It's been a bloody week in the culture wars: First came the news
that abstinence-only pregnancy-prevention programs may work a lot better than we thought. (Sometimes, I say "we" were wrong just to be polite, but this isn't one of those times; only last week I was on our colleague Bonnie Erbe's PBS show
flapping my jaws in favor of the mixed-message approach and insisting that abstinence-only wasn't getting the job done. Live and learn, though; it's not
like this is a theological debate, right
A study of 662 6th and 7th graders published earlier this week in the Archives of Pediatric & Adolescent Medicine found that an eight-hour program encouraging abstinence significantly slowed the race to the backseat, worked far better than a more comprehensive approach, and did not have any effect on condom use when the kids did become sexually active.
Some 33 percent of the kids in the abstinence-only program had sex within two years anyway, which doesn't sound great. But that one-third figure compared favorably to the 47 percent of those in a control group, 52 percent of those in a program that only dealt with safe sex, and 42 percent in a program that taught both abstinence and safe sex. A couple of caveats: The kids in the program were so young that it's reasonable to wonder if the same approach would work with older teens. And the researchers who designed the study said they purposely steered clear of a moralizing tone or any criticism of contraceptives, noting (a tad moralistically?) that most of the Bush-funded abstinence-only programs did poke holes in condoms, so to speak, and were not necessarily as effective. Still, it's surely good news that such simple programs can offer real promise, even if it means we now have to rethink our assumptions about why teen pregnancy and abortion rates have been rising again
Social issues hit the front page a second time on Thursday, with news about a study
that found that some patients classified as living in a 'vegetative state' actually have active, normal inner lives. In Liege, Belgium, 54 such patients were put inside highly sophisticated brain scanners. Of the 54, five produced scans that "flashed exactly like any healthy conscious person's would,'' according to a report in The Washington Post. "These patients, the images clearly indicated, were living silently in their bodies, their minds apparently active. One man could even flawlessly answer detailed yes-or-no questions about his life before his trauma by activating different parts of his brain.''
The study, "Willful Modulation of Brain Activity in Disorders of Consciousness" – yes, headline writers for some publications will stop at nothing to get clicks – was first published online Wednesday in the New England Journal of Medicine.
The humbling news that we know even less than we thought about what goes on inside people who are not able to communicate brings to mind the beautiful film "The Diving Bell and the Butterfly,'' about a French magazine editor, Jean-Dominique Bauby, who was completely paralyzed after a stroke but learned to communicate solely by blinking his left eye – expressing joy, rage, longing for the nurses who cared for him – and eventually dictating the memoir the 2007 movie was based on.
The new study about those classified as in a vegetative state "should change the way we think about these patients'' Nicholas D. Schiff, a professor at Weill Cornell Medical College, told The Post. It should, yes, but will it?
It certainly raises questions some of us had all along about cases like that of Terri Schiavo, the Florida woman in a persistent vegetative state who was starved to death in 2005 after her husband won a legal battle to remove her feeding tube.
Experts quoted in The Post story went out of their way to say that we needn't worry that the judge in that case effectively handed down a death sentence to someone who was alert – and of course, I hope they are right. "[T]he research does not indicate that many patients in vegetative states are necessarily aware or have any hope of recovery,'' the story said. "Many, like Schiavo, have suffered much greater danger to their brains for far longer than the patients in the study.''
Only, before the study came out, wouldn't the experts have argued against its unlikely findings, too? And when we fail to learn from science that doesn't suit us, haven't we jumped in bed with the evolution and climate-change deniers? Those are pairings from which I personally would prefer to abstain.