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Texas Advance Directive Act 2019 Legislature

The Texas Advance Directive Act is being attacked in the State Legislature, again, as it has just about every Session for the last 10+ years. In my opinion, one group is doing the bidding of the trial lawyers to destroy Texas’s tort reform by attempting to force every end of life treatment disagreement into the Courts.
Here’s my explanationof the Act, written in 2016, as an “effort to balance” patients’ rights and the rights of doctors to practice Medicine according to their consciences, using our best medical judgement. And here is an example of a previous attempt to truly improve the Act.
The opponents of TADA would force doctors to ignore their consciences to continue performing procedures and writing orders – for nurses and staff to carry out – against our best medical judgement, while faced with the moral distress of continuing acts that hurt our patient, as organ system after organ system fails, faster than we can compensate, prolonging and increasing his suffering and death.
For example, yesterday, the House passed a useless Amendment to a useless amendment to HB 1504, the Sunset review and reauthorization of the Texas Medical Board.
(22) in complying with the procedures outlined in Sections 166.045iand 166.046, Health and Safety Code, fails to make a reasonable effort to transfer a patient to a physician who is willing to comply with a directive.
Amendment No. 5
Representative Toth offered the following amendment to Amendment No. 4:
Amend Amendment No.4 by Toth to CSHB 1504 on page 3, line 25, between “Code,” and “fails”, insert “willfully”.””
The amendment is useless because doctors don’t handle or arrange transfers between facilities; the hospital social services staff and nurses do. The only possible exceptions might be ER docs in outlying areas, transferring to a larger medical center or a rare phone discussion between doctors about the patient’s course after the two separate staffs have worked out the logistics. Neither of these would apply in the TADA cases.
Importantly, how would the accusation of “willfully fails to make a reasonable effort” be made? Could there be more vague terms in that sentence than “willfully” or “reasonable?” (Especially in light of TRTL’s claim that 60 attempts weren’t reasonable in the tragic case recently ruled moot and dismissed by Texas 1st Court of Appeals, covered here and here.) Is this an attempt to criminalize the actions of doctors, an excuse to sue in a Court of law?
After the amendment passed, one of the lawyer lobbyists paid by Texas Right to Life tweeted a mean little remark:
The lawyer said that doctors who begin the process in TADA “set the 10 day count and sit on their hands.”
I understand that he never had to ask (to order) a nurse to cause pain to a dying patient, but he should understand that doctors don’t “sit on their hands” during the waiting period. We still perform those life sustaining procedures, write orders, and interact with the patient and family.
In order to push their view point they oppose not only other pro-life organizations, but the Texas Catholic Bishops, the Texas Baptists, and Texas Medical Association. Bills such as SB 2129 or SB 2089 would destroy TADA and undermine Texas’ tort reform.
Of course, once in the Courts, the lawyers would have to hire doctors to testify and the judges would decide between the two sides and order doctors to act against their consciences.
That, or lawyers and judges would be placed in the position of practicing medicine: writing medical orders for nurses and staff to carry out.
In the long run, the risk of civil and even criminal liability of caring for patients at the end of life would drive most doctors away from not only intensive end of life care, but increase the risk for any of us who care for trauma, oncology or geriatric patients.

Edit 19 April 2019 BBN: Comments are disabled here. Please comment at my Facebook page, “Beverly Nuckols.” https://m.facebook.com/story.php?story_fbid=10218835564657861&id=1163711361&refid=52&_ft_=mf_story_key.10218835564657861%3Atop_level_post_id.10218835564657861%3Atl_objid.10218835564657861%3Acontent_owner_id_new.1163711361%3Aoriginal_content_id.2226941544065344%3Aoriginal_content_owner_id.110756395683880%3Athrowback_story_fbid.10218835564657861%3Apage_id.110756395683880%3Astory_location.4%3Astory_attachment_style.share%3Apage_insights.%7B%22110756395683880%22%3A%7B%22role%22%3A1%2C%22page_id%22%3A110756395683880%2C%22post_context%22%3A%7B%22story_fbid%22%3A2226941550732010%2C%22publish_time%22%3A1555527649%2C%22object_fbtype%22%3A32%7D%2C%22actor_id%22%3A1163711361%2C%22psn%22%3A%22EntStatusCreationStory%22%2C%22sl%22%3A4%2C%22dm%22%3A%7B%22isShare%22%3A0%2C%22originalPostOwnerID%22%3A0%7D%2C%22targets%22%3A%5B%7B%22page_id%22%3A110756395683880%2C%22actor_id%22%3A1163711361%2C%22role%22%3A1%2C%22post_id%22%3A2226941550732010%2C%22share_id%22%3A0%7D%5D%7D%7D%3Athid.1163711361&__tn__=-R

Prenatal manslaughter?

Something to consider, from a question on Facebook about abolishing abortion and my discussionof the human rights of prenatal human beings:

I read the article. It seems filled with potholes to extend personhood to an embryo. Would then a mother who, through negligence, caused death or damage to the embryo, say [by] falling down the stairs or drinking alcohol, be guilty of manslaughter?

My answer:

The prenatal human is undoubtedly a member of our species, correct?

The risk of abusive prosecuters doesn’t negate the human right not to be killed or justify two classes of human beings, some with human rights, some not human-enough. It certainly doesn’t justify the current abortion on demand: New York’s abortion until birth or Vermont’s proposedconstitutional amendment that prenatal humans “shall not have independent rights under law.”

This is where there is a clear physiologic and philosophic difference between negligence after birth and before. There is no other human relationship equivalent to pregnancy and gestation. Before birth, she’s harming herself first, the child secondarily.

Just as some people had to learn to accept the full humanity of emancipated slaves, there will be a learning curve for the full humanity of the prenatal human. We can do better than Reconstruction and much better than Jim Crow.

There’s previous experience taking the unique relationship into consideration. We already deal with children harmed by alcohol abuse or born addicted to illegal drugs every day.

While there have been abuses, like the drug testing of mothers in South Carolina, it has been more productive to treat addiction than to prosecute as crimes.

*********

Please comment at my Beverly Nuckols Facebook page.

HB 896 Abolish abortion in Texas

#HB896 @TxLeg

The Texas Legislature only meets for 4 months, every other year. Every session, several Bills are introduced that would regulate abortion in our State. Monday night, April 8,the House Committee on Judiciary and Civil Jurisprudence, chaired by Representative Jeff Leach, heard testimony on HB 896, authored by Representative Tony Tinderholt. HB 896 would change Texas law to treat elective abortion for what it is: the intervention intended to kill a member of the human species. The law would require that abortion be treated the same as a felony murder is treated by Texas law: “entitled to the same rights, powers, and privileges as are secured or granted by the laws of this state to any other human child.”

You can watch the testimony in the House Broadcast Archives.

Those of us who believe in human rights must decide whether laws can legitimately divide humans into two classes: those members if our species who are and those who are not human-enough to possess legal, protected (“inalienable”) human rights.

Yes, the law would create complications in a world that’s become accustomed to the act of elective abortion, “spare” human embryos, fetal research on aborted children, and arbitrary “choice” as to which babies live and which are susceptible (in New York State, for instance) to killing on the day before they become citizens by being born.

However, we know how to deal with those complications, because of lessons we learned in our Nation’s history of slavery and the abolishment of slavery. The lives and livelihoods of slave brokers, slave breeders, and slaveholders were disrupted by declaring slavery illegal in the United States, with penalties.

The (dreadful) Supreme Court Dred Scott decision about the status – the “inferior” humanity – of Black slaves has never been overturned by the Courts. In that 1850 ruling, Chief Justice Roger Taney stated that the Constitution affirmed that black slaves were not only property, but “beings of an inferior order” and that they and their descendents could never be citizens of the United States.

Ultimately, a Civil War and Constitutional Amendments 13, 14, and 15 were necessary to outlaw slavery and allow black persons, including former slaves and their children, to become citizens. The 14th Amendment also protected non-citizens, prohibiting laws which “deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

A Constitutional Amendment may be necessary in this case, too, but I don’t think so, because of the way Roe v. Wade was decided.

Roe v. Wade is the Supreme Court decision that declared that there was a “right” to abortion under the Constitution. Justice Blackmun refused to

“. . . resolve the difficult question of when life begins. When those trained in the respective disciplines of medicine, philosophy, and theology are unable to arrive at any consensus, the judiciary, at this point in the development of man’s knowledge, is not in a position to speculate as to the answer.

“Man’s knowledge” has developed since 1973. Philosophers and theologians may still argue (as they do about the civil rights and personhood of neonates, the disabled, and the elderly) but the science is clear. Ultrasounds, MRI’s, and in vitro fertilization have all demonstrated when the life of human beings begins. Just ask the newest technician in the in vitro lab.

As a doctor, I deny that elective abortion is healthcare. I certainly deny that the baby in utero is a part of the body of the mother. It’s not logical to say that the embryo, then the fetus, is not the same organism that we call a baby as soon as he or she is born.

If nothing else, we now have evidence in the form of serial ultrasounds (US) and in vivo MRI’s that demonstrate that human life is a continuum that begins at fertilization.

Even 30+ years ago in training, I saw US used to follow an oocyte from just before ovulation, to the developing embryo in the uterus a few days later. We’ve all seen the US of children as they develop.

Just this month, a research article in the journal Developmental Cognitive Neuroscience reported on sex differences in functional connectivity of neural pathways in the brain, demonstrated by functional MRI of babies in utero.

Questions were raised by the Committee members and citizens alike about a possible death penalty for the felony murder of the unborn child, about women who are coerced into having abortions and whether or not the mother would be charged and subject to penalties.

Well, what penalty does the State impose for procurement of a contract to kill? What charges are brought against the mother who smothers her baby at birth?

It’s true that laws in Texas have never punished the mother who has an abortion. Part of that is out of compassion for the mother who is seen as a victim of circumstances. However, the main reason is that most laws regulating abortion have been passed under the legislation regulating medical practioners and technology, rather than as a civil or human rights issue.

In fact, abortion performed by the mother has always been treated as self-harm, like attempted suicide. But that custom was established before modern information about human embryology. It was long before medical abortion utilizing Mifepristone ( RU486) or methotrexate. We all know now that the mother is not killing a part of her body in an abortion and certainly not when she pays a third party to do it.

I believe that invoking the threat of the death penalty is a red herring. Our homicide laws recognize the right to kill in self defense (for the life of the mother) and mitigating circumstances such as mental illness and in cases of force and abuse by a third party, allowing for different degrees of homicide.

We don’t, however, allow euthanasia or eugenics in the case of born disabled children or give the mother the “choice” to kill by poisoning or distruction of the body of a child who becomes unwanted after birth.

Texas declared the child an individual before birth back in 2003, creating a penalty for third parties who cause the death of a child, except in the case of intentional abortion by a doctor or when the mother herself acts. There have been several convictions under the Texas Prenatal Protection Act.

In light of our expanded knowledge about human biology, it’s time for the Supreme Court to overturn Roe v. Wade and declare what Justice Blackmun deferred: life begins at fertilization and all humans possess human rights that should be protected by the State.

Maybe I’m tilting at windmills, but I would like to see Texas defy Roe v Wade and pass HB 896.

I’ve disabled comments on the blog. Please leave your comments on my Facebook page, “Beverly Nuckols.”

“KITTENS,” before humans

I didn’t believe the opinion article by Tony Perkins of the Family Research Council, that claimed that a Democrat who voted against last month’s S311, the “Born-Alive Abortion Survivors Protection Act,” had then submitted a Bill to prevent the euthanasia of kittens used in scientific research. I assumed it was a spoof or hyperbole.

KITTENS before babies

But no, a simple search proved that Oregon’s Dem Senator Merkley absolutely opposed the Act, even posting a press release and giving his reason in Twitter, @SenJeffMerkley

The Act would not have criminalized anyone. It would only reinforce and clarify the 2002 “Born Alive Infant Protection Act,” by requiring the doctor performing an abortion to provide the same care for a born infant who is unexpectantly delivered alive during a late term abortion that would be provided to any other child in the same circumstances.

The CDC estimates that about 150 babies are born alive during abortions, each year, while acknowledging that the estimate may be low.

Merkley came up with a cute name for his Bill: “Kittens in Traumatic Testing Ends Now.” It’s a shame he didn’t give as much thought to human babies.

“KITTENS,” before humans

I didn’t believe the opinion article by Tony Perkins of the Family Research Council, that claimed that a Democrat who voted against last month’s S311, the “Born-Alive Abortion Survivors Protection Act,” had then submitted a Bill to prevent the euthanasia of kittens used in scientific research. I assumed it was a spoof or hyperbole.

KITTENS before babies

But no, a simple search proved that Oregon’s Dem Senator Merkley absolutely opposed the Act, even posting a press release and giving his reason in Twitter, @SenJeffMerkley

The Act would not have criminalized anyone. It would only reinforce and clarify the 2002 “Born Alive Infant Protection Act,” by requiring the doctor performing an abortion to provide the same care for a born infant who is unexpectantly delivered alive during a late term abortion that would be provided to any other child in the same circumstances.

The CDC estimates that about 150 babies are born alive during abortions, each year, while acknowledging that the estimate may be low.

Merkley came up with a cute name for his Bill: “Kittens in Traumatic Testing Ends Now.” It’s a shame he didn’t give as much thought to human babies.

“KITTENS,” before humans

I didn’t believe the opinion article by Tony Perkins of the Family Research Council, that claimed that a Democrat who voted against last month’s S311, the “Born-Alive Abortion Survivors Protection Act,” had then submitted a Bill to prevent the euthanasia of kittens used in scientific research. I assumed it was a spoof or hyperbole.

KITTENS before babies

But no, a simple search proved that Oregon’s Dem Senator Merkley absolutely opposed the Act, even posting a press release and giving his reason in Twitter, @SenJeffMerkley

The Act would not have criminalized anyone. It would only reinforce and clarify the 2002 “Born Alive Infant Protection Act,” by requiring the doctor performing an abortion to provide the same care for a born infant who is unexpectantly delivered alive during a late term abortion that would be provided to any other child in the same circumstances.

The CDC estimates that about 150 babies are born alive during abortions, each year, while acknowledging that the estimate may be low.

Merkley came up with a cute name for his Bill: “Kittens in Traumatic Testing Ends Now.” It’s a shame he didn’t give as much thought to human babies.

Please comment on my “Beverly Nuckols” Facebook page.

Designer slaves

Brave New World is still in the future, but we have the technology to create betas and gammas, etc. And with potential laws that deny personhood or any rights at all under the law to the preborn, we have the legal climate.

The question is, do we have the social climate?

Tell me: Why not manipulate our offspring any way we want if they aren’t human-enough to possess human rights?

Let me know what you think on my “Beverly Nuckols” Facebook page!

Bashing Trump: Victim shaming, victim denying

Toxic Fact checking!

Toronto Star Washington, DC reporter Daniel Dale (@ddale8) joins in the media’s Trump bashing, with some old fashioned victim shaming: foolish women are deceived into prostitution by “promises of a hopeful future,” not violently kidnapped, gagged and bound.

Well, not often enough for Mr. Dale.

Focusing on the type of tape that President Trump says was used to gag the women, Dale claims that he sought out “experts” who told him that physical, violent kidnapping of women in Mexico in order to traffic them – force them into prostitution – in the US “rarely if ever happens.

Dale quotes a San Antonio “anti-trafficking activist” who woman who has helped 12 such women whose mouths were covered when they were kidnapped. Unfortunately, she didn’t record what was used to cover their mouths.

Oh, and the wall won’t change anything except that it “would merely cause certain traffickers to take more risks and impose higher debts.

After all, less than 2% of women who are trafficked press kidnapping charges.

Dale might put too much weight in the fact that “less than 2%” of women who are trafficked press kidnapping charges. He should listen to the women of Jalisco who tell a story similar to the one the President relates. They then face the resistance of police and authorities with attitudes like Dale’s.

Just how many violent kidnappings across the border would be enough for Mr. Dale and his experts to report the stories of trafficked women instead of a story to prove President Trump wrong?

Cashless Society, Internet to Dystopia?

The dystopias of Rand’s Atlas Shrugged, Orwell’s 1984, or Bradbury’s Farenheit 451 had nothing available to monitor and police behavior and thought nearly as powerful as the Internet.

Oh, my readers probably were relieved when the powers-that-be halted the Obama Department of Justice’s “Operation Choke Point” pressure on banks to shut down gun manufacturers, buyers and sellers. At one point,the New York State Department of Financial Services was enforcing similar pressure and, in Florida, second-hand sellers like pawn shops were targeted.

But that was *government* acting outside of Constitutional guidelines, not private business. . .

Facebook puts you in “jail?” Twitter suspends or bans you? Just a matter of private companies exercising property rights!

Facebook, Apple, Spotify, and YouTube ban and erase/delete Alex Jones on* the* same* day*? Only conspiracy nuts would see a conspiracy in the timing!

How do you feel about your credit card company conspiring and colluding with Internet platforms to monitor – and “de-monitize” – your actions and speech: “sins,” as arbitrarily determined by the arbitrary ethics or whims of a 3rd or 4th party?

In the same month that Jones was kicked off multiple Internet sites, AmazonSmile kicked the Alliance Defending Freedom off its charity donation program because of pressure from the Southern Poverty Law Center. The SPLC deems ADF a “hate” organization because it defends people like that Colorado baker.
In the last month, one Internet “platform” (not only a host for writing and videos, but a way to collect subscription fees using credit cards and PayPal – think of a bank alternative), Patreon, removed the account of anti-PC blogger/YouTuber “Sargon of Akkad,” Carl Benjamin, even though the behavior they claim as justificationwas not on their site, and he definitely did not violate Patreon’s Community Guidelines. He was responding in a sarcastic manner to attacks by white supremacists!
In December, 2018, Patreon suspended the owner of “Jihad Watch,” Robert Spencer, without reason or notice. When Spencer asked why, he was told that, “unfortunately,” the credit card company, MasterCard had forced the ban.
At what point does the use of currency to arbitrarily impose decisions on what is right or wrong become a Federal issue? If two or more supposedly unrelated companies or organizations interfere to limit commerce, is it delusional to see a conspiracy?

Even if you don’t read Revelation as the prediction of the ultimate dystopia, you might agree that there’s a move to force political – ethical – correctness on the public by monitoring and restricting how you spend and receive money. You might even see the possibility that in order to spend and earn money, we could soon need the approval – the “Mark” if not of *the* “Beast, “of some lesser beast, composed of powerful organizations.

“Reliable Allies Refuse to Defend a President Content With Chaos.” (NYT)

Mr. Trump grew angry over his news coverage.

Well, who wouldn’t when confronted with this New York Times headline: “Reliable Allies Refuse to Defend a President Content With Chaos.”

The opening paragraph might add to that anger:

President Trump, who has long believed that he is his own best adviser and spokesman, was forced to test that idea on Friday when few of his allies seemed willing to publicly share in his evident satisfaction with the tumultuous events that have buffeted the White House in the past few days.

This is the online version,of the which has a footnote that explains that the print version carried a more neutral title:

A version of this article appears in print on Page A18 with the headline: Confusion and Controversy Swirl, But the President Remains Positive.

The internet address for the article hints at the original purpose behind the column in the US Politics section of what was once the “newspaper of record:” “donald-trump-syria-government-shutdown.”

Other than a few comments that this is the 3rd shutdown in recent years, news coverage ignores the fact that Schumer and the Senate Democrats “shutdown” the government in January, 2018 when they staged a filibuster over another funding Bill because it didn’t protect DACA.

The President is said to have an “aggressively partisan stance,” but New York’s Democrat Senator Chuck Schumer is the one who ranted on the Senate floor:

“You’re not getting the wall today, next week or on Jan. 3 when Democrats take control of the House.”

You don’t have to wonder how Not-the-Majority-Leader Chuck really feels. And it’s clear that he has “reliable allies” at the NYT.

Border Wall : now or never

For two years, the problem with funding the border wall has been exactly the same that the country faces now: the Senate Dems refuse to budge. It’s down to the last minute, now or never for the wall, and up to the Dems to choose.

The solution is simple: instead of dedicating $10+B in aid to Mexico and Central America, allocate the money necessary to build the wall and secure the border.

What a shame that the division has become so partisan and the talking points so bitterly derisive.

As to the “immorality” that Schumer decries: just as with your home, there is a moral difference between a wall intended to control who comes into the Country and one intended to lock the inhabitants in.

The solution is simple: instead of dedicating $10+B in aid to Mexico and Central America, allocate the money necessary to build the wall and secure the border.

Federal vs. State (FGM) Updated

Update from the Detroit News:
“[T]he judge left intact conspiracy and obstruction charges that could send Nagarwala and three others to federal prison for decades.”

This story has me thinking about the powers of the State vs. the Federal government.

I am a firm believer that the individual States should regulate and enforce both criminal law and the practice of medicine.

States may make what I might consider errors in their specific codes and punishments. However, the 50 States act as individual laboratories for laws and law enforcement. As long as the States rather than the Federal government regulate these areas, citizens have a better access to the Legislators who make the laws and the bureaucracy that implement and enforce them. The voters can speak directly to their legislators in person and at the ballot box and, if truly unhappy or unwilling to wait for often slow legal changes, they can move to a State with laws they like.

These cases involve two doctors and multiple accomplices who conspired to bring girls across State lines in order to carry out Female Genital Mutilation (FGM).

The procedure is described in words and pictures at the link above and at the World Health Organization report(in .pdf), but here’s the short, least-horrifying-I-could-come-up-with version:

Pre-pubertal girls (two of the girls in this case were 7 years old at the time) are subjected to some degree of cutting in their genital area. The procedure may be anywhere between a minor cutting sufficient to cause bleeding without permanent structural or functional change, to removal of the entire labia majora and minora, along with the entire clitoris, with the vaginal opening sewn almost completely closed, only to be opened (obviously, traumatically) at marriage to allow vaginal intercourse and at childbirth.

The clitoris is a sensitive organ and very much an important part of the sexual function of the female body. The cutting site, the scarring, and the consequences of obstructed urine and menstrual flow can be life long. The actual reported goal is to make the girl chaste and impair her ability to engage in illicit sex and blunt her sexual pleasure.

FGM is a criminal act and should most certainly be malpractice under State’s medical codes. These sorts of cases would normally best be brought before the State courts.

The reason that these particular cases should be prosecuted (also prosecuted?) in Federal Court is that the girls were transported across State lines. In addition, they were irreversibly mutilated solely because they are females. If this latter doesn’t come under the 14th Amendment Equal Protection clause, I need a lawyer to explain that protection. In slow, simple language, please.

Now, I know some people will ask how I can oppose what is most likely a religious act and one that seems to come under both parental rights protection and the penumbra of “right to privacy.” And what about male circumcision?

The right to freedom of religion. Parental rights, and privacy do not have precedence over the rights not to be permanently harmed. Unlike male circumcision, there’s no medical reason to perform FGM, FGM directly impairs multiple bodily functions, and carries a significant risk of life long pain, repetitive infections, and even death.

It’s the legitimate function of government under our US Constitution and supported by the Declaration of Independence to protect the rights of individuals from being placed in harm’s way. These cases of mutilation are nothing but harmful for life, were performed on minors who are too young to consent, and were accomplished by conspiracy, using federally regulated telecommunications to make appointments, taking the girls across State lines, and utilized State licensed personnel, equipment, and medications.

I hope the Federal appeals overturn this ruling. Quickly!

Euroean Travel Politics

20180813_0628344140598101829459225.jpg

I’m very careful about politics when traveling. The media far too often tells us that the rest of the world doesn’t like the US since Trump was elected. The “Italian for Dummies” web page even has the phrase, “Non siamo americani.” (We aren’t American.”)

But my experience has been different: a lot of Europeans think Donald Trump is right about border security and limiting immigration. And we’ve heard this from citizens of England and Italy, who go out of their way to express their support of President Trump.

Last month, a British couple stopped to admire our narrowboat on the Thames. When they found out we were Americans, they turned the conversation to politics, support for Brexit and praise for President Trump.

We picked up our car at the Rome Airport on Friday and it happened again. Out of the blue, the 30-something agent asked, “What about Trump?”

I deferred answering to Larry and braced myself for criticism or ridicule of the President from our new aquaintance.

Instead, our Roman friend volunteered his approval of Donald Trump and the “changes’ both our countries are making in response to international pressure to accept overwhelming numbers of refugees.

He talked about the inability to vet the refugees picked up at sea, the effects on Italy’s employment situation, and the financial stress the boat loads of immigrants were causing Italy before his government’s recent refusal to accept ships full of migrants at Italian ports.

He said, “Trump is making changes. People are afraid of change, but this is good change.”

None of the people we talked to – or who made it a point to talk to us – expressed hate or racism. They are worried about the future if their countries and disapprove of “Brussels” forcing regulations on them, not simply afraid of foreigners.

I wonder who’s listening.

(BTW, several different sets of Canadians have initiated similar conversations. All approved of the President and disapproved of Trudeau.)

Is there a solution to the current immigration emergency?

I’m following and responding to the news reports and conversations on Twitter and Facebook about the arrests and separations of alien families because I’m looking for a solution that will work and have fewest unintended consequences.

We can spend all day screaming our objections or justifications and playing political games based on what should have been done and when, in the past and present. Or, we can tell our legislators that we recognize the reality of the circumstances, today, and that we need to make immediate changes, followed by more measured steps.

We urgently need to:

1. Ensure that the very young are safe and nurtured. This is an emergency, because of the damage that we know tactile deprivation has on small children. No more claims that some institutional rule prohibits holding a toddler;

2. Make sure that no more children are “lost” and that even those who are separated can communicate with their parents.

(Hospital arm bands? Schlitterbahn and the Toob renters in my home town use similar bands. The tracking numbers could follow numbers on the bands and would not only work better with digitizing information

Would it be possible/permissible to use RFID and/or GPS?

Delta uses bar codes attached to each suitcase and can text me when my suitcase is loaded or unloaded on the plane. Last month, when I was on a cruise, ATT texted me that I wasn’t covered by their international plan as soon as I stepped on the ship, before the ship left the dock.);

3. Speed up the process of reuniting the families;
(This last will be enabled by the above, but will also require resources for the rapid setting up of family shelters for those awaiting hearings, and hiring personnel for those shelters and judges to hear the cases and lawyers to represent the asylum seekers.);

4. Streamline the process for approving or rejecting application for asylum at the ports of entry. (See above. This may be a useful job for civilians -paif or volunteer – and the National Guard after apprehension and/or initial evaluation by Border Patrol);

5. Fix the laws concerning detention of children separated from their parents, the right of application for asylum for anyone who manages to step on US soil, temporary worker permits that do not allow family to immigrate, and for immigration in general;

6. Continue to identify, arrest, and prosecute people who willfully violate our immigration laws;

7. None of this is dependent upon or contradictory to securing the Border. All of them are enhanced by increased security, however;

8. Stop the partisan game playing!

It should be made clear that our government will follow the law as written. Perhaps we can continue the ads Obama’s Administration is said to have used in Central America.

None of these should be done so that more people show up expecting immediate visas, green cards, or even healthcare and food stamps. They certainly shouldn’t believe that they have a right to immigration or to burden our social infrastructure and taxpayers.

Please comment on my Facebook page.

Edited numbering, BBN

Happy Birth Parent Day

screenshot_20180616-075345_chrome5005037694364168408-e1529155414475.jpg
Google Images for “Baby Daddy” card

That lawsuit I wrote about yesterday would not only would put an end to Texas’ Medical and legal regulations on abortion – including informed consent, waiting periods, and sonograms – the plaintiffs go out of their way to redefine mother and father, too.

From Footnote 1, page 2:
“”1 Most people with the capacity to become pregnant identify as women. Historically, both jurisprudence and public health data have focused on women when addressing reproductive rights and health. But there is an emerging recognition in the law and society more generally that not all people who may become pregnant identify as women. See generally Glenn v. Brumby, 663 F.3d 1312, 1316-19 (11th Cir. 2011)
(holding, consistent with the weight of authority, that the Equal Protection Clause prohibits discrimination on the basis of “gender nonconformity”) (collecting cases); Robin Marantz Henig, How Science Is Helping Us Understand Gender, National Geographic (2017), https://www.nationalgeographic.com/
of all individuals to end an unwanted pregnancy, regardless of gender identity.”
 (I’m sorry, but can’t find a link to the lawsuit on line. It’s “Whole Woman’s Health Alliance et al v Paxton et al, U.S. District Court, Western District of Texas, No. 18-00500.)

From the UK, we see the inevitable results in a time of identity and personal choice :

Lawyers have told a judge that he had been biologically able to become pregnant but had legally become a man when the child was born.

“They say the transgender man wants to be identified as the child’s “father” or “parent” on a birth certificate.”

And, in Ohio:

“Explaining their unusual parenting arrangements, Amy said: “We went through a lot of fertility treatments, until we finally reached a point where we needed to make a decision as to whether we were going to do more medical intervention or if we were going to switch bodies. (emphasis mine)

“We were fortunate enough to have two uteruses. So, after a lot of thought and emotion and difficulties we switched to Chris.

“And while Chris lived as a man and didn’t feel female, he was willing to use his womb for the good of their family.”

Of course, neither Chris nor Amy could donate sperm. So, who is really — is there even — a father?

Or a parent, of either gender or any identity, who sees the child as his own person, human-enough to possess inalienable rights, rather than a political statement and a means to an end?

Safe, legal, and unrestricted?

If the law deems some of our offspring not human-enough to have the right not to be killed, what’s the use of restrictions on the licensed killers?

From the San Antonio Express News, we learn about a new lawsuit filed by the State’s ” largest abortion provider.”

“The lawsuits (sic) challenges numerous requirements including only allowing doctors to perform abortions, rather than clinic staff. It also challenges licensing standards, 24-hour waiting periods and a requirement that an ultrasound be shown to the patient.””

I suppose “Whole Women’s Health” owner, Amy Miller may have a point. Perhaps the ruling against HB2 made whole new conditions for abortion laws. See the timeline of litigation on HB2, here.

Do we even need to license the killers in the first place? Why should only doctors wield a vacuum wand or curette or dispense abortifacients without an ultrasound?

The question is whether this case is unique and sweeping enough to move the Supreme Court to hear another Texas abortion case? And will the Court remain divided as it was on HB2, which was decided 5-3 in the absence of the late Justice Antonin Scalia?

Could this pressure Justices Anthony Kennedy (81 years old) or Stephen Bryer (80 yo in August) to put off retirement a while longer? And will Justice Ruth Ginsberg (85 yo) still be on the Court?

But we don’t have to question where the money to pay the abortionists’ lawyers. Unfortunately, the taxpayer’s of Texas are required to pay the lawyers that represented the plaintiffs $4.5 Million.

06/15/18 12;50 PM Edited to clean grammar, BBN

06/16/18 7:30 AM Edited formatting, BBN

Existing tariffs, duty, and barriers to trade in Canadian law.

Current barriers on imports into Canada from the US affect dairy, wine, telecommunications like TV, cable, and broadcasting, and even software and “cloud” data storage.

The CRTC also requires that 35 percent of popular musical selections broadcast on the radio qualify as “Canadian” under a Canadian government-determined point system.”
This requirement precludes U.S.-based “cloud” computing suppliers from participating in the procurement process, unless they replicate data storage and processing facilities in Canada.”

https://www.export.gov/article?id=Canada-Import-Tariffs

In contrast, there are very few barriers to trade with Mexico.

(Edited to add the link to information on Mexico.)

The Day That Justice Died

Where is the freedom or justice in raiding the attorney/client privilege? Not just the offices and homes of a lawyer, but documents that most of us thought were protected by an all-but-inviolable privilege?

 

Supposedly, Cohen lied to his bankers about why he wanted a loan. Was it by comission or omission???Is it a Federal offence to not fully disclose why you want to go into debt?

 

Stormy Daniels threatened (black-mailed) to make accusations about Trump immediately before the 2016 election, got money and signed a contract, now wants to reneg (she pretty much has) on her contract, but the one who paid the money is the one who is being investigated/harrassed.

 

Why aren’t the Trump people demanding the same deals Hillary’s people got: immunity and non-disclosure agreements before sitting down with the FBI?

 

When were any of the Clinton lawyers or aides’ homes or offices raided?

 

 

Trump wasn’t my first, second or third choice in the Republican Primary of 2016.  And I’ve already mourned the death of the rule of law, back when Comey killed it.  But I agree with the President: this looks like a witch hunt.

Response to criticism about Texas Advance Directive Act

I’ve been having a long Facebook discussion with representatives of organizations, people who claim that I support coercion and killing patients because I defend the Texas Advance Directives Act, 166.0046. (TADA).

I want to respond as fully as I can. ( I’m bandwidth deprived today and will gradually add more links when I reach better signals. See here, here, and here for more explanations from earlier WingRight posts. Links to the law, the press, and previous blog posts by others can be found in those articles.)

First, no one withdraws or withholds *care* of the patient. The patient still receives food and hydration, pain medicine, oxygen by tube or mask, if needed, and other medical treatment.
The 10 day period is the only recourse allowed under Texas law when a doctor refuses a treatment requested by the patient. All legislative attempts to increase the times have been blocked.
For hospitalized patients, the Act is the only way for a doctor to refuse a patient’s request for medically inappropriate treatment without risk of abandoning him. If the doctor doesn’t follow the law, he becomes liable. Although no reason is required by law, in every case I know of the doctor has made it clear that the requested treatment is causing suffering and/or actual harm and violates the First Principle: “Cure when possible, but first, do no harm.”
I have asked who/where are the doctors willing to accept transfer. There must be some doctor willing to accept the patient in order for there to be a transfer. “Facilities” or hospitals can’t accept a patient without an accepting physician. For the most part, doctors in Texas don’t work for a hospital and can’t be ordered to admit or treat by the facility. That no other doctor can be found is actually evidence that the first doctor’s medical judgment is based on good medicine.
Transfer has happened in a couple of examples (that I know of because they have made the press or gone to court), where a doctor disagrees with the original attending physician. I’m sure this has happened in many others that we never heard about because of the transfer.
I didn’t want to cover a specific case, preferring to stick with the issues of ethics. However, my accusers repeatedly brought up Mr. Chris Dunn. His case is very typical of both my experience with patients dying of end-stage hepato-renal failure and the course of other patients I’ve been able to follow through public documents.

It was easy to follow this case. There was a video published by Texas Right to Life (TRTL), a lot of press, statements to reporters by family, lawyers, and TRTL staffers, as well as a couple of lawsuits. I spent the better part of two days once again reviewing the public records.

Virtually all of the hospital medical reports were made public record in the latest appeal by Mrs. Kelly’s lawyers, Joe Nixon and Trey Trainor, BTW. (Another BTW: Senator Nixon, please follow the gown rules for isolation rules in the future. There’s a reason for them.)
There have been many misleading statements and errors about the case in news articles, blogs, and press releases, including both condemnation and praise for the doctors and the hospital by the family members, TRTL, and repesentatives of Empower Texans (ET), (making this review pertinent as the conversation began on Facebook in response to another ET article). The affidavits of the attending doctor, the chairman of the Methodist Biomedical Ethics Committee, the social worker, and legal documents from Mrs. Kelly’s and Methodist’s lawyers have been public records at the Harris County court website and elsewhere online.
Mr. Dunn was transferred from another hospital to Methodist hospital after having a gastrointestinal bleeding episode that resulted in his becoming unresponsive and being placed on a ventilator. He had severe liver failure, kidney failure, and the build up of fluid in his lungs which his mother told a reporter about. His clinical diagnosis was obvious, and supported by records from an earlier hospitalization when he was diagnosed as having a metastic pancreatic mass. He had checked himself out of that hospital against medical advice after refusing a biopsy of his pancreatic mass or further treatment.
On admission, Mr. Dunn wasn’t able to make decisions, as he was suffering from hepatic encephalopathy (which causes delirium) and sedated due to pain and the ventilator. (Note the restraints on his wrists, his jaundice and swollen belly, and his sleepiness and confusion are evident in that video we’ve all seen.)
He didn’t have an Advance Directive or a Durable Power of Attorney for Medical Care. (TRTL’s lawyer John Seago claimed the mother had one.) The doctors turned to his divorced parents to make decisions as co-equal surrogates under Texas law.
Unfortunately, as his sister told one reporter, his dad agreed with the doctor, but his mother disagreed. According to court documents, the elder Mr. Dunn said that he believed that Chris didn’t want to die in the hospital and insisted on removal of the ventilator and transition to comfort care (not the administration of a deadly “serum” as the lawyers claimed in the lawsuit and media). Mrs. Kelly kept asking for more time to talk to family members before making a decision. in their affidavits, a hospital social worker and the Ethics Committe chair, each described the parents’ interaction with one another as a “firestorm.”

It

was obvious that Mr. Dunn needed a legal guardian. That he was unable to make medical decisions is supported by the affidavits of the attending doctor and a later court examiner, as well as the fact that his parents were agreeable to making those decisions.
The Ethics Committee chair and other members documented meetings with the parents and family at least five times over the month after admission, and given copies of the hospital policy on disputes. When the doctor invoked TADA, the Ethics chair met with them again and they were given 3 day’s notice of the committee meeting. (Dispelling the lawsuit and blogging claim that the family wasn’t informed and was surprised by the sudden notice.)
Mrs. Kelly attended the meeting and spoke with the Committee. Both parents were given information about the hospital policy on the TADA and told that the doctor would be allowed to remove the ventilator 11 days later. While Mr Dunn’s father agreed, his mother did not and filed her first lawsuit.
The hospital social workers contacted over 60 different facilities in attempt to transfer. They were able to find a hospice (and presumably a hospice doctor) willing to care for Mr. Dunn on the ventilator at home, but Mrs. Kelly declined that transfer.
The MICU intensivist doctors and hospital voluntarily agreed, without a court order or hearing, to continue the ventilator until a single legal guardian could be named. There was never a restraining order after the initial Agreed TRO. There was never any move to deny the Total Parenteral Nutrition or any other treatment. The doctors, the hospital and the court where Mrs. Kelly filed suit against the hospital requested that the probate court determine a legal guardian to settle the dispute between the parents. The hospital specifically asked for a family member to be named guardian. There never was a move to remove Mrs. Kelly as guardian since she never was the guardian. The probate court hadn’t named a legal guardian at the time of death.
At autopsy, the pancreatic adenocarcinoma was found in the pancreas, liver, lungs, and lymph nodes. There were 20 liters (5 gallons) of ascites fluid in the abdomen due to the liver failure which prevented the production of protein and blood clotting factors. The lungs showed evidence of fluid congestion, aspiration of stomach fluids and pneumonia. The kidneys had failed and were infected. There was wasting of fat and muscle tissue.
The clinical diagnosis was confirmed. Mr. Dunn died of his disease with 40 pounds of fluid in his abdomen, congested lungs, pneumonia and kidney infections, and on a ventilator with total food and hydration by IV. This is not “natural death.”
The court has dismissed the lawsuit(s) in favor of the hospital. The only coercion in this case was against the doctors who evidently gave extraordinarily good care in order to keep him alive while waiting for the surrogates’ decision, then waiting for the probate court to act. And yet, Mrs. Kelly’s lawyers have amended her lawsuit, since dismissed, and filed an appeal which demands a “fair trial” whenever disputes like this occur.
The demands we’ve heard about TADA, to mandate that individual doctors “treat until transfer” or face new civil and criminal liability – even jail time – for doctors who use their consciences and refuse to act against their medical judgment would not only infringe against a doctor’s right not to be enslaved by positively forcing his hand against his will. It would be a moving target, with advances in intensive care technology and the ability to keep a patient’s body functioning with increasing technology.
As to the “Doctors aren’t God” refrain by others: I agree. And I’ve agreed each time someone shouts (or writes) it at me when I won’t refer for an abortion or write that opiate perscription that they are certain is their right.
Inalienable rights are negative rights: the right not to be killed, the right not to be enslaved.
Doctors are human beings with inalienable rights, including the right to conscience and to not have their hand forced to cause harm to a confused and delirious patient who cannot consent to suffer.
As shown by the first month of the Chris Dunn case, we recognize that some times we must stretch our limits. However, not indefinitely and not all our limits.

(Edited 03/11/18 for typos, to add a link, and to clarify points originally made on Facebook in a long debate. BBN)

Disappointed by BVI Immigration 

A month ago, one week after Irma I came into Beef Island as volunteer doctor with a small medical relief group on a charter plane.   I was only given a visa for 30 days, even though I explained that I have a Non-Belonger Land Holder License (NBLHL), but didn’t have it with me when I canceled the rest of our vacation in Europe. 

Today I went to the government offices in Spanish Town with my NBLHL and was refused a visa extension until I could produce a return ticket. The officer informed me that the NBLHL only allowed me 6 months “per annum” and proceeded to examine my passport, as though to check how long I had been present in the Country this year. 

(I had to go up to Flow to get a good signal in order to buy the ticket online. I returned to find the officer leaving for lunch 15 minutes before noon.)

When I came in on September 14, there was no demand for a return ticket. At the timethere was a perceived shortage of doctors and we believed I would need to be self-sufficient for food and water as I wouldn’t have access to power or running water. The prisoners and looters were still at large. 

Thank goodness, nothing was quite as bad as we feared:  The British military had arrived by then; the wonderful people at Nanny Cay took great care of me and the rest of the group and we arrived the first day that Nanny Cay was able to turn on their desalination plant /water maker for a few hours.  


The medical need on Tortola was already improving enough that I was able to come to Virgin Gorda just 4 days later. Although they don’t need me either, I’ve been working at the clinic in Spanish Town at least two days a week ever since. I don’t want a job and don’t need the experience, but feel that I made a contract that I must keep. I also want the docs, nurses, and staff to know me if one of the feared medical crises does arise. 


BTW, That NBLHL I mentioned “authorizes”  immigration “to grant leave to land for a period not exceeding six months…” Not “per annum,” and there is no mention of a return ticket six months in advance. 


Larry and I have also applied for a “permit to reside”  which required the same documentation that we submitted –  and resubmitted after it was lost – for our NBLHL:  letters from law enforcement and character references, and financial statements. We were required to leave the Country while it was processed, but have been informed that it  languished in the Immigration department without action from 5 July to September 4 –  2 months before Hurricane Irma – and that it is most likely lost and will need to be resubmitted. 


If you saw my post last week, you’ll recall that when Larry was finally able to come to the BVI 3 weeks after I did, he was required to pay duty or produce receipts at Beef Island Customs on the 

(I had to go up to Flow to get a good signal in order to buy the ticket online. I returned to find Ms. Smith leaving for lunch 15 minutes before noon.)

When I came in on September 14, there was no demand for a return ticket. At the time, there was a perceived shortage of doctors and we believed I would need to be self-sufficient for food and water as I wouldn’t have access to power or running water. The prisoners and looters were still at large.

Thank goodness, nothing was quite as bad as we feared: The British military had arrived by then; the wonderful people at Nanny Cay took great care of me and the rest of the group and we arrived the first day that Nanny Cay was able to turn on their desalination plant /water maker for a few hours.

The medical need on Tortola was already improving enough that I was able to come to Virgin Gorda just 4 days later. Although they don’t need me either, I’ve been working at the clinic in Spanish Town at least two days a week ever since. I don’t want a job and don’t need the experience, but feel that I made a contract that I must keep. I also want the docs, nurses, and staff to know me if one of the feared medical crises does arise.

BTW, That NBLHL I mentioned “authorizes” immigration “to grant leave to land for a period not exceeding six months…” Not “per annum,” and there is no mention of a return ticket six months in advance.

Larry and I have also applied for a “permit to reside” which required the same documentation that we submitted – and resubmitted after it was lost – for our NBLHL: letters from law enforcement and character references, and financial statements. We were required to leave the Country while it was processed, but have been informed that it languished in the Immigration department without action from 5 July to September 4 – 2 months before Hurricane Irma – and that it is most likely lost and will need to be resubmitted.

If you saw my post last week, you’ll recall that when Larry was finally able to come to the BVI 3 weeks after I did, he was required to pay duty or produce receipts at Beef Island Customs on the items (water filters, etc.) he brought, in spite of the moratorium.

Beyond investing in our home at Nail Bay on Virgin Gorda, Larry and I have done what we could to assist physically and financially in the BVI recovery after Irma. I’m not as enthusiastic about residency as I was in June or even a month ago, and do not feel at all welcomed by the BVI.

Personhood “TBD” 

“To Be Determined,” or the Schrodingder’s cat* version of human rights.

Does the possession of inalienable human rights depend on unknown future facts? Can the moral worth of a human being be determined by the actions of another human being – or by fate, the available and utilized medical technology?

Sherif Girgis discusses the theory of Princeton philosopher, Elizabeth Harman, in today’s Public Discourse. The professor’s view that abortion is – or may be – a neutral act has been the subject of discussion since she appeared in the YouTube video, Philosophy Time, produced by actor James Franco and Eliot Michaelson.

Besides the obvious problems pointed out by Girgis of defining “consciousness” and the TBD “kind” of a human fetus, there are other problems.

First, any concept of “inalienable” human rights would need to be discarded. There goes the Declaration of Independence and the basis of the United States Constitution.

In addition, Professor Harman’s theory would presumably allow the use of bodies of the human species for the benefit of humans with “moral worth,” as long as those bodies are never allowed to become conscious. This is the current practice of researchers using embryos, including those created for the purpose of manipulation and destruction.

But there’s nothing in this philosophy to prevent the intentional manipulation of a human body for research or to benefit others, as long as the body is never allowed to develop consciousness. Continual sedation or mutilation of the brain from the beginning – before consciousness – would prevent the development or acquisition of moral worth and rights.

In the process, “human” rights would cease to exist. The actions of others, laws and location and the potential use of technology would finally determine who is human enough to possess the right not to be killed. (Forget the right not to be “enslaved.”

What happens if (as Girgis proposes) the abortion itself is aborted or fails? Or if the brain isn’t damaged sufficiently to prevent consciousness?

Forget about opening the box: don’t put humans in there in the first place.

*I saw this analogy on a Facebook thread, but thought the same thought before I stole it.

Edited to correct my misspelling of Dr. Harman’s name.

Health Insurance Choice Is Bad?

Health insurance choice is bad?

The San Antonio Express News picked up a Washington Post op ed on those big, bad Republican plans to repeal Obamacare. Originally titled, “The reason Republican Republican health-care plans are doomed to fail,” by the editorial board that declared, “There’s no way to replace Planned Parenthood.”

And it’s bunk, even as prudently renamed and appropriately filed in the Opinion section.

What we are *actually *seeing *today is that costs are rising and insurers are withdrawing from States. Choices are certainly limited if there’s only one insurance company on the exchange and routine screening costs are “free” — But the care for treatment discovered at screenings is subject to high deductibles.

Limited coverage plans with major medical for extraordinary costs – rather than a wish list covered with other people’s money from first dollar – encourages personal responsibility and will cut costs. It would also allow people to own their insurance, rather than have it controlled and limited by current employers.

Science vs. Philosophy

R(obin) Alta Charo has once again been given a platform in the New England Journal of Medicine.

Poor Robin. She conflates ethics and philosophy with science. Although observing what “is” can lead to insight about which actions and manipulation lead to harm and which improve individual and group well-being, Science cannot prove or disprove philosophy, or determine what we “ought” to do.

Ms. Charo continues her career-long advocacy for elective, interventional abortion and against the inalienable human right not to be killed – all in spite of her assertion that she has no conflicts of interest in this essay. By declaring that Trump Administration appointees “embrace alternative science,” Robin makes her own gross scientific error. In addition to confusing “science” and philosophy, she bases much of her objection on an emphasis on “established pregnancies” and ignores the existence of the human embryo after fertilization but before implantation.

The very odd complaint about definitions of gestational age assumes that time varies according to when we start counting days.

Some state legislatures have tried to redefine pregnancy dating, shifting from the standard measure of time since last menses to time since probable fertilization. Such a definition falsely enhances the viability statistics for lower gestational ages and helps to bolster arguments for 20-week limits on abortion rights.

Again: Science is about what 《is,》 while ethics ought to be, not about true  《oughts.》

“Different” (Transgender at 4?)

The TexasGOPVote website chronicles the complaint by a “Conservative, Christian” mom  that her male to female (supposedly) transgender 6 year old shouldn’t be treated differently. I agree with the underlying sentiment that it is not the child’s fault.

The child is treated differently – by parents, peers, school nurses, and any educator, doctor or other professional or official who is complicit with this abuse of a 6 year old child – because the child *is* different. Medicine, physics, and the rest of the observable, measurable and verifiable universe don’t change because a child declares that cold is hot, up is down or boys don’t feel like “she” feels (at the highly experienced age of 6). 

It is disturbing to read about the apparent mistreatment of depression that this mother describes in her earlier blog. So disturbing that I’m inclined to ignore – or at least put off to another post – commenting on the stereotype in the description of “girly girl, Kai, in pink and sparkles” or of  the suggestion in mom’s earlier blog about Joseph as “gay” (at 2!)  for displaying supposedly “flamboyantly feminine mannerisms and love for all things girly.” 

How could anyone so misinterpret the repeatedly voiced desire of a 4 year old to be taken away to heaven because another 4 year old said her father called him a freak as equivalent to hating hair cuts ( or more “feminine mannerisms“)? How can she compare her “secret” research with the proper treatment her son needed?

Unfortunately, a 6 year old claiming to be transgender is different because he or she has had his or her perceptions of the world colored by the same adults who would not allow a child they loved to play with fire or jump off the highest point of the school building. 

The fact is that genetic and phenotypically female girls will always be “different” from Joseph. From the first penetration of the zona pellucida by a sperm bearing a Y chromosome, to the differentiation of the Wolffian duct, to the first time he urinated over someone’s shoulder into the air after birth, Joseph has been a male. Stereotypes aside, he will remain a male, however he acts or is medically or surgically manipulated. The genetic and phenotypical reality of his body will always affect any future medical or surgical treatment.

Hopefully, no one will be complicit with medical or surgical castration or other mutilation until this child is legally competent to consent. In that case,  his body will still be phenotypically male, entering puberty, when he enters middle school, whether as as Joseph or Kai. Now, that will be a  “difference” evident to all the girls, including the ones who have never seen male genitals. 

It will be very evident to the survivors ​of sexual abuse. Hopefully, they called the police after they were abused.

Contrary to the claim in the blog,  Lt. Governor Patrick and the “Bathroom Bill” didn’t start the trans debate.  School districts in Texas were changing policies, entire cities have passed ordinances, and the last President issued an Executive Order that threatened Federal education dollars. 

And preditors are taking advantage of the increased access available due to the transgender debate: men like Paul Witherspoon, Levandus Gacutan, Christopher Hambrook, Richard Rodriquez, Jason Pomare, Sean Patrick Smith, or the many unnamed men who have been not reported to the police when they enter previously gender-segregated areas like poolside changing rooms, shower rooms or gym locker rooms. (I’ll let you research those names.)

Thanks to “Conservative, Christian” mom, the world is being misrepresented to other children who are encouraged to consider pathological behavior as not “different.” Because of “feelings” the rest of us are repeatedly told to ignore the difference –  and observable,  measurable, and verifiable facts. 

And this specific child is being abused. 

Beverly B Nuckols, MD. 

Equal, but special

A Facebook friend, Michael Smith, made an excellent comment about the contrast between “separate but equal,” and “equal, but special.”

I spent some time yesterday at the Texas State Capitol Reagan Building discussing House Bill 2899 by Simmons, which would prohibit local governments and other regulatory authorities from creating a new “order, ordinance, or other measure to protect a class of persons from discrimination; to reduce or expand a class of persons protected under state law from discrimination.”

The consensus of a group of people waiting for the House State Affairs Committee to begin was that the Bill is a thinly veiled “attack” on the LGBT community and transgender persons in particular. The comment that made me go into my Don Quixote tilting windmills mode was about just wanting to “peeing in peace” and the false claims of fears for safety of women and children.

I pointed out that that it is reasonable for women to have fear when confronting a man in a closed space and that we all expected privacy and security in bathrooms, locker rooms and other public places where people disrobe. (Yes, I used the term “disrobe.” And “intimate spaces.” I’m a nerd.)

I was told that I was speaking from “privilege” (!) for my example of caution when entering an elevator with a strange man and objecting to the stereotype that the brains of men and women are different and the assertion that men and women simply think differently. I heard that segregation of the sexes in public bathrooms is a new phenomenon and that the Roman baths, such as those in Pompeii were completely different matters, mainly due to the religion of the time.  And of course, several of the group told of the danger of violence against gays or trans but that there has never been any crime against other people by transgender person

Two of the people claimed to be transitioned from male to female. While demanding “respect,” they told stories of having coworkers fired for refusing to use their preferred pronouns. and engaged in very real “hate speech,” mocking and assigning hateful motives and emotions to me. The same person who pointed out that little boys can be molested in men’s bathrooms then said that *I* was the one who must obviously consider anyone with a penis a predator.

The group was secure in the belief that the fears of violence and abuse of the LGBT community outweigh not only the fears of victims of sexual abuse or parents of children and thousands of years of social norms.

Cities, but claiming to write non-discrimination ordinances create environments where some people are “equal, but special” – or a specially protected class of persons. George Orwell put it another way: “Some animals are more equal than others.”

Law makers to doctors: “Keep the patient alive” 

If only we doctors – or legislators, lawyers and probate judges – really had the power to “keep the patient alive” as this article claims two new Bills  (  HB 4090 & SB 1213) in front of the Texas Legislature will (force doctors to) do. 

The article is misleading in its claim that a committee or a hospital decides whether or not a therapy is given: Texas doctors practice medicine in Texas. Even the Bills make it clear that the “attending physician” makes the decision whether or not to follow the patient’s (or more likely, the surrogates’) medical request.

We – Texas doctors, hospitals, and legislators – have tried repeatedly over the last decade to amend the law, Texas’ Advance Directive Act,   to increase the time frame. Last Session, we helped to ensure that food and water can’t be withheld. The lawyers and those who would have Estate (probate) judges involved in every dispute – even at the bedside of the dying – have blocked effort after effort because the Bills did not include liability for the doctor. 
These Bills are just the camel’s nose under the tent of Texas’s tort reform. Worse yet, we’d end up with medical expert testifying against medical expert in court, with the judge eventually telling the doctor how to practice medicine. It would also severe the “ethicists” who actively seek to undermine conscience protections for health care professionals.
If you’ll notice, the Bills also remove the requirement for the patient to pay for any transfer, too. I don’t suppose that the tort lawyers ​will pay for the ambulance or plane ride.

Do you want Texas law to force doctors to practice against our consciences​? 

How long and how far should any man or woman be forced by law to act against his or her will?

​Would you like to refuse?

Shocking Bill from Texas’ Jason Villaba, Republican State Representative from Dallas’ District 114 :  HB 1938 would make organ donation after death “opt out” for anyone applying for a driver’s license in Texas.

Texas would be the first State to pass such a law.

Organ donation is a public good for those who wish to do so. However, there is no ethical or legal precedent for treating human bodies – living or dead – as public property or commodities.

From the Bill as introduced:

 (2)  for an applicant who is 18 years of age or older:
                     (A)  specifically ask each applicant the
  question, “Would you like to refuse to join the organ donor
  registry?” and state, “If you answer ‘no’ to the previous question
  or do not answer the previous question, you consent to join the
  organ donor registry by performing either of those actions.”; and
                     (B)  if the applicant does not affirmatively
  refuse to be included in the registry under Paragraph (A), provide
  the person’s name, date of birth, driver’s license number, most
  recent address, and other information needed for identification
  purposes at the time of donation to the nonprofit organization
  contracted to maintain the statewide donor registry under Section
  692A.020, Health and Safety Code, for inclusion in the registry.

http://www.legis.state.tx.us/tlodocs/85R/billtext/html/HB01938I.htm

More Fake News (5 year old handcuffed – NOT)

The Baltimore Sun is one of the online news sites I read because it’s more reliable than others. Usually.
Now, they’ve published an opinion piece with a falsehood about “inhumane acts” that were supposedly the result of President Trump’s Executive Order on travel to the United States from certai countries. At less one of those stories was easily debunked with a quick news search.

The story that a 5 year old boy was handcuffed is at false, according to a news report by WUSA9, from Washington, DC:

We tracked down the actual photo to a controversy in Kentucky involving sheriff’s deputies handcuffing young students with learning disabilities, back in 2015.

Another story going around is that a 5 year old Syrian girl was hand-cuffed by Immigration, also at Dulles. 

The anything-but-right-wing Snopes has already published a denial about the little girl. (Of course, the verdict is, “Mixture,” rather than,”False.” Can’t go risk validating anything that might have resulted from the Trump EO, I guess.)

In this case, the father even said the airport officials were kind to the family.

All of which confirms that we need to do our own research and seek out”alternative” sources to confirm or deny “facts” reported in the news.

National Security Letters

​While we were distracted by whether Kellyanne Conway was “lying” about “alternative facts” and how mean Bannon and Spicer are, the FBI quietly lifted the gag order on National Security Letters issued by them during the previous Administration.

Now, I’m not a lawyer, so the following is a lay explanation.

These “Letters” are in fact, subpoenas issued by a government agency. They don’t require a judge or FISA Court review or warrant. 

Get this: the laws authorizing the NSLs are called “Patriot” and ” Privacy” Acts and the gag order provisions have been vetted by the Ninth Circuit of Appeals:

However, the government appealed to the Ninth Circuit Court of Appeals, which vacated her ruling and sent the case back to the district court. Last month that court ruled that the gag order challenge was no longer relevant because the USA Freedom Act had successfully addressed the issue of gag orders

GoogleTwitterFacebook, and others reported the release from the gag order during the last couple of months. Yahoo, along with the others, has been fighting in court and some of the Letters have been disclosed to the targets:

Over the past several years, Google challenged 19 NSLs in court and last year won the right to tell WikiLeaks employees that their data had been requested.

I sincerely thought that all of these sorts of subpoenas were required to eventually go through approval of a FISA Court judge. Hopefully, the Trump Administration will not continue the Obama Administration’s abuse of these Letters and that Congress will correct the law.

Don’t regulate plants!

​Ridiculous! It’s a plant. Which literally grows like a weed – or house plant – and doesn’t require manufacturing or processing to use. What business does government have in outlawing a plant?

Marijuana laws are in the news in Texas, once again. I hear and read plans to make money from taxes and autocratic demands to”protect” people from the plants. The same Republicans who demand legalization of the sale of raw milk and think gambling dollars should stay in the State argue against any decriminalization of marijuana.

Even if you don’t have sympathy for the thousands  jailed for use while the plant is illegal, the raids on gardensseizures of farms or the arrests of people because owners are suspected of growing illegal *plants* should make you consider the harm from draconian narcotics laws. 

In fact, my trouble getting poppy seeds for the hard, back in the’90’s is what changed my mind about these laws. The Clinton Administration was arresting people for selling seeds and dried pods used in crafts:

Somniferum is the only poppy species mentioned in the federal Controlled Substances Act of 1970, where it is listed as a Schedule II drug, the same as cocaine. The entire poppy plant, not just the opium that oozes from its green seedpod, is considered contraband.

“But the law specifically exempts somniferum seeds, those blue-gray dots you find on your bagel. So chew on this: Seed companies can legally sell opium-poppy seeds, but gardeners who buy those seeds break the law by planting them.

Republicans are advocates of personal responsibility and remind others about the words in the Declaration of Independence. We should know that legitimate laws are intended to protect us from the infringement of inalienable rights by third parties — and the government. Laws are not meant to protect us from ourselves.

In a liberty-minded, Republican-controlled State and Nation, there shouldn’t be any laws against growing seeds from your grandmother’s heritage poppies or your new neighbors’ marijuana plants.

Addendum: a 1992 article about poppies at Thomas Jefferson’s Monticello:

Thomas Jefferson planted white opium poppies at Monticello. They grew in the historic garden near Charlottesville, Va., until last June, when they were yanked up.

****

“The center even sold the seeds. Until its governing board — “which has a mania for being legal,” Mr. Fitzpatrick said — decided to press the issue.”

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