What's the difference between a pet pig and a livestock pig though?
They both want blankets and cookies. Or at the very least neither of them wants to stand in a tiny metal and concrete cage and be pumped full of antibiotics, hormones and god knows what else for their short miserable lives. Neither of them want to be bruised because they have only enough room to face one direction their entire lives. Neither of them want their testicles ripped out without anesthetic while they are piglets. Neither of them want to be beaten when they don't eat.

Also, despite what the marketing people say, humans are not omnivores, everything healthwise and physiologically suggests we are somewhere between herbivores and frugivores. It's also backed up historically too by analyzing fossilized poop!

Here is a quite simplified chart, but I think it does a pretty good point of showing how far away we are from typical mammalian omnivores http://www.whale.to/c/10013268_676368449097110_1949968139_n.jpg

I'm not having a go at you, but I just hope you aren't acting according to a few labels that some organisation has set.

You missed the sound of the old man peeing....flushing....then returning without ever using the sink.

Sad, because this issue IS important. These diseases are spreading throughout the world, are deadly, and are making our antibiotics useless. Most people can't even imagine a world without antibiotics, it could get ugly fast. I would bet that nearly every hospital in America is infected with some strain...that's where my mother in law caught one.

From recent experience, I can say these diseases are mostly easily transmitted, sneaky, destructive, expensive, and often deadly. Most people don't find out they have one until they have an adverse reaction to treatment for some other infection, that adverse reaction can be deadly organ failure, high fever (103+) respiratory distress, etc.... Normal treatment with antibiotics can make things exponentially worse! Many can be spread more easily than a cold, and are spreading rapidly worldwide.

I knew this would happen. Talking to you, too, @oritteropo:

I'm leaving it with just this, because people are attached to their bacon and steaks as tightly as they are tied to religion. Perhaps it's again apples to oranges, but I'm guessing a lot of you are the same folks who rant against religion and wonder why people are so stupid and don't look at logic and science, blah blah blah. This is the perfect time to look in the mirror and see a touch of what you're up against. When you've been indoctrinated with something since you were literally born, you fight against being wrong so hard. So, so hard. Seriously. Take a moment, take a deep breath, and take a little search inside looking at how much of you knows for a fact that eating meat is just fine, and how much of it is cognitive dissonance. How much of it is emotional and how much of it is logical. Look at a video of people going on and on about how Jesus Christ is Lord and another video of people going on and on about how much they love bacon. It's kind of disturbing how zealous bacon-lovers get. Try it. It's fun. It's why I became vegetarian only about 4 or 5 years ago. And I gotta say, getting rid of that cognitive dissonance is very, very relieving and satisfying.

Yes, yes, yes. Loads and loads of vegetarians and vegans are unhealthy. Actually, I would argue that most vegetarians and vegans are wholly less healthy than omnivores since most of them have a high-and-mighty "I'm vegetarians/vegan so I'm automatically healthy" and eat some of the most disgusting, heart-disease-inducing, oily, fatty, un-nutririous, processed shit that's ever been made. Look at some of the fake meat stuff to just have a peek.

No. If you actually watched any of the videos you will see that it's not just being vegan that is important. It's to be a healthy vegan. You know, all that shit you can't ever, ever argue is bad for you. Fruits. Leafy greens. Beans. Lentils. Whole grains, occasionally. But mostly leafy greens and fruit.

And there are loads of studies that control exercise and all sorts of other arguments for "NO NO NO! IT'S NOT MY MEAT! STAY AWAY FROM IT IT'S ANYTHING BUT MY MEAT!". I can think of a specific one that I read/watched about controlling for exercise, and I can find it for you if you'd like, but I'm guessing you aren't really interested. They discovered that very aerobic, exercising, running omnivores were as healthy as lightly walking vegans. He even had a cute graphic for it.

And it's not just this guy, either. Head over to Dr. Fuhrman's website for more of the same. Except Dr. Fuhrman is toting stuff to sell, so that unnerves some people. They claim he's just trying to make a buck. But all the money he makes goes to nutritional research.

The last thing I'll say is this:

I honestly don't give a flying shit about what you eat. I don't really care about the environment at all. I'm not planning on having kids, and I'm sure I'll kick the ol' bucket before antibiotics stop working, water is scarce, the waters rise above NYC, and all the other possible doomsday things that'll probably happen within the next 100 or so years. It's true that I also enjoy not feeling guilty for eating animals who live. It'd make me happy if you stopped eating them because the main thing I believe I'm around for is to minimize suffering in the world. So, that'd be nice if more people didn't eat them.

But if you want to live a nice, long, healthy life where you don't die of a stroke, heart attack, or diabetes by the time you're 65, eat better.

There's a reason why the milk, sugar, meat and pharmaceutical companies pump out study after study about how it's totally fine to eat their shit. They spend so much money on it, it's ridiculous.

Cheers to your health, either way.

The ancestry of living beings isn't just traceable through the fossil record. The study of genetics shows us a huge and utterly overwhelming amount of evidence for the common ancestor idea. Common genes can be traced back to show the lineage of different animals and plants and groups of animals and plants.

Homology is a complex subject..it would take awhile to get into. I found a good link that illustrates the argument against it being a proof that macroevolution occured. If you want to take a look we could discuss further:

http://creation.com/does-homology-provide-evidence-of-evolutionary-naturalism

Ring species show that small changes can indeed lead to separate species. Antibiotic resistant bacteria are evolution in progress. You say that just because small changes can be seen it doesn't follow that big changes can evolve but that's stupid. Big changes are just a series of connected little changes.

I guess it depends on who you ask?

Erwin, D.H. (2000) Macroevolution is more than repeated rounds of microevolution. Evol. & Devel. 2:78-84.

the independence of macroevolution is affirmed not only by species selection but also by other processes such as effect sorting among species.

Lieberman, B.S. and Vrba, E.S. (2005) Gould on species selection. in MACROEVOLUTION: Diversity, Disparity, Contingency. E.S. Vrba and N. Eldredge eds. supplement to Paleobiology vol. 31(2) The Paleontological Society, Lawrence, Kansas, USA

Micro- and macroevolution are thus different levels of analysis of the same phenomenon: evolution. Macroevolution cannot solely be reduced to microevolution because it encompasses so many other phenomena: adaptive radiation, for example, cannot be reduced only to natural selection, though natural selection helps bring it about.

Scott, E.C. (2004) Evolution vs. creationism: an introduction. (Westport, Conn: Greenwood Press).

Macroevolution is decoupled from microevolution, and we must envision the process governing its course as being analogous to natural selection but operating at a higher level of organization.

Stanley, S. M. (1975) A theory of evolution above the species level. Proc. Natl. Acad. Sci. (USA) 72: 646-650.

In conclusion, then, macroevolutionary processes are underlain by microevolutionary phenomena and are compatible with microevolutionary theories, but macroevolutionary studies require the formulation of autonomous hypotheses and models (which must be tested using macroevolutionary evidence). In this (epistemologically) very important sense, macroevolution is decoupled from microevolution: macroevolution is an autonomous field of evolutionary study.

Ayala, F.J. (1983) Beyond Darwinism? The Challenge of Macroevolution to the Synthetic Theory of Evolution. reprinted in PHILOSOPHY OF BIOLOGY, M. Ruse ed. p. 118-133.

When discussing organic evolution the only point of agreement seems to be: "It happened." Thereafter, there is little consensus, which at first sight must seem rather odd. -(Simon Conway Morris, [palaeontologist, Department of Earth Sciences, Cambridge University, UK], "Evolution: Bringing Molecules into the Fold," Cell, Vol. 100, pp.1-11, January 7, 2000, p.11)

I'm late back to this party and iI don't have time to properly address all the points you make so I'll just stick to this one.

The ancestry of living beings isn't just traceable through the fossil record. The study of genetics shows us a huge and utterly overwhelming amount of evidence for the common ancestor idea. Common genes can be traced back to show the lineage of different animals and plants and groups of animals and plants.

There really is a lot of very good peer reviewed scientific evidence.

Darwin may well have taken a leap of faith but it is one which has now been backed up with a huge amount of evidence. Evolution is not open for questioning any more than gravity is. It's a very simple process which can even be seen happening around us.

Ring species show that small changes can indeed lead to separate species. Antibiotic resistant bacteria are evolution in progress. You say that just because small changes can be seen it doesn't follow that big changes can evolve but that's stupid. Big changes are just a series of connected little changes.

That said mutations can be big as well as small. We've all seen photos of two headed snakes for example. That happens to be a detrimental change, but if a large change occurred that happened to be beneficial and the individual survived to breed then a large change could occur very quickly. Remember these are chance occurrences, there's no intelligence driving evolution, it's just a simple process of random mutation and natural selection.

If you accept that genes can mutate randomly (something which is known to be fact and can be shown happening) and that natural selection occurs (again something which can be shown happening) then there really isn't anything more to be said. Those two processes, given a lot of time can change an animal or plant dramatically. And time is something life has had a lot of. Even the cambrian explosion you mentioned happened over 20 million years or so.

This is evolution. There's nothing complex about the process, there really isn't. There's no way that mutations and natural selection can fit together in any way that isn't evolution.

Well, I'm a biologist and a medical doctor. Am I qualified to answer?

The fact is, we use WAY more adulterated substances in medicine all the time. From antibiotics all the way up to chemotherapy and radiopharmaceuticals. If you reject GM food as "unnatural" then you should never go see a doctor and certainly never take a prescription medication. I guess you could go suck on a Willow tree if you had a headache, but I doubt it would be as good as manufactured aspirin.

I would also like an honest answer for the question, "Which is worse, world starvation or effects of GM food?"

They also soak it in antibiotics.

1) Don't be confused, and think that I've decided the casting of ant colonies for art is justified. I'm pointing out that the issue is more complex than many, including yourself, may realize. I find the video disturbing... and unlike our resident @ant have not voted for it.
2) Please look up Godwin's law. Using Nazi analogies generally undermines your argument.. it just makes it hard for people to accept that you have thought things through.
3) But hey, assuming that you have thought things through, let's continue with your analogy:
Perhaps the holocaust analogy does work, but to be sure the fire ants are not the Gypsies, they are the Germans. Fire ants are rapidly spreading across the world, drastically reducing both the abundance and diversity of native species. This includes native ant species, as well as a huge range of arthropod prey, potentially plants (through seed consumption), and even small vertebrates (e.g. lizards and ground nesting birds).
If you are arguing from a pacifistic stance, that violence against another creature is never justified, even if it is in the defense of others more helpless or in self-defense, I thoroughly respect that position. Although any violence turns my stomach; I cannot say that I agree.. for sure, the next time I get an infection, I will take antibiotics; the next time I see purple loosestrife, I will tear it from its roots.

@Buck said: "We should close factory farms and teach people how to hunt again."

Hunting can't scale to support a larger population than a hunter-gatherer tribe. So the cost of meat would skyrocket because demand stays high, and supply can't increase.

Meat costing $75 per pound instead of $5 per pound would be a huge reduction in quality of life for everybody.

That's why humans left hunter-gatherer lifestyles in the first place.


The answer will probably end up being the vat-grown meat Silicon Valley is working on now. It will be the health equivalent of organic and free range meat, since it's not fed pesticide food, antibiotics, etc.

Emergency services are all I care about-Bone-sets, stitches, wound care and antibiotics should be free of charge to all citizens of planet Babylon, worldwide. So should general dentistry. The machine (a type of prison) now requires that we play the societal-shuffle according to their economic rules (which are violated with impunity daily by the rule-makers) should not the slave-masters keep their labor force from breaking-down too soon?? Inmates in prisons in the United States receive free emergency and necessary dental maintenance, eh?

Random porcupine fact: Porcupines naturally secrete antibiotics from their skin.

Fresh leaf buds lure them out to the end of branches that cannot support their weight. They end up falling and their own quills stick them when they land. The antibiotics help to ward off infections.

I guess they'd never heard of hormones, antibiotics and force-feeding. Such primitive people.

As an aside. The largest pig-farm in America produces more sewage than the city of New York. Big pig farms aren't more efficient than the small ones, they're environmental disasters as well, but big pig farms can afford lobbyists to make rules more friendly for them, small pig farms cannot.

I guess it's time we stop using those incredibly stupid things called antibiotics because we're breeding resistant organisms for those as well. The facts make it damned clear that the only winner in this race are pharmaceutical companies. Patients pay more for the medicine as germs become more resistant. In another 20 years our antibiotics will be useless, but pharmaceutical companies will happily move on to the next longterm fuckup that is profitable in the short run.

While we're at it we should stop using idiotic chemotherapy and radiation for cancer because we only end up with resistant cells.

Do you really see no benefit to pesticides? Not a single upside? That's strange because they keep selling them. Someone's buying.

wa8it so .. the carrot betrayed him for not passing the doob, and then the aspirin and antibiotic were like, hey.. come with us we are gonna show you some shit... my dude goes hey, im not sure bout this door here... and then heroin zombies grab him to hangout in a closet.

http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.
Related

Upstairs, my 85-year-old father, Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that helped his heart outlive his brain. The size of a pocket watch, it had kept his heart beating rhythmically for nearly five years. Its battery was expected to last five more.

After tea, I knew, my mother would help him from his narrow bed with its mattress encased in waterproof plastic. She would take him to the toilet, change his diaper and lead him tottering to the couch, where he would sit mutely for hours, pretending to read Joyce Carol Oates, the book falling in his lap as he stared out the window.

I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.

Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound. When I was a child, he woke me, chortling, with his gloss on a verse from “The Rubaiyat of Omar Khayyam”: “Awake, my little one! Before life’s liquor in its cup be dry!” At bedtime he tucked me in, quoting “Hamlet” : “May flights of angels sing thee to thy rest!”

Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.

Until 2001, my two brothers and I — all living in California — assumed that our parents would enjoy long, robust old ages capped by some brief, undefined final illness. Thanks to their own healthful habits and a panoply of medical advances — vaccines, antibiotics, airport defibrillators, 911 networks and the like — they weren’t likely to die prematurely of the pneumonias, influenzas and heart attacks that decimated previous generations. They walked every day. My mother practiced yoga. My father was writing a history of his birthplace, a small South African town.

In short, they were seemingly among the lucky ones for whom the American medical system, despite its fragmentation, inequity and waste, works quite well. Medicare and supplemental insurance paid for their specialists and their trusted Middletown internist, the lean, bespectacled Robert Fales, who, like them, was skeptical of medical overdoing. “I bonded with your parents, and you don’t bond with everybody,” he once told me. “It’s easier to understand someone if they just tell it like it is from their heart and their soul.”

They were also stoics and religious agnostics. They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Things took their first unexpected turn on Nov. 13, 2001, when my father — then 79, pacemakerless and seemingly healthy — collapsed on my parents’ kitchen floor in Middletown, making burbling sounds. He had suffered a stroke.

He came home six weeks later permanently incapable of completing a sentence. But as I’ve said, he didn’t give up easily, and he doggedly learned again how to fasten his belt; to peck out sentences on his computer; to walk alone, one foot dragging, to the university pool for water aerobics. He never again put on a shirt without help or looked at the book he had been writing. One day he haltingly told my mother, “I don’t know who I am anymore.”

His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.

Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.

My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.

As we shuffled through the fallen leaves that day, I thought of my father’s father, Ernest Butler. He was 79 when he died in 1965, before pacemakers, implanted cardiac defibrillators, stents and replacement heart valves routinely staved off death among the very old. After completing some long-unfinished chairs, he cleaned his woodshop, had a heart attack and died two days later in a plain hospital bed. As I held my dad’s soft, mottled hand, I vainly wished him a similar merciful death.

A few days before Christmas that year, after a vigorous session of water exercises, my father developed a painful inguinal (intestinal) hernia. My mother took him to Fales, who sent them to a local surgeon, who sent them to a cardiologist for a preoperative clearance. After an electrocardiogram recorded my father’s slow heartbeat — a longstanding and symptomless condition not uncommon in the very old — the cardiologist, John Rogan, refused to clear my dad for surgery unless he received a pacemaker.

Without the device, Dr. Rogan told me later, my father could have died from cardiac arrest during surgery or perhaps within a few months. It was the second time Rogan had seen my father. The first time, about a year before, he recommended the device for the same slow heartbeat. That time, my then-competent and prestroke father expressed extreme reluctance, on the advice of Fales, who considered it overtreatment.

My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state.

When Rogan suggested the pacemaker for the second time, my father was too stroke-damaged to discuss, and perhaps even to weigh, his trade­offs. The decision fell to my mother — anxious to relieve my father’s pain, exhausted with caregiving, deferential to doctors and no expert on high-tech medicine. She said yes. One of the most important medical decisions of my father’s life was over in minutes. Dr. Fales was notified by fax.

Fales loved my parents, knew their suffering close at hand, continued to oppose a pacemaker and wasn’t alarmed by death. If he had had the chance to sit down with my parents, he could have explained that the pacemaker’s battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state. He could have discussed the option of using a temporary external pacemaker that, I later learned, could have seen my dad safely through surgery. But my mother never consulted Fales. And the system would have effectively penalized him if she had. Medicare would have paid him a standard office-visit rate of $54 for what would undoubtedly have been a long meeting — and nothing for phone calls to work out a plan with Rogan and the surgeon.

Medicare has made minor improvements since then, and in the House version of the health care reform bill debated last year, much better payments for such conversations were included. But after the provision was distorted as reimbursement for “death panels,” it was dropped. In my father’s case, there was only a brief informed-consent process, covering the boilerplate risks of minor surgery, handled by the general surgeon.

I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic — where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor — things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.

And so on Jan. 2, 2003, at Middlesex Hospital, the surgeon implanted my father’s pacemaker using local anesthetic. Medicare paid him $461 and the hospital a flat fee of about $12,000, of which an estimated $7,500 went to St. Jude Medical, the maker of the device. The hernia was fixed a few days later.

It was a case study in what primary-care doctors have long bemoaned: that Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all. The incentives for overtreatment continue, said Dr. Ted Epperly, the board chairman of the American Academy of Family Physicians, because those who profit from them — specialists, hospitals, drug companies and the medical-device manufacturers — spend money lobbying Congress and the public to keep it that way.

Last year, doctors, hospitals, drug companies, medical-equipment manufacturers and other medical professionals spent $545 million on lobbying, according to the Center for Responsive Politics. This may help explain why researchers estimate that 20 to 30 percent of Medicare’s $510 billion budget goes for unnecessary tests and treatment. Why cost-containment received short shrift in health care reform. Why physicians like Fales net an average of $173,000 a year, while noninvasive cardiologists like Rogan net about $419,000.

The system rewarded nobody for saying “no” or even “wait” — not even my frugal, intelligent, Consumer-Reports-reading mother. Medicare and supplemental insurance covered almost every penny of my father’s pacemaker. My mother was given more government-mandated consumer information when she bought a new Camry a year later.

And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits.

Shortly after New Year’s 2003, my mother belatedly called and told me about the operations, which went off without a hitch. She didn’t call earlier, she said, because she didn’t want to worry me. My heart sank, but I said nothing. It is one thing to silently hope that your beloved father’s heart might fail. It is another to actively abet his death.

The pacemaker bought my parents two years of limbo, two of purgatory and two of hell. At first they soldiered on, with my father no better and no worse. My mother reread Jon Kabat-Zinn’s “Full Catastrophe Living,” bought a self-help book on patience and rose each morning to meditate.

In 2005, the age-related degeneration that had slowed my father’s heart attacked his eyes, lungs, bladder and bowels. Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen. Long partly deaf, he began losing his sight to wet macular degeneration, requiring ocular injections that cost nearly $2,000 each. A few months later, he forgot his way home from the university pool. He grew incontinent. He was collapsing physically, like an ancient, shored-up house.

In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking.

When bioethicists debate life-extending technologies, the effects on people like my mother rarely enter the calculus. But a 2007 Ohio State University study of the DNA of family caregivers of people with Alzheimer’s disease showed that the ends of their chromosomes, called telomeres, had degraded enough to reflect a four-to-eight-year shortening of lifespan. By that reckoning, every year that the pacemaker gave my irreparably damaged father took from my then-vigorous mother an equal year.

When my mother was upset, she meditated or cleaned house. When I was upset, I Googled. In 2006, I discovered that pacemakers could be deactivated without surgery. Nurses, doctors and even device salesmen had done so, usually at deathbeds. A white ceramic device, like a TV remote and shaped like the wands that children use to blow bubbles, could be placed around the hump on my father’s chest. Press a few buttons and the electrical pulses that ran down the leads to his heart would slow until they were no longer effective. My father’s heart, I learned, would probably not stop. It would just return to its old, slow rhythm. If he was lucky, he might suffer cardiac arrest and die within weeks, perhaps in his sleep. If he was unlucky, he might linger painfully for months while his lagging heart failed to suffuse his vital organs with sufficient oxygenated blood.

If we did nothing, his pacemaker would not stop for years. Like the tireless charmed brooms in Disney’s “Fantasia,” it would prompt my father’s heart to beat after he became too demented to speak, sit up or eat. It would keep his heart pulsing after he drew his last breath. If he was buried, it would send signals to his dead heart in the coffin. If he was cremated, it would have to be cut from his chest first, to prevent it from exploding and damaging the walls or hurting an attendant.

On the Internet, I discovered that the pacemaker — somewhat like the ventilator, defibrillator and feeding tube — was first an exotic, stopgap device, used to carry a handful of patients through a brief medical crisis. Then it morphed into a battery-powered, implantable and routine treatment. When Medicare approved the pacemaker for reimbursement in 1966, the market exploded. Today pacemakers are implanted annually in more than 400,000 Americans, about 80 percent of whom are over 65. According to calculations by the Dartmouth Atlas research group using Medicare data, nearly a fifth of new recipients who receive pacemakers annually — 76,000 — are over 80. The typical patient with a cardiac device today is an elderly person suffering from at least one other severe chronic illness.

Over the years, as technology has improved, the battery life of these devices lengthened. The list of heart conditions for which they are recommended has grown. In 1984, the treatment guidelines from the American College of Cardiology declared that pacemakers were strongly recommended as “indicated” or mildly approved as “reasonable” for 56 heart conditions and “not indicated” for 31 more. By 2008, the list for which they were strongly or mildly recommended expanded to 88, with most of the increase in the lukewarm “reasonable” category.

The research backing the expansion of diagnoses was weak. Over all, only 5 percent of the positive recommendations were supported by research from multiple double-blind randomized studies, the gold standard of evidence-based medicine. And 58 percent were based on no studies at all, only a “consensus of expert opinion.” Of the 17 cardiologists who wrote the 2008 guidelines, 11 received financing from cardiac-device makers or worked at institutions receiving it. Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.

This pattern — a paucity of scientific support and a plethora of industry connections — holds across almost all cardiac treatments, according to the cardiologist Pierluigi Tricoci of Duke University’s Clinical Research Institute. Last year in The Journal of the American Medical Association, Tricoci and his co-authors wrote that only 11 percent of 2,700 widely used cardiac-treatment guidelines were based on that gold standard. Most were based only on expert opinion.

Experts are as vulnerable to conflicts of interest as researchers are, the authors warned, because “expert clinicians are also those who are likely to receive honoraria, speakers bureau [fees], consulting fees or research support from industry.” They called the current cardiac-research agenda “strongly influenced by industry’s natural desire to introduce new products.”

Perhaps it’s no surprise that I also discovered others puzzling over cardiologists who recommended pacemakers for relatives with advanced dementia. “78-year-old mother-in-law has dementia; severe short-term memory issues,” read an Internet post by “soninlaw” on Elderhope.com, a caregivers’ site, in 2007. “On a routine trip to her cardiologist, doctor decides she needs a pacemaker. . . . Anyone have a similar encounter?”

By the summer of 2007, my dad had forgotten the purpose of a dinner napkin and had to be coached to remove his slippers before he tried to put on his shoes. After a lifetime of promoting my father’s health, my mother reversed course. On a routine visit, she asked Rogan to deactivate the pacemaker. “It was hard,” she later told me. “I was doing for Jeff what I would have wanted Jeff to do for me.” Rogan soon made it clear he was morally opposed. “It would have been like putting a pillow over your father’s head,” he later told me.

Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?”

Then came the autumn day when she asked for my help, and I said yes. I told myself that we were simply trying to undo a terrible medical mistake. I reminded myself that my dad had rejected a pacemaker when his faculties were intact. I imagined, as a bioethicist had suggested, having a 15-minute conversation with my independent, predementia father in which I saw him shaking his head in horror over any further extension of what was not a “life,” but a prolonged and attenuated dying. None of it helped. I knew that once he died, I would dream of him and miss his mute, loving smiles. I wanted to melt into the arms of the father I once had and ask him to handle this. Instead, I felt as if I were signing on as his executioner and that I had no choice.

Over the next five months, my mother and I learned many things. We were told, by the Hemlock Society’s successor, Compassion and Choices, that as my father’s medical proxy, my mother had the legal right to ask for the withdrawal of any treatment and that the pacemaker was, in theory at least, a form of medical treatment. We learned that although my father’s living will requested no life support if he were comatose or dying, it said nothing about dementia and did not define a pacemaker as life support. We learned that if we called 911, emergency medical technicians would not honor my father’s do-not-resuscitate order unless he wore a state-issued orange hospital bracelet. We also learned that no cardiology association had given its members clear guidance on when, or whether, deactivating pacemakers was ethical.

(Last month that changed. The Heart Rhythm Society and the American Heart Association issued guidelines declaring that patients or their legal surrogates have the moral and legal right to request the withdrawal of any medical treatment, including an implanted cardiac device. It said that deactivating a pacemaker was neither euthanasia nor assisted suicide, and that a doctor could not be compelled to do so in violation of his moral values. In such cases, it continued, doctors “cannot abandon the patient but should involve a colleague who is willing to carry out the procedure.” This came, of course, too late for us.)

In the spring of 2008, things got even worse. My father took to roaring like a lion at his caregivers. At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night. My frayed mother began to shout at him, and their nighttime scenes were heartbreaking and frightening. An Alzheimer’s Association support-group leader suggested that my brothers and I fly out together and institutionalize my father. This leader did not know my mother’s formidable will and had never heard her speak about her wedding vows or her love.

Meanwhile my father drifted into what nurses call “the dwindles”: not sick enough to qualify for hospice care, but sick enough to never get better. He fell repeatedly at night and my mother could not pick him up. Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house. His chest grew wheezy. My mother did not request antibiotics. In mid-April 2008, he was taken by ambulance to Middlesex Hospital’s hospice wing, suffering from pneumonia.

Pneumonia was once called “the old man’s friend” for its promise of an easy death. That’s not what I saw when I flew in. On morphine, unreachable, his eyes shut, my beloved father was breathing as hard and regularly as a machine.

My mother sat holding his hand, weeping and begging for forgiveness for her impatience. She sat by him in agony. She beseeched his doctors and nurses to increase his morphine dose and to turn off the pacemaker. It was a weekend, and the doctor on call at Rogan’s cardiology practice refused authorization, saying that my father “might die immediately.” And so came five days of hard labor. My mother and I stayed by him in shifts, while his breathing became increasingly ragged and his feet slowly started to turn blue. I began drafting an appeal to the hospital ethics committee. My brothers flew in.

On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing.

After his memorial service in the Wesleyan University chapel, I carried a box from the crematory into the woods of an old convent where he and I often walked. It was late April, overcast and cold. By the side of a stream, I opened the box, scooped out a handful of ashes and threw them into the swirling water. There were some curious spiraled metal wires, perhaps the leads of his pacemaker, mixed with the white dust and pieces of bone.

A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.

The surgeon was forthright: without open-heart surgery, there was a 50-50 chance my mother would die within two years. If she survived the operation, she would probably live to be 90. And the risks? He shrugged. Months of recovery. A 5 percent chance of stroke. Some possibility, he acknowledged at my prompting, of postoperative cognitive decline. (More than half of heart-bypass patients suffer at least a 20 percent reduction in mental function.) My mother lifted her trouser leg to reveal an anklet of orange plastic: her do-not-resuscitate bracelet. The doctor recoiled. No, he would not operate with that bracelet in place. It would not be fair to his team. She would be revived if she collapsed. “If I have a stroke,” my mother said, nearly in tears, “I want you to let me go.” What about a minor stroke, he said — a little weakness on one side?

I kept my mouth shut. I was there to get her the information she needed and to support whatever decision she made. If she emerged from surgery intellectually damaged, I would bring her to a nursing home in California and try to care for her the way she had cared for my father at such cost to her own health. The thought terrified me.

The doctor sent her up a floor for an echocardiogram. A half-hour later, my mother came back to the waiting room and put on her black coat. “No,” she said brightly, with the clarity of purpose she had shown when she asked me to have the pacemaker deactivated. “I will not do it.”

She spent the spring and summer arranging house repairs, thinning out my father’s bookcases and throwing out the files he collected so lovingly for the book he never finished writing. She told someone that she didn’t want to leave a mess for her kids. Her chest pain worsened, and her breathlessness grew severe. “I’m aching to garden,” she wrote in her journal. “But so it goes. ACCEPT ACCEPT ACCEPT.”

Last August, she had a heart attack and returned home under hospice care. One evening a month later, another heart attack. One of my brothers followed her ambulance to the hospice wing where we had sat for days by my father’s bed. The next morning, she took off her silver earrings and told the nurses she wanted to stop eating and drinking, that she wanted to die and never go home. Death came to her an hour later, while my brother was on the phone to me in California — almost as mercifully as it had come to my paternal grandfather. She was continent and lucid to her end.

A week later, at the same crematory near Long Island Sound, my brothers and I watched through a plate-glass window as a cardboard box containing her body, dressed in a scarlet silk ao dai she had sewn herself, slid into the flames. The next day, the undertaker delivered a plastic box to the house where, for 45 of their 61 years together, my parents had loved and looked after each other, humanly and imperfectly. There were no bits of metal mixed with the fine white powder and the small pieces of her bones.

Katy Butler lives in Mill Valley, Calif., and teaches memoir writing at the Esalen Institute in Big Sur.