Bioethics

Truth, Logic, Siri, and PCMag.com

The Lord does work in mysterious ways, but most of the time He just uses the laws of physics and the logic that He invented. Still, I was surprised to find an argument for pro-life versus abortion logic on a technology blog at PCMag.com. And the simple logic of pointing out that abortionists don’t use the word “abortion” when advertising their services is much more telling than I believe the author knew.

“”Siri is doing exactly what it was built to do—provide answers to questions like, “Where can I get an abortion?” using its own algorithms and the online resources it has available to craft answers.

***********

“”Consider the current kerfuffle. This is simplifying things a bit, but the gist of this story is that Siri is getting hung up on a word, “abortion,” because organizations that actually offer abortion services tend not to use the word as much as anti-abortion organizations do. So when Siri goes looking for where to get an “abortion” in the digital wordscape of the Internet, lo and behold, it returns addresses for Crisis Pregnancy Centers rather than Planned Parenthood.””

(via Siri is Dumb. There, We Said It. | News & Opinion | PCMag.com.)

Or, it could be Steve Jobs’ last word from beyond the grave reminding us of all we could have lost if his mother hadn’t chosen life rather than abortion.

For those who don’t use the iPhone: Siri is a voice-activated program that searches for answers to questions. Think of a “Google” that you can talk to.

Okay, I will admit to a lot of bias in favor of protecting the lives of our children of the future.  I’m a pro-life advocate and serve on a couple of Boards for Pro-life advocacy: Texas Alliance for Life which lobbies for pro-life laws and regulations in Austin, Texas and even a “Crisis Pregnancy Center,” Options for Women in New Braunfels, Texas.   But this irony is too rich.

There is no big conspiracy paid for by “anti-abortion” forces to influence us to “Choose Life.” Steve Jobs most likely didn’t set this up before his death in order to contrast his adoption by loving and nurturing parents with abortion and to remind us of what we lose by the death of every child whose life is intentionally ended before birth.

And this is not a “glitch.”

The Creator of the Universe didn’t have to break a single law of nature to point out the simple fact that abortionists don’t tend to admit what they do. Truth and Logic worked as they should in this case.

The Philosophical Argument for Life | Opinion | The Harvard Crimson

Let’s hear it for the class of 2014! Here’s a great example of a thinking young woman who wrote for the Harvard Crimson. The Comments are very good, too!

In response to the growing hostility toward discussion of the abortion issue on campus and dissolution into name-calling, as seen in the impressively consistent vandalism of Harvard Right to Life’s poster campaigns, I’d like to present a philosophical argument for the pro-life position. HRL’s innocuous “Smile, your mom chose life.” posters have been ripped down within hours of posting almost without exception. At a school where free speech and diversity are valued so highly, this is a travesty. However, it seems to follow from the fact that the Harvard community limits its dialogue about abortion to religion and politics. I will set these aside to address the ethics of the situation, without which reasonable discussion is impossible.

The reason there is so much tension and so little understanding between individuals of differing opinions on the abortion issue is that the two sides approach it from completely different angles. The “pro-choice” side emphasizes women and their rights while the pro-life side focuses on the other person involved. We can all agree that women should have control over their bodies—but it is imperative to determine whether or not a second person is involved before we can talk about women’s rights.

The philosophical argument for life has two simple premises one from natural value and one from natural science.

The premise based on natural value is that all human beings have the right to life because they are human. Surprisingly enough, this is the premise that most pro-abortion philosophers will disagree with in the modern debate—they will deny universal values altogether and argue instead that values are simply subjective.

The premise based on natural science is that the life of each individual mammal begins at conception. Modern science has made it nearly impossible to defend the view that the fetus is not human, considering that from the moment of conception it has human DNA, so the issue centers on personhood. If the human is a person only when neurologically functioning as a human, then by that same argument it would be permissible to kill people while they are in deep sleep, in comas, or mentally handicapped. Similar arguments can be made for location and viability. The only time when we can consistently argue the human fetus becomes a person is when he or she becomes human: at conception.

via The Philosophical Argument for Life | Opinion | The Harvard Crimson.

Geron Awarded Grants (under ObamaCare Stimulus)

Just one more failed “stimulus” project? This past week, Geron announced they are no longer pursuing their research in embryonic stem cells. They laid off 66 employees.

The US government should never have been in the business of picking and choosing business winners and losers. We certainly shouldn’t be giving money for destructive embryonic stem cell research.

Included as part of the Patient Protection and Affordable Care Act of 2010, the QTDP program provided a tax credit to encourage investments in new therapies to prevent, diagnose, and treat acute and chronic diseases. Companies, such as Geron, that cannot currently use a tax credit were allowed to apply for a cash grant

in lieu of a tax credit.

To be eligible for the program, projects must show reasonable potential to result in new therapies to treat areas of unmet medical need; prevent, detect, or treat chronic or acute disease and conditions; reduce long-term health care costs in the United States; or significantly advance the goal of curing cancer within a 30-year period.

In addition, preference was given to projects that showed the greatest potential to create and sustain (directly or indirectly) high quality, high-paying jobs in the United States, and advance United States competitiveness in the fields of life, biological, and medical sciences.

Projects were selected jointly by the Treasury Department and the Department of Health and Human Services.

via Geron Awarded Grants Under Qualifying Therapeutic Discovery Project Program.

Geron To End Embryonic Stem Cell Research : NPR

Geron is getting out of the business of doing Embryonic Stem cell research. Trust me, if there were any objective truth to the idea that destructive Embryonic Stem cells could make money, the Corp. would stay in.

From NPR:

Earlier this week, the Geron Corporation announced it was abandoning its research into using embryonic stem cells to treat spinal cord injury. Geron was the first company to get the green light from the FDA to conduct clinical trials using embryonic stem cells. That was way back in 2009. And now, citing, quote, “capital scarcity and uncertain economic conditions,” the company is looking to sell off that part of its business and focus on other work.

via Geron To End Embryonic Stem Cell Research : NPR.

Sexual Harassment is About Power, Not Sex

L.L. Lewis has written about her experience as a 17 year old college freshman, My surreal experience reporting staff sexual molestation to my college administration,” published in today’s American Thinker website.

“How many will blame this woman for writing her story now and claim that she’s exploiting Herman Cain’s “troubles” or the Penn State sexual molestation cases? She’s just asking for it, right?

Ms. Lewis did the right thing, even as a 17 year old, and was treated as though she was the perpetrator, not the victim. “Blame the victim” is common in sexual harassment and that is one reason why the perpetrators get by with it.

What’s often overlooked when we discuss sexual harassment is that the abuse is not due to sexual needs or attraction.  At its base is the power and control that the abuser believes he has. He does it because he can, because he’s smarter than the rest of us, and – because of the sexual element introduced by his actions – he can get his thrills (even without actual sexual acts) and she will be intimidated, limited and/or humiliated  – even more than she already is – if she objects.

The abusers are usually in positions of some power, but not always. They like to take advantage of hourly wage earners and students, but even professional women are not immune. The common thread is that there is some element of “deniability.” — because who would believe them? “He said/she said” is a powerful accusation as well as a comment on the circumstances.

Like this doctor: it’s just part of his job, he was just being friendly and helpful, making a joke, or it was just a compliment, etc. She misinterpreted, needs a sense of humor, or is fantasizing or is just plain ol’ crazy. And  – wait for it – she hates men or is prejudiced for some reason against the man.

There is also an underlying theme among those who should react and protect that “There but for the Grace of God go I,”  and the very real liability that lawsuits could bring. That’s why the Dean of Students in this story made such a point about the doctor being a good husband and family man: part defense, part inoculation against similar accusations.  Who among us has not had some moment when we were tempted or inadvertently found ourselves in a near-compromising position? And everyone has heard the stories about the litigious, gold-digger, the temptress who becomes the scorned woman and exploits laws against sexual harassment for money, advancement or out of meanness.

One of the best things my parents did was to teach me to speak up for myself and to protect myself. I remember Daddy teaching us girls “where to kick” when we probably were too short to kick “there.”  We certainly didn’t have any idea *why.*

I’m not saying that every act of sexual harassment is really threatening or requires a response. I would be willing to bet that every woman and most men remember some episode when they knew that they were made uncomfortable because of their gender, whether in a sexual way or professionally. Most of us let it slide, ignored it and learned to deal with it. I’m proud of similar times in my life. But my cheeks still burn at the memory of others and a couple are just confusing. I am also proud of times when I stood up to harassers and of the couple of times when I defended others.

There are certainly times – as with Mr. Cain’s troubles – when we must judge who is the victim and when “He said/She said” is all we have to go on. My wish is that we who call ourselves Conservatives will attempt to lay aside our own prejudices and emotions to defend the true victims.

TEXAS ALLIANCE FOR LIFE FILES BRIEF IN 5TH CIRCUIT COURT OF APPEALS TO DEFEND TEXAS SONOGRAM LAW

Medicare meltdown, Obamacare next

Texas Medical Association held our Fall Conference today, and the theme was the “Calendar of DOOM!” I’m afraid they’re right.

(Since the Bastrop fire was only  a few miles east of the Austin location, it’s sort of unfortunate that the slogan was “Don’t be burned!” The graphics showed lava flow and volcanoes, but still!)

Even if “Obamacare” is repealed tomorrow, doctors and patients are facing huge  changes in the next few months. It’s too late to avoid a lot of these changes, unless Medicare rules are overturned completely.

Docs who didn’t use electronic prescribing have until Nov.1 to file with Medicare for an exemption to avoid losing an extra 1% on Medicare payments next year (it’s too late, trust me).

The Centers for Medicare and Medicaid have hired private contractors, called Recovery Audit Contractors (RACs), to review doctors’ notes and billings. The RACs make more money if they find more mistakes in the doctor’s office. Errors will be counted as fraud, and fines will be placed. Docs’ will pay up or have their payments from Medicare held, even though they appeal.

All of us who see Medicare patients face a 29.5 % cut as of January 1, 2011.We’ve faced cuts under the inappropriately named “Sustainable Growth Rate” for Medicare (where the more patients are seen, the less doctors are paid because the total spent wasn’t supposed to increase) (see this explanation), but they’ve always been deferred.  Under the “Super committee” legislation that was created under the law that allowed for that last increase in the National debt level, I wouldn’t be surprised if some of this cut goes though.

Doctors have been very restricted in our ability to invest in labs, hospitals, and medical businesses for years. Next year that will be decreased even more. Bean counters, lawyers, anyone other than a physician may own a hospital.

And then, there’s an HMO/capitated managed care plan that was pushed by President Obama and included in Harry Reid’s midnight move to pass “health reform,” called “Accountable Care Organizations.” (Watch this cartoon.)

The Centers for Medicare and Medicaid published rules yesterday

Remember those examples of ideal hospital systems that President Obama used back when he was selling his healthcare reform?  As soon as the law was passed, and we were able to read it, those systems declined.

During the health care debate, the Mayo Clinic, the Cleveland Clinic, Geisinger Health System and Intermountain Healthcare were repeatedly touted as models for a new health care delivery system.

Now, they have something else in common: All four have declined to apply for the “Pioneer” program tailor-made by the Obama administration to reward such organizations.

while keeping costs down. The ACO provision became one of the most highly anticipated elements of the health care overhaul, and providers embarked on a frenzied race to join in as quickly as possible. (via ‘Poster Boys’ Take A Pass On Pioneer ACO Program – Kaiser Health News.)

Stay healthy, y’all!

“If Only There Were A Vaccine for Hysteria” Redux*

World Net Daily sometimes goes off the path, but this time, they are posting emotional noise in the article, “’My headache’s about to explode’: U.S. girls just dropping dead.”  Author Joe Kovacs even goes so far as to support the claim by the organization, Judicial Watch, that the vaccine against Human Papilloma Virus, Gardasil, is harmful by citing a case of “meningococcal disease,” caused by the bacteria, Neisseria meningitides.

The article or the claims have no basis in fact. There was one case of anaphylactic shock, but no other deaths due to the vaccine. There has been no pattern of serious adverse effects and the major problems have been sore arms and fainting which looks like a seizure to those who haven’t seen it before. (I’m a Family Physician who has had fathers faint in my office and the hospital while watching procedures or shots. Mothers tend to sit when I ask them to, so they’re less likely to faint.)

Gardasil is not derived from the actual HPV virus. It is made the same way that insulin is made for patient injection for diabetes: bacteria is tricked into producing proteins that “look” like bits of the virus, but are never in any way active as an infectious agent.

The article notes that there have been over 35 Million doses of Gardasil given in the United States. We have 10 years of experience. Back in 2006, before Governor Rick Perry made news my adding Gardasil to the list of mandatory vaccines for school children, we already had five years of history and reviews of the vaccine. We have all sorts of studies and surveillance going on currently. Take a look at the world-wide surveillance.

Everything that has an effect is likely to have a side effect. However, this article and the hullabaloo over Gardasil is hysteria. There are mechanisms that allow us to predict bodily reactions and enable us to practice medicine: we know how the body is likely to react to disease, a new exposure or stress, or to medications. There is no mechanism for the “my head is going to explode” symptom.

We do know enough to be able to say what does not have a basis in science. Science and medicine are getting *better* at predicting outcomes, not worse. Read up on “biological plausibility.”

In the comments, people are saying that the CDC and FDA are part of big conspiracy, that people shouldn’t trust their doctors. The reason that there are more recommended vaccines is because we are doing research to find more vaccines to prevent diseases, not because some horrible conspiracy is growing.

* We don’t have a vaccine for hysteria, although Michael Fumento called for one back in 1999, in his op-ed on a similar hullabaloo surrounding the anthrax vaccine.

Sequenom to Sell Down Syndrome Test 2 Years After Pullback – Bloomberg

Note the pretty “terminating the pregnancy” phrase that’s used instead of aborting the baby (or even the usual term used, “fetus”).

This new test will, indeed “change the conversation about abortion.” This news story, including comments from utilitarian bioethicist, Art Caplan, Ph.D., will move the conversation much earlier into the pregnancy and remind us about the risk to healthy children in healthy mothers from tests for genetic markers. It will also stir the debate on late-appearing diseases like Alzheimer’s dementia and breast cancer.

(Who knows, we might be getting closer to tests for behavioral tendencies or even the “gay gene,” if one is ever found.)

Sequenom doesn’t indicate whether there are false positives or what the accuracy is in women who are not at “high risk” for having a Down’s Syndrome child.

The blood test is accurate in detecting Trisomy 21, the genetic chromosomal abnormality that most commonly causes Down syndrome, 99.1 percent of the time as early as 10 weeks into a pregnancy, the San Diego-based company said in a statement. The test, and others that will be able to identify genetic abnormalities early in pregnancies, will alter the debate over abortion, said Art Caplan, director of the center for bioethics at the University of Pennsylvania.

“For many people this test makes it morally, emotionally and psychologically easier to have an abortion,” Caplan said in an interview.

Caplan said future prenatal tests may be able to indicate if the fetus had biomarkers for Alzheimer’s disease, or breast cancer, or other diseases. Those tests will raise questions about what issues will trigger potential parents to choose an abortion. A survey published last month in the American Journal of Medical Genetics showed that only 4 percent of parents with Down Syndrome children regretted having them.

Ethical Shift

“Ethically, we are now starting to see the shift in the issue of what counts as a medical disorder, what’s significant enough to test for, what’s a genetic disability or just a difference,” he said. “Many in the Down syndrome community would say it’s just a difference.”

via Sequenom to Sell Down Syndrome Test 2 Years After Pullback – Bloomberg.

Pro-life Pregnancy Centers sue Austin, Texas

In April, 2010, the Austin City Council passed an ordinance targeting Pregnancy Resource Centers (AKA “Crisis Pregnancy Centers”). The Liberty Institute , the Law of Life Project, the Texas Center for the Defense of Life and the Alliance Defense fund have filed a lawsuit on behalf of Austin Life Care and three other centers in Federal Court, citing free speech violations.

Disclaimer: These organizations are joined and supported by Texas Alliance for Life, whose Executive Director, Dr. Joe Pojman is shown in this photo. I’m on the Board of Directors of TAL.

(Seriously? The City of Austin doesn’t believe that it’s obvious to anyone that “Austin Life Care” is not an abortion provider??)

According to an article by “We Are Austin. com” published at the time, the ordinance was aimed at “limited services pregnancy centers,” and could result in fines:

The ordinance says two signs in black and white must read in English and Spanish, that states: “This center does not provide abortions or refer to abortion providers. This center does not provide or refer to providers of U.S. Food and Drug Administration approved birth control drugs and medical devices.”

Each sign must be at least eight and a half by 11 inches and the text must be in a minimum font size of 48 point.

Before the vote, council members questioned how the ordinance will be enforced. The city’s legal team said Austin police will not enforce it, no one will be arrested for not posting the sign, and that enforcement will be complaint-based only. Pregnancy centers that do violate the ordinance, however, can face a fine of $250 for the first offense, $350 for a second offense, and at least $450 for a third offense.

Joining Austin Life Care are the Austin Pregnancy Resource Center, the South Austin Pregnancy Resource Center and the Catholic Charities of Central Texas‘ Gabriel Project Life Center.  ALC has posted the signs, but the other three haven’t done so.

From local TV station KXAN:

The ordinance, which is the first of its kind in Texas, requires each PRC to post a sign at its entrance stating it does not provide or refer for abortions or birth control services. Two of the pregnancy centers refer married clients to primary physicians for birth control, and the third center provides information to women about natural family planning and abstinence, two recognized forms of birth control.

There is no requirement forcing abortion facilities to post signs or provide disclaimers stating what services they do not provide for women.

via Free speech lawsuit filed against city | KXAN.com.

Campbell files to oppose Wentworth for state senate seat | The Gonzales Cannon

Good news for Republicans in the Texas Senate District 25!

Since our current Senator refused to allow me to be introduced as “Doctor for the Day” at the Capitol last May because of my efforts to get him to endorse pro-life causes, guess who I endorse?

Dr. Donna Campbell announced Monday her intention to seek the Republican nomination for Texas Senate, District 25 in order to fill a void of conservative leadership.

Campbell ran unsuccessfully to unseat Congressman Lloyd Doggett in last year’s congressional races, carrying every county but one — Travis County — in that district. She will oppose incumbent seven-term Republican state Sen. Jeff Wentworth, who is viewed as a moderate by most party members.

The 25th District includes Guadalupe, Hays, Comal and parts of Bexar and Travis counties.

via Campbell files to oppose Wentworth for state senate seat | The Gonzales Cannon.

Hat tip to Conservatives in Action.

New Obamacare Regulations mandate contraception, re-define pregnancy as disease

Tomorrow is the last day to comment on the Contraceptives mandate that is included in the 2010 Patient Protection and Affordable Care Act, otherwise known as “Obamacare.” I believe that it’s okay to use real contraceptives – the kind that don’t kill anyone. I’m also cautiously convinced that Plan B doesn’t prevent implantation. (See “Plan B, How It Works and Doesn’t Work,” and “Plan B compared to withdrawal method.”)

However, I have real concerns that “EllaOne” might interfere due to its effect of lowering progesterone, even in post-ovulatory women, and I know that the IntraUterine Device (IUD), when placed early in the pregnancy works to prevent implantation.

The current Administration defines pregnancy as beginning at implantation, not at fertilization, in spite of the known fact that any in vitro fertilization lab tech can tell the difference between an embryo and an unfertilized egg.

Please write a brief e-mail to the Secretary of Health and Human Services, Kathryn Sebelius, at this address E-OHPSCA2713.EBSA@dol.gov

Here’s where to get more information:

MESSAGE TO HHS: “Pregnancy is not a disease, and drugs and surgeries to prevent it are not basic health care that the government should require all Americans to purchase. Please remove sterilization and prescription contraceptives from the list of “preventive services” the federal government is mandating in private health plans. It is especially important to exclude any drug that may cause an early abortion, and to fully respect religious freedom as other federal laws do. The narrow religious exemption in HHS’s new rule protects almost no one. I urge you to allow all organizations and individuals to offer, sponsor and obtain health coverage that does not violate their moral and religious convictions.”

WHEN: Please send in your comments to HHS by the September 30 deadline. Thanks! 9/1/11

Coffee prevents depression?

The bloggers over at the Junk Science blog disagree with the statistical significance of researchers who published an article using data from the Nurse’s Health Study. The article is published in the American Medical Association’s Archives of Internal Medicine.

chocolate

Personally, I’d have bet on Chocolate, but that data is still being cooked.

I’ve posted on LifeEthics.org about the link that previous researchers found between coffee and death from all causes (but only for women, not for men) and between coffee and the prevention of Alzheimer’s dementia.

I have often thought that people who become addicted to nicotine and who regularly use other stimulants to calm down are probably self-treating hyperactivity, possibly chemical/neurochemical depression.

A more thorough review is at WebMD.

Liposuction May Lower Certain Blood Fats, Researcher Says

This makes sense: if there are less fat cells full of stored fat, and less of them to fill after weight loss, then it is intuitive that there will be fewer circulating triglycerides.

Some of us have wondered whether those fat cells, when emptied after weight loss by dieting, cry out to be filled. (or send out hormones or hormone-like signals) to increase calorie intake.

The research doesn’t definitively prove that liposuction caused levels to drop, however, and an outside researcher questioned the value of the study.

The study looked at 270 women and 52 men who underwent either liposuction, a tummy tuck (known as an abdominoplasty), or both. On average, the patients were slightly overweight, although they ranged from nearly underweight to morbidly obese.

The patients underwent fasting blood tests before surgery, one month afterward, and again three months afterward. At three months after surgery, triglyceride levels dropped from an average of 151.8 milligrams per deciliter (mg/dL) to 112.8 mg/dL in patients who underwent liposuction alone, representing a decrease of 25.7 percent; they fell by 43 percent in those with levels considered to be “at risk” — that is, 150 mg/dL or more.

Levels of white blood cells also dipped after liposuction and in patients who had both procedures. (High white blood cell counts are linked with an increased level of inflammation within the body and have been associated with coronary heart disease, high blood pressure and diabetes.) Levels of cholesterol and blood sugar didn’t change significantly.

Commenting on the study, University of Colorado researcher Rachael Van Pelt, who has studied the after-effects of liposuction, said the findings are “virtually meaningless” because triglyceride levels vary from day to day, and the researchers didn’t include a control group.

via Liposuction May Lower Certain Blood Fats, Researcher Says – Health News – Health.com.

Build a straw man, make him die

When will the progressive left admit that ObamaCare is just one version of “spread the wealth? Because the healthcare plan mandates coverage for all illness or healthcare from first dollar, rather than only spending money for the indigent and extremely sick. Worse, the mandate enforces taxes, rather than allowing charity or compassionate care.

Slate.com has a blog post concerning ObamaCare written by Jacob Weisberg, entitled “Let him die.” The author flatly implies that one or more of the Republican Presidential candidates would let a patient die if he can not pay for needed care.

Forget that none of the candidates said any such thing. One man in the audience at Monday night’s debate for Republican Candidates  in Orlando shouted “yeah!” when one of the moderators asked Ron Paul the question. There’s dispute about whether the shout came before or after Congressman Paul answered, “No.”

This incident is being cited as “playing the death card” by another blogger, at the University of Chicago School of Law’s Richard Epstein, who  is not satisfied with calling Republicans names. He suggests that rationing is reasonable:

One telling illustration about this example is that Weisberg does not tell us whether the individual who receives this care lives or dies when the treatment is over.  If we assume the latter, the initial question is whether intensive care at, say, $10,000 to $20,000 per day represents the best use of social resources.  A bit of simple arithmetic says that society has spent $1.83 million to $3.66 million on a venture that may well have kept this person alive in a comatose state or have subjected him to repeated invasive treatments when hospice care may well have been preferable.

(Try not to think about “death panels.”)

Hat tip to Texas Medical Association and Drs.

Huntsman: Nation in “funk,” needs civil unions and embryonic stem cells

Are we sure he’s a Republican?

When asked about highly charged social issues such as abortion, gay marriage and stem cell research, Huntsman said he supported civil unions and believes stem cell research “holds out much promise.” But he said those issues will not be a priority if he becomes president and repeated a theme he hopes will resonate with voters. “I will have a singular focus on the economy,” he said.

via Huntsman: Nation in ‘deep funk’ | SeacoastOnline.com.

LifeEthics | Human Ethics. Human Life

This is exciting, although preliminary, research results. These researchers used what is known about stem cells to look for existing cells in the spinal cord. The genes that “switch on and off” are now known for quite a few stem cell lines and they are matched against all the cell genomes that we have in the data bank, or “Atlas.”

via LifeEthics | Human Ethics. Human Life.

LGBT patients: Reluctant and underserved :: Sept. 5, 2011 … American Medical News

I’ve taken care of pretty much the full spectrum of LGBT patients, including transexuals at various stages of surgical and hormonal therapy. I think the problems I see are very similar to people who don’t disclose all sorts of other things that they do or things that have happened to them.  I’ve had trouble when patients don’t disclose alcohol abuse or that they are survivors of sexual or physical abuse.

My best skill as a doctor is the ability, even when shocked, to deliver a non-committal, attentive, “Oh, okay. Tell me about it.” (and then be alert, patient, and quiet for a while.)

If I could teach doctors one thing, it would be to listen to their patients – especially when they seem reluctant to talk or “Oh, one more thing.” And if I could teach patients one thing, it would be that I really need them to talk to me!

In general, LGBT people have an increased risk of developing cancer and contracting sexually transmitted diseases, including HIV, experts say. They also are more likely to drink alcohol, smoke, use drugs, be overweight, attempt suicide and engage in other risky behaviors than heterosexual counterparts, according to physicians who specialize in treating LGBT individuals. Yet they remain medically underserved, data show.

Twenty-eight percent of transgender and gender nonconforming people postponed medical care when they were sick or injured due to concerns about discrimination, said a 2010 survey of about 7,000 people by the National Center for Transgender Equality and the National Gay and Lesbian Task Force. Gender nonconforming individuals are defined as people who do not fit stereotypes about how they should look or act based on the sex they were at birth.

More than one in five LGBT adults withheld information about their sexual practices from their doctor or other health care professional, said a 2004 survey by Witeck-Combs Communications/Harris Interactive.

via amednews: LGBT patients: Reluctant and underserved :: Sept. 5, 2011 … American Medical News.

amednews: Temporary health workers double risk of harmful drug mix-ups :: Sept. 12, 2011 … American Medical News

Several medical school faculty members and I were talking this week at the American Academy of Family Physicians’ national meeting. They confirmed that medical students and residents still do much of the “scut work” in the hospitals where they are trained. Some hospitals have evaluated the cost of training vs. the money saved by (very) cheap labor, and come to the realization that doctors in training save them tons of money over paid staff.

Just another reason to consider or re-consider funding for medical education in State and Federal budgets!

Health professionals working on a temporary basis in emergency departments are twice as likely to make medication errors that harm patients, says a study of nearly 24,000 drug mix-ups at 592 U.S. hospitals.

Most of the temp workers’ mistakes were administration mix-ups made by nursing staff, who accounted for 76% of the errors. Physicians were responsible for 21% of the mix-ups, and other health professionals accounted for the rest.

via amednews: Temporary health workers double risk of harmful drug mix-ups :: Sept. 12, 2011 … American Medical News.

One more time: Perry, Gardasil and the facts

Governor Sarah Palin and Congresswoman Michelle Bachmann went on Greta Van Sustern’s “On the Record” show on Fox News to accuse Governor Rick Perry of “crony capitalism” because of his Executive Order RP65, which would have mandated Gardasil and which did make it much easier for parents to opt out of all mandatory vaccines.

None of the players explain one very pertinent point: Merck was the only company making the only approved vaccine against the viruses that cause the changes that cause abnormal Pap smears and which lead to cervical cancer. (The only reason to get a pap smear is to check for changes from HPV. Gardasil provides immunity to the specific strains that cause nearly 3/4 of all cervical cancer.)

The Gardasil vaccine (more, here ) was recommended the FDA’s vaccine approval committee, more than 6 months before Governor Perry’s Executive Order. All girls who qualified for the Federal Vaccines for Children program were eligible to receive the vaccine free of charge: Medicaid, CHIPs, and uninsured or those with insurance that won’t pay for vaccines. The Texas Legislature had previously delegated unconditional authority to mandate new vaccines to the Department of State Health Services, which is under Governor Perry and the Executive Branch.

Congresswoman Michelle Bachmann showed her profound ignorance about the germ theory and modern medicine in general, and the Human Papilloma vaccine, Gardasil, in particular. She seems ignorant of the fact that newborns (little, innocent newborns) receive a shot against the STD, Hepatitis B, on the first or second day of their lives, before they go home from the hospital. They get 2 more of the shots by the time they are 6 months old. And (little, innocent) 12 year old boys and girls get a (measles/mumps/rubella) MMR and a tetanus and diphtheria booster (Td)  about the same time. Tetanus, or “lock jaw” is not a communicable disease.

in her zeal to attack Governor Rick Perry, Bachmann did even worse in her post-debate interview with Greta Van Sustern on Fox News. Her emotional, anti-vaccine remarks should be an embarrassment to her.

She told Greta about a conversation with a crying mom who came up to her after the debate, saying that the woman’s daughter suffered from “mental retardation” after receiving the vaccine. “Mental retardation” would not be diagnosed at 9-12 years old. In fact, in over 10 years more than 50 million doses of Gardasil have been given in the United States. There has been more than the usual scrutiny and surveillance for adverse effects. The Center for Disease Control, the FDA and the Institute of Medicine have all reached the conclusion that even with this heightened awareness and concern, there have been no adverse effects from this vaccine other than fainting and allergic reactions that can happen with any medical procedure or treatment.

At the time, Gardasil had over 5 years of history of study in boys and girls, with an official “Four Year Follow Up” article published in the British Medical Journal. To learn more, please see “A Dose of Reason.”

No Time For A Doctor’s Visit? These Apps Can Help | Fox Business

I’m not sure about this “app”

It’s not always feasible to make it to the doctor’s office for every cough and sniffle. Plus heading straight to your doctor can become costly. Here’s a look at apps that will help you maintain your health.

via No Time For A Doctor’s Visit? These Apps Can Help | Fox Business.

Hat tip to Politico’s @benpolitico

Robert P. George: Serious GOP Debate

Set your video recorder to CNN at 3 PM EST on Monday, September 5 in order to watch Senator Jim DeMint, Congressman Steve King, and philosopher and bioethicist Robert P. George question the  Republican candidates for President.  The forum will not be a debate, but a series of individual interviews at the Palmetto Freedom Forum in South Carolina.

Professor George has been called the smartest man in the US and I’ve blogged about him and quoted him many times (best, here) at LifeEthics.org.  As an admitted groupie of men like Professor George and Dr. Leon Kass (sorry guys), the Palmetto forum would be my dream forum!

“I think people are aware that things are not right,” George says. “They are not technical problems to be solved by choosing the best technocrat. . . . People have a sense that the problems run deeper than that, that they have to do, in a very significant measure, with a loss of fidelity over the years, a falling away from our own principles. . . . They are looking for a conversation that goes deeper.”

via A Serious GOP Debate – Robert Costa – National Review Online.

Abortionists ordered to follow disputed ‘informed consent’ law

The court found constitutional the state’s decision to demand abortionists tell patients three things:

That the abortion will terminate the life of a whole, separate, unique, living human being;

That [the patient] has an existing relationship with that unborn human being and that the relationship enjoys protection under the United States Constitution and under the laws of South Dakota;

That by having an abortion, her existing relationship and her existing constitutional rights with regards to that relationship will be terminated.

via Abortionists ordered to follow disputed ‘informed consent’ law.

Breaking: Obama asks EPA to withdraw proposed ozone rule | JunkScience.com

Wow, this would be great if it goes through!

From the “Junk Science” blog:

 

President Barack Obama has asked EPA Administrator Lisa Jackson to withdraw the agency’s proposed toughened ozone standards, citing “the importance of reducing regulatory burdens and regulatory uncertainty, particularly as our economy continues to recover.” The President’s statement is below.

These are rules that would provide no health benefits but cost $1 trillion per year in compliance and kill 7.4 million jobs by 2020.

If EPA administrator Lisa Jackson complies with Obama’s request (no guarantee), this will be a hugely important victory for American workers and the economy, as well as those of us who have been fighting the EPA’s proposed ozone standards.

via Breaking: Obama asks EPA to withdraw proposed ozone rule | JunkScience.com.

Ethical dilemma in fetal stem cell research – UK stroke study | LifeEthics

Ethical dilemma in fetal stem cell research – UK stroke study

“The world’s first clinical trial of brain stem cells to treat stroke has recorded no adverse effects to date, BBC News has reported. The BBC website reports that research using stem cells to treat strokes “is set to move to its next phase” after independent assessors approved continuation of the trial of the experimental treatment. So far the therapy has been tested on three patients left disabled by strokes.”

via Stroke stem cell trial gets extended – Health News – NHS Choices.

The problem is that the cells were harvested from the brains of 12 week old aborted fetuses. The researchers at the University of Glascow, Scotland, working with the company, “ReNeuron,” harvested the cells, manipulated them with genes to induce them to become immortal stem cells that will divide infinitely and now have what appears to an endless supply of proprietary cells for future research and treatments of stroke victims.

More at LifeEthics.org: Ethical dilemma in fetal stem cell research – UK stroke study | LifeEthics.

Rick Perry was right on binational health insurance – Ezra Klein – The Washington Post

Here’s an explanation about the “binational health plan that I keep reading about. Unfortunately, the Legislature only approved a study and there’s never been a law actually allowing the sale of the insurance plans.

To clarify, what Perry referenced was not a merging of Mexico and the United States’ public health systems. It was not, as Wonkette put it, “U.S.-Mexico Obamacare.” Rather, he pointed to a newly passed Texas law, which directed the state to explore allowing private health plans to cover services in Texas and Mexico. Those plans would then be available to any Mexican national or American citizen working within 62 miles of the Texas-Mexico border.

There’s a lot to like about this idea.

First, it targets a big problem in Texas: a lack of insurance. With 26 percent of Texans lacking insurance, the state has the highest rate of uninsured people in the country. Those numbers are even higher in Texas’s border region, according to a 2003 Texas State Senate report.

Second, it’s a private market approach, that would allow insurers to meet an unfilled consumer need. A 2005 study showed that 72 percent of Mexico-born residents of the United States would be interested in a product that covered medical services in Mexico, especially if they had dependents in Mexico who could use those services.

The plan Perry referenced wouldn’t have the state create such a plan. Rather,  it would alter Texas’s insurance regulations to allow private carriers to do so.

via Rick Perry was right on binational health insurance – Ezra Klein – The Washington Post.

Herald-Zeitung (Gesundheit!) and the AP: Dumb and Dumber

I was shocked to see that this morning’s  printed version of my own hometown paper, the New Braunfels Herald-Zeitung, featured a front-page article, “Texas to appeal judge’s ruling,” stating that Texas’ ultrasound law would force women to “undergo an invasive vaginal ultrasound.” This is a lie. Perhaps the problem is that the author only quoted  a lawyer for the New York firm that sued the State of Texas.

(The piece isn’t on the website, but it’s a reprint of the article by April Castro, available at the Houston Chronicle .)

As Federal Judge Sam Sparks wrote when denying the plaintiff’s claim that the law did not provide equal protection under the law because it only applied to women, “This legitimate interest obviously justifies “singling out” abortion providers and the patients thereof, because they pose a serious potential risk to “the life of the fetus that may become a child.”’

The State of Texas regulates physicians, not patients and HB 15 is a set of conditions that a physician must meet before performing abortions. The Supreme Court has acknowledged (along with other thinking human beings) that States (We the People, the rest of us) have a legitimate interest in promoting the life and health of both the woman and her unborn child and in protecting them from fraud and coercion. Nothing in the wording of the law would force anyone to undergo an “invasive vaginal ultrasound.”

Regardless of the oft-repeated claim that an ultrasound is not medically necessary, it is standard of care prior to all abortions. The website of one of the plaintiffs, Alan Braid, MD’s Reproductive Services of San Antonio, informs potential patients that an ultrasound is included in the abortion fee  and “to determine the length of your pregnancy.” It is also standard of care to use the Ultrasound to guide instruments being introduced into the vagina and uterus.

Sparks objected to the mandate that physicians must describe any cardiac activity or development of limbs and internal organs. This is medical information that belongs to the woman, not ideology.

Sparks also claimed that the State intends to “brand” women by having them sign an informed consent paper and the inclusion of that paper in what he called “semi-private, at best” medical records. He is afraid that the record might be used in the future in lawsuits against the doctor, ignoring the fact that this would only happen if the woman who owns the medical information is the one suing the doctor.

(Edited for better sentences, 10:15 AM. BBN)

Office of the Governor Rick Perry – [Press Release] Statement by Gov. Rick Perry on Injunction of Sonogram Law

Gov. Rick Perry today issued the following statement on U.S. District Judge Sam Sparks’ injunction against Texas’ recently-passed sonogram legislation:

“Every life lost to abortion is a tragedy and today’s ruling is a great disappointment to all Texans who stand in defense of life. This important sonogram legislation ensures that every Texas woman seeking an abortion has all the facts about the life she is carrying, and understands the devastating impact of such a life-changing decision. I have full confidence in Attorney General Abbott’s efforts to appeal this decision as he defends the laws enacted by the Texas Legislature.”

via Office of the Governor Rick Perry – [Press Release] Statement by Gov. Rick Perry on Injunction of Sonogram Law.

Critique of Judge Sam Sparks’ Opinion on Texas Ultrasound Law (part 2)

See Part 1, here
Media reports say that due to the injunction by Federal Judge Sam Sparks, the Texas Ultrasound law will not go into effect at all until a higher court rules on it. However, the Judge does note that there is a severability clause and that his injunction is narrow. I’m waiting to see opinions from lawyers as to whether abortionists will be held to parts of the law that are not specifically under injunction.

In the meantime, I wonder how many women will meet the abortionist before they are gowned and sedated for the procedure and how many will insist on seeing their sonograms?

In the second half of the Opinion by Judge Sam Sparks, the Judge outlines the specific complaints brought against the new law, HB 15, (text of the law, here ) . Most of those complaints are dismissed, even as the Judge continues to call the new law “unwise” and ultimately imposes an injunction against enforcement.

Sparks disagrees with the Plaintiffs, the Center for Reproductive Rights out of New York, that the definitions of “medical emergency,”  “sonogram,”  “in a quality consistent with current medical practice,” and “in a manner understandable to a layperson” are unconstitutionally vague.  He also disagrees with the Plaintiffs on whether or not “visit” and “abortion-related services” are unclear to most people.

The major complaints upheld by the judge appear to be that the law doesn’t allow for multiple-physician practices or for a switch if the original doctor who informed the woman about her ultrasound cannot, “through some unforeseen circumstances,” perform the abortion, requires a woman to sign an informed consent acknowledgement, and   forces the physician to “advance an ideological agenda.”  Sparks also does not like the word “soley,” for reasons that I don’t understand.

It is true that one purpose of the law was to ensure that women were given informed consent by the physician who was to perform the abortion, “in a private and confidential setting.” Most abortionists had been satisfying the 24 hour waiting period and informed consent the same way that Dr. Alan Braid’s Reproductive Services of San Antonio,  had:  over the phone  or by referring the woman to the information on the Internet.

However, it doesn’t appear that Sparks overturned these requirements, since the injunction overturns the objection to the requirement that women receive private and confidential informed consent and the exception for those who live more than 100 miles from the abortion clinic. The opinion only finds fault with the lack of accommodations for “unplanned substitutions.”

The judge makes a surprising statement about the requirement that a copy of the informed consent be inserted in the medical record of the woman:

Compounding this problem is newly-added section 171.0121, which requires both that a copy of the above certification be placed in the pregnant woman’s medical records (presumably permanently), and that the facility that performs the abortion retain a copy for at least seven years.See H.B. 15, Sec. 3 (adding TEX. HEALTH & SAFETY CODE ANN. § 171.0121). Given the nature of the certification and the Act’s retention requirements, it is difficult to avoid the troubling conclusion that the Texas Legislature either wants to permanently brand women who choose to get abortions, or views these certifications as potential evidence to be used against physicians and women.

Sparks says that the medical record is “semi-private,” and is concerned that it might someday be subpoenaed for use in a court case. The only time that these would be seen in Court is if the woman herself sues the doctor.

Sparks also engages in a bit of ideological speech of his own about the requirement for the abortionist to describe  “the presence of cardiac activity,” and “the presence of external members and internal organs.”

“ The Court does not think the disclosures required by the Act are particularly relevant to any compelling government  interest, but whatever relevance they may have is greatly diminished by the disclosures already required under Texas law, which are more directly pertinent to those interests.”

and, from page 50:

The net result of these provisions is: (1) a physician is required to say things and take expressive actions with which the physician may not ideologically agree, and which the physician may feel are medically unnecessary; (2) the pregnant woman must not only passively receive this potentially unwanted speech and expression, but must also actively participate—in the best case by simply signing an election form, and in the worst case by disclosing in writing extremely personal, medically irrelevant facts; and (3) the entire experience must be memorialized in records that are,at best, semi-private. In 7 the absence of a sufficiently weighty government interest, and a sufficiently narrow statute advancing that interest, neither of which have been argued by Defendants, the Constitution does not permit such compulsion.

Edit to add this question: How can a doctor “not ideologically agree” with the facts visible on the sonogram when describing heart or limbs?

In my opinion, the worst part of the ruling is Spark’s legal-speak on “compelling’ and his insistence on bringing back the ever-moving line of “viability:”

Second, while Casey refers to the government’s interest in potential life as “important,” “substantial,” and “legitimate,” it stops short of characterizing it as “compelling.” Indeed, one of the holdings of Roe v. Wade, and one this Court does not interpret Casey as having overruled, was that “[w]ith respect to the State’s important and legitimate interest in potential life, the ‘compelling’ point is at viability.”

Tell me, Judge Sparks, just what is “viability?” 24 weeks, 20 or 18 weeks?

link to Part 1 and “sticky” added September 5, 2011 12:19 PM BBN

Doing the work skilled providers won’t

Will someone tell me why it is logical for Federal Judge Sam Sparks to assume that “less-skilled providers”  will be willing to meet the “onerous requirements” that more-skilled providers won’t?

” The Court has grave doubts about the wisdom of the Act, but that is no legal basis for invalidating it. The Act’s onerous requirements will surely dissuade or prevent many competent doctors from performing abortions, making it significantly more difficult for pregnant women to obtain abortions. Forcing pregnant women to receive medical treatment from less-skilled providers certainly seems to be at odds with ‘protecting the physical and psychological health and well-being of pregnant women,’ one of the Act’s stated purposes.”