Praying Mantis

Other than in the mirror I had never seen a praying mantis till this one appeared on my doorstep in Costa Rica. I recognised him immediately as a kindred spirit.  He is named I suppose for his shape rather than his story. But his story really calls for prayer indeed. The male praying mantis upon making love to his precious wife suddenly finds at mutual orgasm, she literally bites his head off.  She thereby gets the nutrients to conceive her young and no doubt writes poetry thereafter about her tasty impaler.

St. James Anglican Church - Easter Service 2012

Easter lillies adorned the church.  Part of the festivity of Easter. Christ is Risen!  Christ is Risen, Indeed.  Hallelujah!  George Telemann's Trumpet Air began the Entrance Rite.  We all stood.  Even Gilbert who'd had his own rambunctious entrance jumping up and down to see his friends, Elizabeth, Phil and Alice.
Now the Solemn Festal Procession of clergy in finest raiment took place.  Around the church they walked to end before the Easter Garden, a hand crafted scene of the tomb of Jesus opened.  On the third day he rose.  The processional hymn was "Hail thee, festival day!"  Collects and Greetings and Kyrie Eleisen followed. Gloria in Excelsis.
The first reading was from the Book of Acts, Act 10:34-43, Peter telling the disciples they are witnesses. "They put him to death by hanging him on a tree; but God raised him on the third day and allowed him to appear, not to all the people but to us who were chosen by God as witnesses, and who ate and drank with him after he rose from the dead."  Thanks be to God.   The cantor sang the psalm with the line "His mercy endures forever."
The second reading was from Paul to the Corinthians, 1 Corintians 15:1=11 saying "Christ died for our sins.....that he was raised from the dead...."  The word of the Lord, Thanks be to God.   Alleluia.  We all sang the Sequence Hymn, Christians to the Paschal Victim.
Then there was reading from the Holy Gospel, John 20:1-18 telling of Mayr Magdalene coming to the tomb and finding it open.  "Woman why are you weeping."  Then Jesus said to her ""Mary", and she said "Rabbouni" And he said "I am ascending to my Father and your Father, to my God and your God. "   The Gospel of Christ, Praise be to thee, O Christ.
We took our seats to listen to Father Mark Greenaway-Robbins give his moving sermon. He began reviewing the week's teaching done in services by Mother Jessica Schaap.  He went on to give his message that Jesus' resurrection was a message to us for our 'own breaking out of the tomb'.  We too could share in the new life offered to us if we break out of the tomb.  From death to life was the message in his celebration of the central mystery of Christian rebirth. It was a mesmerizing uplifting sermon followed by sacred silence.  We stood and all the congregation together recited the Nicene Creed.  I found myself especially hearing "I believe in the Holy Ghost, the Lord, the giver of life, who proceedeth from the Father and the Son.......I believe in one, holy catholic and apostolic Church, I acknowledge one baptism for the remission of sin.  And I look for the resurrection of the dead, and the Life of the world to come. Amen.'
Phil on his last day with the church before going with Elizabeth to work in medical research in Saudi Arabia shared the prayers of the people. "Hear us, Lord of Glory.!"Following that we shared the Peace. Gilbert loves this best because we all greet each other and people about come and pet him and speak to him and he jumps up on anyone he can. I keep him on short leash but he forgives me this because it's a great break in the service for him. He'd been lying quietly till then resting his chin on the kneeling cushion.
The Liturgy of the Holy Eucharist followed. The choir sang, "Holy, Holy, Holy, Lord God of Hosts.  The prayer of consecration was recited by the priest. Then we all recited the Lord's Prayer kneeling.    In time Laura and I and Gilbert joined in the lines that lead to the altar where Laura and I but not Gilbert received the blood and body from the priest.  Returning to our seats we knelt meditating on Jesus and Easter.  The communion Motet was chanted, "Christ the Lord is risen again! Christ hath broken every chain! Hark, the angels shout for joy, singing evermore on high, alleluia! The communion hym was "Now the green blade riseth.There was the concluding rite.
And Elizabeth and Philip were called to the altar whre where they were blessed and anointed before moving to their new home in Saudi Arabia.
That was followed by the blessing for all and the dismissal.  The deacon chanted "Let us go forth in the name of Christ, alleluia, allelulia, Thanks be to God, alleluia!.  The cantor sang Regina Coellie "O queen of heaven be joyful, Alleluia," We all followed with "Rejoice and be glad, O Virgin Mary, alleluia.
The final hymn was "Jesus Christ is Risen Today".  I love this hymn of celebration and we all sang with the choir rejoicing.
In the church hall Gilbert wanted to join the children on an Easter Egg hunt but chocolates are not good for dogs and he'd no doubt knock over a 2 or 3 year old in his exuberance.  After when we shared in the going away cake for Elizabeth and Phil I did let Gilbert lick my fingers.  Matias was there and he's grown so tall. I'm always amazed at the growth spurts of children. Often it's week's or months between times I see them and despite my negligence they've been growing furiously on their own. After coffee Laura and I departed to the sunshine outdoors ready to begin another Christian year.

Mazda MX-5 Miata GT

Year round motorcycling in Vancouver is cold rainy and windy.
"Why don't you drive your truck?" a friend asked.
"There's no parking in Vancouver."
"Then you'll just have to get a car like everyone else."
"I don't want to get a car. I feel like I'm driving in a cage."
"What about a convertible"
And that's how I began looking for a sportscar.
I remembered the years I had a Ford Mustang and how I loved that car. Just like my Harley Electraglide. When I got in my Mustang I wanted to head for the open road.  But I didn't need the back seat.  Now I wanted something smaller too.  Something easy to park, really maneuverable. And I wanted a trunk. In Vancouver anything is stolen if it's left in the car and people break windows just to snatch and grab cellphones.  A trunk made things out of sight out of mind, even if a lock only keeps an honest man out.  I didn't want to tie up a lot of money either.
My wiser older brother Ron who'd had a motorcycle before me had bought a sportscar with his wife Adel when they were younger.  Dad never had much to say about them but then he was really a truck man. Mom and he liked their American Motor sedan too.  Remember her in her mink coat and him in his suit driving to church in their Ambassador.  They always had to have a back seat for the kids and grandkids though.  If I'm not riding a motorcycle,  a 2 seater sportscar is just fine for me.  
The list of car choices got short pretty quickly.  Smart Car - great but no trunck.  Cooper - no trunk but otherwise fine.  Back seat possibilities.  VW bug convertible. I phoned the dealer and all I got was an electronic message. Made me think that maintenance could be a problem. Still I loved the VW bug, rabbit and Vanagon's I've had.  Checked out the PT Cruiser convertible too. I 'd rented PT Cruisers and loved the ride. Reminded me of the HHR I loved.  All the American cars were great but bigger than I needed.
That's when I came back to the Miata. I'd seen one on the street and loved it. A Prrofessor of Pharmacy friend had one and he absolutely loved it . All the ratings on internet were great.   It was under$30,000 new where as if I wanted a BMW or Porche or any of those others I'd have to go to a $50,000 plus price tag which meant I'd have to sell a kidney.   I'd get $10,000 on my Ural Sidecar Motorcycle if I traded that in  so with $10,000 down and that I'd only have to finance $10,000.  Not bad with the two year rates these days. My Scotia and TD Banks are Canadian with bank managers I like.  It was the American banks that hated their citizens not the Canadians. Dad always paid cash where he could but secured loans were relatively okay. The real one armed bandit crack equivalent was the credit card. I watch mine like a venomous snake I've got as a pet.. .
Laura and I decided just for fun to check out the 'feel' of a Miata.   I'd sat in some other sports cars on lots but never the Mazda.  So there we were one day at Morrey Mazda in North Vancouver.planning only to sit in one.  I did and "it fit" like a very fine glove.
"You know we've got a 2011 model which was used as a demo ,  has only 10,000 km on it and is $10,000 off the new price." Erik, the delightful salesman told me. I knew what Eve felt like in the Morrey Garden of Eden.  All the Mazda cars were bright shiny apples but the Miata was the prettiest of all.  It was like history repeating myself too..  I remembered the day I'd gone from a Harley Davidson Roadster to the Electraglide I truly love because Trev Deely had a low mileage demo on just such a sweet sale.  One of best decisions of my life.
Erik was a tall handsome man who sold me on Mazda and Miata simply by showing me the features and telling me how much he enjoyed his.  He was 6'2".  We talked about motorcycling. He admitted he'd given up riding a decade past falling in love with sports cars.
"I love my miata." he said.
So we took it for a test drive.  Laura stayed with Gilbert. I drove the 2011 Miata around the neighbourhood and out on the highway and back.  What a ride!  Great open air biking feel with the same sense of feeling the road cornering. And perky, too  On the highway it just lit out with a whole lot of muscle under the hood. . 167 hp 4 cyclinder but the car is under 3000 lbs. My 1600 cc Harley motorcycle is nearly a thousand pounds.  Great torgue.  Same kind of responsiveness.
"Two side air bags for collision and front air bags.    Head rest acts as a kind of roll bar but there's reinforcing back there. You can get more reinforcing for the headrests as an accessory.  But the feature I like best," Erik said, " is the automatic emergency braking. If you slam on the brakes, say if a kid runs in front of you, electronically the car senses the fast braking motion and brings all the braking pssible to bear without ceasing up." I tried it and we stopped with my guts in front of the car.
2.0L engine, Double overhead Cam. 4 cylinder. 16 valves.
167 hp at 700 rpm  140 ft lbs @ 5000 rpm
Rear wheel transmission.  I've got 6 speed manual.  I confess I think automatic sportscars are for weenies.   I love the brakes.  Disc brakes - ventilated front disc and solid rear disc brakes.   There's tire pressure monitoring too though I haven't found it yet.  I heard about that first when I got my RV.  Something I'd like on my Harley too.
The folding 12 second hard roof is what makes it. I was afraid to have a cloth top in downtown Eastside Vancouver.  There's problems with people knifing the tops for fun or profit.  I just didn't want to have to face the bother of replacement.  Thieves are most awful for forcing one to deal with insurance beurocracy, the appointments and delays. All over Vancouver millions and millions of dollars in lost productivity is a product of the high downtown theft rate. I've had my vehicles broken into several times.  The insurance doesn't cover the lost and never covers the thousands of dollars lost time dealing with insurance  and repairs.  So I loved the hard top.  Best of all worlds.
The key fob works the lock and it's one of those proximity ones. If it's in my pocket the car is mine.
"This one is 'fully loaded'", Erik told me. All the accessories.  The base car rate for a new one was around $28,000 but fully loaded GT or Grand Touring could add another $10,000 to the car price total.  Great Bose sound system too with Serius Satellite Radio installed.  I've still got to get that working. But Laura and I loved the Serius comedy channel on the new Jeep we'd rented in Ottawa last month.   I've had my I tunes playing through the Bose system.Selah, Bach and Chantel all sound terrific.  Love having the controls on the steering wheel.
When Eric and I got back I took Laura for a spin and she said, "I love it."  Most imporstant, she said,  "There's room enough for Gilbert here too."   That's what counted. I knew Gilbert would sit on the seat but didn't know if he and Laura would have enough room together on 'his' side of the car.
So I bought it.  At least the bank and I did.  I needed more  good excuses  to go to work too.
Now it was hard to wait for delivery and harder to wait for the weekend day trip. But  Laura and I and Gilbert have driven down to Bellingham, stayed the night there. The winding tree and sea Chuckanut Road I love doing  on my Harley on the Oyster Bike Run was a whole lot of fun in the Miata. . With the wider vehicle the road is a whole lot narrower. Easier and better feeling on the bike but still a great experience driving a winding and curving country road..  Love the sunshine and wind in the hair. Had to stop at Skaggit Harley though to get a leather harley ball cap. Had to have that and my hair in a pony tail because my hair had been whipping  my face raw.  Usually it gets bunched inside a helmut. .  With the heated seats and interior heating it was a really comfortable ride. Truly decadent.
Loved looking ahead at a storm cloud, turning to Laura and saying, "I think I should put the roof up or we might get wet."  I pulled over to the side.  12 seconds later  and we were ahead of the rain and snug as a bug. I confess I felt pretty good when a biker went by going the other direction soaked from head to toe. I must be getting soft.  But I sure have paid my dues. I knew too well what that guy was feeling like and  I know I was feeling a whole lot more warmer.  And still I felt really 'cool'.
Tthere's something to be said cruising along with Steppenwolf wailing over the speakers too. Laura and I had loved seeing John Kay at the Sturges North Biker Festival last year.  With the top up I felt more  like I was  in the cabin of a little jet fighter plane than a boring old car. . The whole console is so well made and arranged for viewing.  Laura and Gilbert beside me was pretty great too.   i think I know what Tom Cruise feels like now.
At the Best Western in Bellingham and the Best Western Navigator in Everett we just took the overnight luggage out of the trunk and signed in. The trunk holds just enough for two to make a week road trip I'd figure. This weekend road trip we had room left over. I imagine we could even throw in the tenting camping gear we had for weekends on the motorcycle.  Pretty tight but just what we need. I'd not be going hunting with this car. No room for hauling loads.  That's what my trucks for.
This is perfect for my needs in city and weekend road trips.  I'll be riding the harley still and even taking Laura along. But Gilbert doesn't like any long trips in his box at the back when there's the  three of us on the bike.  At most a day run and that's stretching it for him.  He's liking the sportscar pretty much but the top coming up kind of scares him a bit even if he tries to put on a brave dog face.
"I love my Miata".  This one is 3rd generation and there's more than a million sold. Reminds me a bit of my room mate Roberto's MG.  I was 20 then.  I'm 60 now but kind of feel like 20. And looking over at Laura. She kind of looks like 20 with her blond hair and smile and the two of us racing up the I5.  What an adventure!   I love my Miata!

Ethnocentrism and Psychiatry

Ethnocentrism is the judgement of another culture based on one's own culture.  It's most significant when the ethnocentric individual comments on other people's language, behaviour, customs and religions.  The term ethnocentrism was coined by William G. Sumner who saw the tendency for an 'ingroup' to judge others against the standards set within it's own group.
I studied anthropologist Franz Boas who chronicled the west coast natives.  He felt very strongly that anthropology should try to transcend ethnocentricity.  He developed the principle of 'cultural relativism'.  Malinowski is cited as developping 'functionalism'.
I see colleagues sometimes and others describing my patients through a biased lens and sometimes even catch myself doing it.  Until one questions such things as the 'perception of time' and 'money' and 'mating behaviour' in one's own culture it's difficult to appreciate other cultures choices.
I've found it worthwhile to consider that all the existing cultures are like birds or animals and that they have some internal benefit to their members or they wouldn't have survived this long. I think it's worthwhile to be respectful.

Easter Thoughts 2012

Easter is the time that Christ died on the cross and was resurrected into heaven after appearing to his friends and disciples on earth. He is said to have rejoined God.  He said he was the son of God.

According to reincarnation thoughts an individual can aspire in time to return to God but Jesus apparently didn't do this journey of his own desire but rather was sent by God.  Some say as a sacrifice. That's certainly the way St. Paul saw it.  It was a basic tenet of the Christian faith too. That Jesus died for our sins. That the death of Jesus corrected the sin of Adam.

I say God came to check out his creation and the authorities whacked him .  His death though didn't stop him.  The idea of him was like good radiation. It spread through creation at all levels.  The authorities brand was 'fear' and the Jesus brand was 'love' and 'hope'.

E=MC2 tells me that matter is slow energy.  I am made in the image or imagination of God.  I'm a spiritual being in a spiritual existence.  I am more than Darwinian Evolution. I am more miraculous than anything I can imagine. I am a sacred being in a wondrous sacred dream.

And I have a friend. I have talked to Jesus as a friend since I was a child. My mother introduced me to Jesus kneeling beside my bed as a child.  My mother said that there was an unseen friend in the darkness.

Sailing solo through storms in the north Pacific I loved listening in the long lonely nights to the Christian rock band Third Day's song ,'there's a light at the end of the tunnel.'  Dr. Moody, the psychiatrist who studied people who had near death experiences, said they described meeting a being of shining light at the end of a long tunnel.

Prior to Jesus Gods had been like the warriors who mastered the world and ruled the world.  In contrast Jesus was a 'servant king'. He washed the feet of his disciples.  He preceded the Magna Carta by about 1200 years.  To hear the politicians talk they're always original.  Jesus made democracy possible though.  Some might say the world is unfolding as it should and Jesus' death on the cross was what set in motion the emacipation of the individual.

When I have been locked up I have prayed to Jesus.  I have been comforted by the thought that there is good and that God is good and that God with his infinite power can have a direct connection to every aspect of creation even me when I have been most down.  Indeed at such times Christ has come to me and I have been lifted 'as on Eagle's wings'.

The authorities from my perspective often get things wrong. Like killing God.  This was done by the leader of  Roman Empire, the priests and scribes.  When the people were given a choice they chose Barnabbus over Jesus. I've often made mistakes like that in my life. This is the inexact sinful muddling nature of existence.

So Easter I cry.  There's a song that says 'were you there when they crucifided my lord.'  When I was younger I thought of myself in Christs shoes, getting beat up by the Judges, Lawyers, Authorities, Administrators, Principals, Police, Priests, parents and anyone who was a bully or had the power to be.  Then decades back I realized that I was the one killing Jesus with my worry. Everytime I was afraid and worried I was disobeying Jesus' command "Do Not Be Afraid".  In not trusting in Jesus or the Lord I thought I knew better. I second guessed Jesus and daily was in a way rejecting him and his teachings, turning my back on him as Petter did till the cock crowed.

Christianity is a trinitarian religion with three gods in one and the mystery of how this is.  God the creator, Jesus Christ and the Holy Spirt are one, each an aspect of the whole. Jesus is my advocate, my personal savior, the great physician.

I have been a healer like Jesus. I have followed in his life and wondered all along at my failing to raise the dead yet refused to believe the dead were raised as miracles when they were.

I am at my best when I remember I have only this day and that I must live in the present. Practicing the presence of the lord.  I am at my best too when I think this is just a chapter in a book of life in which I don't know the ending but it goes on long after death.
I am at my best when I'm reading the Bible and studying scripture.  I am at my best when I'm studying the teachings of holy men and women and great physicians and healers.  I am at my best when I am listening for the wee small voice for guidance. I don't do enough of this.  It takes Easter to wake me up to the basics of existence. Too often I'm caught up in the business of life and not focussing my attention on what is utterly important, my relationship with God, my relationships with his son Jesus.

I think about Jesus more in the days of Easter week reading the Bible more, meditating more and praying that this time this year I'll get it right and be right with the Lord.  I want to be serving my Lord Jesus.  I want to be walking in a righteous path rather than scurrying to catch up or lagging behind. There's a special place where I'm right with the Lord and I've been there often and want to be there always.

I've actually tried to give up God but it was like giving up breathing.  I lived without reading my Bible much and life wasn't as good. I spent time with people who were utterly materialistic and life became minimalist like talking kitchen English or speaking to demented people.  There was just so much more one couldn't talk to because it's too disturbing to them.  I don't talk about Jesus as much as  I want to becuase some people don't like to hear about my thoughts on that.  Also I don't have to talk about Jesus when I'm asking someone to pass the butter. There's a time and place for everything.

Most people just want to get something from me. I like my generosity. But they don't know that that's St. Francis. He asked that he be made a channel and I feel all power comes from God so knowledge, money, energy, strength and healing all come from God and I am just a conduit for that so God wants me to give as the sun gives daily and freely.  I take naturally. I find that I am replenished however by God and when I remember that I'm like C.S. Lewis says, talking to the architect rather than talking to the wall.

Jesus gave his life for mankind. It's no big deal for me to give some money at church. Just for the pageant that's a weekly event with the theatre and the song and the Ted's Talks and the participation ritual for an hour or an hour and a half I"d pay $50 to a few hundred dollars if it was just 'theatre'.  If we use the 'entertainment' analogy, Christianity is great entertainment and so I don't mind paying.  What I like is that I've been welcomed into the church when I had no money too.  So the money isn't about what makes the whole thing go round. Yet it's important for people to understand that money is spiritual energy and charity is something the church does. My church does a lot of charity. I give money to my church knowing that my church gives to the poor what the poor need most in turns of material and spiritual gifts. I'm surprised to learn that some people who have been to some obscure likely to be forgot play or concert have never been in a church at easter. These same people will fly to other countries to watch bull runs or religious parades or ethnic celebrations but have never taken the time to participate in the Christian Easter Pageant.  Then on the other hand I regret this if I don't get to church early because there are so many tourists or Christmas and Easter Christians out at Easter and it's sometimes hard to get a seat.  My evangelica nature is often at loggerheads with my self centredness. I Martha and Mary daily.

The secular are forever taking credit for everything. To hear aetheists speak they are God but mostly our civilization as I know it was developed by theists and God loving people.  I believe that God loving people are more human than those who don't know God.  I call my "higher power" Jesus but accept that others use different names. Ultimately  Jesus Christ means 'god within, god will come again.'  It's an exclusive brand though everyone is welcome.

Easter is the time God died on the cross in utter despair. This is the way I feel when I am sick or am being cursed by the authorities and judged by the scribes. I am rarely 'blameless' like Jesus but I share the feelings. When I'm persecuted I relate to Jesus.  I cry out "MY God, My God, why hast thou forsaken me.'  That's what Jesus said too.

It's like night coming down. The world went black from noon till three in the afternoon during the crucifixion when Jesus then cried out and died on the cross. It was a cosmic event.

The resurrection is like morning after the darkness. Jesus is resurrectied, and ascends into heaven.  A marvellous metaphor.  In the 24 our cycle of life where I realize that yesterday is but a memory and tomorrow still a dream I am faced with life as Jesus did. And Jesus prayed and talked with his father and obeyed his father.

I am thinking about Easter. I am looking forward to being part of the celebration of life that occurs in church. I am thankful to have been a participant in Palm Sunday.  I look forward to Good Friday and Easter Sunday.

Thank you Jesus for another Easter week.  Watch over my loved ones,  my minister, his family, the clergy,  and the church this time this year.

Revelations - Elaine Pagels

Revelations, "Visions, Prophecy and Politics in the Book of Revelations", by Elaine Engels was just published this year,2012, by Viking Press. Pagels is the Harrington Spear Paine Professor of Religion at Princeton University. I've so enjoyed previous books by her. The first I read was Gnostic Gospels, a thoroughly intriguing discussion of the questions raised by new digs uncovering gospels excluded by Constantine when Christianity became the state religion.  Her Beyond Belief, The Secret Gospel of Thomas was equally fascinating. Thomas is the one gospel that has been almost re included into the Bible by protestant authorities.  The Origin of Satan was disturbing to say the least. I may disagree with Professor Pagels findings but her research is impeccable and thoroughly thought provoking. Now there are other books of her that I've read including one on Judas. Now I'm excited to get down to reading Revelations. I've not been particularly interested in Revelations because it seemed so metaphoric.
The difficulty is finding time. I want to read Revelations in the Bible again also. I came across this book in Chapters looking for a gift for a friend, and now must find sometime to study what I really want to study.  Most of my life though I've been studying what I need to  for the sake of patients, something I love to do.  But there's been all this other reading I have to do which often isn't relevant to my life, or for  my patients but some how serves the interest of others with their own agendas.
I can't wait to read Pagels Revelations. Maybe with more prayer I may even gain some insights into Revelations, itself.  To date it has been a real mystery.

Controversies in Bioethics

1) It is now possible to keep people alive who are in coma for years.  When should we pull the plug?  This was a question that I faced as a first year surgical resident in the Intensive Care Unit. The questions which had to be considered were a) What was the chance of survival.   b) if a person survived and came out of coma what would the quality of life be expected at c) who was going to pay for the equipment for the length of time it would need to be in use.
At the time we only had a half dozen respirators. I worked with Dr. Jack Hildes in Community Medicine and we discussed his experience with  iron lungs in the polio epidemic.  Dr. Hildes developed a volunteer bagging brigade which would bag people with respiratory failure and then have them on the more poweful iron long respirator for a period of time each day.  The government committee decision making was so slow that hundreds more people would have died but Dr. Jack Hildes personally  mortgaged his home to buy more iron lungs which coupled with the volunteer bagging brigades kept dozens of people alive through their acute episode. Subsequently there were people who lived out their lives in iron lungs.
So I made decisions on who lived and who died often in the intensive care unit. Family were involved but I was careful to ensure them that I was responsible for the decision not them, saving them from potential guilt.  I pulled the plug. I didn't like it.  Naturally.  I had senior colleagues who I was discussing this with too though some of the decisions were made more swiftly with limitted input because the damage was catastrophic.
I routinely called off resuscitations and was involved in the decision to end resuscitations up until a decade back.  I believe I may have been involved in dozens of such decisions.  It was something I did as a country gp, an emergency doctor, as a surgical resident in intensive care.  I have been involved in the decision as a psychiatrist later in my career and doing a locum covering emergency in my years as a psychiatrist I was involved in these decisions. Once a nurse wanted to continue after I wanted to quit so I went with her call and the girl revived. That was one of the last cases I was involved in like this.  I felt peculiar that I'd not 'believed' really.
I've sat in committees and talked about this subject with a variety of people. When I was younger I enjoyed the discussions more than when I got older. Older I found that I really only wanted to hear from people who'd been directly involved in pulling plugs themselves. One of my native friends made the decision to end a family members life. She told me that all the academic considerations were irrelevant in the moment of decision making.  My minister friend asked to end treatment on her family member said much the same.  I found myself that my own 'ideas' changed a 'quantum' level after my first plug pulling.  Today I know when I will pull the plug and yet administration and bean counters have wanted me the doctor to pull the plug sooner. Theres' always pressure to get rid of the sick and move the dead. It's like a factory out there and the boss man wants things moving and there's all manner of subtle pressure placed on the doctor to 'perform'.  I think I was jaded by the time I wanted to call the resuscitation before the nurse. I wanted to go back to bed.  She was young, a Christian, a believer and were it not for her, the girl would have died.  We went the extra mile like I and countless other doctors had done time and time again.  When we stopped we usual felt comfortable.
The last 99 emergency I was involved in was in the US about 5 years ago. . I was the third responder and another doctor, an internist, I admired had arrived with the nurse before me.  Guy collapsed in a hospital.  We did everything with the crash cart and a half dozen doctors and a full range of medicine over the next half hour or so. Then I admired this fellow because he said, "Is there anyone who thinks we should continue?" At that time there was about 20 people there. Family and hospital staff, administration and clergy had all arrived in the middle of this day.   No one said we should.  We stopped. The man had never resumed breathing and his heart beat had never returned. It was a 'witnessed' arrest but the doctor knew that he had an underlying terminal illness already. The nurse and I in the example before where she kept going was an 'unwitnessed arrest'.  There's far less hope with unwitnessed arrests.

2) When does life begin?  When I did my abortions I was told that I was killing the equivalent of a tumor. It was early days.  6 weeks . A couple of d&cs'. But I 'm a hunter and a fisherman and I felt "life" switch off like I do every time I shoot or catch my food.  I never did another abortion after that.  All the evidence confirms that life begins early. I switched from pro abortion to pro life years later.  I don't think we accept murdering children so we have to be clear about when we as a society accept anyone taking a life. Long ago we decided children had rights and stopped parents from killing their own. The idea 'its' my body' is a bit outdated when a child occurs. This all may be resolved soon with extrauterine birth vats.  Scientists usually have solutions that philosophers would still be discussing millenia hence. The philosophers would have nice hair doos though.
Sure, you keep your body, but the state will not let you kill a 'viable child' as we can save the life of that child.  This debate has gone on a long time and I've been on both sides of it. The venomous things said to me by the pro abortion group and the threats have been difficult.. All the pro life doctors I know, like me, have had their lives threatened. I just don't do abortions and don't recommend them routinely. Yet I have had tremendous pressure on me to do so. I have paid hundreds of thousands of dollars for my political incorrectness in this matter too.   Increasingly we are told that we have to make referrals to doctors who do. Why should I support a colleagues business plan. I can recommend that people contact the authorities and they the authorities would recommend whatever. I don't think I would ever have felt clean recommending a patient see Dr. Mortgentaller.
I certainly don't judge a woman who has an abortion today either. I certainly would rather abort than pass a basketball out my ass.  Yet I don't think society is really discussing the matter appropriately when so many women are going overseas to pay women to use their wombs whereas here a pregnant woman can't do such an obvious thing. Abortion clinics are just the end of a long line of abuses of pregnant women.  I loved when conservatives argued that women should be paid $50,000 a child to stay home and raise them rather than being told to have an abortion or be a single mother who can't afford even the cost of day care and certainly won't be encouraged to get a law degree or medical degree if you have a child to care for .
I can see the same thing said to me as a doctor about euthanasia. " You must refer your patient to  Dr. Kevorkian."  I don't think I'd feel good recommending Dr. Kevorkian, either. I met a woman doctor who fleed from Russia after she couldn't sleep for nightmares after hundreds of abortions .She just wanted to practice medicine without having to do abortions and the state woudln't allow her. Now in China they've solved the feminist problem by aborting generations of women.
This discussion needs to go on at a state level reviewing the new input from technology. I personally have no concern about birth control or morning after pills and believe that these preventions should be readily available. I am not sure though that I should be required to pay for your condoms. I don't even know I want to pay for you to have children.
So this is an area that is ripe for further bioethics discussion.  Right now abortion is a high paid low risk extremely lucrative business which attracts the most mercantile doctors. I don't think I should question my colleagues industry in a free market society. We aren't yet lining up tobacco company CEO's against the wall and shooting them so until we are willing to do that I don't think we can stop business men and women doctors from making a killing.
3) Who gets the first brain transplant?  There is a whole lot of discussion in bioethics about organ transplants. I'm in favour of politicians being first when it comes to brain transplants but I'm not sure that those who are selling their brains would offer superior brain material to what's already in office.
4) All longevity enhancing technologies are an area of controvery in regards to how they are distributed. For years I've read hundreds of scientific and futuristic novels discussing some aspect of bioethics and longevity. My favourite was the fellow who had organ transplants to stay alive and then decided that he'd have multiple vaginas and penile attachments after winning a galactic lottery. He slimed when he walked and was a very suspicious character. The book itself was highlu humorous but if you really are interested in bioethics you'd better start taking an interest in science fiction. Gattaca remains my favourite movie about genetics and bioethics.
5) Plastic surgery - we seem to accept that rich get new faces and the poor don't. I didn't question this until I got old. Now I'm a little miffed that I can't get my botox for free like I can fungal cream.
6) I work in addiction and there's no end of discussion about bioethics in the Canadian Society of Addiction Medicine, International Society of Addiction Medicine and the American Society of Addiction Medicine. Right now all the rage is the availability of marijuana and heroin to the public. At another level the questions is who should get it at what price. People who are willing to pay $300 a day for heroin are having it provided by the state for free.  That's the research package but should heroin addiction be allowed for the poor?  Interesting question.  Diversion with drug courts could be decided in a variety of different ways than it is now.
7) There's a lot more questions that arise with new advances in science and understanding and they are all controversial.  Who should be involved in the decision making is increasingly a question. In England the committee to discuss these matters were set up in such a way that a doctor participating would not be held accountable for his views. Indeed most of my colleagues who are pro life or anti euthanasia are afraid to speak their mind because they know that promotions in departments depends on whether you are pro or against global warming. As everyone knows euthanasia is good for the planet as it will reduce global warming.   There has been interesting research though that says that 'experts' have no superior advantage over children or janitors in making these kinds of moral and ethical decisions. As a psychiatrist I was subjected to the studies in which people on waitlists got better faster than those who were given treatment. In the fine print it was a selection of patients but I'd be most interested in these kinds of studies being done in these types of questions. Having always enjoyed Plato and Jesus I note that neither needed degrees and their listeners and participants didn't have degrees in the debates that have so profoundly touched history.  Can a dying health care system afford a bioethicist.  Given the choice of a consultation with a bioethetist about my much needed facelift would I want $300 more discussion or $300 more plastic surgery. If you looked in my mirror you'd know my answer to that question.
Bioethics then at it's best should end up in parliament. Unfortunately in Canada due to a serious democratic glitch of the last couple of decades soon to be resolved it is that often the case that  these questions are decided by lawyers and judges, individuals with extreme bias and tendency to the least variety in opinion by selection process and the hierarchal nature. Doctors even are more diverse in their opinion but less diverse than a normal collection of citizens asked to conclude what is best in the matter of ethics.  Juries worked well in this sense until jury selection, psychologists , and the ability to skip jury duty, like skipping the Vietnam War ,disrupted an otherwise good thing.  Today the jury is something out of American Idol mixed with the Survival reality series.
8) My research interest that got me going into community medicine and onto psychiatry was 'non compliance' and 'non adherence to medical regimen'.  I did research on this back in the early 80's  Then as a psychiatrist I was fascinated by 'borderline personality disorders' because they were a next generation of 'antisocial personality disorders' when it came to 'civil disobedience'.  There were alot of other things about this 'class of patients' but I'd heard that in the 20th century, if you want to know all of psychiatry you studied schizophrenia, in the 21st you study 'borderline personality disorder'.  The 'bipolar spectrum disorder' was a classic redefining and overlap that avoided dealing wit h the human by  devolving the question  to the 'my brain is well and your brain is not"and I will drug your brain to make it look like my brain." However we'd all seen that with antisocial personality disorders in contrast to psychopaths they could be turned around and went on to make the finest citizens. The same was true in my practice with borderlines.  I watched dozens of psychiatric patients became famous artists and other citizens when their personality disorder was addressed. Unfortunately there was no magic pill and the treatment required individual, group and medication therapy.  A bit more complex than the 3 minute psychiatric psychopharmacy visit allowed.
Yet what better topic for bioethics than borderline personality disorder as a whole. No group is more disenfranchised and stigmatised in society. Schizophrenics at least have Friends ie Friends of Schizophrenia.  It's not surprising there's no Friends of Borderlines Personality Disorder Society out there holding car washes. .
Eventually I moved into addiction work because this again is an area where all aspects of bioethics come to the fore and this overlaps with borderline personality disorders which I've always contended were untreated ptsd until proven otherwise.
So core to modern medicine is 'change' or 'no change'.  And social darwinism is naturally killing my patients because the successful like to say they were born that way where people like Jared Diamond emphasize the environment to explain even population variance.  Judith Herman has written eloquently why 'trauma' is something that even psychiatrists shy away from.
Whether one believes in fate or free will colours all aspects of the bioethics discussion too.  But most importantly who is paying for the discussion and what the ambition is of the participants will certainly colour the discussion. I've always contended you can't know anything about bioethics decisions if you can't follow the money trails or the egos.
Right now I'm going for the ice cream.