who would otherwise have grown up blind. Their apparent victory against the epidemic was greatly hailed as a triumph of the then still relatively new concept of double-blind randomized studies, and it led the U.S. Congress to greatly expand the funding for this kind of medical research.

The authoritative propaganda about this alleged triumph and the welcome prevention message against a baffling epidemic instantly led nursery doctors around the world to severely restrict the breathing help for all preemies and so to start the systematic but undisclosed euthanasia program the study designers had intended with their recommendation to “not preserve the defective persons”. Many of the rank-and-file doctors may have been duped by the scientific-sounding announcement of this indictment against oxygen, but at least some of them must have known that this gas could not suddenly have become the culprit after so many decades of life-saving without ever blinding a single baby. Still, they all went along with the officially proclaimed convenient solution to the blinding epidemic, including all the nursery doctors in the many religious hospitals. These would normally have objected to this huge slaughter of the innocents which dwarfed even the massacre of babies and toddlers ascribed to the Biblical villain king Herod, but the alluring power of the eugenic promise seems to have overridden their consciences.

The withholding of sufficient oxygen is a torture even worse than the notorious waterboarding. To get an idea how this suffocation may feel to a baby, compare, for instance, the account of the adult Biosphere 2 volunteers who became sluggish, weak, sore and depressed when the oxygen levels in their sealed enclosure dropped just a little, and who felt profound relief when they could again breathe oxygen-enriched air[16]. The babies’ pain is likely to be even greater than the sensation of imminent asphyxiation experienced by subjects of waterboarding which is hard to tolerate even for robust adults. That adult torture is usually stopped before the victim suffers any permanent damage, but the preemies have to endure their protracted deprivation for hours or even days and weeks on end without any relief, to the point that many of them incur life-long brain injuries or even die from the ordeal.       

So far, there has been no investigation of this vast modern crime, like those conducted for the much smaller-scale unethical syphilis studies in Guatemala and Tuskegee, or the equally infamous Human Radiation Experiments. Although some of that oxygen-withholding carnage is well documented, no one has held the medical community accountable for this massive killing and maiming and agony which cannot be entirely explained away as mere error or ignorance.

That bogus Cooperative Study's openly biased verdict against life-saving oxygen is now an unquestioned cornerstone of the intensive care nursery industry's theory and practice although it blatantly disregarded all previous evidence and decades of experience, and it accepted a single new contradictory finding without further evaluation. This indictment of oxygen also could never be duplicated or confirmed despite several attempts to do so. And yet, its fake and deceptive recommendation for large-scale euthanasia through oxygen rationing still affects the daily life in intensive care nurseries around the world probably more than any other single study ever did.

2.) The recent deceptive SUPPORT experiment of oxygen withholding

A more recent demonstration of the medical establishment’s willful ignorance about the role of oxygen, and of its deeply rooted disregard for the victims of its ongoing suffocation program, came to public attention in the SUPPORT experiment. This was conducted in the U.S. from 2005 to 2009 to further restrict the oxygen breathing help for premature babies because many earlier attempts to establish an optimal level of oxygenation for the infants had remained inconclusive since they were all based on the same wrong assumption of a link between oxygen levels and blinding risk. Most of those earlier studies that had bothered to report their mortality rates had shown an increased number of deaths with lower arterial oxygen saturation levels[17]. However, the SUPPORT researchers expressed the hope that modern measuring methods of oximetry would allow a better calibration for the administration of oxygen, and that this would somehow reduce the consistently encountered mortality increase from restricting this life-saving gas.

Still, the callous designers of this blatantly ethics-violating SUPPORT experiment openly expected that four percent of the infants in their low-oxygen group would either die or suffer permanent brain damage from the lack of this life-saving gas[18]. They knew they could not get any parents to accept this risk for their children because blindness is a non-fatal condition and can in no way justify risking the lives of the children in the mere hope to avoid blinding. Accordingly, they lied to the parents about these significant risks associated with their knowingly lethal study. Then they went ahead anyway to try and find out whether reducing the oxygen would also reduce the rate of blinding from ROP. Predictably, they killed 23 “extra” babies in their low-oxygen group, or 3.5 percent of the babies enrolled in it, close to their expectation, and with a probability of 96 percent that these deaths were correlated with the oxygen reduction[19]. They also caused permanent brain damage to a still undisclosed number of additional victims.

Clearly, if any parents had been informed about these well-known risks they could not have legally consented to offer their child for this dangerous experiment. Parents are allowed to make decisions on behalf of their child only for his or her benefit, and the unsafe SUPPORT protocol did in no conceivable way qualify since even the researchers themselves expressed concerns about the safety of their subjects (but not to the parents). Yet, despite the obvious impossibility of legally obtaining the informed consent of the parents, this knowingly baby-asphyxiating medical research atrocity was approved by the U.S. National Institutes of Health and by the rubberstamping Institutional Review Boards at all 23 participating hospitals.

Parallel studies with the same protocol were launched in Australia, New Zealand, and the UK under the names BOOST II, BOOST NZ, and BOOST UK, plus a Canadian version called COT which was conducted not only in several Canadian hospitals but also recruited study sites in Argentina, Finland, Germany, Israel, and the U.S.[20]. In none of these countries did any of the many involved officials publicly object to this premeditated abuse and asphyxiating of extremely vulnerable research subjects. The unanimous approvals of these experiments reveal the continuing influence of the long-standing world-wide crypto-eugenic euthanasia attitude, and of the oxygen-blaming brain-wash propagated decades ago by American and British researchers. Moreover, the consistent failure at all levels of all those countries’ health systems of all the alleged safeguards against such medical research atrocities exposes also the hypocrisy behind all the unctuous international Declarations of Medical Ethics.  

In the U.S., this failure also shows that all the solemn “never again” vows about the inhumane Human Radiation Experiments and the repeated official apologies for the equally infamous syphilis studies in Tuskegee and Guatemala were just window dressing. (For more examples of equally unethical U.S. medical research abuses, see the several lists at the website of the non-governmental Alliance for Human Research Protection [21] as well as their report on the Origins of Bioethics in the utilitarian American eugenics movement[22]). Despite the clockwork regularity of information about more and more such medical research atrocities becoming public, the U.S. government gave so far only lip service to preventing their repetition but made no real changes to its supervision of medical research ethics. It also still fails to assure the protection of human research subjects against the common medical “Research über Alles” enthusiasts and their influential defenders.

The so-called Atrocities Prevention Board, established in 2011 as an agency of the U.S. Government, appears to deal only with atrocities and genocide in other countries and is not charged with preventing atrocities at home, preferring to point out the splinters in others’ eyes instead of the log in their own. 

When the scandal about the long-ago syphilis study in Guatemala surfaced, President Obama asked the Presidential Commission for the Study of Bioethical Issues to reassure him about the safety of current research subjects. To comply, this Commission made a show of holding several public meetings and requesting comments (which it ignored) to then tell the U.S. President and the American people that subjects of U.S. medical research here and abroad were now adequately protected against abuses like those in the Tuskegee and Guatemala syphilis studies it ritually condemned. This assurance was highly hypocritical because the Universities led by the Chair and Vice-Chair of that Commission had just actively participated in the knowingly lethal and therefore even worse deceptions and abuses of the criminal SUPPORT experiment[23]. Yet, the Commission omitted to mention this conclusion-contradicting fact although its leaders had been reminded of it before they offered their knowingly false assertions.

Adding to this official lie, the Directors of the U.S. National Institutes of Health and two of its Departments not only defended the plainly unethical SUPPORT protocol by falsely claiming the researchers had been unaware of the risks but also offered the deliberately wrong and potentially lethal assertion that oxygen saturation levels as low as 70 percent were safe[24]. However, the authors of the study they cited for this bogus claim had specifically stated that the infants in their trial were virtually never at this merely nominal low level[25]. Also, three of the SUPPORT researchers had previously written in a letter to the editor at the NEJM: “Infants who died spent a higher proportion of time (p < 0.001) with saturations below 80 percent”[26]. Yet, these leaders of the U.S. Health system willfully misrepresented the known facts with a new and recklessly patient-endangering falsehood to cover up the earlier research crime they had approved and funded.

The so-called Office for Research Integrity saw nothing wrong with the continued baby-blinding either. Their contact person for the 2006 World Conference on Research Integrity told me, in response to my documentation of massive research frauds that keep blinding thousands of babies around the world, that “we will likely not have time to consider individual cases in detail” but aimed mainly to “harmonize policies and communicate concerns [between countries]”.

That Office did not reply to several additional reminders about research frauds in studies of ROP. Indeed, it has a poor track record for detecting flaws in medical research and seems to rely mostly on the publishing journals’ traditional system of peer review while ignoring alerts from outside their small clique. It cannot conduct its own investigations or even initiate any at the affected universities but can only oversee those launched there. If that ORI does anything at all, it appears to have no discernible impact. In November, 2010, the Journal of Medical Ethics analyzed 788 clinical papers from many countries that had been retracted between 2000 and 2010. It found that 197 of them, or 25 per cent, had been pulled for research frauds. India and the U.S. both topped the list of frauds as a proportion of all retractions from these countries, with 34 and 32 per cent, respectively. These high levels of fraud were virtually the same in both countries although, for over 20 years by now, the U.S. had its ORI to supposedly promote research integrity and to deal with research misconduct whereas no equivalent agency exists in India. This lack of difference in the results led an editorial in the 11/30/2010 Telegraph - Calcutta to conclude that “this study provides no evidence that ORI’s existence has led to a lower scale of misconduct”[27].

The U.S. Office for Human Research Protections is a similarly misnamed do-nothing agency. It raised no objection against the SUPPORT study’s blatant contempt for the “medical ethics” Codes and for the relevant Federal Regulations while this study proposal passed through the approval process, and it did not react to the planning or conduct or publication of that knowingly baby-killing medical experiment. Instead, the OHRP had to be alerted to the flagrant ethics violations by an outsider a year after its publication[28]. Even so it took two more years to send a “letter of determination” to the lead researcher to complain about the lack of informed parental consent. And then it backed down and suspended any penalties when the researchers as well as various so-called “bioethicists”, the editors of the New England Journal of Medicine and of the Journal of the American Medical Association, plus the above cited top officials at the NIH raised objections against even this feeble slap on the wrist. All these apologists claimed against all evidence that there had been no foreseeable risks although the researchers had described those risks, and although the entire US$20million experiment had been conducted to quantify those very risks more precisely than previous studies.

In response to these objections, the OHRP held a public hearing in August, 2013, to determine whether the informed consent rules had been properly complied with although it was evident that they had been roundly ignored, and that the researchers had shamelessly lied to the parents about the well-known risks. Now, more than another year later, the OHRP confirmed its earlier finding that the researchers had failed to inform the parents about the significant risks associated with their study. In response, it proposes now to rewrite the very clear single-paragraph Article One of the Nuremberg Code[29] as well as the Federal Regulations which specify that the informed consent of the research subject to any known risks from the research is absolutely essential; both of these leave no wiggle room but the OHRP wants to add an escape door to let it exonerate the researchers.

Indeed, the OHRP tries to confuse this very clear issue with nine pages of muddying verbiage about “comparative effectiveness research” and “standards of care”. First, it appears to accept the SUPPORT defenders’ bogus assertion that the two oxygen regimes used in that experiment were two different standards of care that the researchers wanted to compare. Several presenters during the OHRP’s public hearing over a year ago had shown that this was not true, that the researchers had instead split the then existing standard into a high and a low oxygen version. Neither of these reflected the entire standard practice, and both of them were well-known to hold different risks for the babies, including death, brain damage, and blindness.

In addition, the researchers had tampered with the oxygen level readings to systematically misinform the caregivers about their actual values. There is no conceivable way how this deliberate deception can be included in any “standard of care”.

Then, after stating that the word “should” in their guidance means something is recommended or suggested but not required, as opposed to “must” for something mandated, they water down the Medical Ethics Codes and Federal Regulations by declaring on page 7:

“If a study is designed to discover the degree to which that particular harm will or will not occur, the possibility of that harm occurring is clearly foreseen by those responsible for the design and conduct of the study. The risks should accordingly be disclosed to the people who are being asked to be exposed to that risk as subjects in the study.”

and again on page 8: “If researchers design and conduct a study for the purpose of evaluating a particular risk, then that risk is significant enough that it should be disclosed to the prospective subjects who are actually exposed to it. (emphasis added) 

In the cases so described, the risks must be disclosed with no excuse from that legal requirement, but the OHRP phrasing allows the SUPPORT researchers to avoid being held accountable for their violation.  

Next, the OHRP tries to illustrate the SUPPORT case with a hypothetical example of administering to a child two different doses of radiation that may stop a cancer now or cause one later and that are both “consistent with clinical care guidelines and considered to be within the standard of care. There is little evidence available comparing the outcomes …”. This example does not apply because neither of the oxygen regimes in the SUPPORT experiment corresponded to a standard of care, and both carried well-documented risks. Moreover, the low-oxygen regimen increased the risk of death which puts it into a completely different category, unlike the two radiation doses that might both result in unspecified cancers. And here again, the OHRP says the parents should be informed about the relative risks, as if this disclosure was optional.

The OHRP’s “Guidance on Disclosing Reasonably Foreseeable Risks to Research Evaluating Standards of Care” is therefore not applicable for the case it alleges to address. It appears designed only to give the SUPPORT researchers a free pass and to justify the OHRP’s caving in by keeping  the long overdue penalties suspended or by even cancelling them.

That failure to obtain the informed consent of the parents is not even the most serious of the breaches the OHRP failed to address. The Ethics Codes and Federal Regulations are as simple and unambiguous about knowingly killing research subjects as the Biblical Commandment “Thou shalt not kill”. However, the OHRP never bothered to mention the even more critical and plainly criminal violation that the SUPPORT researchers had intentionally exposed their subjects to an increased risk of death for their research to prevent blindness, and that they had thereby killed 23 “extra” babies. This premeditated homicide for medical research is no different from the medical atrocities that led to the Nuremberg Code, but the OHRP ignored it completely.

This casual treatment of premature babies as disposable guinea pigs seems also to have eugenic racist undertones because premature babies are disproportionately black. Despite a recent narrowing of the previously even larger gap, the preterm birth rate among non-Hispanic blacks is still more than 1.5 times the rate of non-Hispanic whites[30].

The Office for Human Research Protections is not in the least concerned with protecting research subjects from anything. Protecting them would mean preventing their abuse instead of merely observing it after it happened. Imagine that an Office for Fire Protection limited itself to staring at the cold ashes of a building only long after it burned down, instead of proactively enforcing Fire Code rules about the flammability of materials, installation of sprinklers, safety of electrical panels, and so on. But the OHRP appears unable or unwilling to grasp the basic elements of preventive protection: not only did they not object to the blatantly unethical SUPPORT study protocol before it was started, they even stood idly by when some its researchers called openly for the equivalent of arson.   

Indeed, some among the designers of the SUPPORT experiment had suggested already in 2003, before their initial proposal for the trial, to skip the informed consent formality because this “defensive documentation” would likely reduce enrollment or make it impossible to begin with if its risks had to be explained to the parents[31]. And after the SUPPORT results had been published, some defenders of that protocol claimed more prominently that the consent requirement in all the current Codes of Medical Ethics is a well-meaning but inconvenient and annoying hindrance against research projects where a full disclosure of the risks is likely to dissuade many or all potential subjects from participating. Those proponents of unfettered medical experimenting on unconsenting subjects complained that obtaining consent was a bothersome, expensive, and counterproductive "defensive documentation" that would reduce the number of babies enrolled or could even prevent some experiments from ever starting. The title of their most recent paper even suggested that the consent requirement could be as deadly as a "python's embrace" in that it strangled potentially life-saving research and kept it from being conducted[32].

Yet, the Office ostensibly in charge of protecting humans from just such unrestrained research did not publicly object against this proposed throwback to Pre-Nuremberg “bioethics”. It accepted instead this return to a total lack of protection for uninformed and unconsenting subjects of rogue and even deadly medical research.

3.) Medical denials that the blinding is caused by the excessive nursery lighting

Besides killing 23 human subjects for their research and concealing that well-known risk from the parents, the SUPPORT researchers also ignored their obligation to base their experiment on a thorough knowledge of the scientific background and a careful assessment of the risks and benefits, as required by the Nuremberg Code and the Helsinki Declarations of Medical Ethics for Human Experimentation. Their goal was to prevent or reduce the blinding of the infants from ROP which they gullibly assumed, against all historical evidence, to be caused by excess oxygen.

However, already the discoverer of ROP had written early-on that the most logical cause for this damage to the most light-sensitive organ was the babies’ premature exposure to light. Although he did not yet connect these dots, he was right because the ROP epidemic had started in the U.S. the year after the commercial introduction of fluorescent lamps, and the same parallel repeated itself after World War 2 in other industrial countries as those lamps became available there and the ROP epidemic broke out just as suddenly in their wake.

Reese and a few other doctors pretended to test the effect of light during their campaign of blaming oxygen, but they all patched the eyes of the allegedly protected infants only up to 24 hours after birth[33]. They knew that thermal eye damage from intense light, such as staring at the sun or at a welding arc, accumulates within a few seconds. They should also have known from the analogy with photographic film that lesser intensities act slower but cause the same result with just slightly longer exposure times although the formal quantification of this photochemical process in retinal tissues would be confirmed only several years later.

Systematic research from the 1960s on to prevent eye damage from industrial lasers showed indeed that bright light inflicted its latent eye damage typically in a matter of minutes, not multiple hours or even days. It also established that the most retina-damaging light is in the “blue-light-hazard” wavelength region from 430 to 440 nanometers. Fluorescent lamps emit a major part of their energy precisely in the middle of that most dangerous range, at 435.8 nm. Adult eyes are somewhat protected from that hazard because our lens and vitreous become yellow as they age and so do not let all this blue-violet penetrate to the retina. By contrast, the eyes of babies are still very transparent and lack this protection, and those of preemies are even more vulnerable because their retinal vessels are still developing and are therefore during this stage extremely sensitive to any irradiation. Yet, the typical intensive care nursery lighting of 60 to 100 foot-candles exposes their retinae in less than 15 minutes to the amount of damage-weighted retinal irradiance that the U.S. industrial safety guidelines have established as the danger limit for adult workers over an eight-hour shift[34].

Bluelightbarrier

Fluorescent lamp spectrum

The yellow curve shows the spectrum emitted by the Deluxe Cool White lamp from Sylvania which is similar to that from other makers of the same model. The horizontal axis gives the wavelength in nanometers and the vertical axis the intensity of the irradiation in Watts per ten nanometers. The tallest spike is at 435.8 nanometer in all fluorescent lamps. It is actually higher than shown on this graph which averages the energies over bands 10 nm wide. This wavelength is right in the middle of the area of greatest vulnerability to blue-light damage for all mammalian retinae which ranges from about 430 to 440 nanometers and is here represented by the gap in the red “retinal protection barrier”.  (Graph by the author: Bluelightbarrier.tif)

 

To test the role of light in ROP, regardless of wavelength, researchers in three D.C. area hospitals covered in 1982 all the baby incubators with gray filters to reduce the irradiation of the babies from 60 foot-candles to 25 ftc. This drastically reduced the incidence as well as severity of ROP in all the birth weight groups, with a chance of only one in a hundred for the smallest babies that this might be a fluke. However, some doctors commenting in the NEJM quibbled that this study was of the before-and-after type, and this gave them a pretext to reject these embarrassing findings[35].

This flimsy excuse to ignore the nursery lights did not convince the public, so two pediatric retinal surgeons rigged in the 1990s the bogus LIGHT-ROP experiment to silence the critics of the nursery lighting with the ex cathedra clout of a multi-hospital medical study. Although many of the references these surgeons cited described light damage from quite short exposures, they again delayed the eye patching in their allegedly protected groups for up to 24 hours and so again “proved” the innocence of the fluorescent lamps[36]. Their knowingly deceptive result is now enshrined on the NIH website as the reigning dogma and helps to prolong the profitable ROP epidemic which provides a steady stream of captive customers for pediatric retinal surgery.

Denying the damage done by the nursery lights also helps to drive other businesses such as, for instance, the supply and maintenance of oximeters for monitoring the arterial oxygen levels of all premature babies (although it has been known since 1924 that the retinal oxygen levels are independent of those in the peripheral vessels which the oximeters measure instead[37].) Oxygen control is one of the major activities in a typical intensive care nursery where one third of the expenses, itemized as Ventilation and Oxygen Administration, goes typically for oxygen management and measuring.

Providing those oximeters is so profitable that their major manufacturer, Masimo Corporation, paid more than $930,000 in just the last five months of 2013 to selected doctors as consulting fees, travel costs, and gifts to promote their equipment, including $60K to the editor-in-chief of the journal Pulse Oximetry[38]. But instead of warning about the very real risk of death from oxygen rationing which the SUPPORT experiment had reconfirmed, the Masimo press release about it crowed instead “New Multi-Center Study Finds Clinical Practice Change with Masimo SET Pulse Oximetry Reduces Severe Eye Damage More Than 50% in Premature Newborns[39], as if the “extra” deaths caused by the use of their equipment could simply be ignored.

Other areas of ROP-related profits are regularly touted to investors in telemedicine, which allows the remote diagnosis of the eye damage from digitally generated and transmitted RetCam images, and in drug development where at least seven major pharmaceutical companies have potential therapeutic candidates in the pipeline[40].

 

Preemie with eyes patched

Blinding preemies with nursery lamps

The eyes of this premature baby are patched to protect them from the bright fluorescent lamps used to reduce the bilirubin level in his bloodstream. These bilirubin lamps are only three to five times brighter than the typical intensive care nursery lighting to which the babies' unprotected retinae are exposed 24 hours a day. They are well-known to cause eye damage, but the only slightly less intense regular ceiling lamps are somehow deemed safe, contrary to all evidence.
(Image: EyePatchedPreemie02.tif, photo by author)

 

4.) Ending the cover-up of the mass euthanasia against premature babies

The fake LIGHT-ROP trial as well as the Cooperative Study oxygen fraud need to be exposed and retracted before any progress can be made to end the ROP epidemic. Unfortunately, many nursery doctors and editors of medical journals are strongly opposed to any examination of these blatantly false and fraud-based dogmas. They prefer to deny and cover up any evidence that the oxygen restrictions are causing death and brain damage and that bright nursery lighting harms the babies’ eyes. For instance, I had sent my documentation of this harm to the journal Pediatrics[41], to the Journal of the American Medical Association, and to the New England Journal of Medicine. None of them refuted any of the evidence I presented, but none of them informed their readers about this easy way of ending the baby-blinding epidemic. See also my open letter to the Editor-in-Chief of the Nature Publishing Group in which I pointed out the hypocrisy of Nature to unctuously condemn past medical abuses while covering up the clear evidence for the blatant present ones[42].

Most recently, I submitted to PLoS Medicine an article about the ethics violations in the SUPPORT experiment and the role of fluorescent light in ROP but was told “we do not think that [your material] would be of the wide general interest that we are seeking for PLOS Medicine's general audience”. I pointed out that the ROP epidemic was a major cause of childhood blindness around the world and resubmitted my paper but was told that it provided “no stronger evidence for the association” with nursery lighting than my earlier cited work although that editor did not point out any weakness in that earlier argument. He simply refused to publish the unrefuted evidence against the current failed and lethal approach to the baby-blinding – see my correspondence with this journal that uses the misleading slogan “Open for Discovery”[43].

Instead of acknowledging the unrefuted scientific evidence against the fluorescent nursery lighting in the baby-blinding, the eugenics-infected medical establishment keeps barking up the wrong tree and tries again to blame the problem on genetic reasons. As the most recent example, a December 14, 2014, headline at the Science Codex reads “Major blood vessel gene contributes to vision loss in premature infants” and introduces an article that begins

“A gene known to play a major role in constricting blood vessels also appears to be a major player in the aberrant blood vessel growth that can destroy the vision of premature babies. Endothelin gene expression is greatly increased in the retinal tissue of a mouse model of retinopathy of prematurity, a condition that significantly affects about 1,500 infants annually, resulting in blindness in about half those babies, according to researchers at the Medical College of Georgia at Georgia Regents University.”[44]

Besides understating the number of infants affected each year by an order of magnitude, these gene-blaming researchers fail to explain how this alleged gene materialized only in 1940 since the effect it is supposed to cause was totally unknown until that time, but such followers of the eugenics template appear impervious to facts and logic.

The long discredited pseudo-science of eugenics which caused the ongoing euthanasia program against premature babies appears also to still shape the utilitarian “ethics’ at the U.S. National Institutes of Health where Dr. Ezekiel J. Emanuel headed the Department of Bioethics until 2011 when he joined the bioethics faculty at the University of Pennsylvania (the President of which also headed the falsely reassuring and crime-complicit Presidential Bioethics Commission). Although Emanuel claims to oppose legalized euthanasia, he recently proposed in The Atlantic that he wanted to die at 75 because “this deadline forces each of us to ask whether our consumption is worth our contribution”[45]. It is hard to see a difference between this comparison of consumption and contribution on one hand, and on the other the eugenicists’ infamous concept of “useless eaters” that served the Nazis as the motive for their ruthless euthanasia program. The recent resurgence of such eugenicist talk, like that cited at the beginning of this piece, seems indeed to confirm the now open and unabashed return of that previously still hidden movement.  

Moreover, this resurgence of open eugenics is not limited to talk. It is also reflected in the medical community’s reaction to the results from the SUPPORT experiment. A little over a year after its publication, on August 6, 2011, the San Luis Obisco News quoted the Medical Director of the local NICU as saying that "newer guidelines just coming out lower the amount of oxygen given to preemies even further." Similarly, an article by Laura Landro in the Wall Street Journal of July 19, 2011, stated

"'Some neonatal intensive care units are cutting back on the high levels of oxygen traditionally given to premature babies. (...)  Nurses used to be taught that babies should have a blood oxygen saturation level of 99 per cent and appear glowing pink and healthy', Ms. Rikli says. 'It was hard for some nurses to accept reducing blood oxygen levels to the 85 per cent range, despite research linking higher levels to blindness. It takes constant vigilance and persistence to show nurses the data and to hold them accountable,' she says."

The advocates of tighter restrictions on breathing help omit to say that the medical experiment behind these new guidelines for lower oxygen levels had killed 23 "extra" babies in the low-oxygen group, and that the SUPPORT researchers had announced as their result: "Our data suggest that there is one additional death for approximately every two cases of severe retinopathy that are prevented.”

There is no version of real ethics that would consider such a skewed trade-off acceptable, but those “newer guidelines” based on the illegal SUPPORT experiment advised nursery doctors that it is better to kill preemies than to let them grow up blind, confirming the widespread medical attitude of “better dead than blind”.

Actually, from the narrow and cynical perspective of some doctors this may be true because parents are less likely to sue their baby’s doctor over that baby’s death than over his or her blindness. It may therefore be in the doctors’ interest to just kill off the most vulnerable babies, just as they have been doing for the past sixty years, based on crooked research and intentionally baby-killing guidelines.

After these initial reactions, there has been more medical debate about the lessons to draw from the SUPPORT experiment. However, the euthanasia method of killing babies to keep them from growing up blind has not been clearly and definitely repudiated. This very fact shows the continuing powerful influence of eugenic thinking in modern medicine, both in the U.S. and also in other countries that follow the oxygen restriction doctrine propagated by American eugenicists.

It is time to introduce real ethics instead of eugenic-tainted “bioethics” into this evidence-disdaining and patient-harming approach to treating premature babies. Unfortunately, you cannot expect the leaders of the medical establishment to stop circling their wagons and to start admitting the ongoing mass asphyxiation. During the initial euthanasia program in Germany, it was also not the doctors who objected to this perversion of their Hippocratic Oath but much of the resistance came from the religious community. Despite the high personal risks for any opposition to the regime, the nurses and staff in the mostly Catholic institutions who took care of the disabled began to obstruct the killing policy when they became aware of it. Led by some courageous bishops, particularly Von Galen and Von Preysing, they started demonstrations against the euthanasia program. As Wikipedia tells it, citing a 2011 account by the Catholic News Agency, “There were demonstrations across Catholic Germany - Hitler himself faced angry demonstrators at Nuremberg, the only time he was confronted with such resistance by ordinary Germans”[46]. As a result, “Hitler ordered a halt to the killing of adults (though maintained the easier to conceal murder of children)”[47].

These opponents of euthanasia three quarters of a century ago risked their freedom and often also their lives to follow their conscience against the systematic murdering of the “unfit” and “burdens to society”. Today, by contrast, the even more widespread mass suffocation program against premature babies remains virtually unchallenged. The many self-described “pro-life” organizations I contacted limit themselves to oppose abortion but appear totally indifferent about the fate of the babies after they are born.

However, Pope Francis recently opposed euthanasia in his address to the Association of Italian Catholic Doctors and stated that

"Attention to human life, especially that in greatest difficulty, that is, to the sick, the elderly, children, deeply involves the mission of the Church. The Church also feels called to participate in the debate that relates to human life, presenting its proposal based on the Gospel. (…) In ancient thought and modern thought, the word “kill” means the same thing. The same evaluation applies to euthanasia: we all know that with so many old people, in this culture of waste, there is this hidden euthanasia”[48].

This calling of the Church, and attention to its intended mission to be the “Salus infirmorum”, or “health and help for the sick”, is greatly needed to counter the prevailing “bioethics” which wants to dispose not only of old people but also routinely eliminates children at risk to grow up disabled.

The initially cited Xavier Symons said that this Pope “may be the single most influential bioethical voice in the world”[49]. That may allow us to hope that Pope Francis will use this influence to counter the “progressive spiritual emptiness which no amount of academic honors and degrees can fill” and which afflicts not only the Curia to which he addressed this remark but equally many members of the medical “priesthood” who are also “living in a state of absolute dependence on one’s own often imaginary views”[50]. Maybe he and some of his followers can even cure doctors around the world, whether of any faith or none, from “the disease of indifference towards others”, and make them accept the Commandment “Thou shalt not kill” as well as Matthew 18:14 “It is not the will of your Father in heaven that one of these little ones should perish.”

 

Endnotes:

[1] Alex Schadenberg: “Canadian philosopher promotes euthanasia of disabled newborns and infanticide”,  posted at http://www.mercatornet.com/careful/view/15290

[2] See, for instance, “Eugenics making a comeback as a respectable policy” by Xavier Symons, 9 Nov 2014, as posted at http://www.bioedge.org/index.php/bioethics/bioethics_article/11207, citing the Journal of Medical Ethics doi:10.1136/medethics-2014-102400 published  on November 4, 2014, at http://jme.bmj.com/content/early/2014/11/04/medethics-2014-102400?papetoc

[3] As cited in: Support Study Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network: “Target Ranges of Oxygen Saturation in Extremely Preterm Infants”, posted in the May 16, 2010, online issue of the New England Journal of Medicine, at http://www.nejm.org/doi/full/10.1056/NEJMoa0911781

[4]Abstract of Discussion” after Algernon B. Reese, M.D., New York: “Persistence and Hyperplasia of Primary Vitreous; Retrolental Fibroplasia -- Two Entities”; in Archives of Ophthalmology, Vol. 41, Nr. 5, May 1949, paper on pages 527-549, quotes about “defective germ plasm” and “not zealously preserving these defectives” on page 550 top, as also cited in http://retinopathyofprematurity.org/01Summary.htm .

[5]  See, for instance, Hess JH. “Oxygen Unit for Premature and Very Young Infants”.  American Journal of Diseases of Children, April 1934, 47: 916-917, see page 917 for birth weights. For more examples dating back as far as 1893, go to http://retinopathyofprematurity.org/22oxygenslander.htm

[7] A.E. Samaan: “Harvard and the Holocaust”, March 2, 2013, http://raceofmasters.com. For a more detailed and broader account, see Samaan’s book: “From a ‘Race of Masters’ to a ‘Master Race’: 1948 to 1848”, 2012.

[8] Edwin Black: "War against the Weak: Eugenics and America's Campaign to create a Master Race", Thunder Mouth Press, New York, 2003, page 146. For more information about the eugenicists’ promotion of infanticide and their war on blindness, see my account at http://retinopathyofprematurity.org/20oxygeneugenics.htm

[9]Abstract of Discussion” after Algernon B. Reese, M.D., New York: “Persistence and Hyperplasia of Primary Vitreous; Retrolental Fibroplasia -- Two Entities”; in Archives of Ophthalmology, Vol. 41, Nr. 5, May 1949, paper on pages 527-549, quote on page 550 top, as also cited and discussed at http://retinopathyofprematurity.org/01Summary.htm .

[10] See, for instance, Martin S. Pernick: "The Black Stork: Eugenics and the Death of 'Defective' Babies in American Medicine and Motion Pictures since 1915", Oxford University Press, New York, 1996, and its discussion at http://retinopathyofprematurity.org/20oxygeneugenics.htm.

[11] Martin S. Pernick: "The Black Stork: Eugenics and the Death of 'Defective' Babies in American Medicine and Motion Pictures since 1915", Oxford University Press, New York, 1996, see pages 3 to 5, and 86 top, also note 9 on page 192 citing the Baltimore Catholic Review of November 19, 1915.

[12] Evans PJ. Retrolental Fibroplasia. Transactions of the Ophthalmological Society of the United Kingdom, 1952, 71: 613-16, quotes on pages 613 bottom, 614 top, and 615 middle, as discussed at http://retinopathyofprematurity.org/22oxygenslander.htm

[13] Kinsey EV. Cooperative Study of Retrolental Fibroplasia and the Use of Oxygen. Archives of Ophthalmology, 1956, 56: 481-543.

[14] Kinsey EV. Cooperative Study of Retrolental Fibroplasia and the Use of Oxygen. Archives of Ophthalmology, 1956, 56: 481-543, see Table 8A on last, unnumbered, page of  Appendix.

[15] Silverman WA, Blodi FC, Locke JC, Day RL, Reese AB: “Incidence of retrolental fibroplasia in a New York nursery”, Archives of Ophthalmology, 1952, 48:698-711, see page 698 for admissions, birth weight, and mortality.

[17] For instance, in the trial reported by Bancalari E, Flynn J, Goldberg RN, Bawol R, Cassady J, Schiffman J, Feuer W, Roberts J, Gillings D, and Sim E. Influence of Transcutaneous Oxygen Monitoring on the Incidence of Retinopathy of Prematurity. Pediatrics, May 1987, 79: 5: 663-669, see page 664 right, middle, the closer monitoring of the then recommended more generous oxygen rationing levels was associated with about one extra death in twelve among those babies with very low birth weights.      

[18]  Support Study Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network: “Target Ranges of Oxygen Saturation in Extremely Preterm Infants”, posted in the May 16, 2010, online issue of the New England Journal of Medicine, at http://www.nejm.org/doi/full/10.1056/NEJMoa0911781

[19] Support Study Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network: “Target Ranges of Oxygen Saturation in Extremely Preterm Infants”, posted in the May 16, 2010, online issue of the New England Journal of Medicine, at http://www.nejm.org/doi/full/10.1056/NEJMoa0911781

[20] All these experiments were conducted in parallel as part of the international NeOPrOM study, headquartered in Sydney, Australia. This study is posted at http://www.biomedcentral.com/content/pdf/1471-2431-11-6.pdf. See Askie LM, Brocklehurst P, Darlow BA, et al.: “NeOProM: Neonatal Oxygenation Prospective Meta-analysis Collaboration study protocol”, BMC Pediatrics, January 17, 2011, see page 10 for the description of the founding group, and Table 1 on pages 28 to 30 for a comparison of these five parallel studies. The combined results of the three BOOST trials were published on May 5, 2013, at NEJM.org under the title "Oxygen Saturation and Outcomes in Preterm Infants" and predictably reported a significantly higher rate of death in the low-oxygen groups. The results of the COT trials are discussed at Eduardo Bancalari, MD; Nelson Claure, MSc, PhD: "Oxygenation Targets and Outcomes in Premature Infants", JAMA. 2013;309(20):2161-2162. doi:10.1001/jama.2013.5831, http://jama.jamanetwork.com/article.aspx?articleid=1684964. That discussion includes this gem of trying to explain away the fatal effect of oxygen restriction: “Data from infants enrolled in COT after the pulse oximeter software update showed 2.7 percent higher mortality in the lower compared with the higher saturation target group. However, this difference was due to a decrease in mortality in the higher saturation group rather than a change in the lower group with the new software.”

[21] See the “News Sections” in the navigation panel at http://www.ahrp.org/cms/content/view/18/87/. 

[24] Kathy L. Hudson, Ph.D., Alan E. Guttmacher, M.D., and Francis S. Collins, M.D., Ph.D.: “In Support of SUPPORT — A View from the NIH”, N Engl J Med 2013; 368:2349-2351, June 20, 2013 DOI: 10.1056/NEJMp1306986, as posted at http://www.nejm.org/doi/full/10.1056/NEJMp1306986rss=
searchAndBrowse


[25] Tin W, Milligan DW, Pennefather P, Hey E. "Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation", (Arch Dis Child Fetal Neonatal Ed 2001;84:F106-F110).

[26] Waldemar A. Carlo, M.D., Neil N. Finer, M.D., Marie G. Gantz, Ph.D., reply to “Letter to the Editor”, n engl j med 363;13 nejm.org september 23, 2010, as posted at

http://www.nejm.org/doi/pdf/10.1056/NEJMc1007912

[28] See the second half of my page “Alleged Parental Consent Forms” for the relevant correspondence with OHRP, as posted at http://retinopathyofprematurity.org/48BioethicsConsent.htm. The OHRP’s inertia raises the question: what is the value of a watchdog whom you have to wake up and then ask to please bark?

[29] See the Federal Register for the OHRP draft about which research risks need to be disclosed: Guidance on Disclosing Reasonably Foreseeable Risks in Research Evaluating Standards of Care, allegedly posted at http://www.regulations.gov/#!documentDetail;D=HHS-OPHS-2014-0005-00 (From at least December 10 on, this web page produces only an error message that “we could not load document HHS-OPHS-2014-0005-00”). This rewriting is hair-splitting sophistry, as if the Nuremberg Code’s mandate to disclose “all inconveniences and hazards reasonably to be expected; and the effects upon his health or person, which may possibly come from his participation in the experiment” were not clear enough.

[32] [Simon N. Whitney, MD, JD. The Python's Embrace: Clinical Research Regulation by Institutional Review Boards, Pediatrics 129 (2012). http://pediatrics.aappublications.org/content/129/3/576.full?sid=395f53b6-259b-4654-97b4-3a5c96e2b893]

[33] LOCKE JC, REESE AB. Retrolental fibroplasia - the negative role of light, mydriatics, and the ophthalmoscopic examination in its etiology. Arch Ophthalmol 1952: 48: 44 47 (see page 44), as discussed at  http://retinopathyofprematurity.org/37studiesoflightandROP.htm

[34] See my peer-reviewed report “Baby-blinding retinopathy of prematurity and intensive care nursery lighting”, Iatrogenics  (The Official Journal of the International Society for the Prevention of Iatrogenic Complications--ISPIC) Volume 1, Issue 2, dated April-June 1991: 2: 68-85 but distributed in Summer 1992. It is posted at http://retinopathyofprematurity.org/Babyblindinglights01.htm

[35] GLASS P, AVERY GB, SLUBRAMIANIAN KNS, KEYS MP, SOSTEK AM, FRIENDLY DS. Effects of bright light in the hospital nursery on the incidence of retinopathy of prematurity. New Engl J Med 1985: 313: 401-4, as discussed at http://retinopathyofprematurity.org/37studiesoflightandROP.htm

[36] Reynolds JD, Hardy RJ, Kennedy KA, Spencer R, van Heuven WAJ, Fielder AR for the LIGHT-ROP Cooperative Group: Lack of Efficacy of Light Reduction in Preventing Retinopathy of Prematurity, NEJM May 28, 1998, 338 (22):1572–6. See the discussion of the frauds in this experiment at http://retinopathyofprematurity.org/40fraudsinLIGHTROP.htm. Also, some of the most incriminating portions from the Manual of Procedures for that rigged LIGHT-ROP trial are posted on the pages beginning at http://retinopathyofprematurity.org/LIGHT_ROP_Manual01.htm 

[37] as cited in Weiter JJ. Phototoxic Changes in the Retina, in Miller D. (ed.): Clinical Light Damage to the Eye, Springer Verlag, New York, 1987, pages 79-125, see pages 86 and 122.

[40] See, for instance, the “Research and Markets” report of November 11, 2014, at http://www.businesswire.com/news/home/20141111005741/en/Research-Markets-Global-Retinopathy-Prematurity-Therapeutics-Pipeline#.VJAE6cmrFHM and the CNN Money Report on Shire R&D about their SHP607 protein replacement therapy being developed for the prevention of ROP, as posted at http://money.cnn.com/news/newsfeeds/articles/prnewswire/
enUK201412092875.htm .

[41] See, for instance, http://retinopathyofpremuturity.org/ROPTVGoodMorningAmerica.htm for a transcript of my August, 1989, live TV discussion on Good Morning America with Dr. Gerald B. Merenstein, Chairman of the Committee on Fetus and Newborn of the American Academy of Pediatrics, Professor of Pediatrics and Acting Chairman of the Department of Pediatrics at the University of Colorado in Denver, in which this “expert” claimed, contrary to his own earlier writings and his presumed knowledge that babies come from dark wombs: “Even something as simple as keeping the lights very low may have an adverse effect that we are not aware of”.  

[45] Ezekiel J. Emanuel: Why I hope to die at 75: An argument that society and families – and you – will be better off if nature takes its course swiftly and promptly”, The Atlantic, October 2014, pages 75 to 81, quote on page 81.

[46] http://en.wikipedia.org/wiki/Catholic_resistance_to_Nazi_Germany , section on Euthanasia, citing the Catholic News Agency; 3 October 2011, as posted at http://www.catholicnewsagency.com/column.php?n=1657 

[47] http://en.wikipedia.org/wiki/Catholic_resistance_to_Nazi_Germany , section on Euthanasia, citing Richard J. Evans; The Third Reich at War; Penguin Press; New York 2009, pp. 99–100

[48] Pope Francis’ address on November 16, 2014, to the Association of Italian Catholic Doctors, as posted at http://www.zenit.org/en/articles/pope-francis-address-to-association-of-italian-catholic-doctors

[49] Xavier Symons: “Pope condemns euthanasia, calls for a new ‘human ecology’”, Bioedge, November 24, 2014, at http://www.bioedge.org/index.php/bioethics/bioethics_article/11231,

 
 

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