who would be candidates for euthanasia - the child who suffers from mental retardation, the grandfather who has recently suffered a stroke resulting in expressive aphasia, the untreated alcoholic patient who abuses his or her spouse. Family members often experience frustration or even mental anguish as a result of these patients and their diseases. One may argue that these patients are in a different category, because they do not have terminal cancer. Unfortunately, there are many diseases that are terminal. Most patients with congestive heart failure have a poorer diagnosis than many cancer patients. Alcoholism is a disease with a very high death rate if it is not properly treated. After all, life itself is fatal. If we accept Yuen's criteria for euthanasia how will we defend our reluctance to kill alcoholic patients whose drinking dulls their intellect and causes their families mental anguish and whose disease is often fatal. Yuen mentions the cost of caring for the terminally ill and suggests that euthanasia is an acceptable alternative to the financial burden such care imposes on our health care system. If we can justify the deliberate taking of a human life on economic or other grounds can we really be far from doing the same in the case of physically or mentally handicapped patients or any other patient who is a drain on our economic resources? Obviously, if the medical profession agreed that euthanasia were an acceptable solution to the economic problems of our system there would be a tremendous amount of pressure on patients to agree to a premature death. I believe this would be a tragedy. Many of my patients have spiritual beliefs that are in direct opposition to the practice of euthanasia. They believe that God will decide when their life on 446
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earth should end; they do not believe that physicians ha-ve this divine wisdom. They recognize that their families may suffer mental anguish as they die, but they trust that we will mobilize the appropriate support systems. I believe that these patients would suffer tremendous mental anguish as they struggle to be true to their spiritual beliefs yet feel pressured to yield their lives for the sake of economic responsibility. As physicians we must guard against any discussion of euthanasia that lacks sensitivity to the spiritual needs of our patients. I believe the medical profession will truly have earned the disrespect of society if it looks to such drastic solutions to our economic health care problems. Kenneth J. Crowe, MD PO Box 1690 Melfort, Sask.
Secondhand tobacco smoke: early insights T Nhe general interest in the potential damage caused by secondhand tobacco smoke appears to be spreading. Dr. A. Stewart Allen's historical contribution to this topic (Can Med Assoc J 1991; 145: 1200) is timely and interesting. It brings to mind my teacher E.P. Pick, professor of pharmacology at the University of Vienna, who as early as 1930 discussed this issue
ex cathedra, perhaps earlier than other teachers and researchers. He referred to the presence of tobacco smoke as "streams" and added another source of secondhand smoke, namely that originating in cigarette stubs crushed underfoot and extinguished in ashtrays. Milo Tyndel, MD 316 Lytton Blvd. Toronto, Ont.
Diatribe cloaked in scientific language I n his review of the book Kinsey, Sex and Fraud: the Indoctrination of a People' (Can Med Assoc J 1991; 145: 989-990) Dr. E. Robert Langford accuses the authors of producing "a diatribe cloaked in scientific language" and characterizes them as being "uncomfortable with the belief that sexuality can be a positive and enriching part of the human psyche."
Langford offers only opinion dismiss the considerable body to of evidence in the book about the research deception of Kinsey and his colleagues, evidence that fraud expert Walter Stewart of the National Institutes of Health finds "serious and disturbing." Langford's is the defensive and dismissive approach to alleged scientific misconduct that makes subsequent exposure even more damaging. It is fraud to use a survey sample that (as we now know) has an unduly high proportion of prisoners or ex-prisoners (approximately 25%), sex offenders and other sexually unconventional groups - proportions wholly unrepresentative of society - and to claim that you have "applied all of the techniques of a statistically sound population survey."2 A further travesty is to take data from the experimental masturbation of several hundred children - some as young as 2 months and some stimulated for as long as 24 hours at a time and claim to have provided a valid picture of the normal "sexual history of the human male" and to have proved that such history "thus begins in earliest infancy." The ethics of this are even worse than the science. (Stopwatch measurements and physiologic observations on the orgasmic response of 188 children came, it is claimed, from interLE 15 FEVRIER 1992
CAN MED ASSOC J 1992; 146 (4)
earth should end; they do not believe that physicians ha-ve this divine wisdom. They recognize that their families may suffer mental anguish as they die, but they trust that we will mobilize the appropriate support systems. I believe that these patients would suffer tremendous mental anguish as they struggle to be true to their spiritual beliefs yet feel pressured to yield their lives for the sake of economic responsibility. As physicians we must guard against any discussion of euthanasia that lacks sensitivity to the spiritual needs of our patients. I believe the medical profession will truly have earned the disrespect of society if it looks to such drastic solutions to our economic health care problems. Kenneth J. Crowe, MD PO Box 1690 Melfort, Sask.
Secondhand tobacco smoke: early insights T Nhe general interest in the potential damage caused by secondhand tobacco smoke appears to be spreading. Dr. A. Stewart Allen's historical contribution to this topic (Can Med Assoc J 1991; 145: 1200) is timely and interesting. It brings to mind my teacher E.P. Pick, professor of pharmacology at the University of Vienna, who as early as 1930 discussed this issue
ex cathedra, perhaps earlier than other teachers and researchers. He referred to the presence of tobacco smoke as "streams" and added another source of secondhand smoke, namely that originating in cigarette stubs crushed underfoot and extinguished in ashtrays. Milo Tyndel, MD 316 Lytton Blvd. Toronto, Ont.
Diatribe cloaked in scientific language I n his review of the book Kinsey, Sex and Fraud: the Indoctrination of a People' (Can Med Assoc J 1991; 145: 989-990) Dr. E. Robert Langford accuses the authors of producing "a diatribe cloaked in scientific language" and characterizes them as being "uncomfortable with the belief that sexuality can be a positive and enriching part of the human psyche."
Langford offers only opinion dismiss the considerable body to of evidence in the book about the research deception of Kinsey and his colleagues, evidence that fraud expert Walter Stewart of the National Institutes of Health finds "serious and disturbing." Langford's is the defensive and dismissive approach to alleged scientific misconduct that makes subsequent exposure even more damaging. It is fraud to use a survey sample that (as we now know) has an unduly high proportion of prisoners or ex-prisoners (approximately 25%), sex offenders and other sexually unconventional groups - proportions wholly unrepresentative of society - and to claim that you have "applied all of the techniques of a statistically sound population survey."2 A further travesty is to take data from the experimental masturbation of several hundred children - some as young as 2 months and some stimulated for as long as 24 hours at a time and claim to have provided a valid picture of the normal "sexual history of the human male" and to have proved that such history "thus begins in earliest infancy." The ethics of this are even worse than the science. (Stopwatch measurements and physiologic observations on the orgasmic response of 188 children came, it is claimed, from interLE 15 FEVRIER 1992
