BEIRUT: New footage posted on the Internet appears to have been filmed by a Syrian rebel who points the camera along the barrel of his gun as he executes 10 unarmed prisoners.
The grisly video, posted on YouTube Thursday, shows 10 men wearing T-shirts and camouflage trousers lying face down next to a building and a lookout tower. Even before the shooting, two of the men are not moving and one has blood coming from his torso.
“I swear to God that we are peaceful,” begs one of the men to the camera, which is being held by the gunman. Cowering, the man gets up to plead with rebels. As he approaches a rebel off-screen, a shot is heard and he returns holding his bloodied arm.
“We swear to God we are Sunni,” another says while someone off camera chants “execution, execution!”
Another of the victims repeats that the men are “Sunni from Deraa” before the cameraman points the camera along the barrel of his Kalashnikov assault rifle and shoots the men.
“God is great. Jabhat al-Nusra,” he says, referring to the secretive Jabhat al-Nusra – Arabic for “the Support Front” – an Islamist rebel unit with links to Al-Qaeda that has claimed responsibility for several suicide bomb attacks around the country.
The gunman gets on the back of a pickup truck and the camera pans to show the man who had been shot in the arm still moving. More shots are fired and his body spasms.
The authenticity of the footage could not be independently verified. Comments accompanying the video said it was filmed in Ras al-Ain, a town on the border with Turkey where pitched battles have raged in recent weeks.
Syria’s uprising started with peaceful protests which were harshly suppressed by troops and has evolved into a civil war in which foreign jihadi fighters have joined ranks with defecting soldiers and armed civilians.
Separately Friday, a regional military commander for Al-Nusra in the northern Hasaka region told the Associated Press his men do not fear death and they are determined to form an Islamic state.
“Thanks to our strong faith we do not fear death, because we think that if you are killed at the hands of this regime, then we will be martyrs and we will go to paradise,” Sheikh Abu Ahmad said.
“We want Shariah [Islamic law] to be applied because it’s the right path for all humanity,” he added. “All these constitutional laws couldn’t realize the people’s happiness.”
It’s difficult to gauge how much power Jabhat al-Nusra has in the uprising. Although Abu Ahmad said only a tiny fraction of the group’s fighters are foreign, others have estimated that its fighters come from Libya, Tunisia, Egypt, Saudi Arabia, Iraq, the Balkans and elsewhere. Many are veterans of previous wars who came to Syria for what they consider a new “jihad,” or holy war, against Assad.
The fear of Islamic extremism resonates deeply among Syria’s many ethnic and religious minorities.
The Assad dynasty has long tried to promote a secular identity in Syria, largely because it has relied heavily on its own Alawite base in the military and security forces in an overwhelmingly Sunni country.
Islamist rebel groups in Aleppo province, including the two largest, Liwa al-Tawhid and Al-Nusra Front, have rejected the National Coalition of opposition forces acting to unify Free Syrian Army rebels in return for greater Western support. The rise in Islamist sentiment has worried Western powers mulling arming the rebel opposition.
In Aleppo’s eastern district of Shaar, where Islamist fighters have a strong presence, demonstrators booed the rebel Free Syrian Army Friday in videos posted on the Internet by activists.
“The Free [Syrian] Army are thieves, we want an Islamic army,” the demonstrators chanted angrily as they marched through the streets.
LAGOS (Reuters) - The leader of Nigerian Islamist sect Boko Haram praises jihadist movements across the globe and singled out the United States, Britain, Israel and Nigeria as enemies in a new video, according to a translation by the SITE monitoring service.
The 39-minute video "Glad Tidings, O Soldiers of Allah", posted in a jihadist forum, features a speech by sect leader Abubakar Shekau with an unusually international focus for a group that has often seemed more pre-occupied with local gripes.
Unlike previous video speeches, which he delivered in his native Hausa tongue, the one posted on Thursday is in Arabic. Shekau pledges solidarity with Islamist fighters everywhere.
"Nigeria and other crusaders, meaning America and Britain, should witness, and the Jews of Israel who are killing the Muslims in Palestine should witness ... that we are with our mujahideen brothers in the cause of Allah everywhere," he said, according to SITE's translation.
The video appears to confirm the fears of security agents that Boko Haram has ambitions to join forces with other Islamist groups pursuing a more explicitly global, anti-Western agenda - like al Qaeda in the Islamic Maghreb (AQIM), based in Mali.
Almost 3,000 people have been killed in fighting since Boko Haram launched an uprising in northern Nigeria in mid-2009, enraged by the death of its former leader Mohammed Yusuf in police custody during a crackdown on the sect.
The video wishes "glad tidings" on Islamist warriors in "Islamic Maghreb" (the Sahara) and "the Islamic State in Mali", as well as Somalia, Libya, Afghanistan, Iraq, Pakistan, Yemen and "usurped Palestine".
He list "martyrs" in the global fight against world powers like Britain and the United States, including Osama bin-Laden.
"Don't think that jihad stops with the death of imams, because imams are individuals," he tells them. "Think how many sheikhs and men were martyred ... Did jihad stop? No. Jihad doesn't stop until Allah wills it to be stopped."
The video ends with footage of fighters undergoing military training, then cuts to weapons and equipment it alleges were taken as spoils from the enemy, SITE's translation says.
Boko Haram's favourite targets are usually local in character: Nigerian security forces, Christian worshippers or any politicians and clerics who speak out against it.
It has only claimed responsibility for one attack on a Western target - a bombing of the U.N. headquarters in Abuja that killed 24 people in August last year - but security analysts fear it could soon carry out more attacks like this.
Security sources say Boko Haram has for years been sending fighters to train with AQIM in the Sahara. Some set up camp in Timbuktu after Malian Islamists seized control of it in June.
"Boko Haram may be Nigeria-centric with respect to its attacks, but it clearly sees itself as part of the broader international jihadist movement," said Jacob Zenn, analyst at the Washington-based Jamestown Foundation.
BEIRUT (Reuters) - At least 12 Lebanese gunmen were killed in a Syrian army ambush in the central Syrian province of Homs, a security source and people close the men's families said on Friday, a sign that Lebanon is getting further tangled in Syria's war.
The sources said the Lebanese men were killed near the town of Tel Kalakh and were from northern areas of Lebanon which are sympathetic to the majority Sunni-led revolt against Syrian President Bashar al-Assad.
The Syrian Observatory for Human Rights said 30 Lebanese fighters had gone missing and a second security source said they were accompanied by nine Syrians as well as Libyans, Egyptians and Yemenis.
The 20-month-old crisis in Syria, which started with peaceful protests but descended into a civil war with sectarian undertones, has deepened divisions in Lebanon.
Lebanon's Shi'ite militant group Hezbollah sided with Assad - whose Alawite sect is close to Shi'ite Islam - and clashed with Sunni fighters in the southern city of Sidon this month. There have also been intermittent clashes between Lebanese Alawite and Sunni residents in the port city of Tripoli.
The small country is still rebuilding after its own 15-year civil war.
Syrian troops were garrisoned in Lebanon until 2005 when anti-Syrian demonstrators took to the streets, accusing Damascus of assassinating former Lebanese prime minister Rafik al-Hariri, a Sunni.
As people looking at New York City from afar frequently ask me about our mayor for the past decade, I penned some notes. First of all, as a profound democrat, I regard the 2009 New York City mayoral election as subtle testimony to both the power and the limitations of the people. The initial surprise was that Michael Bloomberg, the incumbent, got only 51% of the vote, with approximately 200,000 fewer fans than he had won only four years before. more>>>
Blaise Pascal was a theologian and also one of the earliest scientists. In his book Pensees (Thoughts, 1660) some of his comments are relevant to our current dilemma: what should be the relationship between science and religion? more>>>
An issue that has been debated at least since the time of Socrates is “Can art or philosophy be divorced from politics?” Self-proclaimed defenders of what they like to call "pure art" have chosen as a classic example of political censorship the informal ban over many years by Israeli radio and television on the operatic works and symphonies of Richard Wagner, a composer whom the Nazis idealized. more>>>
Friday afternoon in Jerusalem, the day seems different as people prepare for Shabbat. Public offices, banks and post offices in Israel are closed. Stores close early and traffic is sparse. The city slows down, gradually enveloped in a cloak of calm silence, a question waiting to be asked. That transformation is exemplified in Machane Yehuda, the shuk, Jerusalem's central marketplace, and the Kotel, the Western Wall of the Temple Mount. more>>>
“The Freest Journalist in Canada”: An Interview with Ezra Levant
by Jerry Gordon (December 2012)
Ezra Levant is not your typical Canadian. He is outspoken and driven to seek out the truth about dangers to free speech and homeland security in our neighbor to the north. Fortunately for Canadians his truth telling appears nightly on his program, The Source on the Sun News Network. more>>>
Scooters are abandoned amidst last night’s takeaway trash outside the university’s big iron gate. At 8:40am on Saturday morning no one wants the 4,000 Korean won coffee-and-waffle set available through a hole in the wall. Nevertheless, it feels like a day of days. We are going somewhere to watch something, be part of something, and, I feel sure, celebrate something. It’s not often you get to do that, and it is why football (soccer) supporters will travel the length of their countries to expend otherwise coffee-and-waffle set disposable income on watching a match. Let’s go. more>>>
A Portrait of Elizabeth: Shona Farmer from Zimbabwe
by Geoffrey Clarfield (December 2012)
Elizabeth was born in 1964. She is a tall, high cheek boned Shona speaking daughter of farmers in the central plateau area of Zimbabwe. To get to her house you walk five kilometers from the nearest city centre. Her one room house beside the beehive kitchen/reception room is set among green farms and rocky brown outcrops, streaked with dark black lines and perforated with tufts of trees. Chickens and chicks run around her compound. That is her “income generating project” as it is labeled in development jargon, as she farms about four acres with maize and vegetables, some which will be eaten and some which will be sold in the local market. more>>>
November 2012 in the Middle East left the world wondering if the worst was yet to come. Casualties in the Syrian rebellion had reached over 40,000. Syrian opposition forces had taken over missile bases and were in battle with the beleaguered Assad regime's forces along the demilitarized zone with Israel on the Golan Heights. Exchanges of shelling occurred with IDF units stationed there and cries of “allahu akbar” could plainly be heard. more>>>
"Not the Time to Conquer Gaza": Israel’s Operation Pillar of Defense
by Jerry Gordon (December 2012)
Israel’s Operation Pillar of Defense was basically a rocket war against Iran and Hamas that did not achieve the objective of destroying the military capabilities of Hamas, the Palestinian Islamic Jihad (PIJ) and the Palestine Resistance Committee. It demonstrated the superb technical capabilities of Israel’s Iron Dome system that intercepted a virtual onslaught of rockets from Gaza. Rockets supplied by Iran had expanded their reach to cover Southern and Central Israel and over half of the country’s population of 3.5 million people who had to seek shelter in less than 20 seconds given a red alert. more>>>
Why the Left Frequently IS Right....And Vice Versa
by Fergus Downie (December 2012)
In Arthur Koestler’s wartime novel Arrival and Departure, there is a striking scene where the author introduces a prototypically modern Nazi diplomat who expounds on the intrinsically modern and revolutionary character of the Third Reich, before descanting on a vision of Europe, in which history and tradition are rendered a junkyard. It is worth quoting at some length as it highlights a feature of the fascist imagination which is rarely explored with any intellectual rigour and consistency. more>>>
The World View of Hasan al-Banna and the Muslim Brotherhood
by Joseph S. Spoerl (December 2012)
Founded in Egypt in 1928, the Muslim Brotherhood has emerged as a force to be reckoned with, not only in Egypt and the Gaza Strip, where it has won elections and assumed power, but also in Europe and North America, where it has been very successful at forming national Islamic organizations claiming to represent Muslims in non-Muslim countries.1 It is more important than ever to understand this group and its ideology. more>>>
Hannah Arendt, the Holocaust, and the State of Israel
by Richard L. Rubenstein (December 2012)
2006 marked the centennial of the birth of Hannah Arendt, one of the best known twentieth-century German-Jewish thinkers.[i] Arendt was a participant in what Harvard’s H. Stuart Hughes characterized as “the most important cultural event - or series of events- of the second quarter of the twentieth century,” namely, the flight of German-trained scholars - both Jewish and non-Jewish-from Hitler’s Europe to the United States and England.[ii] I personally was a grateful beneficiary of Adolf Hitler’s unintentional gift to America. When in 1942 I began to study with the newcomers, I realized that they possessed a level of scholarly authority, knowledge, thoroughness, and insight that was new to me. more>>>
Muhammad Would Not Enter A House That Contained Dogs Or Statues
Already, in France and in Italy, there have been Muslim plots against statues and other works of art (most famously, the fresco depicting Muhammad in the cathedral in Bologna); statues have already been vandalized or destroyed. Why should Muslims, when they feel strong enough, treat Western works of art any differenty than they treated them in the Middle East, or in Afghanistan (the Bamiyan Buddhas were merely the largest and latest in a long history of such destruction), or in former Byzantium (see, if you visit Hagia Sophia, the vandalized and destroyed art-work throughout what was once the most famous church in Christendom).
Broadcast on Al-Alam (Iran), but also justifiably outraged by the Ikhwan's representative, here. The hysterical exaggeration simply cannot be avoided; it's part of the atmospherics of societies suffused with Islam, like conspiracy theories. Nothing to be done about it.
Hezbollah Upset The Sunnis Keep Attacking Shi'a And Can't Quite Figure Out Why
From the Hezbollah site Al-Manar:
Hezbollah Calls on Syrian, Iraqi Peoples to Disavow Takfiris
Hezbollah strongly condemned Thursday the terrorist attacks against Syrian civilians and Iraqi pilgrims, killing and wounding a number in both countries, and causing more pain, suffering, and instability to both dear peoples.
“Hezbollah strongly condemns this absurd killing and bloodshed of innocents to implement a devilish western will that is totally far from divine teachings and human nature,” a statement by Hezbollah Media Relations said, adding that “killing the biggest number of innocents in Syria and Iraq aims at creating sectarian strife as well as planting malice and enmities among citizens of one country.”
“This requires both dear peoples’ determination and disavowal from the criminal Takfiri elements,” it stressed.
Hezbollah further pointed out that “targeting pilgrims’ processions in Hillah and Karbala was a crime against humanity and human conscience, as those killers did not even exclude women, old men, and children who were in a spiritual phase of devoutness, and were seeking to be close to Allah through His faithful guardians.”
In conclusion, Hezbollah held the responsibility of the attacks on Damascus Countryside to the Arab and Western military support to militants, and wondered about “the role of the humanitarian aid that some Lebanese figures are presenting, and in this context, whether this would help in spreading democracy, prosperity, and peace among the Syrian people.”
"Takfiris" refers to those Muslims who accuse others who claim to be Muslims of of not being true Muslims, or of apostasy. The Takfiri are Sunnis, and many of those they now attack as Infidels-- as in Pakistan, in Iraq, in Syria, -- are Shi'a Muslims. Non-Muslims, of course, can only take satisfaction in such developments. Hezbollah, on the other hand, has to worry about the Sunnis of Lebanon, and Sunnis outside of Lebanon, treating Hezbollah as a group of Infidels, and as the Alawite regime will be fully occupied in fighting to survive and have nothing left over to support Hezbollah (and might even try to recall some of the weaponry it sent to Hezbollah for its own use), a Sunni-Christian-Druze alliance against Hezbollah, aided by Sunnis outside, would constitute a real threat.
The UN General Assembly voted for the "New Nazi State"
Haj Amin al Husseini wih Adolph Hitler PA President at UN General Assembly 11-29-12
Berlin, 1941Source: AFP/Getty Images
Gulio Meotti in his Arutz Sheva (Israel National News) column, "I Stand Ashamed that My Country Voted for the New Nazis"expresses the sentiments of many of us about yesterday's vote granting the Palestinian Authority (PA) so-called observer status equivalent to what the Vatican has at the UN and Italy's abstention.
It is a veritable J'accuse:
At the United Nations we are witnessing the creation ex nihilo of a foreign country, which never existed, and accepting the claims of the “Palestinian Arabs”, by giving them the land whose memory kept the Jews together as a people and brought them back to Jerusalem after the Holocaust.
The Western community at the United Nations, including my miserable Italy, just adopted the Nazis' strategy. Cunning in wickedness, the Germans dangled before their victims the possibility of saving themselves at the expense of other Jews.
In this case, the Jews to be sacrified are all of those living in Judea and Samaria, but ultimately it is the entire State of Israel, since a Palestinian State would only arise upon the fall of Israel.
I am ashamed that my country will vote for the first step towards officially prohibiting Jews or any other faith from living in a certain area, the first since Nazi Germany, which sought a country that was “jüdenrein”, or cleansed of Jews.
I am ashamed that my country will vote for those who plan to take down Theodor Herzl’s picture from the wall of the Knesset, remove the seven-branched candelabra which is the expression of Am Yisrael (the People of Israel), abolish the Chief Rabbinate and turn the name of the state into Falastin.
I am ashamed that my country will vote for the PLO, an organization of murderers and Holocaust deniers now officially dedicated to the mass deportation of Israel’s Jews.
I am ashamed that my country will vote for a state that tortures inmates in prisons, that throws political dissidents from the roofs of public buildings, that puts to death human beings simply because they are guilty of apostasy and that will be a combination of corruption, dictatorship, Islamic theology and “Bin-Ladenism ".
The same could be said for those other major countries in the EU that either abstained or voted for the change in status for the PA.
Bravo for the 9 countries that voted to reject it. The 138 that did are largely members of the virtual world caliphate the Organization of Islamic Cooperation or the Non-Aligned Movement currently headed by Israel's sworn enemy, the Islamic Republic of Iran and 22 Member Arab League including Egypt currently headed by an Islamist Muslim Brotherhood dictator. This was Mahmoud Abbas' last gasp as the long term, holocaust denying and corrupt leader of the PA that has consistently refused to negotiate a deal for peace with Israel. The Oslo Accords of 1993 are finally interred with this vote at the UN General Assembly. The PA purposefully chose the date for this upgrade in status vote, as it was the 65th anniversary of the UNGA vote to partition the former League of Nations Palestinian Mandate held by the British into a Jewish and an Arab state, that was rejected instead the 1948-1949 War for Independence ensued as did several other wars and countless terrorist actions and Intifadas with thousands of casualties.
As Caroline Glick noted in her Jerusalem Post column, the 1947 rejection of the UNSCOP partition plan followed naturally from the Grand Mufti of Jerusalem, Haj Amin al Huseini and Muslim Brotherhood backer annihilationist program in Nazi Germany during his tenure as Herr Hitler's house guest. al Husseini championed the final solution in the death factories of the SS and opposed deals that would have spared Hungarian Jews and Jewish children from death in the gas chambers and other unspeakable means. His legacy can be found in both the PLO and Hamas Charters, the latter who will do everything in its limited powers to ethnically cleanse the space between the river and the sea of Jews. The same goes double for Hamas' arms supplier of repute, the Islamic Republic of Iran. An Islamic Republic of Shiite Mahdists that says nothing about the heinous Shiite Muslim neighbors in the Iranian city of Isfahan who butchered a Jewish woman in front of her family so that they could covet the family's property adjacent to a Mosque. The Islamic Republic of Iran as leader of the Nn-Aligned Movement voted for PA observer status.
But this last hurrah for Abu Mazen, the arabic nickname for PA President for life, Mahmoud Abbas, may give him only a few moment of adulation by his subject in Ramallah, awaiting the forensic report on whether the late PLO leader Arafat was poisoned. Hamas's media victory lap in the recent eight day war has had a line up of fellow Islamist visitors of note from Qatar, Turkey, Egypt and Tunisia, while few have trekked to Ramallah.
Jonathan Schazer of the Washington, DC-based Foundation of Defense of Democracy noted in a 1330AMWEBY Middle East Round Table discussion to be published in the December New English Review Abbas' isolated and diminished status in comparison to Hamas in Gaza:
Gordon: Jon, the Palestine Authority, is about to go to the UN to request a vote on observer status in the UN General Assembly. Given the tea leaves of responses from the non-align movement it looks like they are going to get that. What is the implication of that and why did Hillary fail in her last meeting in Ramallah to convince President Abbas to defer this?
Schanzer: I think it is a foregone conclusion here that the PLO is going to get what they need. They are going to need about two-thirds of the vote and they have about 135 out of 193 countries. If you subtract those members who are going to abstain, I think they are going to have that number handily. What is interesting is that the US was not able to talk the PLO down from this. This is Abu Mazen's [Mahmoud Abbas] big move. I think that he sees this as his legacy. He has been under a lot of pressure. He has been failing to deliver the kind of governance that Palestinians want. On top of that, people just fail to see his overall strategy of non-violence against Israel, and yet the West Bank hasn't really changed. Nothing has. Conditions don't improve. In terms of what happens next, I think they are going to get this. The idea here is that they are going to internationalize the conflict. They are going to pursue the Israelis at the International Criminal Court or the International Court of Justice. This is the plan. Whether it works is still unclear. I think Abu Mazen is gambling basically his entire career on this move and you just don't even know what is going to happen until it's done. I think it's probably going to land with a thud to begin with, but then where the PLO takes it from there is another story. In the meantime, what they have done is anger the United States. They have made things difficult for the Israelis to work with them. Abu Mazen looks completely feckless. He looks completely irrelevant after this most recent conflict in Gaza. Hamas has sucked all the oxygen out of the Palestinian question. It is all about Gaza right now. Everybody is looking at what Hamas is doing and nobody seems to care much about the PLO. What you are going to see this week at the UN is Abu Mazen saying, me too, me too, I'm a leader, I'm a leader. The question is whether it is going to resonate and the answer may be that I'm just not sure.
The PA may use its new found UN observer status to launch legal action against Israel in the International Courts at the Hague. However, it may well jeopardize tax remittances from Israel. A bi-partisan resolution in Congress was proposed by a number of US Senators suggesting cutting US aid to the PA as a result of this change in non-state status resulting from yesterday's UNGA vote.
They could start with ceasing voluntary donations to the UNWRA system that funds fully a third of the half billion in annual operations of refugee camps in the West Bank, Gaza and several surrounding Arab countries maintaining 4.0 million plus in poverty and squalor awaiting 'returns to their ancestral' lands in what is now Israel.
Jonathan Tobin writing in Commentaryexpressed the views of many when he wrote:
So long as Palestinian nationalism is based on the negation of Israel rather than a positive vision for themselves, peace is impossible. While the UN vote won’t change much of anything on the ground, there should be no mistake about the basic continuity between the Arab positions of 1947 and today.
Ukip takes second place in Rotherham and Middlesborough by-elections
Last week I mentioned Yvonne Ridley standing as the Respect candidate in the then forthcoming Rotherham by-election. She came in fourth, behind the BNP who were third. Ukip came second. After I wrote about Ridley another far more important story broke. The Social Services of Rotherham Council, led by a hatchet faced old bag named Joyce Thacker, found out (a tip off, like it was a crime, which it is to them) that a married couple who are experienced foster parents for the council were members of Ukip, the United Kingdom Independence Party. The family of children they were fostering were immediately taken away from them. They were declared unsuitable to have children as 'Ukip do not believe in Multi-culturalism'. In order to accomodate the children at such short notice with foster parents who do toe the Politically Correct line the brothers and sisters, who were thriving, have been split up, which is considered very bad practice.
Rotherham is one of the councils that did not act to protect girls in their care from the attentions of Muslim rape gangs - indeed their response to a plea for help from one such little girl was to offer her Urdu lessons to help her. Joyce Thacker, a graduate of Common Purpose, used to be head of Youth Services in Bradford. The rape gangs operated in Bradford as well.
So Ukip did well in Rotherham, and were doing very well, considered neck and neck with Labour until the postal votes were brought in.
But in case anyone thinks it was just the Joyce Thacker efffect in one town they also came second in yesterday's by-election in Middlesbrough, where the vacancy occured not due to the criminal theft of the previous MP but his unfortunate early death.
Ukip also came third in the Croydon by-election.
Now the bad news - the Labour party won all three seats. Expecting that result Robert Colville wrote this in the Telegraph on Monday. And he was right.
Rotten boroughs like Rotherham are poisoning British politics.
What more does Labour have to do to lose the Rotherham by-election? The former MP, Denis MacShane, was hounded out of the Commons for making fraudulent expenses claims. The council is the target of national scorn after it took three children away from loving foster parents for the "crime" of supporting Ukip – a scandal made worse by its ham-fisted attempts to justify itself.
In short, Labour couldn't have had a worse campaign if its candidate had spent the past few weeks yelling abuse at passers-by from the steps of Rotherham Minster. But it makes no difference. Come Thursday's by-election, that candidate, Sarah Champion, is on the shortest possible odds to be returned to Parliament. And once she's in there, it will take an Act of God – or some idiotic MacShane-style rule-breaking – to get her kicked out.
A small start would be to make voting in person the normal option, and postal votes only by special permission for a small minority of people who are housebound or working away. Postal vote are abused, and often cast so far in advance of the election that the voter is not aware of events that might change his opinion.
As Life Expectancy Increases Will the Elderly Become a Greater ‘Burden on Society’?
At dinner the other night, a cardiologist spoke of the economic burden on modern society of the elderly. This, he said, could only increase as life expectancy improved.
I was not sure that he was right, and not merely because I am now fast approaching old age and do not like to consider myself (yet) a burden on or to society. A very large percentage of a person’s lifetime medical costs arise in the last six years of his life; and, after all, a person only dies once. Besides, and more importantly, it is clear that active old age is much more common than it once was. Eighty really is the new seventy, seventy the new sixty, and so forth. It is far from clear that the number of years of disabled or dependent life are increasing just because life expectancy is increasing.
There used to be a similar pessimism about cardiopulmonary resuscitation. What was the point of trying to restart the heart of someone whose heart had stopped if a) the chances of success were not very great, b) they were likely soon to have another cardiac arrest and so their long term survival rate was low and c) even when restarted, the person whose heart it was would live burdened with neurological deficits caused by a period of hypoxia (low oxygen)?
A paper in the New England Journal of Medicine examines the question of whether rates of survival of cardiopulmonary resuscitation have improved over the last years and, if so, whether the patients who are resuscitated have a better neurological outcome.
The authors entered 84,625 episodes of cardiac arrest (either complete asystole or ventricular tachycardia) among in-patients in 374 hospitals in their study, which covered the years 2000 to 2009. They found that, between those two years, the rate of survival to discharge from the hospital for patients who had been resuscitated increased from 13.7 to 22.3 per cent. This improvement was very unlikely to have been by chance alone. Moreover, the percentage of those who left the hospital with clinically significant neurological impairment as a result of their cardiac arrest decreased from 32.9 per cent in 2000 to 28.1 per cent in 2009. Extrapolating to figures in the United States as a whole, where there are about 200,000 cardiac arrests per year among hospital in-patients, the authors estimate that 17,200 extra patients survived to discharge in 2009 compared to 2000, and 13,000 extra with no significant neurological disability – if, that is, the 384 hospitals were representative of US hospitals as a whole, which they may not have been.
Of course, it is usually possible to extract pessimistic data from the most optimistic data. The study could have emphasized that, thanks to improvement in cardiopulmonary resuscitation, 4,200 extra patients with significant neurological disability were being discharged from hospitals annually, a burden, as the dinner guest would have put it, on society.
In addition, only 22.3 percent of patients given CPR survived to discharge while 54.1 percent responded initially to it. This means that in 2009 31.8 percent of patients resuscitated died in the hospital after initial success; in 2000, the figure had been only 29.0 percent. Presumably patients who responded initially to resuscitation but subsequently died used up a lot of expensive resources in the meantime.
The authors are cautiously optimistic. They admit that the improvement might have been due to something other than better technique of CPR: a change in the nature of the patients having it, for example. Nevertheless, these results are more encouraging than those of a previous study, which showed no improvement in survival of CPR patients in the Medicare system between 1992 and 2005.