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bnuckols

Conservative Christian Family Doctor, promoting conservative news and views. (Hot Air under the right wing!)
bnuckols has written 1105 posts for WingRight

Why the fuss about Amy Coney Barrett?

Politics are heated, these days. One hot spot is the imminent confirmation of Judge Amy Coney Barrett to the Supreme Court of the United States after the unanticipated (yet expected) death of Ruth Nader Ginsberg last month.

A lot of us have expressed our concerns about what has been called “social eugenics,”experimenting with basic societal institutions and our children’s future. (Example: the unexpected problems of forced single parent homes and racial disparity in prisons from the way we pay aid to families and “the War on Drugs.” )

Huge changes were mandated by SCOTUS, rather than State by State, or even at the Federal legislative level, through legislation by our elected representatives. Controversial social change – either direction – is better accepted if it comes socially, then politically.

Judge Amy Coney Barrett has demonstrated the ability to rule based on law, separating religious matters from the meaning of the law. The ABA isn’t adverse to withholding approval for judges, yet gave a glowing recommendation of “Very qualified” and testified about their deliberative process and in favor of confirmation at the Judiciary Committee this morning.

“If you like your (money), you can keep your (money).”

Joe Biden doesn’t believe we have a right to know his plans before the election, but we do know he plans to take more (tax) money from high earners, surviving businesses and successful investers. Why not punish the “rich?”

Perhaps Biden can raise the $4Trillion he wants to spend by only raising Income tax (to 40%) & Social Security tax (12.5%)on the 1.8% of people who earn 25% of the income in the US & who pay 40% of the US’ income taxes.

“Fair share,” right?

But we also know he plans to increase corporate taxes (to 28%), capital gains taxes (to 40%) and increase the estate tax.

Selling your home or investment real estate? Part of the profit is capital gains tax & Biden plans to raise the maximum tax to 39% from 20%.

Currently, most profit on your primary residence for most people is exempted. Will Biden pledge to save the exemption? (Would he answer that question before the election?)

How many small businesses that managed to hang on through COVID would survive paying an increase in corporate taxes from 21% to 28%?

“No one earning under $400,000.”


Paraphrasing a couple of Biden’s role models,
“It depends on what the meaning of is, is”
or,
“If you like your (money), you can keep your (money).”

On Blame

Amid sanctimonious reassurance that they don’t wish bad things on the President – or his “cronies” – Facebook, Twitter, and, certainly, the media are claiming that the President is responsible for each and everyone of the US deaths due to COVID-19.

(I won’t link to the sites, giving them more traffic. It’s easy to find samples.)


What would you have done? Scare tactics? Usurp State & local government with Federal force?

How would you shut down the economy and our kids’ education even more severely without imposing martial law, forbidding even “mostly peaceful” protests, using military guns to enforce your edicts?

The people getting sick aren’t just “Trumpsters” running around in MAGA hats at the White House.

In fact, most cases are nursing home patients and household contacts, people who necessarily live together.

And just as many, if not more, have died of suicide, overdoses and homicide – in addition to the increase of deaths due to heart attacks, strokes, and Alzheimer’s because of the lockdowns and lost jobs and businesses.

From Milwaukee, “[D]eath tolls would amount to 514 overdoses, 455 COVID-19 deaths, 193 homicides, and 120 suicides.”

And, no, the President hasn’t “lied” about the serious nature of the virus. In my opinion, he has chosen to give the best case, rather than worst case scenario whenever possible.

About the “Born-Alive” Debate

For those interested in the Born Alive issue, here’s a “pro-choice” leaning “FactCheck.org” article that generally has the details right. It’s the conclusion that is flawed.

We don’t know the specifics of President Trump’s Executive Order, but there’s quite a bit of controversy in social media and the news media.

The Fact Check article claims that neither the 2002 Act nor the 2019 (failed) Bill are necessary due to homicide laws in the States as well as Federal law.

However, there has always been a very real debate about both the babies on the cusp of viability and babies born alive in the process of an induced abortion.

The latter was addressed in the 2019 Bill that failed to pass. Specifically, that Bill (would have) mandated standard of care medical attention.

75th Anniversary of the WWII Victory for the West

How did the 75th Anniversary of VE (Victory in Europe day, May 8) & VJ (Victory over Japan day, August 15) pass with so little acknowledgement, no celebration?

My mother was 8 years old in 1945, Daddy was 9. They each told us about the celebrations, the relief, the joy that accompanied the end of the War.

Thank you to all the men and women who sacrificed and died to protect our inalienable human rights from being infringed by demagogues and tyrants who dehumanized innocents as well as combatants.

A modest proposal for COVID-19 response (Or, I’m not King, but)

JAMA table 1, comparing efficacy of masks

(This isn’t medical advice, since it would be unethical to treat people I can’t examine and follow. But this may be a good list of recommendations for discussion.)

If I were in charge of the public health response to COVID-19, I would implement the following:

1. Let physicians practice medicine!

Stop the political, weaponised threats censorship, and cancelling!

Pharmacy Boards should never get between a doctor and patient except in matters of life and death or illegal practice. Politicians, State Medical Boards and our House of Medicine professional organizations should defend our legal practice of medicine rather than threatening physicians and changing the rules during a pandemic.

2. Encourage shared information & fact-checking among physicians as part of our missions of education & transparency.

3. Suggest voluntary use of masks in public places or self-isolation for those worried about their vulnerability. Traditionally, we quarantine the sick and at-risk and new-comers, not the healthy or people in place with a low risk of exposure.

JAMA review of masks, August 2020

4. Where a high percentage of the local population tests positive, local authorities should consider – and have the ethical responsibility to – impose higher isolation measures like masks and public distancing. The threshold for mandates must be locally determined with public input, and explained – clearly, frequently.

This means you, anti-maskers!

5. Stress that surgical procedure masks are nearly as effective as N95 masks, blocking nearly as much aerosols and viral particles for both wearer and those around us. Medical providers and those with a high risk of prolonged close contact need fitted N95 masks, the rest of us don’t.

Single layer cut-up T-shirts and homemade masks, balaclavas or bandannas, aren’t very effective protection at all, either for the wearer or the people around us. N95 Masks with single valves are a money-maker, but not nearly as effective as surgical masks, even with an added filter layer.

5. Educate the elderly & vulnerable about extra infection-avoiding and -control precautions, advising self-imposed near-quarantine for the most vulnerable of them.
6. Recommend Vitamin D & zinc over the counter supplements, possibly Vitamin C – which are harmless to virtually everyone, if not beneficial, to everyone.
7. Make Rapid tests for in-home testing available at nominal, sliding scale cost, on demand and at first symptoms or exposure. (This may be a place for donations by crowd funding.) Back up positives with the PCR tests, quarantine all rapid positives until cleared by PCR.

8. Begin early prophylaxis with hydroxychloroquine/zinc and/or inhaled steroids for the willing & likely exposed.

10. Open the schools, let the kids be kids on the playground. Utilize younger teachers and aides in the classroom. Supervision & protection for vulnerable teachers & students can be achieved as necessary with distance learning measures.
11. Make sure we have lots of Hydroxychloroquine/ azythromycin/ zinc/ vitamin D to begin at the first symptoms (I know the literature is mixed, but every article or study that I’ve seen it’s all flawed, see below**).
12. For both of my homes, in Texas, USA and in the British Virgin Islands, we should open the borders to anyone willing to quarantine in a government-secured location for 14 days & planning to stay at least 30 days (maintaining strict isolation & infection control precautions).
And, the most risky proposal of all...
10. I’d sanction the Chinese government-connected businesses and confiscate their assets to pay for it.

REFERENCES

** I follow the literature as best as I can: every single peer-reviewed study is flawed. However the anecdotal evidence for some protocols is very strong. If necessary to avoid politics, let the controlled trials continue but let willing physicians continue our ethical off-label prescription. We could just pretend we’re giving malaria prophylaxis, if it makes you feel better.
Prophylaxis dosing:
Hydroxychloroquine: 400 mg. twice on day one 200 mg twice on day two, then 200 mg. Twice a day every 4 days

Treatment dosing (always allowing treating physicians who prescribe determine need & frequency of alternate doses & monitoring)

This isn’t a prescription!

Hydroxychloroquine: 400 mg. twice on day one then 200 mg. twice a day for either 5 or 10 days;

Azithromycin: 250 mg. tablet, 2 on day one, 1 on day 2 to 5;

Budesonide: unit dose via hand held inhaler or nebulizer twice a day. (I’m looking for references for this one. )

Zinc 150 mg. to 250 mg. a day indefinitely. (Best evidence for lozenges or syrup multiple times a day. See references.)

Vitamin D, 1000 IU a day, up to 4000 IU is safe

Vitamin C, No set dose, but extra will be excreted in the urine or feces, can cause diarrhea.

References

Journal of the American Medical Association review. Published August 11, 2020. (Free, with Tables)

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769443?guestAccessKey=53b2b8ec-df1a-4ca4-88ce-abf6c4fa470c&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=081120

CDC recommendation on cloth masks:

https://wwwnc.cdc.gov/eid/article/26/10/20-0948_article

John’s Hopkins recommendation:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-face-masks-what-you-need-to-know

Zinc:

https://www.uchealth.org/today/zinc-could-help-diminish-extent-of-covid-19/

Journal article on treatment for the common cold: https://www.acpjournals.org/doi/10.7326/0003-4819-125-2-199607150-00001

Unpublished, non-peer reviewed: https://www.researchgate.net/publication/47794995_Zn_Inhibits_Coronavirus_and_Arterivirus_RNA_Polymerase_Activity_In_Vitro_and_Zinc_Ionophores_Block_the_Replication_of_These_Viruses_in_Cell_Culture

Hydroxychloroquine/azithromycin protocols

International Journal of Infectious Diseases (Henry Ford or Ashad report):

https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

https://www.ijidonline.com/article/S1201-9712(20)30600-7/fulltext

On synergistic effect of hydroxychloroquine plus steroids:

https://www.ijidonline.com/article/S1201-9712(20)30613-5/fulltext

Budesonide

Description of study in progress on treatment for loss of smell in patients without severe symptoms:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370627/

Vitamin C safety:

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-c/faq-20058030#:~:text=For%20adults%2C%20the%20recommended%20daily,Nausea

Note: comments are off. Please comment on my Facebook page, Beverly Nuckols.

Edited 31/08/20 12:30 for mis-spellchecked word. BBN

Answering Trump Derangement Syndrome

A long post written for Facebook, pretty much self explanatory:

Friday, as I often do, I wrote a blog for WingRight about (and posted an additional link to an informative interview with) Dr. Scott Atlas.

Although I seriously considered tagging you, I decided not to. I certainly don’t add the heading, “to my Democrat friends.”

I enjoy discussing ideas, ethics, and politics, but try to avoid disharmony and criticising personalities as much as possible. I’ve muted your posts because the hostile tone and – frankly – the rude and sometimes obscene posts from your other friends.

Did you hear about the peace deal brokered by President Trump between Israel and the United Arab Emirates? The expectation is a domino effect among other Middle East nations.

As to the new Postmaster General: Mr. DeJoy ran a successful and profitable freight and supply chain business for 35 years.

The mail delivery horrors you list are pure politics and distraction. We have a PO Box in the USVI, but, as with our businesses in the US, we have always used FedEx for time-sensitive mail. Even Amazon had slowdowns over the last 5 months, due to volume, staffing difficulties, and the practical matter of barriers to product delivery from (China) foreign manufacturers.

The collection box removals have been going on for years. The changes in the USPS are reportedly being made to improve productivity, but politics…

Assume Democrats that oppose the President, as well as Republicans that support him, work for the post office and that Republicans want every one of their ballots properly and efficiently delivered, too.

For the response to COVID-19, I recommend the interview between Dr. Atlas and Peter Robinson on Stanford University’s Hoover Institute “Uncommon Knowledge.”

The facts are that most virus mitigating measures were State responsibilities and there is no legal way for Federal involvement.

It’s not “all age groups.” Under 60 years old, the risk of severe illness is equal to the risk from influenza.1/2 of cases are asymptomatic or very mild symptoms. 99% of deaths are in people over 25 years old.

2/3 of deaths in many states were nursing home patients. 80% in Michigan. (The latest rumor is that it was *intended* by the Democrat Governors to cut the elderly population.)

The “killing” happened due to 1.) failing to protect our elderly and forcing nursing homes to accept COVID-19 positive patients and 2.) lost lives and years due to the lock downs, closing schools, and destruction of the economy. Excess deaths are greater than those explained by the virus. (Deaths due to delayed treatment for strokes, heart attacks, cancer, but as high as a 35% increase in some areas of Michigan, in ER visits for severe child abuse.)

California served as a lab for testing draconian methods like prolonged lock downs, chained parks & banned beaches, even requiring masks while exercising out doors, i.e., running and cycling! Yet, the hospitalizations, and deaths equal or exceed States that reopened, like Texas.

I had hoped that naming Harris as nominee for VP candidate would stop the Democrat talking points about adultery. At least no one claims that Trump built his career by an affair with a married power broker.

And, since you bring it up, “bullying” should be off the table, too. Harris put people in jail for marijuana, blocked possibly exonerating DNA evidence in a death row case and kept people in jail after they should have been released. This fact check from January, 2019 about Accusations made by Biden and others, is actually very fair,

The Epstein talking point conveniently skips the history: Trump banned Epstein from his properties back in the early ’90’s, after the sexual predator was exposed. The one woman who claimed to connect Trump & Epstein filed and dropped 3 suits in 2016, using a fraudulent address in the first.

Trump explained the comment about Maxwell: his 1st thought, like that of many of us, was that Epstein didn’t kill himself.

My politics focus in ethics and defending inalienable human rights and the Constitution. Abortion infringes the right not to be killed and mocks the concept of all the rest.

Even the 2nd Amendment goes beyond defending and enforcing the 1st Amendment and the rest of the Constitution: the right to self defense is a corollary to the right not to be killed.

You should really lose the accusation about children in cages since those pictures were from 2014, Obama’s ICE. The result of the huge caravans.

The rest of your comments are pure opinion, even going so far as to ask whether Melania is happy.

Ending on a positive note: Trump isn’t racist!

Consult this (Dr.) Atlas

Dr. Scott W. Atlas, former Chief of Neuroradiology at Stanford University Medical Center, current Senior Fellow at Stanford’s Hoover Institute, author, and public health policy consultant was added to the White House COVID-19 task force this week. Unfortunately, he and his appointment have already become a political target by some.

Far from being unqualified, or someone who “clearly wouldn’t know science if it kicked him in the atlas” (see above link – I refuse to give clicks to the original source or the ignorant woman who spoke those words), Dr. Atlas speaks common sense, science-based truth, as in this video from 23 June, 2020 interview with Peter Robinson of the Hoover Institute’s. “Uncommon Knowledge.”

In fact, Dr. Atlas states what I’ve been saying since I heard about the virus outbreak in Italy, while attending Carnivale parades just a few miles away in

Carnivale float, Nice France, depicting Chinese labor in Fashion industry.

Nice, France: the reaction by governments and fearful people has been just as bad if not worse than the results of the infection itself.

The initial lockdown was correct, but we have new data – and new models – every day. Yet, we are still acting as though the early models were accurate.

Worse, instead of “flattening the curve,” the call is to conquer or eliminate the virus “at all costs.” The latter has never happened and will never happen with a Coronavirus. There is the possible exception of the elimination of smallpox, a much more deadly disease, at the cost of egregious human rights violations and even deaths.

I’m surprised that anyone would attack Dr. Atlas or his qualifications. Before you dismiss him, please listen to his testimony and critique the facts rather than the source.

Interview with Dr. Immanuel

14 minute interview with Houston TV reporter.

She’s a warrior, all right! Worth your time!

I would like to see some data, but lots of other doctors report the same results, and I’d like to see some of their patient information, too. (Ages, other meds, vitals, timing, symptoms.)
She does say wear a mask if you can’t be on prophylaxis and to make other people comfortable. I would call her regimen a “treatment” rather than a “cure.”

But the biggest fuss has been about Dr. Immanuel’s religious beliefs. I’ve heard Baptist, Assembly of God, even Church of Christ preachers say much the same about the hidden powers in the world. Maybe not the origins, but their existence and, as Jesus Himself said, the need for prayer and fasting to deal with them.

I’ve been told that her religious views are a distraction and counter-productive for the Medical issues and “science.” But Dr. Immanuel doesn’t even bring up her religion until she’s questioned in this interview and didn’t bring it up at all in DC.

The detractors don’t understand the cultural background and how many Christians – across the spectrum from those who believe in the indwelling of the Holy Spirit to those who only remember the story of St. Michael – will recognize the theme.

Dr. Stella Immanuel and political eugenics

Were you triggered by the religious views of Nigerian born and trained, Texas licensed and practicing, Dr. Stella Immanuel?

Not only is she a passionate, powerful, and persuasive speaker and a professional black woman who committed the sin of going against the grain on an unreasonably politicized medical treatment. Worse: she was praised by President Trump. So, she had to be put under the political microscope.
There was a video of a press conference held on the steps of the Supreme Court in Washington, DC by a group called “Front Line Doctors.” The group spoke in favor of Hydroxychloroquine therapy for treatment of COVID-19 an included a Congressman from North Carolina and 15 to 20 doctors. Virtually all of the various online video tech hosts keep censoring the video, removing it almost as soon as it’s posted.
After reading about the censorship of the video, I was able to access a site and watch about 10 minutes before called away from my phone. When I came back, the video had been removed.
The five docs I originally heard (& possibly the 10 to others who were lost to censorship) spoke about their experience and preferences for treatment. Were any of the other docs the object of deep background scrutiny?
I disagree with some of the claims made in the video, especially the use of the word “cure” (rather than treatment) and with the opposition to the routine use of face masks to decrease exposure and viral load.

Dr. Immanuel only talked about her clinical experience. She spoke about successfully treating patients with Hydroxychloroquine for malaria in Nigeria and, along with zinc and Zithromax (azythromycin), as treatment for COVID-19 in her practice in Texas.
Ignoring the fact that the WHO resumed trials of Hydroxychloroquine June 3, the policy that masks were not helpful was promoted by both the WHO and CDC just a couple of months ago. Are the old documents from these organizations being removed from servers?
From what I understand, Dr. Immanuel is a preacher in addition to being a doctor. The things I’ve read about her sermons seem bizarre to me, but they remind me of a certain Chicago minister who had a few bizarre beliefs about HIV/AIDS, the US, and roosting chickens.
Nigeria has a different folklore tradition than mine in Texas; with a background of animalism and spirits, instead of our Greek mythology and Judeo-Christian history.
Cultural explanations and practices for disease have evolved, but traditions and habits persist: in the West, we knock on wood or throw salt over our left shoulder to chase off the “evil humours” that were the explanation for something that couldn’t be seen before microscopes.

I trained in South Texas, where I learned to ask about and counsel on the curanduras’ advice and practices. Curanduras still tell mamas to put pennies on baby’s umbilical cord to ensure an “innie”belly button and to place raw eggs under the bed to draw away sickness. Never was able to do as well with devotees of homeopathy & “adjustments” for asthma and “subluxation” or the irrational opposition to vaccinations.
I’ve had my medical and political credibility questioned because I’m a Christian. In contrast, I try to be respectful of people of different ideologies, evaluating their actual knowledge of science and practice of medicine, no matter what I think about their religion.
Would the theories of the origins of disease have been familiar to people from Dr. Immanuel’s culture? More importantly, does she understand and practice medicine according to the germ theory and current science?

There are no PROVEN therapies for COVID-19! Hydroxychloroquine/zinc/azithromycin is no more “unproven” than any other. It’s “unproven” that HCQ is unsafe.

(As of Midnight, 30 July, the video was available at https://www.bitchute.com/video/09K3kIwzeewO/?fbclid=IwAnR2E-LChNhpqOktcV4GPeT0ZS79cdf1tjdlnfNSlpGNWMCW6vVYYnHLCbjU so I was able to watch the rest of the docs.I am impressed especially by Dr. Joseph Ladapo, beginning at minute 33.)

A real class act

CNN has an opinion piece disguised as a report on yesterday’s “hearing” with Attorney General William Barr. Even as the author, Jerry Herb, repeatedly declared statements by Barr and President Trump as “false,” he took note of the poor treatment of Barr by the Democrats.

“Jerry Nadler of New York and the panel’s Democrats did not offer Barr any niceties congressional witnesses typically receive. Democrats repeatedly cut off Barr’s responses, accused him of being wrong or lying and made clear they weren’t interested in the explanations he was offering. Barr wasn’t allowed extra time at the end of each lawmaker’s five minutes to respond to questions that witnesses typically receive — forcing Republicans to use their time to let Barr push back on the Democratic accusations.”

Indeed, rather than a ” hearing” to learn from General Barr, the Democrats made sure *they* were heard. One after the other ranted angrily and refused to allow the General to speak, much less respond to any questions. All too often, the Dem shouted, “I’m reclaiming my time!”

(“I’m reclaiming my time!” “I’m reclaiming my time!” “I’m reclaiming my time!” It started sounding like one of the rioter’s chants.)

There were few questions with an opportunity to answer, only
character attacks and accusations that the AG is guilty of politics and doing the bidding of the President. (Wingman?)

More than once AG Barr was accused of racism and causing people to die. One man flatly declared that the Attorney General of the United States was guilty of breaking his oath of office. And, of course, there were threats of impeachment.

Cedric Richmond from Louisiana ironically gave us a great example of racism by noting that when the AG came to his office, he didn’t have a black staffer.

Is there supposed to be a “quota?” Isn’t hiring according to race the definition of “racism?”

I kept waiting for someone to have a stroke – not the AG, he was usually amazingly cool and calm.

(Or spontaneously combust?)

Bizarrely, toward the end of the day, Nadler committed the most egregious act by harshly refusing AG Barr’s request for a 5 minute break.
The meeting began an hour past schedule: Nadler was late because he had an automobile accident on the way to the Capitol. He then jumped into a hostile rant about Barr, skipping the Chairman’s routine notification that the witness could request such breaks as needed.
Throughout the day, the Representatives had, as is customary, individually left the hearing room, coming and going at will. The Attorney General, however, sat for over 5 hours with only three (3) 5-10 minute breaks. There was no lunch break and no scheduled recesses.
The only reason to breech the usual House protocol – not to mention common courtesy – in such a way would be to force the 70 year old witness to ask repeatedly before being excused.
The Democrat members of the House “Justice” Committee could have acheived the grandstanding they apparently craved by simply holding a press conference or giving one of their “One Minute” speeches. Rather than *hearing from* the Attorney General of the United States, they shamefully went out of their way to abuse – and even humiliate him.
I agree with the General: Nadler, indeed each of his Democrat colleagues, are a “real class act.” Not.

General Barr is, however.

(This is an edited version to clear up typos.)

COVID-19 Treatment – Analysis of 65 global studies showing high effectiveness for early treatment

https://c19study.com/?fbclid=IwAR2QTfcqe3nlW81BG8rE7pgxyUMgMlcPC2J7Un3xDTT2mqsazlHTzJurpFc

39 of the studies were peer-reviewed.

Kristallnacht mobs or Gestapo? Burn, smash stores as police watch

“Police made no effort to interfere…” This is happening to Americans all over the US and multiple factions compare their opposition with the abusers of Nazi Germany.

There’s been looting and vandalism in broad daylight, and 2 months of nightly destruction of property and fires in Seattle, Washington and Portland, Oregon. (And Atlanta, Georgia, New York City, Chicago, Minneapolis, St Louis and virtually every large city in the US) This weekend in Columbus, Ohio, a peaceful rally was disrupted by obscene “Black Lives Matter” protestors, with one woman waving what looks like severed male genitals (here, at about 6:35).

Local police are being *ordered* to stand down and limit their efforts to interfere by Mayors and Governors, but when they do – or Federal law enforcement is sent in – who is criticized, even called the “Gestapo?”

House Majority Whip James Clyburn, D-S.C., compared federal law enforcement in Portland to Nazi Germany’s Gestapo police force on Monday.

Sometimes, even “Black Lives” are victims of both vandalism and assault.

The parallels with Kristallnacht are not precise, but they’re there: the rioters have unofficial approval from the same local governments that are throttling down law enforcement. Only, this time, another governing body would stop the vandalism if allowed.

The question is not whether Godwin’s law has been broken, but whether we learned anything from history in general. I’m also reminded of the chair of the French Revolution which ended when the original leaders were sent to the guillotine, and George Washington’s response to the Whiskey Rebellion with an army of Federal soldiers attacking members of the mob who were accused of harming Federal agents and burning the home of one a official.

How long will the voting public allow their elected officials to be “distracted” by the anarchy and politics?

(Edited for grammar 21/07/20 17:30. BBN)

Say her name: Jennifer Long, murder victim

Jennifer, 16 yo

All humans have the right not to be killed, except to defend life. Because I believe and defend this right, I hate the death penalty. I’m not sure that “punishment” is an ethical element of “capital punishment.” Ethicists and philosophers, as well as religious leaders, disagree about whether human life is endangered more by allowing killers to live versus execution.

This 2001 article about the 1998 kidnapping, rape, murder by stabbing, and dismemberment of 16 year old Jennifer Long takes my sympathy away.

While on parole after serving 17 years for shooting a robbery victim in the head twice, the man whose name I won’t give, killed two women, one 16 years old and the other, 80.
Jennifer’s murder was the first of at least two. Convicted and in a Kansas prison for beating 80 year old Mary Ruth Bales, a frail survivor of childhood polio, to death with a claw hammer, the murderer tried to game the prison system. He offered to trade information about an unsolved case – Jennifer and her death – for a transfer from a State to a Federal prison.
The murderer of two, attempted murderer of at least one, was executed by Federal authorities, 22 years after Jennifer and Mary died at his hands.

Laugh or cry? (Mueller, Stone, Trump)

Special Prosecutor Robert Mueller wrote an op-ed for the Washington Post condemning President Trump’s commutation of the sentence of Roger Stone.

We made every decision in Stone’s case, as in all our cases, based solely on the facts and the law and in accordance with the rule of law. The women and men who conducted these investigations and prosecutions acted with the highest integrity. Claims to the contrary are false.

Mueller must live in some alternate reality. Since we know that Mueller’s team didn’t uncover the lies used against Carter Page or Michael Flynn – and some of them actually were the ones who lied – how can anyone believe that the Stone prosecution was more honest? Why are we supposed to accept that no evidence in favor of Stone has been withheld, no accusations are known to be false?

Only after Inspector General Horowitz investigated the FBI handling of a “counter intelligence” surveillance into the Trump campaign, did we learn that the investigation into Carter Page was based on a bogus & even falsified FISA application. At least some at the FBI knew Page actually reported to the CIA & one agent stands charged with lying in the FISA application.
Only a deeper investigation by the DOJ – after the Mueller and Inspector General investigations – discovered documents revealing communication between FBI agents that had been withheld from the Michael Flynn defense team, the court, and the Senate. Texts, emails and handwritten notes indicate that Michael Flynn was set up. Even after his initial investigation was about to be closed it was reopened by Strzok, Comey, others on “the seventh floor.” Former President Obama and Vice President Biden directed at least some of the later investigation, at a January 5, 2017 meeting. Texts show the “302” report of the Flynn meeting w/Stzrok was rewritten by Stzrok & Page. It appears from defense attorney letters that Flynn was coerced into pleading guilty to protect his son from similar harassment.
Mueller missed all of this, yet we’re supposed to care about his comments about ethics or trust his investigators?

The Mueller investigation and charges and even the whole FBI surveillance of the Trump Campaign reminds me of 1995/96 when I was foreman on a Federal District Grand Jury in San Antonio during Bill Clinton’s impeachment hearings for perjury & obstruction of justice. Many times, when I swore in a witness, some jury members and even the witness would laugh. “Nothing but the truth.”
Integrity? Laugh or cry.

43% of COVID- 19 deaths linked to nursing homes

Traditional germ theory explains the deaths & spike in COVID-19 cases in the US better than any political accusations going around. But, some politicians do carry real blame, however denied:
“”You had this political conspiracy theory that the deaths in nursing homes were preventable,” said Mr. Cuomo.””

At a press conference today, New York Governor Andrew Cuomo insisted that his March order requiring NH’s to accept COVID positive patients from the hospital didn’t cause deaths – in spite of the fact that it’s estimated that those orders caused more than 6300 such transfers.

The NYTimes previously reported 43% of COVID19 deaths have been linked to nursing homes.
State NH deaths

Click to view the percentage of death in NH by State

The problem with the spread of disease has been a lack of common infection control where it counts: in the care of the most vulnerable in nursing homes (“NH” ) and hospitals, as well as the failure to protect healthcare workers who come into close contact with the vulnerable and infected — and who travel between facilities & the community.
The first reported US case led to an outbreak in a Washington State nursing home and the local hospital. It began after a traveler returned from China – while that country still denied person-to-person spread – and sought treatment at the hospital. Employees carried it between facilities and into the community.
In spite of this history, New York & New Jersey governors each ordered nursing homes to accept COVID positive patients from the hospital & the Minnesota Department of Health insisted that hospitals discharge positive patients back to NH’s that weren’t prepared. It’s estimated that 1/4 of NY NH workers contracted the disease between March and June.

NY didn’t mandate NH testing until mid-May. NJ required testing by May 26th!

The Atlantic” gives more details about the lack of anticipation about the NH risk in a July 6 article.
The cycle of poor infection control in facilities caring for the vulnerable elderly – with inadequate protection for residents, employees, & their contacts – spread the virus.

Wear a mask if you, too, are at risk or will spend time with someone who is. Wash your hands! But, please don’t politicize this disease.

SCOTUS redefines words. Again. (Say goodbye to single sex sports & spaces)

There’s a right way and a wrong way to change a law. The Constitution doesn’t provide that the Courts make the big decisions, leaving the inconsequential matters to Congress. And yet, nominally “textualist” Supreme Court Justices Gorsuch and Roberts joined with the”living document” Progressives to do it the wrong way.

Gorsuch wrote the majority opinion in Bostick v. Clayton County and got at least two points right:

  1. “When the express terms of a statute give us one answer and the extratextual considerations suggest another, it’s no contest. Only the written word is the law, and all persons are entitled to its benefit.” and,
  2. There’s no way that the 1964 Congress would have intended for the word “sex” to include sexual orientation or gender identity.

In his 37 page argument, Gorsuch stuffed and fluffed strawman after strawman to fit an extratextual interpretation of “because of …sex” into the redefinition of “sex.” As noted in the dissents by Justices Alito & Kavenaugh, his is a redefinition that wasn’t even attempted when SCOTUS redefined “marriage” in Obergefeld.

In other words, as Justice Alito wrote in his dissent, Gorsuch and the majority “legislated.”

I agree that this law needed changing to give more protection to employees in the public market place. Congress should have been encouraged to work out those protections, while also preserving religious freedoms and single-sex spaces and even women-only sports. I can’t help but wonder whether – perhaps – both political Parties took a dive, hoping the Supreme Court would do exactly what they did.

And the Country will witness lawsuits, year after year, that might have been averted.

In the meantime, though, I’ll bet Senator Chuck Schumer feels caught in a whirlwind of his own. What price, now, Chuck?

Virtue signalling

A friend just posted a definition of “virtue signalling” and asked, “Is this supposed to be a bad thing?” His definition: “the action or practice of publicly expressing opinions or sentiments intended to demonstrate one’s good character or the moral correctness of one’s position on a particular issue.” (I also found it on Google, attributed to Oxford Languages.) Well, no. It’s not supposed to be a bad thing. But in the real world, it too often is. The definition I found on Dictionary.com touches on the important distinction: the righteousness and superiority of the virtuous.
“the sharing of one’s point of view on a social or political issue, often on social media, in order to garner praise or acknowledgment of one’s righteousness from others who share that point of view, or to passively rebuke those who do not. “
Instead of “tolerance,” the virtuous demand positive affirmation of their superiority, and in fact seem (to me) to be expecting and finding offence. It’s too often weaponised, used to “cancel” previously unsuspecting people, especially on social media.

Petty lies

The Democrats and their allies in the media lie about the small things, it shouldn’t surprise us when they ruin lives by lying about the real issues.

From just one weekend, just three of the petty lies:

  1. Hitler and a Bible: even Snopes agrees that it was photoshopped.
  2. White House lights turned off because of riots: photoshopped photo from the Obama era.
  3. Tear gas ordered to facilitate a photo shoot: the Park police deny that they used tear gas.

About that tear gas, there’s proof in the photos and videos they didn’t falsify (yet?): the police aren’t wearing gas masks.

Here

And, here, where neither the horses nor the police are affected the way they would have been by tear gas.

Please leave comments at my WingRight Facebook page.

Right to Life, COVID, 16 May, 2020

The “Right to Life” means the negative right not to be killed by intentional acts. It’s not the right to force others to invest our life, liberty or property other than the duty to intervene against infringement. This is a basic negative right, not a positive right.

There’s a huge difference between personal responsibility in avoiding a risk to yourself and actively causing harm to someone else. Self-defense rather than selfish demands, using only appropriate force on others.

You know, the old “your right to swing your fist ends at my nose!” (Especially Appropriate in this case.)

*You* take the actions *you* believe are responsible. Only frequent places/businesses that require masks if you want, do the work necessary to maintain the social distancing you are comfortable with. Don’t force everyone else to do your work for you.

In-Justice “In like Flynn” (after 3 years)

This all makes me physically ill. Documents withheld for over 3 years.

Hand written note “get him to lie.”

Special ProsecuterMueller’s investigation had some of these documents. Did Horowitz?
I have said that justice died the day that Kelo was decided and Terri Schiavo was killed by medically pulling her feeding tube & threatening her mother with Sheriff’s deputies guarding her to ensure dehydration.

Then, Comey pulled his Hillary stunt and the DOJ handed out immunity like candy. Then, the Russia hoax, and impeachment with Schiff claiming ownership of interview documents.

Law enforcement forcing the elderly to sit on sand rather than beach chairs and parents arrested for playing with their own children.

Now FISA courts subverted, 66 yo’s are arrested in their homes in SWAT assaults, and this, with Flynn. The FBI leadership planned to go after Flynn, in order to prosecute or get him fired.

Then, the documents and others proving the plan were held – hidden – for over three years in spite of a judge ordering them turned over.

The real story is the lies they told, and especially the fact that they hid these documents 3 years after they were ordered by a judge to turn them over!

They didn’t appeal the judge’s rulling: they obstructed justice, hiding and denying their existence! The Sztrok/Page texts were supposedly destroyed, remember? Then some were turned over as if the complete record.

Justice is dead and the body has been repeatedly mutilated.

Edit: 509 PM AST 30/04/20 To add 2nd & 3rd to last paragraphs BBN

Test the story! (COVID-19 Fake News)

Even after all this time, bad explanations – fake news and myths – are being spread in Social media about COVID-19.
One of the more pernicious is the accusation that the hypoxia caused by COVID-19 isn’t due to pneumonia or ARDS. Oh, no, instead, there’s a “secret, ” new mechanism for the morbidity and mortality caused by COVID-19. The theory is based on the fact that one of the complications in the sickest COVID-19 patients, as well as earlier SARS1 and MERS patients, is increased coagulation that causes lots of tiny blood clots in the tiniest blood vessels in all the organs if the body. We’ve known for quite a while that viruses cause inflammation, causing the body to inappropriately produce antibodies against proteins called phospholipids. These antibodies attack the platelets and red blood cells, causing blood clots.
Last night I was referred to what my Facebook friend, a non-physician, called “one of the more detailed links” on the research. I would hate to see the others.

Right at the top of the page is this disclaimer: “”Anyone can publish on Medium per our Policies, but we don’t fact-check every story. For more info about the coronavirus, see cdc.gov.'” Good advice.

The author the blog post isn’t identified except by a pseudonym and avatar. While he does admit that he’s not a doctor, we aren’t given a real name, much less a profession or qualifications and clicking on the avatar yeilds no information. There’s not even a link or citation for the origin of the “scientific” quote upon which he bases his entire premise.
(In contrast, a quick Google search, “Coronavirus red blood cell iron,” yeilds an article,“Debunking the hemoglobin story,” by a man who not only gives his name, he also describes his credentials, a seven (7) year MD/Ph.D program in hematology. He tells us he is writing with two other, *named,* Ph.Ds. Dr. Armdahl is worth reading for more detail than I give, here.)
The pseudonymous author has a brand new explanation for the hypoxia due to COVID-19: the virus supposedly breaks iron free from the hemoglobin molecule in red blood cells (RBC), poisoning the cells so they can’t carry oxygen. That is proposed as the cause of hypoxia, low oxygen, that leads to the need for increased oxygen and ventilation, as well a being responsible for the damage to organs other than the lungs.
The first author describes the virus “attacking” the red blood cell (RBC) with a “glycoprotein ” produced by the virus. He’s apparently unaware that the RBC does not have a nucleus or the cellular apparatus to produce proteins, much less copies of viruses. That’s a dead end for that virus particle and for any virus that does work that doesn’t enable reproduction.
Further, where is the evidence that these glycoproteins exist in the blood or bone marrow (where RBCs are produced) in concentrations that are significant? Where are the measurements of these mythical glycoproteins , any free iron or the RBCs containing free iron?
Why would there be a “secret?” ***What would be the purpose of the medical community ignoring a valid explanation of the etiology for morbidity and mortality due to SARS-CoV-2? *** The hematologists would be all over this.
The pseudonymous writer isn’t happy with promoting fake physiology and function of the RBC. He also displays his ignorance of the fact that we’ve known at keast since 2007 that the proper treatment for ARDS is low, not high, tidal volume ventilation. More important still, are personalized ventilator settings. More information, here.
If I may make a suggestion, when you come across a story that interests you and that seems new and significant – especially if it’s outside your area if expertise – don’t just share it. I suggest that you do a search looking for evidence that it’s false, as well as evidence that it’s true. Test the story!

#BVILove, #Coronavirus Delayed, not “beaten.” (One small country’s COVID-19 story)

Here in the small Nation of the British Virgin Islands, we’ve delayed, but we haven’t “beaten,” or completely avoided, the disease caused by the novel, or new, Coronavirus, COVID-19. Everyone who hasn’t yet been infected is still at risk. A lot of us will eventually catch the virus if and when we once again interact with the world at all.

If you want to learn about the current state of the science, this video is excellent by a fantastic teacher.

The Nation has done an excellent job of blunting the effect of the disease, beginning with closing all ports of entry to everyone except residents, back in March, followed by a 6 day “lockdown” with an in-home curfew at night and limitedbusiness and shopping.

Beginning about April 2, Government began enforcing a 24 hour in-home curfew, shutting business and forbidding residents from leaving our homes.

There have been 5 people with positive tests. 4 of them caught the disease in other countries and one person may have caught the disease from the last of those 4. The first 3 had mild cases and appear to be recovering.

Unfortunately, that last case was a woman whose disease was only discovered when she became very sick and had to be admitted to the hospital. She died the next day. One of her contacts has tested positive, but has mild symptoms. Unfortunately, not all of the people she might have interacted with have been identified and tested.

Hopefully, over the last 6 weeks, the BVI health department has had time to plan and prepare for multiple sick patients.

Even more: I hope that researchers around the world will come up with good treatments and discover why some patients get so sick so fast.

If there’s ever a vaccine, it’s years away There haven’t been any successful vaccines for other human strains of coronavirus.

It appears from some recent random testing in the US, that about 25% – 30% of an exposed population contracts the disease. Most either have no symptoms or mild symptoms. A small minority gets sick enough to be hospitalized, and a fraction of those end up in the ICU.

You may have heard about the high “case fatality rate,” reported anywhere from 0.01 to 10. Remember that this statistic only counts those who have been tested, predominantly those sick enough to be admitted to the hospital.

There is good news in addition to the fact that most infected people have mild or no symptoms: evidence that we have immunity after recovery comes from one of the treatments undergoing research: serum containing antibodies from the blood of recovered patients helps other people get well.

The scary part of the story is that the virus is very contagious, largely because people without symptoms can spread the disease. Medical personnel have been surprised by what appears to be the unprecedented, rapidity of the onset of Acute Respiratory Distress Syndrome (ARDS) in some patients, usually about day 12 to 14 of the symptoms. In a matter of a few hours, patients become very short of breath, requiring intubation. 80%- 90% of those intubated have died in the ICU.

The virus can also cause the body to produce proteins causing increased coagulation (the tendency for blood to clot). It also can directly infect the heart muscle and brain.

As our country opens up, and goes back to (relatively) more normal interaction, it’s important to remember that infected people may not have symptoms, but are still able to share the virus and spread the disease. They don’t know they have it and you certainly can’t tell by looking at them.

We will probably see our neighbors continue “social distancing” and wearing face masks when we leave our homes. And yes, inevitably, some of us will get sick.

“Mostly False,” Politifact “Fact Check”

Researching the what-about-isms & dueling accusations about who didn’t take the novel coronavirus seriously enough, soon enough, I came upon a “fact check” on PolitiFact that defies understanding except as a lie. An intentional lie.

Let me tell the story with screen shots, no more.

“Mostly False”

Biden quote Number 1:

Biden quote link, here

Biden quote Number 2:

Link, here

Biden quote number 3:

Link to this quote, here.

Front lines in the ICU with COVID-19

Reality is teaching a hard reality lesson with COVID-19.

This video concerns the minority of COVID-19 patients who require intensive care and the less than 1 percent who die of the disease. The discussion about the course of the disease and treatment is possibly too technical and brutal for the general public, so watch the whole thing with care.

However, I’m hoping to spur conversations about end of life in light of the broader COVID-19 crisis and specific crisis events.

This is a tough, highly technical discussion between Dr. Zubin Damania, a blogger otherwise known as “ZDoggMD” and Barbara McClean, MN, RN, CCRN, NP-PC, an expert in Critical Care & Intensive Care medicine in an Atlanta, Georgia teaching hospital with over 100 ICU beds. The first few minutes show Barbara McClean as a compassionate caring practitioner and educator. I believe and trust what she says about the worst case (stressing, again: fortunately these are the minority!) outcomes with COVID-19.

If you want to get to the meat of the video, there’s a “philosophical discussion” about the very real, unique in this modern age, futility of CPR in COVID-19 patients whose hearts stop due to the disease at 35:00 to 41:00.

There’s also interesting information about Personal Protective Equipment (PPE) difficulty (not shortage, but the physical reality) at the segment 30:00 to 35:00 minutes.

COVID-19 is, as Ms. McLean says, an unpredictable, sometimes deadly disease. Currently, patients can go from minor symptoms to death due to respiratory failure and cardiac arrest in as little as 4 hours. There is very little success to date in attempts to resuscitate patients who “code,” whose hearts stop, while in distress due to the virus.

I can’t stress enough that we need to talk, we need to make decisions among our families and to understand that this disease takes some options, some autonomy we have come to assume are our rightful “choices,” completely off the table. This disease doesn’t care what we want.

I’m unable to turn comments back on for this post. Please post comments to my Facebook page and I will try to keep up with replies. Let’s keep this on the level of philosophy and medical ethics. I will delete political criticisms.

Let’s keep this on the level of philosophy and medical ethics. I will delete political criticisms.

People ‘shed’ coronavirus early, but most likely not infectious after recovery

A study of only 9 people, but it’s a start.

Essentially, you can spread the virus even when your symptoms are mild, but probably won’t after 8 days.

Don’t eat the COVID-19 (Coronavirus)

The good news is that we were warned and it’s Spring, not Winter. (And we don’t routinely greet acquaintances with real kisses in the US.)

The really good news is that you aren’t helpless.

Chances are, most of the people who get sick picked the germs up with their hands and put them in their mouth, nose or eyes. (Gross, I know, but, trust me, I’m a doctor and a mother. I can be more gross than that when I want to get your attention.)

I tend to be a skeptic about panics, and so much of the news coverage about coronavirus is political hyperbole, but … I’m reading some worrisome stories from doctors dealing with the outbreak of COVID-19 in Italy.

Don’t panic, and don’t share! The coronavirus is spread by particles, droplets that have to enter your body by way of your nose, mouth or eyes. While it’s possible that someone might infect you by sneezing or coughing in your face, most viral infections are spread because of poor personal hygiene.

Virtually no one is immune to this coronavirus and we won’t have a vaccine for months, so people are panicking. I’m not, and here are some reasons why:

The US isn’t Italy. For one thing, we have a younger population. And, although the Lombardy region in Italy is modern and advanced, we have a higher intensive care capacity.

After all, we easily absorb the burden of influenza: up to 49 million infections, half a million hospitalizations, and 50,000 deaths every year due to influenza and hardly anyone even notices.

And we’ve had more warning than they did.

Here’s how fast influenza spreads each year in the US. If we don’t practice excellent self- protection, it’s a preview of how fast COVID-19 could spread.

Confirmed hospitalization history for Influenza in the US. Red = 2019-20, Orange =2017-2018

What’s the rate of spread of influenza in the US each year? This year? The graph above shows the historic rates of confirmed hospitalizations in the US. The red line is this year and reflects just over 16,000 patients, so far. The bright orange at the top is 2017, when we had a poorly matched vaccine.

There have been 200,000+ positive influenza tests reported to the CDC this year, 16,000 hospitalizations, and 136 pediatric flu deaths – not elderly patients with chronic diseases – this year.

We call it “seasonal” influenza for a reason. People tend to share the virus more in winter because of Thanksgiving and Christmas gatherings (and travel) and because children are in school. Sharing germs.

The coronavirus cases in the US sometimes have unknown “patient 1,” but the bulk have all involved clusters of patients with known physical and/or close contact with someone who was sick. The deaths have mainly been patients in one nursing home and a (different) hospital. In these sites, sick people were exposed to the droplets much more than you or I might be, because medical treatment accidentally aerosolized secretions.

COVID-19 symptoms are a fever over 100.5, a dry cough, and, for some, rapid onset of trouble breathing. Ther might be a runny nose or diarrhea, but there isn’t vomiting.

Use common sense and easy-to-achieve precautions. Wash your hands, don’t touch your face (eyes, nose, mouth), stay out of crowds, kindly and gently use what influence you have to encourage others to do the same.

If you get a fever, don’t go to the ER unless you are having trouble breathing. Call your doctor, and “self-quarantine.”

Most of all, Don’t share your germs and don’t pick up others’ viruses and put them in your body.

(Comments are closed. Please comment on my Facebook page.)

To kill or not to kill – or even to call it killing?

It seems that an advocate of Euthanasia and Assisted Suicide (EAS), which is legal in Canada since 2016, complained to the “The Protection of Conscience Project” administrators about their use of the word, “killing,” rather than “Medically Assisted Death” (MAD) when writing about the law. The wording of the objection exposes the potential limitations even on thoughts, much less the act of refusal, of physicians who object to participating in EAS.

In response, Sean Murphy, an Administrator of the Project, discusses and defines the acts and prohibitions involved in EAS, threatened conscience protection in law as decided by Canadian legislators and courts, and policy statements of the Canadian Medical Association.
A recent case decided by the Supreme Court of Canada considered “whether or under what circumstances physicians and institutions should be allowed to refuse to provide or collaborate in homicide and suicide.” While the Canadian courts have not made it illegal to refuse, the author points out that the Canadian Medical Association now considers EAS medical treatment. Although refusal isn’t illegal, if it becomes “unethical,” the licenses of conscientious objectors may one day be at risk. (Mr. Murphy let me know that the CMA is trying to respect both views)*
Just as all inalienable rights are dependent on the protection of the right to life, all medical ethics principles (autonomy, beneficence, justice) are based on the foundation of nonmaleficience, “Cure when possible but, first, do no harm.” This is the First Principle of Medicine.
The editorial gives an useful “litmus test” for discerning between ethical and unethical acts carried out under the umbrella of medical therapy: it’s considered a “failure” if the patient doesn’t die as a result of EAS.
In contrast, the intent of withdrawal or withholding medical treatment is not necessarily to cause death, but to stop acts that are unwanted or medically inappropriate because they do not heal, cure, slow the progression of the disease or relieve pain and suffering, but actually exasperate suffering and may cause damage beyond that inflicted by the disease.
To use a current case in the news in the USA (which I recently covered here), Baby Tinslee Lewis’ doctors wish to withdraw life sustaining treatment that they believe is medically inappropriate. The doctors would not consider it a failure if, rather than die of her severe heart and lung damage, she continued to live.
Canada is already far down the slippery slope of mandating participation in induced (elective) abortion and “MAD” by designating each as “therapeutic and medical services.” The Project Conscience authors rightly predict the possible consequences:
“[I]f the state can force unwilling people to kill or help to arrange for the killing of other people, there would seem to be nothing that the state cannot demand of its citizens. This would promote the development of dangerous forms of authoritarian and even totalitarian government: ultimately more effective and deep-rooted, perhaps, within a democratic framework than they ever have been in dictatorial regimes.”

(*EDITED An earlier version stated that licences were at risk. Not yet.

BBN 11 February 2020 12:30 AM)

More thoughts on Texas Advance Directive Act

I was asked about the #BabyTinslee case and what we should do, what can we do, in the disputed cases.

We need to educate more. People don’t understand basic medical ethics in this day of “choice.”

Autonomy doesn’t supersede nonmaleficience. In other words, the First Principle of medicine, “Cure when possible, but first do no harm,” always should guide us, rather than “wants” or “choice.”

In the end, doctors are the ones actually performing the acts and we’re most likely to understand the projected outcome. We benefit from oversight by colleagues and the community, both informally and in the process prescribed by the Texas Advance Directives Act.

Some people demand that every one of these cases go to court, for “due process” and “cross examination.”

But judges and courts can’t be as knowledgeable as doctors are. Their decisions are necessarily informed by dueling (paid) lawyers and (hired) medical experts.

In all the cases that have gone to court, the family has had quite a lot of notice, but the 48 hour notice before the committee meeting is perceived as too abrupt, especially since the relationships all appear to be adversarial by that point.

(And who could get your family to a meeting in 2 days?)

The 10 days isn’t thought to be long enough to arrange a transfer, either. Again, in many of the Court cases, the attempts to find another doctor willing to accept the patient’s care has begun before the committee meeting.

Doctors acknowledge the great trust and privileges we are given by agreeing not to abandon our patients. When we have a disagreement with a patient or surrogates (usually a familymember), we accept that we must continue treatment for a period of time. But not indefinitely.

If we could get the reforms that have been attempted to lengthen the statutory timeframe (multiple times) since before 2005, the TADA would be much better. It’s still the best process we have, currently.

A Lawyer, A Life, A Lie

Lawyer Wesley Smith has done good work in the past on end of life issues, but he is once again lying in order to score political points.

In his January 7, 2020 op-ed column for National Review, Smith accuses the doctors in the Tinslee Lewis case of wanting her to die, writing, “continued life is precisely what the doctors/bioethicists don’t want.”

Smith laughably misnames Texas’ Attorney General, Ken Paxton:

(He’s also evidently unaware that Tinslee’s “parents” are actually a single mother. Which would be irrelevant other than the fact that he refers to the “parents,” so often.)

Mr. Smith is so wrong. The doctors do not want Tinslee to die. They want to stop causing her near death several times a day.

They want to do for Tinslee,  not to her.

Tinslee’s doctors report that due to the delicate balance of Tinslee’s lung capacity and heart function she has 2-3 “death events” every day, each of which requires aggressive resuscitation efforts.

The difference between doctors and this lawyer in the tragic case of Tinslee Lewis is that the doctors are at the bedside all day, every day.

The doctors are the ones putting their hands on and minds to work for Tinslee while  Smith sits in his office calling them murderers and writing about coercing them to act against their best medical judgment. Her medical records submitted to  the court report that her doctor and nurses often spend time educating and counseling Tinslee’s single mother.

Shame on lawyer Smith for once again distilling months of highly competent, complicated and excellent care down to an accusation of murderous intent.

That’s a lie.

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