Friday, December 22, 2006

Piergiorgio Welby
Piergiorgio Welby is dead. He died because his physicians honoured his clear will to end his life that had become intolerable for him in the natural course of degenerative disease of the neuromuscular system for which there is no cure so far. They cut off the artificial ventilation that had maintained his failing respiration.
Conventional medical ethics demand the maintenance of life support as long as a patient ist not brain-dead, on the basis of the assumption that a cure for the disease responsible for the failure of physiological functions might be available in a foreseeable future. In the conscious patient with a chronic condition which steadily continues to deteriorate, the situation is different. Even if there is non cure in sight, some, but not all patients with similar conditions are able to adapt to their situation (tetraplegics, but also some persons with degenerative neuromuscular disease, such as famous astrophysicist Stephen Hawking). What if a patient is uncapable in the long run to cope mentally with her/his condition? Is it correct to view the decision to commit suicide per se as the result of a pathological process that could be treated successfully, e.g. depression?
Where are the limits of coercion that can be used in order to maintain life when a fully conscious person, capable of reasoning, clearly declares that she/he is no longer willing to undergo the treatment imposed by the failure of her/his physiological functions? Where is the line between a treatement that is lived as torture by the patient and the obligation of the health care provider to respect
codified ethics and legal rules?
These questions are now raised in Italy and will produce a useful debate on the responsibility of legislators in medical and bio-ethics, as well as the responsibility of the individual health care provider and the freedom of choice of the conscious patient. The outcome of the debate will show us if respect for the individual person is strong enough to block attempts by fundamentalist religious authorities and political movements to enforce therapies that eventually become equivalents of torture.

Wednesday, December 20, 2006

Le jugement de Tripoli - Une "affaire Calas" en Libye?
Le jugement de Tripoli (cinq infirmières bulgares et un médecin palestinien condammnés à la mort pour le présumé crime d'avoir infecté des enfants d'un hôpital de Bengasi avec le HIV) évoque la mémoire de l'accusation lancée par Voltaire auf 18e siècle au sujet de l'affaire Calas à Toulouse. On espère pour ces condamnés mais aussi pour la Libye toute entière l'entrée en scène d'un Voltaire autochthone qui aurait le courage de défier les perversion du système judiciare en place et de faire corriger ce jugement catastrophique.
Claudio Magris and the "Lumpenbürgertum"

Claudio Magris, in an interview with the Neue Zürcher Zeitung (december 20, 2006), has an interesting definition for the followers of former Italian Prime Minister Silvio Berlusconi:
"Lumpenbürgertum". The term is apparently derived from "Lumpenproletariat" (Russian:
Люмпенпролетариата), which in classical Marxist terminology describes the dispossessed masses "without class consciousness", which are therefore considered as useless for the systematic buildup of a revolutionary movement. The terminology suggested by Claudio Magris deserves some reflexion: first, the perception of the "Lumpenbürgertum" as a mass without "class consciousness" may be biased. The followers of Silvio Berlusconi are proud to consider themselves as the elite of postmodern liberalism, even if their conception of liberalism may be closer to mafiose ethics than to classical liberal thinking.
On the other hand, from a post-communist and post-fascist point of view, the masses may very well serve a revolutionary cause, but in a quite different way than Marx thought.
The "Lumpenproletariat" and the "Lumpenbürgertum" or "Lumpenbourgeoisie"
(Russian: ЛюмпенБуржуазии ) has been useful on various occasions during the 20th century for the orchestration of "coups d'état" (German: Staatsstreich, Spanish: golpe, Italian: colpo di stato). A colleague of Claudio Magris, Curzio Malaparte,
described the technique of the coup d'état in his famous book "tecnica del colpo di stato" back in 1931. The author describes the power struggle within the Russian revolution that led to Stalin's dictatorial regime, the methods used by Mussolini to get into control of Italy, and predicts the success of Hitler in Germany. At that time Malaparte is convinced that Hitler is a "particularly intelligent communist". The book has been published first in France, and then in Vienna, to be immediately forbidden in fascist Italy and in Nazi Germany. It is still recommended for those who like to look at history from different angles.
A modern edition of "tecnica del colpo di stato" has been published under the direction of the actual chief of the historical service of the Foreign Office (servizio storico del ministero degli esteri) of the Repubblica Italiana, Francesco Perfetti, at Mondadori, in 2003.
If we combine the terminology of Claudio Magris with the Malaparte's observations, the conclusion that Silvio Berlusconi has been (or still is) an admirer of Malaparte's tecnica del colpo di stato and that his most important personal success may be to have awakened the consciousness of his fellow citizens of the possibility of a colpo di stato within the framework of a democracy...

Saturday, December 16, 2006

Will Swiss physicians opt for the health care kolkhoz?
The Neue Zürcher Zeitung NZZ reports today that the Swiss Medical Federation FMH has decided not to take sides in the vote on the socialist health insurance initiative due next spring.
By leaving the decision to the members, the FMH abandons definitely the defense of the liberal traditions of the medical profession. It is evident that one of the central motives for doctors to opt for a centralized federal health insurance scheme is their growing anger about the unreliable, inconstant and mostly aggressive politics of the various social insurance companies active in Switzerland under the umbrella of heavy federal and cantonal legislation.
Another probable motive is a change of paradigm in the autostereotype of the medical profession. Many young physicians no longer can imagine to engage in an independent and entrepreneurial professional activity.
Once they leave the hospital environment where they have become accustomed to be employees - mostly at an age where they are married with children and anxiously avoid professional reiks, they are often seduced by the possibility of entering into a so-called "tiers payant" relationship with the social insurance companies, under a contract where there is no need to ask payment from their patients, an where they can relay on payment by the insurance company. The tradition of the "tiers garant" system that had strengthened the relationship between primary care (and specialized) physicians and their patients by allowing direct comparison between price and performance, with payback by the insurance company to the patent has become shaky. It was the "tiers garant" method that allowed direct control of price and quality by the client, but since this system no longer exists in hospital treatment, young physicians are no longer prepared to enforce it.
As an economic editorial in the Neue Zürcher Zeitung a year ago said: "Before WTO, the Federal Constution had to guarantee the health of the farming profession, after WTO the Constitution might have to guarantee the health of the medical profession..."
Back in the Soviet Union, independent farmers, the so-called kulaks, were forced into the kolkhoz system of collective farming. It is one of the paradoxes of our era, that twenty years after the downfall of the Soviet system, Swiss farmers seriously prepare temselves to find their economic niche under the conditions of globalisation, and Swiss physicians increasingly lean toward collectivistic solutions of the healthcare system.
The crucial question is whether a majority of physicians will be tempted to seek shelter under an umbrella that would be a late imitation of the NHS in Britain, at a time when even in countries with a longstanding socialist tradition, there is a continuous shift away from state-controlled financing of the health care system.

Sunday, December 03, 2006

Minarets in Switzerland - Grey Wolves and Grey Bears


The debate on whether minarets are good or bad in Switzerland should
not be left to the extreme right of both Turkey and Switzerland

A legal row over the permission to build a minaret between a
Turkish Cultural Association which is said to be related to the
extreme right nationalist group "Grey Wolves" and the local political
authorities of the municipality of Wangen near Olten in the Swiss-
German Canton Solothurn has now evolved into a major subject for a
group of political activists within the Swiss People's Party, to be used in the federal parliamentary election year 2007.
The major arguments brought forward against minarets in Switzerland are the
following:

a) Minarets could transform traditional architectural
structures, often protected historical monuments, among them, and
particularly prominent, churches, some of them built even more than
1200 years ago. Minarets would present a menace to the cultural
tradition of the country. This argument is most strongly present in
the Italian-speaking Canton of Ticino with it's impressive
"Campanile" with their characteristic stone roofs, often standing
alone beside a rather modest basilica or chapel. Resistance against the constructions of minarets is strong here on the aforementionned grounds

b) Minarets should not be permitted because they represent the
religious fundamentalism, aggressivity and intolerance that has been associated lately with the Muslim world in general, as a consequence of the rhetoric of fundamentalist groups within Islam. This argument is probably the one most often brought forward

c) the minaret of Wangen is considered to be a religious pretext for implanting
extremist, probably terrorism-prone political organization. This is the argument used by the local opponents to the project.

d) A mosque is a Mosque even without a minaret (in fact there are historical mosques without the characteristic stiletto type minaret, e.g. in Africa, as the picture of a Sankore mosque in Timbuktu shows)



Source: Road to Timbuktu
http://www.pbs.org/wonders/Episodes/Epi5/5_wondr6.htm

The real problem lies in the nature of the exponents of both sides.
The Turkish nationalist extreme right (the Grey Wolves) has been
known for decades for it's violence-prone rhetoric and behavior.
On the opposite side, in Switzerland, Ulrich Schlüer, member of the group most active in the fight against minarets (the "Egerkinger Gruppe") - let us call them
"Grey Bears" - has been known for years for his inflammatory
nationalist rhetoric. This type of rhetoric rhetoric easily creates an
atmosphere of confrontation where words facilitate the use of fists by frustrated citizens, and eventually of knives, guns and/or explosives, which in turn would justify heavy police intervention.
In the long term, an authoritarian regime , e.g. of the type of Mr
Putin's ideal: "Dictatorship of the Law", might be the consequence.
It is not known if Mr Schlüer has ever been to the Middle East or
to Northern Ireland, where there is overwhelming evidence for the
devastating consequences of a systematic build-up of violence through
violent rhetoric. It is difficult to imagine that Mr Schlüer really
desires this type of political climate in Switzerland, but the public still
waits for a formal dementi.

During the wars in Former Yugoslavia (Croatia, Serbia, Bosnia, Kosovo) systematic mutual destruction of cultural heritage was
an important method of "cultural genocide", as the images below of two destroyed churches in Vukovar (Croatia),of two mosques in Stolac (Bosnia) and of the title page of a book on "Spiritual Genocide" testify:




























These destructions are the concrete results of a longterm, unrestrained, uninterrupted and systematic mutual discriminatory discourse



A reminder: In Zurich-Balgrist,a mosque with a minaret that had been built 43 years ago lies peacefully next to the evangelic-reformed (protestant) church.