No, your right. The destructive uses of a gun can be overlooked when we consider their constructive use as, err, a high powered holepunch? Indeed was it not a happy accident when we discovered that this household tool was also extremely potent as a weapon!

Ok Mr S. Emantics, we give objects purpose through our use of them, but we also design objects for specific purposes. Occasionally it turns out the what we intend something to be used for actually works better as something else. This is not the case with firearms. They are designed to kill, killing is what they are good at. Knives can also kill, but they aren't quite as good as a gun, and i don't see too many people dicing veg on a cutting board with a mac10. So yes, we do accept certain premature deaths more readily than others because we all accept that knives and cars have significant uses beyond killing people. We legislate with this in mind, we don't let people carry long knives in the street, we don't allow people to turn their cars into spiked mad max death buggies, we don't let people pervert the purpose of these tools. So where are the ancillary benefits of firearms. What use is accelerating a projectile that may or may not be designed to penetrate flesh actually give us, because a lot of people have a hard time seeing it.

You know, after 9/11 nobody was talkin about banning planes. There is a reason for that.

No, firearms are not designed to "kill". They are designed to accelerate a projectile in a specified direction. Some projectiles are designed to expand when they hit flesh, other projectiles are designed to cut perfect holes in cardboard or paper. As a comparison example a knife is designed to part molecules and a hammer is designed to collide two masses together.

Their designated use is determined by a human's choice. They may be designated for use as a weapon or for putting holes in paper targets.

Just recently a lady decided to mow down someone who threw some chips at her car. You can use just about anything as a weapon even if it is designed for something else.

In regards to guns vs cars - he has a point. Cars do cause significantly more death each year. It's just not purposeful death, therefore it's a risk we take because it is impersonal - an "accident". I don't know the relative risk but I'd say you're more likely to die in a car accident than to be massacred. Should we accept one sort of premature death more readily than another? (I don't know)

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.
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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.

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I hate being premature.

It is a let down for everyone involved.

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>> ^lantern53:

why? WHY? wwhyyyyyy? *boooohooohooo*.


To quote Speechless in the Karl Rove thread:
Your tears are sweet delicious nectar.

:-]

A bit of premature adjudication there.

^@ bobknight33

Your 50 million is way off the # was 30 Million and that doesn't divide who can afford but choose not to get it and whose who really cant afford healthcare. (At least with the individual mandate those who can pay but choose not to are required to pay back into the system).

That # is reported around 12 million. (Where did you find this percentage i have yet to see it in an official report?).

Now is it worth you paying 2600 more in insurance just to cover 12 Million? (Covered below).

Amount of Deaths due to the absence of healthcare: More than 26,000 working-age adults die prematurely in the United States each year because they lack health insurance, according to a study by the consumer advocacy group Families USA, estimates that a record high of 26,100 people aged 25 to 64 died for lack of health coverage in 2010, up from 20,350 in 2005 and 18,000 in 2000. also 22,000 deaths nationwide in 2006.

"Lives are truly on the line," said Families USA Executive Director Ron Pollack, who supports the reform law. "If the Affordable Care Act moves forward and we expand coverage for tens of millions of people, the number of avoidable deaths due to being uninsured will decrease significantly."

What is the republican healthcare solution?.

Source: Reuters, 6/20/2012 http://www.msnbc.msn.com/id/47892292/ns/health-health_care/t/report-uninsured-americans-die-each-year/#.UEKmKdbiZO8.

the Henry J. Kaiser Family Foundation has analyzed census data to provide a closer look at the people without health insurance in the U.S. Its report, focused on people younger than age 65, found 45.7 million "nonelderly" uninsured people in the U.S. last year (including the elderly, the number of uninsured was 46.3 million). Low-income adults without dependent children — who generally do not qualify for government programs like Medicaid — were hit hardest. Despite heated rhetoric on the issue, immigrants are not driving the problem; 80% of the uninsured under age 65 are native-born or naturalized citizens. The uncompensated cost of providing health care to the uninsured last year was $57 billion, three-quarters of which was picked up by the Federal Government.

Most uninsured Americans work: Of those under age 65 without insurance, 8 in 10 are members of working families. Only 19% are in families with no one working. However, 62% of the uninsured have no education beyond high school, limiting their ability to boost their incomes or advance to jobs that may offer health care. The uninsured were three times more likely to have trouble meeting basic monthly expenses like rent and food.

Of those without health insurance, 11% reported being in fair or poor health, compared with 5% with private coverage. Nearly a quarter of the uninsured say they've forgone medical care in the past year due to its cost, compared with 4% who receive private care. As a result, the uninsured are more likely to be hospitalized for avoidable health problems.

Government programs are making a difference for children: Despite overall increases, the number of uninsured children last year fell by 800,000, to 8.1 million, thanks to expansions in Medicaid and state programs covering minors. (The total in 2006 was 9.4 million).

Young adults with no children are especially vulnerable: Programs such as Medicaid and Medicare insure millions of parents, children and disabled people. But low earners without dependent children are offered few resources when it comes to health insurance; they comprise 58% of uninsured Americans as a result. At 30%, those ages 19 to 29 have the highest uninsured rate. Racial minorities are also disproportionately represented; about one-third of Hispanics and one-fifth of blacks go without insurance, compared with 13% of whites.

Most people know that millions of Americans lack health insurance, but this report helps give that enormous group a human face. That many unemployed workers lack health insurance is not a surprise, but many of us may not realize that so many working people do as well — a troubling fact that lends credence to the reform efforts under way.

Source: TIME, Oct. 14, 2009 http://www.time.com/time/health/article/0,8599,1930096,00.html#ixzz25GkXZCFq

I'm glad you enjoyed the video and I appreciate your thoughtful reply. I'll reply by saying that if you accept meaninglessness as a fact, then there are many implications to such a belief. For instance, if it true that life is meaningless then it is also true that there is no such thing as justice. It means that any truly terrible things that happen to you will never be adequately recompensed, and that frequently, the purveyors of such will get away with it scott free. It means that ultimately, might does make right, and he who has the gold makes the rules. If you are smart enough to get away with it, or powerful enough to avoid the consequences, you will never face any justice for any evil that you've done.

It also means that everything you have worked for and dreamed about could be randomly taken away from you at any moment, and so could all the people you love and care about. One moment you are an eternal optimist, the next, you get into a car accident and become a parapalegic. Now, you can say that this could happen to you even if there is a God, since it obviously happens to people all the time. This is true, but, if this life is all you have then it means that the hope you have is a very limited and fragile commodity. Hope is not a limited commodity for a Christian. For instance, the closer you are to death the less happy and hopeful you will become. When you're young, you don't concern yourself with it as much, even though it could happen at any time. As you get older, you start to realize how little time you have left to accomplish your goals. Your mobility starts to decrease, the sharpness of your intellect and your beauty fades. You become less desirable to others and to society in general. What this means is that your happiness is always situational. Eventually, when enough tragedy happens to you, you will break down and the future will become more and more like a millstone around your neck.

Yes, some people are able to squeeze some happiness out of desperate circumstances, and more power to them, but they have no real hope. A meaningless universe provides you with zero hope in the end. Many people believe they will achieve some lasting legacy but think about all the people you remember from the last century. Shockingly, a poll done by college age kids from America and Germany showed that many of them had no idea who Hitler was. If no one can remember Hitler, they probably won't remember you either. Where does that leave you? Your best case scenario is that you lead a completely pointless life where you hopefully experience a modicum of pleasure before expiring prematurely, never having reached anything near your true potential, with all your love and dreams being cruelly erased from existence forever.

People become depressed because of a lack of hope. If you look at the world today, and constrast it to our history, you will see that nothing has really changed on planet Earth. For all of our so-called progress, humanity is just as sick and depraved as it always has been. Evil is increasing, not decreasing, and mankinds destructive appetites will never be satiated. There is no hope in man, but there is in God. I think you know that.

Now, you make an argument about following your bliss, but if what is good to do is simply what makes you feel good, then you could excuse some of the worst crimes in history. People murder, rape, cheat, steal, etc because it makes them feel good. I'm sure Hitler took a lot of pleasure in what he did, and was following his bliss for aquiring absolute power. You can't use what feels good as a compass for what is right. Now, I think you're trying to insert the caveat that we shouldn't do what causes harm to people, but what if it is someones bliss to harm people? You would be stopping their bliss and thus violating your own rules. In short, there is no way to impose any absolute standard of morality when you are determining it by a completely arbitrary standard. In a meaningless Universe there is no right and wrong, so why shouldn't you just do whatever you want? Why waste your time trying to navigate some moral landscape that you don't even believe exists? Why not just take what you can, when you can, before you lose the opportunity?

For myself, what led me to start thinking about what was true was to notice how much this world was going down the tubes, and with seemingly no one in the drivers seat. I noticed the love I felt from this world being slowly drained away, year by year. I saw that humanity was on a collision course with ultimate destruction if nothing changed. If life is meaningless then it doesn't matter. But deep down, you don't really believe its meaningless, and neither did I. That's probably another reason why you're depressed. Your head says its meaningless but your heart tells you that this is a lie. Until the two reconcile you will never be happy and you will never be truly free. It's only Christ that can reconcile them, because He knows the reason that you're here, and only He can point you in that direction. It is only by discovering the meaning of your life, the reason that you're here, that will lead your mind and heart to agree with one another.

>> ^messenger

This program makes a bold point about hormone and chemical levels being much more strongly correlated with longevity than is likely to be the case. There are a lot of other factors that contribute to premature aging and susceptibility to certain illnesses and diseases, diet, exercise, and lifestyle among them.

To be sure, fasting is probably not a terrible idea for most of those of us who have been brought up eating a Western diet. There's probably something to be said for the human body failing to evolve quickly enough to adapt to the continuous supply of sugary, salty, and fatty foods on a nearly 24/7/365 basis -- rather than the feast/famine environment during the first million years of its evolution... But a switch to eating real foods, not too much, and mostly vegetables is clearly a good way to go.

To continue this lesson, it is important to note that most bomb technology doesn't use enriched uranium alone. The other key material compound is plutonium. For all intents and purposes, all plutonium is man made (with only traces of 244 found in nature, of which is completely unsuitable for weapons..Pu244). Plutonium is usually needed in a bomb because of its much lower critical mass. This lower mass makes bomb fabrication easier, but that creation of plutonium is by no means trivial.

You need huge facilities, dedicated to the sole purpose of uranium exposure. Like the video mentions, normal uranium is mostly U238, this junk gains value in the creation of plutonium. Weapons grade plutonium is a special isotope of plutonium, Pu239. This need is very specific, the different isotopes of Pu can have so very serious implications for bombs. Lets go over them as we as we go over how uranium is exposed to make this very special isotope

First, we start off with U238...the fuel stock. This isotope is bombarded with neutrons. These neutrons are occasionally absorbed by the uranium, turning it into U239. U239 is highly unstable, and quickly decays (in 23.45 minutes) to neptunium 239. This will in turn, decay into Pu239 (in about 2.3 days). Sounds easy, right? Not exactly, neutron absorption isn't something you can control with ease. What I mean is, there is little to stop our Neptunium or Plutonium from absorbing neutrons any more or less than the Uranium (in fact, their absorption cross sections are typically much larger...they are more hungry of neutrons than uranium in other words). When this undesired absorption happens, the neptunium and plutonium eventually becomes Pu240...and that is a big problem.

Plutonium Pu240 is HIGHLY undesirable in a bomb. Pu240 is a medium lived isotope of Plutonium, meaning it decays pretty quick, but it is HOW it decays that is the problem. Pu240 often decays by spontaneous fission. Having spontaneous fission in your fission bomb is just as undesirable as it sounds. Firstly, all even number isotopes are poor fission candidates, so for every even number isotope in your bomb, that lowers the bombs over all yield (because they prefer to fission themselves, and for very little return energy). This is further complicated by high densities of Pu240 causing your bomb to prematurely detonate, ya...bad news. The levels of Pu240 represent yet another challenge in the level of heat they generate from their rather quick decay, though, considering the previous 2 issues, this one is less problematic, though still troublesome. And lastly, there is nothing stopping our Pu240 from absorbing yet another neutron causing yet another isotope of plutonium to arises, namely Pu241.

Pu241, being an odd numbered isotope heavier than lead makes it a rather good subject to undergo fission. It doesn't have the same set of problems as Pu241, but it rapidly decays (14 years) into Americium 241, which is not fissile, and has a halflife of 432 years. These factors add large amounts of heat to the bomb, and reduce overall yield, as well as detract from critical mass.

The solution for this is a very low tech, time consuming, laborious process with produces tons of waste and very little plutonium. One has to expose small blocks of uranium to neutrons under a very brief window. The brief window decreases the chances of undesired neutron absorption and negates much (but not all!) of the heavier forms of plutonium being created. After exposure, they are left to decay, then after a few months, are chemically processed to remove any plutonium and other undesirables (this is also very very hard, and I won't even go into how this is done), then re-exposed. This yields gram(s) at a time. To make a weapons, you need 10 killos, at least...for one bomb...if everything went great. This means you need HUGE facilities, HUGE staff, and HUGE uranium resources. Your facility would be obvious and serve no other purpose, use tons of energy, and pile up radioactive waste of the kind no one wants, heavier than uranium wastes...the worse of the worst. No such facility could exist alongside some traditional uranium facility and not be noticed, period, end of story, done.

We haven't even covered bomb making problems, of which killed some of our top minds in our own bomb program. A set of incidents revolving around a specific bomb type, after taking 2 lives, was dubbed the Demon core. These are the reasons over half the budget of the DOD gets soaked up in nuclear weapons, and we haven't even covered some of the more important aspects (like delivery systems, one simply doesn't walk into Mordor). Nuclear weapons are hugely expensive, hugely conspicuous, require massive facilities and require a level of sophistication that is completely absent from the training of reactor nuclear scientists.

Reactor research and materials are orders of magnitude different from weapons grade materials and research. No bomb in history has EVER been made from reactor grade plutonium because the levels of Pu240 and Pu241 (and we haven't even covered Pu238!) are blisteringly high, way to high for weapons. Isotopic separation for Pu would be even more costly than uranium because of their mass similarities (compared to U235 and U238) and need a different set of enrichment facilities specially tailored to plutonium enrichment, of which all the people who knew something about that are Russian and American, and most likely dead or work classified to the highest degree.

The problem of nuclear weapons via reactor development is all a game to ratchet up the fear machine to get a particular end. It isn't a technical problem, it is a political problem. In the end, though, emerging technology could make enrichment easier anyway, so many of the issues I mentioned might eventually fall to the wayside (not within the next 10 years I imagine; for interested parties, google laser enrichment...coming to a world near you, but not exactly tomorrow, it's awesome stuff though). Eventually, the US is going to have to get used to the idea of more and more nations owning the bomb...but that issue is completely unrelated to reactor design and research. Reactors and nuclear weapons share about as much in common as cars and space shuttles...trying to link them as a dual proliferation argument is a political game and doesn't map on to them technologically.



I should note that I am not yet a nuclear engineer, but I did stay at a holiday inn express.

re-*promote (because a bug prematurely ended the last one)

re-*promote (because a bug prematurely ended the last one)