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Title: ARE YOU…’HEALTHY’? ,  By: Buckley Jr., Wm. F., National Review, 00280038, 07/06/98, Vol. 50, Issue 12

Section: On The Right

Dateline: NEW YORK, JUNE 5

Dr. Sherwin Nuland of the Yale School of Medicine raises the interesting question: Are we moving in the direction of asking the medical profession to enhance life and, along the way, to prolong it? Dr. Nuland’s concerns have to do with the vectors of medical research, and how they bear on the public definition of health. The search for that definition brings along a whole trainload of ancillary questions, among them, Is this something that should be covered by insurance or federal aid or health maintenance organizations? For instance?

Well, viagra has received the most notice in recent months, and the attitude toward it of reigning arbiters of federal aid is unsettled. One analyst says distinctions need to be drawn on viagra as needed by elderly men to fulfill passionate — needs? inclinations? diversions? Everything, in the judgment of such as that analyst, depends on distinguishing which of the three it is. But that inquiry is as a practical matter pretty difficult to bring off, and raises the whole question of enhancement of life as distinguished from the curing of infirmity.

Dr. Nuland lists other current drugs. Prozac relieves depression, but the widespread use of it suggests (this is now your pundit talking, not Dr. Nuland) that many are taking it as a Feelgood pill. But what about Propecia, which is said to mitigate, or even relieve, baldness? Is such relief an exercise in medical concern, traditionally understood? Anybody can make the case for anything, granted, but it is less than shamanism to contend that, hair on the head being natural, the lack of hair on the head draws attention and, contingently, affects the mood. The decent limits to self-esteem are not exceeded by men who wear toupees or use Propecia, nor by women who use cosmetics and go in for face-lifting.

But a lot of that kind of thing brings on sure-enough hubris. “Manipulation of the cellular aging mechanism raises expectations of human life extended indefinitely.'’ Dr. Nuland gives us the absolute barrier on that kind of dreaming. The human species is built to last a maximum of 120 years. Nothing can change that. What can be done is to edge up toward that limit, an asymtotic approach. Whereas at the turn of the century we could expect to live 45 years, now we can expect to live 75, and we are presumably continuing to edge in the direction of longevity, always on the understanding that the biological limit can’t be crossed.

All such developments continue to remind us of the auto-hypnosis in which so many of us are caught up. To say that everyone in America has the “right'’ to health treatment is of course to say that everybody in America has the duty to provide health treatment. The very abbreviated perspective gives you Mr. Jones charging his doctor’s bill via Medicare — to somebody else. As once put in this space, health care is defined as somebody else paying for it. The medical saga dramatized by Dr. Nuland in an essay for the New York Times is the galloping expansiveness of care that creeps in under the umbrella of “health'’ for reasons we can’t simply dismiss as semantical. We are pretty well habituated to understanding that psychological care is plainly a matter of health, and if a man’s psychological health rests on his ability to do something about his baldness, why isn’t that an exercise of that right we begin by saying all Americans have?

In his famous book, How We Die, Dr. Nuland reminded us of the facts of death. That was only four years ago, and he spoke of AIDS as perhaps the most “devastating'’ of deaths, probably “now with us for the duration of human history.'’ But the treatment of AIDS is now much advanced, and there is talk of moving in the direction of a vaccine. And the big news is Dr. Judah Folkman’s two drugs capable of destroying sizable cancerous tumors in mice.

Dr. Nuland is now giving time to the Bioethics Committee of the Yale -New Haven Hospital. He writes with some pride about the brilliance of modern medical research, but pauses pregnantly to wonder whether there is the requisite wisdom. “Absent from many news reports are the uncertainty and hedging characteristic of the clinically directed research. And of course the often well-justified enthusiasm and optimism of the scientists themselves carry public opinion along in a powerful wave of assurance.'’

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By Wm. F. Buckley Jr.

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Source: National Review, 07/06/98, Vol. 50 Issue 12, p59, 1p

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