Just, the audacity. fuck.

let me be as clear and direct as I can be: I have no interest in the personal sexual lives or private decisions of people i'm not married to.

@bobknight33 Do you want the United States of America to make decisions about what gender an individual can be or has to be?

Let us say that a human being has XX Male Syndrome https://medlineplus.gov/genetics/condition/46xx-testicular-difference-of-sex-development/ where the person would present as male although have XX chromosomes, have a penis and testicals that are non functional sexually, and will NOT grow facial hair but WILL grow breasts.

Which bathroom should the person use? You want to answer don't you? See? that's the difference between you and me. I don't fucking care where this person takes a shit just as long as it's not on my front porch.


YOU, meanwhile, for someone tossing around accusations of "groomer" (grooming is defined how again? ohhh right you do things so that the child does what YOU want kind of like training a dog i imagine)
YOU seem to have a lot to say about what they do and dont do sexually. What they do or don't do with their genitals. What in the fuck kind of person spends their time dictating what children can do with their genitals or not and wants to tell them where to shit and what drinking fountain to use "HEYYY that's a water fountain for non-queers only!"


What
the
fuck

is your problem?


HOW in your mind can YOU be the one strongly opinionated on what these kids do or dont do and you go out of your way to advocate for that and support politicians who think alike

How can THAT be,, AND you are accusing the people who are disinterested in the insanely personal and private decisions of gender and sexuality, the people who don't care about that stuff and want to leave it to the individuals, but you

YOUUUU want to tell them what bathroom to use and which sports teams they cna play on and which hospitals they can get care at and if they can receive care as a person who is transgendered YOU (the one wanting to make decisions about kids genitals via your elected officials, YOU) YOU are calling someone else a groomer.


FUUUUUUUUUUUUUCK YOUUUUUUUUUUUUU


You groom animals because you want X behavior to happen, and you don't want Y behavior to happen.


YOU, are doing the thing, where you're doing stuff... that leads to the modification of behavior. Do you understand that?

I had to quit discussing things like this in private thanks to bob (and his sock puppets). I refuse now because he likes to be a completely different person in private, admitting things he would never admit in public conversation, admitting he’s lying, that Trump is an awful human being, etc. he ruined it.
Sorry…replying publicly.

If you can’t/won’t answer one simple question, there’s no point. I’m sick of answering all of yours and having you dodge mine….especially sick of it since you refuse to even acknowledge my answers and pretend I didn’t give you a straight answer. I refused to answer one red herring, biased, loaded, off topic question because I disagreed wholeheartedly with its premise, but answered every other you asked.
I feel like you’re wasting my time here..

I must point out, the question you continue to ignore trumps every question you asked….how can you deny the rights of legal women to compete in publicly funded contests as women? It’s their constitutional right to not be discriminated against based on gender. Case closed. Nothing overrides that legality.

I answered your question 3 times now. If you can’t understand, why keep trying? One last time, but I’m out. I’m not going to answer you without the same consideration.

There is no evidence that xx vs xy denotes one automatically has an advantage based on just chromosomal arrangements. None.

Women CAN be stronger, faster, better than men in most arenas, and vice versa. Genetic gender may indicate a likelihood random men will be stronger than random women, it alone does not dictate biological differences that can/will be advantageous in athletics. Hormone levels, hormone therapy, supplements, mental fortitude, training, environment, opportunities, dna, rna, diet, HGH, etc can all go into creating (or erasing) those possible physical “advantages” you reference, not just chromosomal arrangements. Since that’s true, discrimination based on chromosomal arrangements is not just wrong and illegal, it’s ignorant and evil.

I’ve been over that 3 times, now 4. I’ve given specific examples. What’s the issue in comprehension? Are you even reading? What?!

I’m bored of this. We won’t get anywhere with this one sided discussion where only one of us answers questions or pays attention to the answers. Fuggetaboutit. This isn’t a discussion

Have a nice day. Bye.

@newtboy,

Per my very first sentence in thread, I also oppose gov using this as a wedge issue to rally their base.

Meaning, I 100% am in agreement that nobody(gov or otherwise) should be banning trans kids(and adults) from anything, competitive sports included.

I did point out a single biological fact:
-Whether a person is born with XX or XY chromosomes has a significant impact on development that impacts performance in sports.

You jump all over that observation though, like raising it is hateful, denying peoples right to exist, and on. It is not.

And your observation that the performance advantages aren’t 100% of the time favouring XY folks is the red herring. Of course there are areas were the difference is an advantage, others were it’s neutral, and yet others a disadvantage. In a large population you also always have the possibility of individuals overcoming those odds.

Pointing to those facts though like they mean specific advantages don’t exist is the red herring.

In addition to that one fact, I also proposed applying the same standards for fairness in competition equally to everyone.

And it’s on this point I am automatically decried as hateful, evil and maliciously acting against people’s right to exist….

If your only looking for a villain to demonize there’s no point attempting further discussion.

You got a very straight answer, you just didn’t like it. Ironic to claim something you don’t like doesn’t exist while arguing that something that doesn’t exist bothers you.

I’ll try again, but I can only explain it to you, I can’t understand it for you. Women can outperform men, so clearly there’s more to it than just gender, more than just the shape of your 23/24th chromosome. If there wasn’t, the worst man would always outperform the best woman. That being the case, discriminating based on gender is not just wrong, it’s illegal. That goes for trans people too, they aren’t excluded from having rights just because you seem to want it that way.

I note there’s no answer at all about excluding a group of citizens from publicly funded events. Don’t like that question I guess. No answer for it, I guess. Straight or otherwise. Last try to get anything resembling a answer at all.

Absolutely a blatant Red herring. I refuse to cooperate with your ridiculous loaded cherry picked false premise fantasy.
Try asking a realistic question on point instead of a loaded, ridiculous fantasy hypothetical you think makes your point. Your question implies that you believe trans women are just ordinary men.

If we pick the 100m sprint and had the two categories and trans people were allowed to compete with their current gender (with specific requirements, like they are), would you expect the trans athletes to always dominate?
Same question, but 50k race.

If so, why?
If so, explain why that hasn’t happened even though they’ve been competing in the Olympics under those rules for near 20 years now.
If not, what’s your point? I think I know, your point is that trans women are men, an ignorant, inflammatory, intentional insult to them and what they go through to be comfortable in their own bodies.
No surprise since you support just excluding them because you assume wrongly that a trans woman is a man in a dress. It’s ignorance and intolerance dancing together in your mind, making false assumptions and attempting to deny rights to others based on them. I might note, sexual orientation and gender are two categories that in America we are barred from using to discriminate against someone. I must assume you aren’t American, so what’s your dog in this fight? Just trans hatred?

Now explain why trans kids shouldn’t be allowed to compete in school competitions. Last try to get an answer.

Now explain how this is different from the racist arguments for excluding blacks from sports.

Edit: now explain why women like these need protection from other women….

If you are talking policies that govern individuals, average is meaningless, you need to include the outliers. What I really said was, on average it’s somewhat true a bit more than half the time….with many exceptions, so incredibly far from a rule…far from “I can agree”.

You said “ Are you saying you do not believe that people who are biologically male(By which I mean XY) have an advantage in athletics over people who are biologically female(by which I mean XX)?”.
I pointed to one instance where (I assume) chromosomal males do not have an advantage over a chromosomal female in an athletic field….just an example of why I don’t believe it’s always true that people who are biologically male(By which I mean XY) have an advantage in athletics over people who are biologically female(by which I mean XX)..one you can’t contradict.

People are never equally gifted or talented, not even with themselves yesterday or tomorrow. I find the premise faulty.

Appears to, so far, in most but not all categories.
In many, the difference is minimal and an exceptional female will surpass males one day in most. Top ranked Kenyan woman already routinely beat top ranked non Kenyan males in long distance running, for one example.

I won’t extrapolate from a temporary skewed position, it leads to ridiculous conclusions….so I won’t be able to agree.
I can agree people believe that.

It’s not just sexual biology. It has nothing to do with genitals. It’s hormones, dna, rna, mental toughness, upbringing, training, health, environment, opportunity, etc. if someone born a woman wants to compete with men, and your position is correct, what’s the harm? If a trans woman, born male but never going through male puberty or taking estrogen and hormone blockers to reverse the effects wants to compete against women, what proof do you have to show any advantage? Two athletes excelling? Out of how many?

Now how expert are you in this field? Expert enough to define the exact point where each person has an advantage vs a disadvantage? I doubt it. But you think it’s fine to deny them the right to participate based on your ignorant assumptions. Do you accept such ignorant, biased assumptions to determine what you may do, how much you may participate in public events? I doubt you would accept it for a second. Think about that.

You want to equate them to non trans people while trying to prove how they’re so different. Pick a lane please.

No matter what your opinion, denying a citizen a chance to compete in public sports is totally unAmerican. I notice how you ignore that, as if to concede it under your breath. It doesn’t go unnoticed that you can’t address that. It IS the point.

Edit : as to the olympics, they have allowed trans gender athletes since 2004. If trans women are really men, why haven’t those records become equal between men and women?

100%.
Rhonda Rousey could kick my, or your, ass.
Her 23 & 24th chromosomes being different from ours doesn’t negate that.

On average is what you said somewhat true….mostly (there are athletic disciplines that benefit female physique strongly, and there are exceptions to every “rule”)…. but sports are played by the exceptional, and a shitload more than chromosomal arrangement and genital assignment determines how exceptional a person is in a given field.

It is possible that the best woman in a sport is better than the best man, true in almost all sports, equally possible a man born a girl could be better, or a woman born a boy…If you can’t accept that, then yes, we must live in two separate realities.

What about hermaphrodites? Can they play for either team, or none at all?

Again, denying a citizen their right to participate in publicly funded sports is pretty damn unAmerican. If your not American and your culture differs, that’s on you and not my business.

CRISPR-Cas9
Bring me a gene
Encoding for a specific protein
Make a few snips at this coded locus
You work so well inside a streptococcus
Cas9
I'm so alone
Without your scissors in my chromosome
Cut me up and do it clean
CRISPR-Cas9 bring me a gene

CRISPR-Cas9
Keep me a gene
A viral sequence you've already seen
Chopped into bits and stored as genomic
With clustered repeats
That are palindromic
Cas9
Bind with this code
Use it to target infections of old
Immunized like a vaccine
CRISPR-Cas9 keep me a gene

CRISPR-Cas9
Cut me a gene
With a precision that I've never seen
Unzip a strand and interrogate it
Seek out your sequence until you locate it
Cas9
Lock into place
And do your job as endonuclease
Chop just like a guillotine
CRISPR-Cas9 cut me a gene

Snip snap!
CRISPR-Cas9
CRISPR-Cas9

CRISPR-Cas9
Bring me a gene
By commandeering my repair routine
A strand to match your severed location
For some homologous recombination
Cas9
Cheap and precise
Rewriting genomes from microbes to mice
And soon the humble human being
CRISPR-Cas9 bring me a gene

CRISPR-Cas9
Give us a gene
Give us a miracle like that one Nazarene
‘Cause giving the lame their legs and the blind their sight is
In view for dystrophy and retinitis
But CRISPR-Cas9
What if you fall
Outside our power and inside us all
That really could incite a scene

When this terrible wonderful power unsettling
Opens the door to unethically meddle
Is ev’ry congenital malady bettered
Sufficient to warrant genetics unfettered
To modify man in the manner of Gattaca
Raise up a mammoth or make a rattata
Dramatical medical means to eradicate aging
Or cancer or make a fanatic
A mass epidemic a weapon nefarious
Single mosquito to wipe out malaria
Send in a viral infection to ferry a
Cure to the cells of an HIV carrier
Freed of disease as we're free to uncover
What nature and accident failed to discover
And free to be other than
All that we ever have been

CRISPR-Cas9
CRISPR-Cas9

Oh CRISPR-Cas9
Bring us a gene
You wondrous ribonucleoprotein
You have the power to vanquish or save us
Who would have thought that the microbe that gave us
Cas9
S. pyogenes
The source of strep and flesh-eating disease
Housed this marvellous machine
Full of uses great and obscene
CRISPR-Cas9 bring us
Please don't sting us
Cas9 bring us a gene

With adenine
And thiamine
Incite a scene
Cas9 bring us a gene!

Congratulations! Your comment on How Chimp Chromosome #13 Proves Evolution has just received enough votes from the community to earn you 1 Power Point. Thank you for your quality contribution to VideoSift.

This achievement has earned you your "Silver Tongue" Level 37 Badge!

TONS of things cure cancer. All day, every day. Doctors have no clue what cancer is. All they can do is cut, burn, or poison and cross their fingers.

I didn't say Cannabis was THE cure. It is A cure used by thousands with amazing efficacy. Everyone is different.

Here's 60+ studies for your perusal if you insist on the superiority of western scientific research:

"Cannabis, and the cannabinoid compounds found within it, has been shown through a large cannabisplantamount of scientific, peer-reviewed research to be effective at treating a wide variety of cancers, ranging from brain cancer to colon cancer. Below is a list of over 60 studies that demonstrate the vast anti-cancer properties of cannabis.
Studies showing cannabis may combat brain cancer:
Cannabidiol (CBD) inhibits the proliferation and invasion in U87-MG and T98G glioma cells. Study published in the Public Library of Science journal in October 2013.
Tetrahydrocannabinol (THC) can kill cancer cells by causing them to self-digest. Study published in the Journal of Clinical Investigation in September 2013.
CBD is a novel therapeutic target against glioblastoma. Study published in Cancer Research in March 2013.
Local delivery of cannabinoid-filled microparticles inhibits tumor growth in a model of glioblastoma multiforme. Study published in Public Library of Science in January 2013.
Cannabinoid action inhibits the growth of malignant human glioma U87MG cells. Study published in Oncology Reports in July 2012.
Cannabidiol enhances the inhibitory effects of THC on human glioblastoma cell proliferation and survival. Study published in the Molecular Cancer Therapeutics journal in January 2010.
Cannabinoid action induces autophagy-mediated cell death in human glioma cells. Study published in The Journal of Clinical Investigation in May 2009.
Cannabinoids inhibit glioma cell invasion by down-regulating matrix metalloproteinase-2 expression. Study published in Cancer Research in March 2008.
Cannabinoids and gliomas. Study published in Molecular Neurobiology in June 2007.
Cannabinoids inhibit gliomagenesis. Study published in the Journal of Biological Chemistry in March 2007.
A pilot clinical study of THC in patients with recurrent glioblastoma multiforme. The results were published in the British Journal of Cancer in June 2006.
Cannabidiol inhibits human glioma cell migration through an independent cannabinoid receptor mechanism. Study published in the British Journal of Pharmacology in April 2005.
Cannabinoids inhibit the vascular endothelial growth factor pathway (VEGF) in gliomas. Study published in the Journal of Cancer Research in August 2004.
Antitumor effects of cannabidiol, a nonpsychoactive cannabinoid, on human glioma cell lines. Study published in the Journal of Pharmacology in November 2003.
Inhibition of glioma growth in vivo by selective activation of the CB2 cannabinoid receptor. Study published in the Journal of Cancer Research in August 2001.
Studies showing cannabis may combat colorectal cancer:
Cannabigerol (CBG) can inhibit colon cancer cells. Study published in the Oxford journal Carcinogenesis in October 2014.
Inhibition of colon carcinogenesis by a standardised Cannabis Sativa extract with high content of CBD. Study published in Phytomedecine in December 2013.
Chemopreventive effect of the non-psychotropic phytocannabinoid CBD on colon cancer. Study published in the Journal of Molecular Medecine in August 2012.
Cannabinoids against intestinal inflammation and cancer. Study published in Pharmacology Research in August 2009.
Action of cannabinoid receptors on colorectal tumor growth. Study published by the Cancer Center of the University of Texas in July 2008.
Studies showing cannabis may combat blood cancer:
The effects of cannabidiol and its synergism with bortezomib in multiple myeloma cell lines. Study published in the International Journal of Cancer in December 2013.
Enhancing the activity of CBD and other cannabinoids against leukaemia. Study published in Anticancer Research in October 2013.
Cannabis extract treatment for terminal acute lymphoblastic leukemia of Philadelphia chromosome (Ph1). Study published in Case Reports in Oncology in September 2013.
Expression of type 1 and type 2 cannabinoid receptors in lymphoma. Study published in the International Journal of Cancer in June 2008.
Cannabinoid action in mantle cell lymphoma. Study published in Molecular Pharmacology in November 2006.
THC-induced apoptosis in Jurkat leukemia. Study published in Molecular Cancer Research in August 2006.
Targeting CB2 cannabinoid receptors as a novel therapy to treat malignant lymphoblastic disease. Study published in Blood American Society of Hemmatology in July 2002.
Studies showing cannabis can combat lung cancer:
Cannabinoids increase lung cancer cell lysis by lymphokine-activated killer cells via upregulation of Icam-1. Study published in Biochemical Pharmacology in July 2014.
Cannabinoids inhibit angiogenic capacities of endothelial cells via release of tissue inhibitor of matrix metalloproteinases-1 from lung cancer cells. Study published in Biochemical Pharmacology in June 2014.
COX-2 and PPAR-γ confer CBD-induced apoptosis of human lung cancer cells. Study published in Molecular Cancer Therapeutics in January 2013.
CBD inhibits lung cancer cell invasion and metastasis via intercellular adhesion molecule-1. Study published in the Journal of the Federation of American Societies for Experimental Biology in April 2012.
Cannabinoid receptors, CB1 and CB2, as novel targets for inhibition of non–small cell lung cancer growth and metastasis. Study published in Cancer Prevention Research in January 2011.
THC inhibits epithelial growth factor-induced (EGF) lung cancer cell migration in vitro as well as its growth and metastasis in vivo. Study published in the journal Oncogene in July 2007.
Studies showing cannabis may combat stomach cancer:
Cannabinoid receptor agonist as an alternative drug in 5-Fluorouracil-resistant gastric cancer cells. Study published in Anticancer Research in June 2013.
Antiproliferative mechanism of a cannabinoid agonist by cell cycle arrest in human gastric cancer cells. Study published in the Journal of Cellular Biochemistry in March 2011.
Studies showing cannabis may combat prostrate cancer:
Cannabinoids can treat prostate cancer. Study published by the National Institute of Health in October 2013.
Non-THC cannabinoids inhibit prostate carcinoma growth in vitro and in vivo: pro-apoptotic effects and underlying mechanisms. Study published in the British Journal of Pharmacology in December 2012.
The role of cannabinoids in prostate cancer: Basic science perspective and potential clinical applications. Study published in the Indian Journal of Urology in January 2012.
Induction of apoptosis by cannabinoids in prostate and colon cancer cells is phosphatase dependent. Study published in Anticancer Research in November 2011.
Studies showing cannabis may combat liver cancer:
Involvement of PPARγ in the antitumoral action of cannabinoids on hepatocellular carcinoma (CHC). Study published in Cell Death and Disease in May 2013.
Evaluation of anti-invasion effect of cannabinoids on human hepatocarcinoma cells. Study published on the site Informa Healthcare in February 2013.
Antitumoral action of cannabinoids on hepatocellular carcinoma. Study published in Cell Death and Differentiation in April 2011.
Studies showing cannabis may combat pancreatic cancer:
Cannabinoids inhibit energetic metabolism and induce autophagy in pancreatic cancer cells. Study published in Cell Death and Disease in June 2013.
Cannabinoids Induce apoptosis of pancreatic tumor cells. Study published in Cancer Research in July 2006.
Studies showing cannabis may combat skin cancer:
Cannabinoid receptor activiation can combat skin cancer. Study published by the National Institute of Health in October 2013.
Cannabinoids were found to reduce skin cancer by 90% in just 2 weeks. Study published in the Journal of Pharmacy and Pharmacology in July 2013.
Cannabinoid receptors as novel targets for the treatment of melanoma. Study published in the Journal of the Federation of American Societies for Experimental Biology in December 2006.
Inhibition of skin tumor growth and angiogenesis in vivo by activation of cannabinoid receptors. Study published in the Journal of Clinical Investigation, in January 2003.
Studies showing cannabis may combat other types of cancer:
Bladder: Marijuana reduces the risk of bladder cancer. Study published in the Medscape site in May 2013.
Kaposi sarcoma: Cannabidiol inhibits growth and induces programmed cell death in Kaposi sarcoma–associated herpesvirus-infected endothelium. Study published in the journal Genes & Cancer in July 2012.
Nose, mouth, throat, ear: Cannabinoids like THC inhibit cellular respiration of human oral cancer cells. Study by the Department of Pediatrics at the State University of New York, published in June 2010.
Bile duct: The dual effects of THC on cholangiocarcinoma cells: anti-invasion activity at low concentration and apoptosis induction at high concentration. Study published in Cancer Investigation in May 2010.
Ovaries: Cannabinoid receptors as a target for therapy of ovarian cancer. Study published on the American Association for Cancer Research website in 2006.
Preparation and characterisation of biodegradable microparticles filled with THC and their antitumor efficacy on cancer cell lines. Study published in the Journal of Drug Targeting in September 2013.
CBD Cannabidiol as a potential anticancer drug. Study published in the British Journal of Pharmacology in February 2013.
Cannabinoids as anticancer modulators. Study published in the Progress in Lipid Research journal in January 2013.
CBD inhibits angiogenesis by multiple mechanisms. Study published in the British Journal of Pharmacology in November 2012.
Towards the use of cannabinoids as antitumour agents. Study published in Nature in June 2012.
Cannabinoid-associated cell death mechanisms in tumor models. Study published in the International Journal of Oncology in May 2012.
Cannabinoids, endocannabinoids and cancer. Study published in Cancer Metastasis Reviews in December 2011.
The endocannabinoid system and cancer: therapeutic implication. Study published in the British Journal of Pharmacology in July 2011.
This list was compiled in part by Alchimiaweb.com.
– TheJointBlog"

About the song from Wikipedia:
The title (46 and 2) references an idea first conceived by Carl Jung and later expounded upon by Drunvalo Melchizedek concerning the possibility of reaching a state of evolution at which the body would have two more than the normal 46 total chromosomes and leave a currently disharmonious state. The premise is that humans would deviate from the current state of human DNA which contains 44 autosomes and 2 sex chromosomes. The next step of evolution would likely result in human DNA being reorganized into 46 and 2 chromosomes, according to Melchizedek.
Furthermore, the song references a wish to experience change through the "shadow"; an idea which represents the parts of one's identity that one hates, fears, and represses, this exists as a recurring theme in the work of Carl Jung.



My shadow's

Shedding skin and
I've been picking
Scabs again.
I'm down
Digging through
My old muscles
Looking for a clue.

I've been crawling on my belly
Clearing out what could've been.
I've been wallowing in my own confused
And insecure delusions
For a piece to cross me over
Or a word to guide me in.
I wanna feel the changes coming down.
I wanna know what I've been hiding in

My shadow.
Change is coming through my shadow.
My shadow's shedding skin
I've been picking
My scabs again.

I've been crawling on my belly
Clearing out what could've been.
I've been wallowing in my own chaotic
And insecure delusions.

I wanna feel the change consume me,
Feel the outside turning in.
I wanna feel the metamorphosis and
Cleansing I've endured within

My shadow
Change is coming.
Now is my time.
Listen to my muscle memory.
Contemplate what I've been clinging to.
Forty-six and two ahead of me.

I choose to live and to
Grow, take and give and to
Move, learn and love and to
Cry, kill and die and to
Be paranoid and to
Lie, hate and fear and to
Do what it takes to move through.

I choose to live and to
Lie, kill and give and to
Die, learn and love and to
Do what it takes to step through.

See my shadow changing,
Stretching up and over me.
Soften this old armor.
Hoping I can clear the way
By stepping through my shadow,
Coming out the other side.
Step into the shadow.
Forty six and two are just ahead of me.

Ok then all we have to do to test this theory is take a chimp and fuse chromosome #13 together and we will create a human. I'm sure if it took millions of years to do by chance we would still see it occurring in nature with apes. Science is more than capable to do this now with the mapping of the human genome so lets see if they can make a human out of a monkey or will creation make a monkey out of the evolutionist?

I like the new Beetle. They've done enough changes to still be recognised as a Beetle but removed the necessity of not having a Y chromosome to be seen in it

I'd still get the Golf or Jetta, however

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.