This post is partnered with a Timeline on Sex, Fertility, France and Serotonin on RxISK


I am on a listserve that includes Trudo Lemmens a vocal opponent of Medical Assistance in Dying (MAiD) in Canada. Canada seems to be going about MAiD particularly enthusiastically. Quite apart from Trudo being a long standing friend, I am impressed with the coherence, morality and passion of his position.

There are others on the listserve like Jack Noble, mentioned some posts back, who have had brushes with serious illness and eloquently expressed a wish to have some control over the manner and timing of their passing. An increasing number of people probably feel this way.

Up till now my concerns with Canadian MAiD lay in two areas Trudo doesn’t cover.  Young people with antidepressant induced treatment resistant depression (TRD) or post-SSRI Sexual Dysfunction (PSSD) have turned to MAiD as a way out. I know 18 people who have MAiDed or Suicided in the last year or two for this reason.

Getting rid of drug induced problems this way doesn’t seem right. I invite people, who are in touch before MAiDing, to consider a hunger-strike outside the HQ of the company making the drug that caused their problem. The company wins if they just go quietly.

Coming to Jack, my problem with MAiD is this.  If it were available over the counter so Jack and others were truly in control of it – this would be fine.  It’s the prescription only status of it that worries me. I’m worried because everyone assumes doctors are nice people and cannot envisage the possibility that some of us might enjoy killing. Just like we once found it hard to believe clerics might abuse children.

If Jack approached me to help him exit and I agreed, I think he and the rest of you would be safer if I knew I might be charged with murder afterwards and required to present a case to a jury and Jack’s relatives. If they were persuaded I was helping Jack live the life (as it were) he wanted to live I think juries would acquit.  Remove that oversight and I see abuse ahead.

Liberté Égalité Fertilité

Emmanual Macron has put another option – Assistance in Dying Altruistically (AiDA) on my radar. Last week he announced a French Fertility Crisis.  Invoking Wartime, he called for a Demographic Rearmament. A videoclip from his Press Conference features in Pharmageddon and HealthCare Climate Crisis.

Fertility rates are plummeting in the West (Japan, Australia etc). For forty years they have been below the 2.1 replacement rate.  At 1.5, even if life expectancies were still increasing (which they have stopped doing), the population must decline. Japan is below 1.3 and estimates are it will have 80% of its current population in 2070.  Spain and Italy are at 1.2 and estimates are they may only have 75% of their current population by 2050.

In addition to Macron’s video, Pharmageddon and HealthCare Crisis features a video lecture by Charles Medawar who coined the term Pharmageddon. Last week’s RxISK post Medicine, Civilization and Cradles covers other angles on this crisis.

We tend to think of what is happening in terms of an aging population – Vieillissement. It’s not. Youth are vanishing. There are fewer babies per woman and for two decades fewer women having babies.  If we magically stopped the temperature rising now beyond 1.5 C, we are told the ice would still go on melting for decades. Prior temperature increases are built in.

As things stand, increasing fertility won’t now stop the population of young people falling.  We are now opening nursing homes and closing schools. Hedge funds have spotted elder care facilities as the investment opportunity of choice.

Outside the US, social services and social structures were built on having 5 tax-payers per recipient of pensions etc in the 1960s. That fell to 3 per recipient in the 1980s.  We now have 1.4 tax-payers per recipient.

The constant refrain with Covid was that we need to manage the virus not just to save lives but to prevent our health services being over-run and collapsing. Many people I know working in hospitals said this was a smokescreen for health services already cut to the bone and collapsing in countries from Canada to France.

Part of this collapse stems from putting vast amounts of health dollars into funding drugs given to healthy people for risk factors, which rather than keeping people out of hospital, as company adverts suggest, increase the risk of them ending up in hospital.  It is likely that more than half of current hospital treatment centers on repairing the harms done by prior treatment.

Part of our problem stems from our inability to extract tax dollars from the wealthy. The Mephistophelean pact we now have lets Hedge Funds take over social care and elder care and then extract our tax dollars from social welfare budgets.  It’s no longer Emmanuel, Justin, Bill or Rishi getting our tax dollars, it’s a Hedge Fund

Hedge Funds are also buying up housing stock and apartments for rent. This privatization lays the basis for one of the two major points Emmanuel and everyone else makes about fertility – people put off having children till they can afford housing and the age they can do this is getting pushed back to an age where women’s fecundity is rapidly declining.

This supposedly explains why for the first time in history, women over 30, who are less fecund, and turning to IVF/ART, which has a low success rate, are having more children than women under 30.

There has been much talk about diverting public funds into affordable housing and providing other incentives to women to have the 2.3 children they say they want.  But there are no funds in the public purse to do this. We blame the 1% who are not paying taxes but it’s not less and less funds in the public purse – there is less and less of a public.

Liberal democracy depends on this public base. Perhaps this is why Vladimir and Xi are pretty sure the days of liberal democracy are over.

The political perception of a looming crisis goes back to the 1990s. In 2005 George W Bush picked up Clinton-Gore plans to reform the much thinner US social security net. Without reform W said, we will be faced with impossible choices between – “staggering tax increases, immense deficits, or deep cuts in every category of spending”.

Part of the Bush-Clinton-Gore idea was to get ordinary folk to pay their benefits into hedge funds who could buy up social care and housing stock – in some sense, we could be told we owned it.

Liberals were outraged. Tax the wealthy was the answer. Even some of the wealthy began pleading to be taxed.

Trudo’s, my Trudo not Canada’s Trudeau, response to people opting for MAiD because there is no other ‘treatment’ and no social supports is to insist we should not let the State neglect its duties and actively or passively push people into dying for want of ‘Care’.  This response might once have been called Liberal but as it’s the Liberal Party pushing MAiD in Canada, Liberal no longer seems the right word.

It is hard to argue with Trudo’s point but, as Macron seems keenly aware, current population dynamics mean it will now take decades before we can do this.


Marcon’s new policy is heavily influenced by Salomé Berlioux and La Peau des Pêches, her book about her infertility. Salomé was under 30 when she had to face the prospect of infertility. As she portrays it, this was a couple issue, neither him nor her.

Salomé and Samir Hamamah lay the basis for Emmanuel’s demographic rearmament in:

Rapport sur les causes d’infertilité :  Vers une stratégie nationale de lutte contre l’infertilité

Besides Hedge Funds laying a no risk bet on women’s ovaries beginning to fail by the age of 30, their report outlines another factor in Rearmament – perturbateurs endocriniens – endocrine disrupting chemicals.

In a 137 page report, over 50 pages are given over to these PEs, as found in air, water, food, places of work, cosmetics, plastics etc, with the different classes of tricky agents we are besieged by almost lovingly described.

One page, in contrast, is given to prescription drugs which, like the SSRIs and other psychotropic drugs, are more potent endocrine disruptors than anything else we have. No mention of drug names here, or drug classes other than the cytotoxic drugs and over-the-counter poisons like alcohol, nicotine and cannabis – see Sex, Fertility, France and Serotonin.

This dynamic seems to map onto a Rapists and Abusers are always Strangers dynamic when in fact Familiars, known to us, are more likely to be the Rapists and Abusers.  Pesticides are strange to us, and easily blamed, like immigrants. Our SSRIs are familiar, accessed through the comforting reassurance of a doctor, who tells us there can be no harm.

SSRIs wipe out sperm counts, cause implantation failures, miscarriages and birth defects but above all are leading to younger people having less sex and if they get PSSD unable to have sex.

See Medicine, Civilization and CradlesSex, Fertility and SSRI Timeline.

In terms of what comes next, note there is a rapidly growing Male Infertility Industry along with MAiC medical assistance in conception, aka AMP assistance médicale à la procreation, aka IVF, aka ART – all of which at present have dismal success rates but all of which point to our growing belief in technologies.

Our From Cradle to Grave framing of life may need to be replaced with From MAiC to MAiD.

Alternate Solutions

1A.  A vast increase in immigration.

Some countries will deny citizenship to immigrants – Japan, Germany, and Switzerland. The US prided itself on taking people in and making them citizens, but this was when they had a West where people could go. In a lot of countries, possibly including the US still, a majority of current citizens will likely see the need for immigration and welcome diversity, but others won’t. A currently very hot political issue seems likely to get hotter

Spain is estimated to need several million immigrants pretty soon to avoid its social structure collapsing.

Despite riots linked to non-native communities feeling alienated by France’s ideal of universality, until recently in official statistics, the French felt reasonably comfortable with immigration at a 50,000 per year rate. It has just jumped to 200,000 and will be a key card across Europe in June elections.

In Germany, right wing parties have coined a new term to add to Great Replacement ideas – Remigration. Trains East anyone?

Britain is paralyzed by its inability to not just stem a flood of possibly 400,000 migrants per year but even to process them.  It is desperately trying to put them on planes to Rwanda and pay Rwanda lots of money to keep them there – while at the same finding it has been accepting refugees from Rwanda.

1B.  Immigrants and Communities

Whatever about citizenship, given the effects of SSRIs – Sex, Fertility and SSRI Timeline – if immigrants become not just the way to fund current social security but perhaps offer a mass surrogacy program to kickstart a demographic rearmament rather than replacement, they will have to be prevented from taking Western Meds

Non-native doctors, for instance, will have to stop telling the communities they come from to stop stigmatizing mental illness and antidepressants. Stop telling their parents and siblings not to opt for community support rather than Western technical advances.

This will be a very un-comfortable step for the French who pride themselves at aiming at universality and are wary of the idea of communities.

When the histories of this period are written, will Western technical advances, like the SSRIs, be seen as advances in therapeutic techniques or advances in propaganda techniques?

When Trudo talks about MAiD he finds it hard to resist a jab at Stan Kutcher, a Liberal Party Senator, who is a leading pusher of MAiD in Canada. Given the demographic doomsday we face, perhaps future generations won’t view Stan Kutcher in the light Trudo now views him.

But, of course, Trudo (and I) also mention SK’s role in Study 329 and his links to GSK. The spinning of an ineffective and dangerous drug as safe and effective is emblematic of what has led to the current problem. So maybe SK won’t be viewed in such a good light.

2. Assistance in Dying Altruistically (AiDA)

Many people on the listserve including Jack and I are all part of what might once have expected to be the pointy top of the population pyramid. The pyramid, however, has inverted and we are now part of a top-heavy bit balanced, with an ever increasing wobble, on a pointy base.  We all have children, who likely won’t easily be able to get housing and have our grandchildren who might in several decades time stabilize the pyramid.

For those who haven’t heard The Grand March from AiDA – its worth listening to.

Verdi’s AiDA essentially altruistically committed suicide by hiding in the prison of her love Radames, who was condemned to death for love of her over country. There could be no better name for this option.

Who’s for AiDA?

3. The Shipwreck Option

Shipwreck of the Singular develops ideas in Pharmageddon, the book. The book took 4 years to get published.  There was no prospect of Shipwreck being published by a mainstream publisher. A new publishing venture, a co-operative had to be set up Samizdat Health.

Co-operatives may be part of the social capital we need to invest in as capital goes out of fashion. Co-operatives were once a way in between capital and labor.  They were not a wishy-washy, middle of the road, we believe in nothing movement – much more a we believe in each other movement as the Irish name for its cooperative movement, Sinn Fein, indicates.

Shipwreck is built on the idea that we need biological answers to our current problems.

The 1930s and 1940s saw an embrace of biological determinism with biological answers to social problems being promoted and put into action in German hospitals and on Trains heading East.

The biological answer now needed is a reverse biological determinism. Biology is a source of diversity. Social structures give us Standardization. At the very least the answer we now need is to reduce heavily standardized therapy burdens, primarily medication burdens.

Written 6 years ago, Shipwreck ends with what still appears to be a unique proposal for an escape route from the difficulties Emmanuel and Salomé and an increasing number of folk are grappling with. You’ll have to buy it to find out what that escape is. It’s not AiDA.



The post Liberty, Equality and Fertility first appeared on Dr. David Healy.

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