Saturday, October 19, 2019

No Easy Answers - Science Has Limits That It Can't Avoid - Pretending It Doesn't Is Immoral And Dangerous

My mother was, in her early career, a nurse who had worked in hospitals in Boston in the late 1930s and through WWII.  She saw many of the major advances in modern medicine, first hand.  I remember her talking about life before and after the discovery and distribution of penicillin, how she said it was like a miracle to see patients who she would have seen die of what became easily treatable infections get better in days and leave the hospital healthy people.  

She also saw the enormous expansion of blood donation and transfusion during WWII as she worked in hospitals which received large numbers of soldiers, sailors and marines as they were sent back to the U.S. many of whom had survived due to field hospital transfusions.   My father was one of those, they met in the hospital where she worked.  So, I owe my existence to that combination of a war and modern medical advances.   That is part of the enormous complexity of so many lives of those at that time and after.   What that tells us about the relationship between supreme evil and the human experience of what is good is too complicated for me to figure out.  I think it's too complex to tease any simple and coherent meaning from.  We can just be aware of it and think about it but I wouldn't look for anything so easy as a general conclusion from it.  Any general conclusions asserted will have to leave out so much as to likely be false.

Going through paperwork in my duties as an executor, I found a record of blood donations made by another relative who died of hepatitis C.   Most of the blood donations were made in the 1950s through the 1970s.   Hepatitis as classified today, into types A, B, and C was a progressive thing, the different strains were identified at different times.  Though a "non A- non B" strain of hepatitis had been known for a long time, the actual discovery of  type C wasn't until 1989.   It was two years after that that my own father was diagnosed with hepatitis-C.   In looking at his medical history which, since his enlistment in the military after Pearl Harbor was quite complete, they said the only known way he could have gotten the virus was through the field hospital transfusion that had saved his life.   He was a frequent blood donor as so many veterans of his age were.  It was the right thing to do, based on the knowledge of the time.   Thinking about the paperwork I've just been through, I have to wonder how many people were infected, unknowingly, with a serious and often fatal disease through what was, based in the scientific knowledge and best practice available based on that scientific knowledge, a good thing, a generous thing to do.  Who knows if there are other, unidentified types of hepatitis. 

I am not saying this to attack the practice of blood donation, to which, as I said, I owe my existence and to which my father owed his life and the more than four decades he lived carrying a blood borne disease no one knew about.  I'm saying this, first, to give an example of the extremely limited success of science, especially in areas of enormous complexity which biological and medical science must deal with.  Every time we introduce foreign matter into a body, the full range of consequences of that decision are unknowable.  If the foreign matter is tissue from another living being or blood components which can carry viral, bacterial or other infection, the potential to do harm is always going to be there.  Certainly one of the things we know is that only a tiny number of such potential infectious agents is known to us at any time, new ones can either become common in the human population or arise through mutation of existing organisms, micro-organisms reproduce at such a huge rate, in relation to the bodies they inhabit, that that potential is not something which will ever end.  

I am also saying this because of what it tell us about human inability to make fully informed moral decisions.  Based on what was known, what my father, what my other relative did was generous and good, though unknown to them, they may well have been infecting unknown numbers of people with a deadly infection.  That is certainly true at least as a potential whenever we give blood.  Ironically, due to the policy decisions around the AIDS epidemic of the 1980s, my blood was not wanted - though I didn't practice the kinds of sex that left me open to HIV (and hepatitis)* transmission, men of my identity was told not to donate - my relative was still occasionally donating during that period.   What we know today would make what was - for all he could have known - a morally laudable act, immorally irresponsible. 

I don't have any general moral assertions to make,  this is given as something to think about.  Having been bitten by a tick this last week, with all of the rising knowledge of the dangers of that indirect transmission of blood borne pathogens between mammals, it makes me wonder what we don't know about donation by those who have been bitten by ticks.  But without taking the very serious leap into that darkness, we know people will die for want of a blood transfusion. 

*  I've mentioned before that one of the reasons I would not engage in anal sex was because I knew, even in the 1960s that it was a very likely means to transmit or be infected with hepatitis and other, untreatable sexually transmitted diseases.   Not to mention other problem with it.  I saw the period in which anal sex was normalized as "the real gay sex" among gay men, mostly through porn of the period, the same way it has become normalized for the far larger numbers of straight people who engage in it, today.    It is one of the most ridiculously amoral things I've found online that those who proclaim, loudest, their devotion to science will, as easily as the most scientifically illiterate, disregard it when their preferences and desire to appear kewelly transgressive mandates they pretend it's not there.   I have never had a sexually transmitted disease because I engaged only in non-penetrative sex with one man.  I assume he was faithful to me, I've never had any evidence he wasn't, though we didn't live together.  Promiscuity is another major means of infection, who needs ticks when people choose to infect each other.  One of the major and most dangerous limits of science is when people choose to ignore it.

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