Obama's Hidden Advantage?

According to this expert, that president's big advantage is that he's not attracted primary opposition in his bid for re-election.  The left may be dissatisfied with him for not showiing more economic leadership, being a bit of waffler on same-sex marriage, and letting our troops stay in Afghanistan, but not enough actually to run someone against him.

A glance at recent history, the expert observes,  shows that incumbents who don't generate primary opposition win, and those who do lose.  In the latter category most recently,  there's Ford, Carter, and Bush the elder. (And after all the primary-unchallenged Bush the younger was re-elected, which amazed me at the time.)

In the case of Ford, the way he became president (an unelected VP coming to office because the president resigned rather than be impeached) gave him less legitimacy than any other incumbent in our history.  And he seemed to possess the qualities of an able but uninspirational caretaker of the office in troubled times more than those of someone who would want or deserve his own term.  So it's really quite amazing that Ford survived the Reagan challenge for the nomination (and that was partly because the Gipper got off to a kind of lazy start).  It's just as amazing that he came from way back to almost defeat Carter (showing what a weak candidate Jimmy was).  So nobody should generalize from the case of 1976.

In the cases of Bush and Carter, the primary challenges were't the causes of their defeat, although their unusual weakness of their presidencies probably generated the challenges.  Republicans were dissatisfied with Bush for lacking his own agenda and raising taxes;  he tried to be the heir to the Reagan revolution without any revolutionary fervor.  Being merely conservative is no way to maintain your power (see Machiavelli).  Buchanan was not a big deal of a challenge, but Bush's shortcomings generated the independent challenge of Perot, which really did do him in.  Republicans didn't much care that Bush lost;  it was better, many thought, to give up power rather than limp along exhausted and demoralized.  (They had been in too long.)  (Many Republicans had a similar view in 2008--given the incompetence of of Bush the younger's administration, it might be better to retreat and come back later.)

Carter had alienated himself from all sorts of Democrats, and the country was in, as he said, a messy malaise.  It's amazing that he survived the Kennedy challenge, and the victory actually propped him up for a while.  (Kennedy lost because of his ambivalence about becoming president; he wasn't driven by the relevant ambition.) The primary challenge was hardly the cause of one-term Jimmy.

Obama, from the beginning, knew that he would have no real trouble from the left.  A Progressive president in this day and age is a precious piece of luck that no one with any responsibility on the left would dream of undermining.  The Democrats are hardly suffering from fatigue, and, despite it all, they know their president is an admirable man.  And of course a challenge from the left to our first African-American president that was the cause of his defeat would be a rather justifiable cause of Democratic regret and blame. 

Obama's low approval rating (low to mid 40s) and bad economic numbers do call to mind the case of Carter.  Someone might say his situation is closer to Reagan's in 1983, and both the economy and the president bounced backed nicely by November 1984.  But we're not going to have that kind of bounce on either front this time.  It's likely that the president, if he wins re-election, will do so narrowly, because he hasn't attracted any voters he didn't get the first time and he's certainly lost some, maybe a lot.  It's certainly possible that the streak of re-election being connected with no primary opposition will be broken.

To be fair, Obama does have this in common with Reagan:  Nobody doubts that he's a real Progressive, just as nobody doubted that Reagan was a real conservative.  That's the main reason why  neither generated a challenger from within his own party when times got tough.

So it's true that not having any kind of effective challenge from the left gives the president lots of advantages, including ideological and tactical flexibility.  A second advantage, of course, is the Republicans haven't come up with a really attractive alternative--no one with the charm and competence of Clinton or Reagan--yet.

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The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

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