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?
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.
But if you want information about the (correction, it’s Friday, not Thursday, repeat as necessary ) Friday , January 27, 2017 March, you probably should search for “Anti-abortion March.”
The New York Times managed to “report” that Kellyanne Conway will speak at the 2017 National March for Life in Washington, DC on Friday , without once calling the March by its proper name. The only time the organization responsible for 44 years of the “Anti-abortion March” is named, is when giving the job title of the president of March for Life, Jeanne Mancini.
This year’s March wasn’t held on the anniversary of Roe v. Wade, as it has been in the past, due to the inauguration events on Friday and, I suspect, the Women’s March on Saturday. The inauguration events didn’t prevent us from attending the 2009 March the day after Barack Obama was sworn in, but I imagine the concern about the two opposing groups clashing in front of the Supreme Court was just too much this year.
Friday is probably not the best day for families, school groups and people who have regular jobs, but I expect it will be well attended, since we’ve been promised a “heavy administration presence.” There have been related Marches for Life all over the country all week (Idaho, San Francisco, Tulsa and Raleigh, where it was noted that both the Women’s March and the March for Life were held at the same time – but across town from one another.)
You might also search for “Rally for Life,” as the Texas Rally for Life will be held in Austin on Saturday, January 29. Beginning at 12:00 – 1:00 PM, marchers will gather at 18th & N. Congress Ave. and then begin the short march to the South Steps of the Texas State Capitol.
(Edited to correct the day of the week of the March for Life in Washington, DC. BBN)
The future includes so much more than a 10 year old video, for people who don’t have memory problems.
Forget the Clinton’s sale of nights in the Lincoln Bedroom and misplaced furnishings from the White House and, later, the State Department offices. Go ahead, laugh at the “Reset button.”
But don’t forget the pay-for-access that continues to this day. Please don’t dismiss Clinton’s complicity with the sale of US uranium and her own dismissal of the deaths of four Americans at Benghazi or of “our posterity” in the case of the unborn children whose lives are ended by elective, intentional abortion.
These recollections make a difference today and for the future.
What place will there be in a Clinton II Administration for people who oppose abortion or who prefer to continue to include “under God” in the Pledge of Allegiance? Can we tolerate another 4 years of IRS discrimination against conservative non-profits? Do we need to have more lawsuits against nuns or regulations forbidding Christians from praying in the name of Jesus?
We certainly won’t be invited to any closed door meetings on HillaryCare. And there’s no telling how many boxes of FBI files and billing records will disappear never to be “recalled” if Clinton gets another shot at the White House.
I would much rather hold Donald Trump to his promises than watch Hillary Clinton keep hers.
Beverly B Nuckols, MD
“After a special workshop held at the Brocher Foundation in Geneva, Switzerland, over a dozen bioethicists signed a ten-point“Consensus Statement on Conscientious Objection in Healthcare.” The group stated that “healthcare practitioners’ primary obligations are towards their patients, not towards their own personal conscience”. As a consequence, “healthcare practitioners who are exempted from performing certain medical procedures on conscientious grounds should be required to compensate society and the health system for their failure to fulfil their professional obligations by providing public-benefitting services.” They also stated that “Medical students should not be exempted from learning how to perform basic medical procedures they consider to be morally wrong.”
“This implies that regional authorities, in order to be able to provide medical services in a timely manner, should be allowed to make hiring decisions on the basis of whether possible employees are willing to perform medical procedures to which other healthcare practitioners have a conscientious objection.”
Timely still, this essay by CS Lewis on “subjectivism.” Please watch the last few minutes – from about 10:30 in – if not the whole 13.
Lewis asserts that the idea that “good” can vary or is a product of evolution or conditioning will ultimately lead us to a society divided between the “conditioners” – eugenicists, (capital s) State educators, and producers of mass propaganda – and the conditioned.
Those conditioners sound like our community organizers and progressives, who, in denying the time-tested absolute, ” self evident truths – while demanding that we accept the latest declaration of the “Social Justice Warriors” as . … absolute, self evident truths.
While questioning the validity of any authority in order to demote conscience to opinion, they assume authority and invoke the conscience of the conditioned to enforce compliance. How often do we find ourselves shamed for objecting to actions that have been considered shameful for thousands of years by nearly every society on earth?
And since the SJWs (or their conditioners) de- and re-construct “truths,” their own consciences allow them to believe that they and their allies aren’t bound by the same “truths” that they hold the rest of us to.
So, the next time yo find yourself the target of ethnic/gender/social conditioners for expressing truths that Aristotle, Hippocrates, the signers of the Magna Carta or the Declaration of Independence – or even Jesus – would have recognized as self evident, turn their argument back on them. What is their authority, where is their evidence and how valid is it?
*The authors of a study published in the New England Journal of Medicine admit to a narrow focus that ignored the multiple methods of funding Family Planning in Texas, looking instead at a single type of “provider” – Title X clinics like Planned Parenthood (“PP”) – and a single source of funding for a specific set of services: long-acting reversible contraceptives such as the IUD and implants and injectables.
Yet, in typical fashion, the reports about the study claim much more. For example, the Texas Tribune has an article out, “Texas disavows Controversial Women’s Health Study,” about the political fallout due to the skewed conclusions of the authors and the even more skewed editorializing in the media.
While the NEJM article (free article!) states in the “Methods” section that,
“After the exclusion, the provision of injectable contraceptives fell sharply in counties with Planned Parenthood affiliates but not in counties without such affiliates; subsequently, the numbers of claims in both groups of counties remained relatively stable during the next 2 years. In contrast, the provision of short-acting hormonal methods changed little in the two groups of counties in the quarter after the exclusion and declined steadily thereafter.” (Emphasis mine. )
the Tribune article reports that in answer to criticism,
Joseph Potter, one of the UT researchers who co-authored the study, said in an email that the paper addressed the “specific question” of how the exclusion of Planned Parenthood from the Texas Women’s Health Program affected women. Nothing raised in Traylor’s letter, he said, contradicted the researchers’ conclusions.
“We made no claims about access to reproductive health care as a whole in Texas,” he said, and he stood by the finding that claims for long-acting contraceptives fell after Planned Parenthood was excluded from the women’s health program.
The law in question, SB7, was passed with bipartisan support in 2011, a year when Texas, along with State budgets all over the Nation were tight. Although family planning was cut, no specific vendor was “excluded” and PP was not even mentioned in the legislation. Only because PP did not offer continuing, comprehensive care, that business would effectively be cut out.
The Obama Administration took great offense at our State’s attempt to take care of the whole woman and refused all Family Planning Title X money for Texas Medicaid.
Instead, Obama intervened to specifically direct $13 Million of Title X funds to a private organization,the Women’s Health and Family Planning Association of Texas (“WHFP”) which funds only Title X clinics, almost all of which are now Planned Parenthood businesses), so no money was lost even at PP.
The State Health Services no longer managed those Medicaid matching dollars once allowed by a special Medicaid waiver. Instead, State funding for the Family Planning programs and the Texas Women’s Health Program, was replaced by State dollars and directed toward programs and doctors that offer continuing, comprehensive care, such as Federally Qualified Health Centers (FQHC), State, County and local clinics and hospitals, and fee for service doctors that participate with Medicaid. Women could be diagnosed and treated for a much broader spectrum of health problems and their families were welcome at the same clinics.
Senator Jane Nelson, Chair of the Senate Finance Committee and sponsor of the Bill, objects to the implication by the NEJM that the authors were writing on behalf of the State. In her letter to the Executive Commissioner of Texas’ Department of Health and Human Services, Chris Traynor, Senator Nelson noted,
“This study samples a narrow population within the Texas Women’s Health Program (TWHP) — which represented only 33 percent of the overall number of women enrolled in our women’s health programs in Fiscal Year (FY) 2014. This ignores hundreds of thousands of women being served through the Expanded Primary Health Care Program; the Family Planning Program; and the 628,000 women of child-bearing age receiving full Medicaid benefits, 75 percent of which received contraceptive services in FY 14. Women often rotate in and out of our state programs, so we must look across our entire system to determine whether we are truly meeting their needs. Just because a claim for service was not submitted to TWHP does not mean a woman went without that service.
The study also creates an impression that fewer Texas women are accessing long-acting reversible contraceptives (LARCs). That’s simply not true. Across our state programs, there were more claims for LARCs in FY 2014 than there were in FY 2012 when Planned Parenthood was still a provider.”
In other words, women with private insurance and women who never had access to PP had similar numbers.
And another thing: Potter, a sociologist at UTAustin and the co-author quoted above, was the one who told the LA Times that, “It’s not like there is a large, over-capacity of highly qualified providers of effective contraception out there just waiting for people to show up.”
On behalf of Texas’ Family Physicians, OB/Gyns, Pediatricians and Internists who accept traditional Medicaid and who had been unable to access the money in those competitive Title X grants awarded to PP, I’d like to inform him that yes, we have been waiting – for a chance to offer our patients this care.
But other than that ….
Death, lies and video
Supported only by his imagination, what he saw in videos produced by Texas Right to Life lawyers, and a news article,Dr. Phillip Hawley, Jr., M.D., wrote “A Tragic Case of Modern Bioethics; Denying Life-Sustaining Treatment to a Patient Who Wanted to Live” about the truly tragic, but inevitable death of Chris Dunn. Hawley erred by pretending to read the minds of doctors and hospital representatives and calling complete strangers “utilitarian” “murderers.” Before discussing the ethics of his accusations, it’s necessary to explain the meaning of the documented facts, available in news sources, blog posts and court records:
It is very unlikely that Chris understood his condition, the questions the lawyers were asking or the consequences of his “prayer.” That he was unable to make medical decisions is supported by the fact that his parents had been making his medical decisions. The Harris County judge agreed with the hospital’s request that a single legal guardian be named by a separate court.
“Life-sustaining treatment,” “medically inappropriate” and “Artificially Administered Nutrition and Hydration” are legal terms defined in the Texas Advance Directive Act (TADA), which outlines the exact procedure and language for communications between doctors, the hospital committee, and patients or their surrogates. The use, monitoring and adjustment of a mechanical ventilator is in the definition of “life-sustaining treatments.” TADA specifically excludes “Artificially Administered Nutrition and Hydration” (AANH) in the definition of “life sustaining treatments,” which would argue against the accusation that his doctors planned to withdraw “food and water.”
The only legal reason under TADA to remove any “life-sustaining treatment” is that it is deemed “medically inappropriate” by the attending physician and then only if the hospital medical or ethics committee “affirms” that decision. If and when they are withheld, the Act specifically prohibits “mercy killing” or otherwise intentionally intervening with the intent to cause death by artificial means.
Additional demands by Chris’ mother, Mrs. Kelly, and the lawyers in blogs and news articles would have also fallen under the legal definition of “life-sustaining treatment.” These demands included a biopsy in order to determine a definitive tissue diagnosis for the clinically apparent pancreatic cancer and liver lesions, a surgical tracheostomy and the removal of the ventilator (to be fair, I believe they meant the tube through the vocal chords), less sedation, searches for and trials of treatment of the cancer, and the non-standard use of an indwelling drain for the ascites (large exudates in the abdomen due to high pressures in the liver and the failure of the liver to make necessary proteins). These are invasive, potentially painful and, based on the reported size and effects of the mass, the extent of liver damage visibly evident in the videos as temporal wasting and copper-colored skin, ascites and the GI bleeding – they were very unlikely to lengthen his life, much less cure his cancer. In fact they could be very likely to hasten – or be the immediate cause of – his death.
Chris died in the ICU on full life-sustaining treatments, including the ventilator and intravenous AANH.
The doctors are on record as basing their decision on the suffering caused by the treatments to their patient, Chris. This is consistent with the known side-effects of the ventilator and even reports from Chris’ mother, who told reporters that Chris suffered from the treatments and fluid building up in his lungs despite the ventilator. And yet, Dr. Hawley made sensational statements such as:
“For patients with terminal illnesses, this standard often leads to the utilitarian question: Is the patient’s life still worth living?
“In Chris Dunn’s case, the committee’s answer was “no.” Relative strangers with little or no knowledge of his values and beliefs weighed his “quality of life” and decided that he no longer deserved to live.”
“. . . How did these committee members who had only recently met the patient—if they ever met him at all—know that it was in his best interest for them to end his life?”
“. . . But, somehow, we are to believe that these committee members were able to deduce existential truths about what was in Chris Dunn’s best interest?”
The physicians who cared for Mr. Dunn for over a month had certainly met him and members of the Methodist Hospital Biomedical Ethics Committee met with the family several times. Court documents are clear that the doctors believed the life-sustaining treatments were causing suffering and that the committee agreed that the treatments were medically inappropriate. There certainly is no evidence that the doctors or the committee members sought to intentionally “end” Chris’ life. “Medically inappropriate treatment” is not an “existential truth” and never in the patient’s best interest.
(Some may remind us that suffering can have benefits. However, Mr. Dunn couldn’t consent to suffering, much less benefit from the suffering, whether as a medical treatment or a willing religious self-sacrifice.)
Robert P. George is one of my heroes a conservative tenured professor of law and ethics at Princeton and one of the founders of the Witherspoon Institute, an organization known for its defense of Judeo-Christian ethics based on natural law, and the parent organization of Public Discourse. He has helpfully outlined a “key” to evaluate the withholding or withdrawing of life-sustaining care:
“[T]he key is the distinction between what traditionally has been called “direct killing,” where death (one’s own or someone else’s) is sought either as an end in itself or as a means to some other end, and accepting death or the shortening of life as a foreseen side effect of an action or omission whose object is something other than death—either some good that cannot be achieved or some evil that cannot be avoided without resulting in death or the shortening of life.”
George and Hawley each point to a value in medicine that is higher than autonomy or even preserving life at all costs: the duty of physicians to care for the patient. “Cure when possible, but first, do no harm.”
The lawyers didn’t just sue to maintain “life-sustaining treatments,” or even Mrs. Kelly’s right to force the doctors to treat Chris the way she wanted them to. The lawsuit, blog posts and public statements document the ultimate goal to have TADA declared unconstitutional and to force all doctors to give patients and surrogates the right to demand any and all desired treatment indefinitely. The power of State courts, law enforcement and licensing would be used to force Texas doctors to carry out acts against our medical judgment, education, experience and conscience.
What justification can the lawyers and Dr. Hawley give for not believing the physicians who care for patients daily and hourly when those caretakers document that the patient is suffering?
What kind of physicians will we end up with if the State can force us to act without judgement or conscience?
What kind of State would we have?
Based on a video and his imagined conversations between “malevolent” and “utilitarian” doctors and hospitals, Hawley declares Texas a “morally impoverished society.” Ignoring sworn statements from the physicians and misrepresenting TADA, he distorts the purpose of the Texas Advance Directive Act, which is to address the problems encountered when patients and surrogates disagree., Only by assuming evil intent is he able to force doctors to prove a negative and distract from any possibility of a conflict between the equal and inalienable rights of the patient and the doctor.
While the video of Chris apparently praying to be allowed to live wrenched at our emotions, it was used to tell a false story upon which Dr. Hawley built his harmful assumptions. We would all do well to remember my Mama’s advice: Don’t believe anything you hear and only half of what you see.”
Edited for grammar and decrease wordiness and formatting (1-15-16). BBN
And stop “sharing” them!
Remember who the real opponents are: the Dems!
No matter how juicy the gossip, consider waiting a few hours for the rest of the story to come out.
(BTW, this is a test of my mobile app.)
Posted from WordPress for Android. Typos will be corrected!
Liberty is not simply the freedom to act, it’s the more fundamental freedom not to act. Remember the proverb that “The right to swing your fist ends at the tip of my nose?” True liberty includes the right *not* to make a fist at all. To force the hand of a person against his will other than to defend the higher-priority right to life is to enslave him.
The same sex marriage ruling and protected status for “sexual orientation” is the latest socialist infringement on the inalienable right to liberty. In the name of “equality,” “fairness” and even “liberty,” they attempt to give government the ownership of all property and the means to earn it.
In particular, they demand that people of conscience either deny their faith or get out of government and public activities, including business and earning a living. (For real life examples, read the earliest few comments, here. Or here.)
People who want what they want, when they want it, and from whom they want it seem to have no problem forcing other citizens to act against their will. In order to devalue the right of conscience and religion they deny the rights in the First Amendment of the Constitution – or the very existence of inalienable rights at all.
The Board of Labor of Oregon just gave us a perfect example just this week. Brad Avakian, the judge in the Sweet Cakes Bakery case, has slapped the couple with a gag order. He would deny them free speech as well as the free exercise of their religion.
Here’s the justification for that order.
(Thanks to Kelsey Harkness!)
The Supreme Court of the United States, States and local governments cannot create a world of gumdrops and lollipops, where everyone likes everyone and everything they do. There is no right not to be inconvenienced, much less the right not to be offended. The right to liberty of anyone may not be infringed for the benefit of another person’s pursuit of happiness without significant distress to society and government.
Read the Declaration of Independence to see what happens when governments attempt to do so.
Wells Fargo is celebrating “diversity” in their new ad showing two women learning sign language. The story reveals that the women are a lesbian couple, about to be the “new mommies” to an adopted girl who is deaf.
(Oh, look! The gay couple are doing such a good thing! Celebrate their goodness! Ignore the political and spiritual realities! And attack anyone who points out those realities!)
Wells Fargo could have simply depicted a traditional married couple, a man and woman, a doing the same thing — perhaps even learning a language in order to do mission work. Instead, they went out of their way to celebrate a small population that a much larger population considers to be practicing a sinful lifestyle.
How I wish the company had used their advertising dollars to give attention to Samaritan’s Purse, an organization that is “Helping others in Jesus’ name.” Talk about diversity! Take a look at how they are helping mommies around the world.
There’s still 2 more days for early voting in the Comal Independent School District Bond and School Board Election. Regular Election Day is May 9.
Here’s the times and places for early voting on Monday and Tuesday!
(Thanks to the New Braunfels Republican Women for the information!)
May 4 & 5 – Early voting
During early voting, you have the opportunity to cast both votes at one place!
You can cast both your votes for New Braunfels City Council (Districts 3 & 4) and Comal ISD School Board (Districts 1, 2, 5, & 6) and school bond locations at:
The Comal County Elections Office May 5 – 8am to 5pm
178 E. Mill Street, Suite 10 May 4 – 7am to 7pm
New Braunfels 78130
Bulverde City Hall May 4 – 8am to 5pm
30360 Cougar Bend May 5 – 7am to 7pm
Garden Ridge City Hall May 5 – 8am to 5pm
9400 Municipal Pkwy May 4 – 7am to 7pm
Garden Ridge 78266
Early voting for CISD School Board (Districts 1, 2, 5, & 6) and school bond only:
May 4 & 5 – 7am to 7pm
Bill Brown Elementary Hoffmann Lane Elementary Rebecca Creek Elementary
20410 Hwy 46 W. 4600 FM 306 125 Quest Ave.
Spring Branch 78070 New Braunfels 78132 Spring Branch 78070
Comal ISD Support Serv. Indian Spring Elementary Smithson Valley Middle
Admin. Bldg. 25751 Wilderness Oak 6101 FM 311
1404 I-35 N. San Antonio 78261 Spring Branch 78070
New Braunfels 78130
Church Hill Middle Kinder Ranch Elementary Timberwood Park Elementary
1275 N. Business 35 2035 Kinder Pkwy. 26715 S. Glenrose
New Braunfels 78130 San Antonio 78260 San Antonio 78260
Clear Spring Elem. M.H. Specht Elementary
550 Avery Parkway 25815 Overlook Parkway
New Braunfels 78130 San Antonio 78260
Saturday, May 9 – Election Day – Polls open from 7am – 7pm
New Braunfels City Council (Districts 3 & 4)
Election Day polling locations at:
**NB City Council District 3 – Seele Elementary School, 540 Howard Street, New Braunfels
**NB City Council District 4 – Faith United Church, 970 N. Loop 337, New Braunfels
For City Council District Map – http://www.nbtexas.org/DocumentCenter/Home/View/1480
(also listed on your Voter Registration Card)
Comal ISD School Board (Districts 1, 2, 5, & 6) and school bond only
Election Day polling locations at:
Single Member District 1 Single Member District 2 Single Member District 3
Clear Spring Elementary Faith United Church Rebecca Creed Elementary
550 Avery Parkway 970 N. Loop 337 125 Quest Ave.
New Braunfels 78130 New Braunfels 78130 Spring Branch 78070
Single Member District 4 Single Member District 5 Single Member District 6
Smithson Valley Middle School Bulverde City Hall M.H. Specht Elementary
6101 FM 311 30360 Cougar Bend 25815 Overlook Parkway
Spring Branch 78070 Bulverde 78163 San Antonio 78260
Single Member District 7
Garden Ridge City Hall
9400 Municipal Parkway
Garden Ridge 78266
We may not ever solve the problem of an irresponsible tabloid press and sensation-seeking media, since the freedom of speech is too important to infringe. But we do have power over those we license as physicians.
Dr. Walt Larimore enters the vaccine debate in his blog, not by suggesting forced vaccination, only the regulation of physicians. I wouldn’t support the recommendation without some leeway — I’m certainly not going to approve of every vaccine without a time trial in this very diverse lab that is the United States.
However, Dr. Larimore and his guest author, Dr. Russell C. Libby, are right to raise the ethical and medic0-legal responsibility of physicians who are licensed by the State and who advocate against good science and medical standards.
From the article:
“State medical boards must decide if the actions of healthcare practitioners who advocate against vaccination and undermine the public health efforts of their communities warrant investigation and intervention. There are a number physicians and other licensed healthcare professionals who trivialize and discourage immunization, whether it be for philosophical, financial, or self-promotional reasons.
“When the patients they influence contract preventable disease and have bad outcomes or they cause the spread to a vulnerable population, they should be held liable for malpractice. If it is in the midst of an outbreak or epidemic, medical boards need to sanction or suspend licenses.”
I’ve spent quite a bit of time — especially over the last week – attempting to educate interested people (including a family member) about the safety and usefulness or efficacy of vaccines. My motto for these arguments has always been that, “Truth will out,” and, “If we’re right, we should be able to teach and convince.”
However, within the last week, an irresponsible Texas radio host trotted out the discredited and un-licensed doctor who fabricated the MMR/autism fraud and a Canadian newspaper published a hit piece on Gardasil. (You can find them easily on Google – I won’t give them “hits” from my page.)
When licensed physicians – men and women who should know better – spread demonstrable lies, even after being found guilty of fraud or when demonstrably spreading harmful misinformation, there should be consequences.
Contrast the Hippocratic ethic in which a physician recommends treatment to his patient, based on his best medical judgement in the patient’s interest, with that of the “veterinary ethic,” where decisions are made by the “payor” — or owner. Now, consider the effect of Government regulations which arbitrarily force doctors to learn protocols and guidelines (rather than adjust to the patient’s course of illness), to fit a patient’s illness into International Clinical Diagnoses (out to the nth decimal place) and which withhold payment when a patient becomes ill enough to need readmission to the hospital within 30 days of the last admission.
In an article published online by Cato, Dr. Jeffery Singer lays out the history of the destruction of Medicine as a profession. In the past, Dr. Singer described the ethical transition toward the “veterinary ethic.”
Each of these articles is worth your time and consideration. The first article gives one of the best explanations of the Government move to “coding” of medical diagnoses in exchange for
payment “reimbursement,” on through the forced move to Electronic Medical Records without evidence that patients will benefit and Accountable Care Organizations which assign patients to employee “providers.” The second, earlier article, reviewed the necessary change in medical ethics to allow doctors to practice without – or in contradiction to – their conscience.
Forget patient autonomy, long elevated by the lawmakers, lawyers and Ph.D’s (in the name of “Bioethics”) above the traditional physician Hippocratic values of beneficence and its foundation, non-maleficence. In the world of Government medicine, your life is in the hands of the “payor:” the Golden Rule of “He who has the gold makes the rules.”
“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.–That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed . . .”
Yes, I’m using the Declaration of Independence to explain the ethics of quarantine. In fact, I suggest that the inalienable rights to life, liberty and “the pursuit of happiness” actually requires that a “just government” quarantine people who endanger the life of others, while doing as much as possible to preserve the rights of those who are quarantined.
The threat of the Ebola virus has spurred the discussion about quarantine in the United States, due to the high mortality rate of the disease. We’ve forgotten the quarantines of the past and most people are unaware of the existence of Presidential Executive Orders concerning formal lists of “Quarantinable Diseases.”
Inalienable or fundamental rights are negative rights. Consider the proverb that “Your (inalienable) right to swing your fist ends at my nose.”
Negative rights are limited to prohibiting action, in contrast to positive rights, which would force others to act for our benefit. That means that we have the right not to be killed, enslaved, or coerced into acts by others – you have the right to swing that fist as long as you don’t hit anyone else by intention or accident.
However, when a third party’s action or negligence threatens to infringe on our fundamental rights we have the right to protect ourselves and our fellow citizens, in the form of government, have a duty to assist us.
This protection should involve the use of the least force possible, for the least time possible, and we must take care not to become guilty ourselves of unnecessarily infringing the inalienable rights of others by abusing the government enforcement of quarantine. When government acts to limit the liberty of people by quarantine, it is imperative to ensure that there is a real threat to the lives of others, to limit the time of quarantine to the time the person is a possible threat, and to protect the lives of those people by providing food, shelter and medical assistance for those who can’t provide for themselves.
Not only is it ethical to implement restrictions on people coming to this country from areas where the disease is epidemic, it is the duty of government to protect the right to life of our citizens by implementing procedures for involuntary quarantine within our borders.
Forty years ago the words “fertilization” and “conception” meant the same thing to doctors, lawyers, and embryologists alike: the joining of the 23 chromosomes in the sperm with the 23 chromosomes in the oocyte (“egg”) to form a new complete, unique human organism. “Contraception” was defined as any method that worked before the existence of the embryo by preventing fertilization. These were the hormonal treatments and devices that prevent ovulation of the egg and condoms, diaphragms and sterilization that serve as “barriers” between the sperm and egg. Drugs and devices that may or may not end the life of the embryo after fertilization were legally and correctly called “abortifacients.”
However, legalized abortion and the ability to accomplish fertilization through in vitro methods led to new legal definitions of “pregnancy” and “conception” as beginning at implantation rather than fertilization. Even in vivo, healthy human embryos in healthy mothers were deprived of legal protection as human beings for at least the first 5 – 10 days of their lives, the window of opportunity for implantation when the developing embryo grows to hundreds of cells organized in 2 or 3 recognizable tissue layers and interact with the mother’s body in ways that may affect the timing of birth or risk of diabetes and other health concerns. Possible abortifacients that work after fertilization but before implantation were redefined as “emergency contraception.”
In spite of what you may have heard on the news, the June 30, 2014 Burwell v. Hobby Lobby decision by the Supreme Court of the United States (SCOTUS) didn’t deny birth control for anyone. Everyone may still purchase his or her own FDA-approved birth control. SCOTUS simply ruled that the government can’t force some employers to buy things that they believe are immoral.
In fact, Hobby Lobby only asked to be exempt from purchasing insurance plans that paid for specific drugs and devices used for “emergency contraception.” Before the passage of the Affordable Care Act (“ObamaCare” or ACA), the company purchased insurance that included true forms of contraception, including,
- Those that prevent ovulation by preventing the normal ups and downs of the hormones estrogen and progesterone, such asBirth-control pills with estrogen and progestin (“Combined Pill”),Birth-control pills with progestin alone (“The Mini Pill”),Birth control pills (extended/continuous use), Contraceptive patches, Contraceptive rings,Progestin injections, andImplantable rods
- Those that act as “barriers” to fertilization by preventing the union of sperm and egg: Male condoms, Female condoms, Diaphragms with spermicide, Sponges with spermicide, Cervical caps with spermicide, Spermicide alone, Vasectomies, Female sterilization surgeries, and Female sterilization implants.
The problem is that regulations written by the Obama Administration mandated that all insurances pay for all pregnancy “preventatives” approved by the FDA, including drugs and devices that may function after fertilization to end the life of the new human embryo:
- Pills that mainly delay ovulation but may impair implantation and development of the placenta if fertilization takes place, such as over-the-counter Plan B and generic levonorgestrel tablets, and ella, which requires a prescription, and
- Devices that mechanically and hormonally make the uterus inhospitable to implantation by the embryo, such as intrauterine devices like the copper-T, Mirena, and ParaGuard. These are inserted up to 5 days after unprotected intercourse to prevent implantation and then left in place to prevent fertilization and implantation for as long as 5-10 years.
Although the words we use do not change the fact that the human embryo is the same human life before implantation as after, they can change his or her legal status.
For questions about the decision and history behind it, read this!
Remember, no one is forbidden to buy anything. However, the US Government will not force people or their companies to pay for devices and drugs they believe are immoral.
The Affordable Care Act regulations issued by the federal government, however, required twenty different preventive methods or services, including sterilization and pregnancy counseling. Depending upon how lower courts now interpret the Hobby Lobby decision, companies that fit within the Court’s “closely held company” bracket and offer religious objections could be spared from having to provide any of those services through their employee health plans.
In three cases in which a federal appeals court had rejected the challenges to the mandate, the new Supreme Court orders told those courts to reconsider, applying Monday’s decision. The companies or their owners had taken those petitions to the Court.
On three petitions filed by the federal government, involving appeals court rulings rejecting the challenges by corporations. their owners, or both, the Justices simply denied review.
I’ve had privately insured and Medicare patients – and at least two families visiting our town from Canada – ask me to keep records about one or another history or ailment. I told them I’d do my best, but explained the legal problems with Medicare laws. Since 1997, doctors have been prosecuted for refusing to allow Medicare auditors to see everything in the office. One woman doctor was arrested for refusing to unlock a drawer in her (private?) desk.
And now, the IRS wants control of your medical care.
The confidentiality of the medical relationship and records has to be maintained or patients will not disclose the true nature of their problems. This results in harm to the patient and prevents the physician from truly helping the patient.
Ignoring the law, another County Clerk unilaterally decides to issue marriage licenses. This is how the law has been undermined in California and other States. (And why it’s important to vote “down-ballot.”
That was on display in Colorado on Wednesday afternoon, when the county clerk in the liberal city of Boulder announced she would issue same-sex marriage licenses even though the 10th Circuit — which along with Colorado and Utah includes, Kansas, New Mexico, Oklahoma and Wyoming — stayed its decision pending appeal. The state’s attorney general declared the licenses invalid because Colorado’s gay marriage prohibition is still the law, but Clerk and Recorder Hillary Hall said she would continue to issue them until stopped by a court.
Today is the one year anniversary of mob and chaos that Leticia Van de Putte and Wendy Davis initiated and encouraged when the Texas Senate began to vote on a law to prohibit abortion after 20 weeks and require doctors who perform abortion to have privileges at a nearby hospital and to use the FDA guidelines that they agree to use before becoming eligible to This was the response of one woman to prayer and a crucifix last year at the Texas Legislature.
The women were following the leader of a man who shouted, “Whose choice?” by chanting “My choice.”It strikes me as odd that every time I witnessed one of these chanting/response sessions, a man was leading the women. That’s not the version of feminism I expected.
This picture came from a video that I took on July 2, during House testimony on HB5, which later became law prohibiting abortion after 5 months and protecting women who chose to undergo abortion.
**The Texas Solution as it appeared in the final 2012 Platform of the Republican Party of Texas:
The Texas Solution – Because of decades-long failure of the federal government to secure our borders and address the immigration issue, there are now upwards of 11 million undocumented individuals in the United States today, each of whom entered and remain here under different circumstances. Mass deportation of these individuals would neither be equitable nor practical; while blanket amnesty, as occurred with the Simpson-Mazzoli Act of 1986, would only encourage future violations of the law. We seek common ground to develop and advance a conservative, market- and law-based approach to our nation’s immigration issues by following these principles:
1. Secure Our Borders – The U.S. Border must be secured immediately! We demand the application of effective, practical and reasonable measures to secure our borders and to bring safety and security for all Americans along the border and throughout the nation.
2. Modernize the United States Social Security Card – We support the improvement of our 1936 Social Security card to use contemporary anti-counterfeit technology. The social security card will not be considered a National ID card for U.S. citizens.
3. Birthright Citizenship – We call on the Legislative, Executive, and Judicial branches of the United States to clarify Section 1 of the 14th amendment to limit citizenship by birth to those born to a citizen of the United States with no exceptions.
4. Create an Effective and Efficient Temporary Worker Program – A national Temporary Worker Program should be implemented to bring skilled and unskilled workers into the United States for temporary periods of time when no U.S. workers are currently available. The program should also require:
• Self-funding through participation fees and fines;
• Applicants must pass a full criminal background check;
• Applicants with prior immigration violations would only qualify for the program if they paid the appropriate fines;
• Applicants and/or Employers must prove that they can afford and/or secure private health insurance;
• Applicants must waive any and all rights to apply for financial assistance from any public entitlement programs;
• Applicant must show a proficiency in the English language and complete an American civic class;
• Temporary Workers would only be able to work for employers that deduct and match payroll taxes;
• All participants would be issued an individual Temporary-Worker Biometric Identification ard that tracks all address changes and both civil and criminal court appearances as a defendant.
Remember: Senator Bob Duell was instrumental in convincing the medical community to adopt voluntary procedures to protect patients and families affected by the Texas Advance Directive Act, even though actual amendments to the law have been blocked by the very people attacking him.
How much “freedom” does a third party Political Action Committee have in their paid ads? Is it wrong to challenge them legally when the ads are blatantly false?
In this case, the ad opens by implying that Senator Duell is responsible for the too-short 10 day period allowed to find alternate care when the family or patient disagrees with the doctor at the end of life.
Senator Duell was not in the Senate when the Texas Advance Directive Act was passed in 1999. Members of the PAC, Texas Right to Life, were present and lobbied in favor of the Act.
In contrast, Senator Duell has for years been a strong advocate for amendments that would have increased the power of families to protect their loved ones in the case of disputes with the doctor. The amendments would have changed the waiting period to at least a month before any disputed decisions by the doctor would take effect.
As to the challenge, Senator Duell has excellent support for his case:
The Texas Catholic Conference and Catholic Bishops of Texas, who supported Deuell’s bill, have debunked the claims. They said that Texas Right to Life “has tried to stoke fear through ridiculous claims of non-existent death panels and assertions that doctors are secretly trying to kill patients. Both claims are absurd.” The Catholic Conference also ripped Texas Right to Life for spreading “fabrications” about the position of Catholics on the issue.
Here’s one of the tough questions. (Lots of parenthetical explanations, too.)
I believe that the doctors should have gotten the best informed consent that they could obtain and allowed an attempt of vaginal delivery. I can’t bear the idea of “tying down” a mother for forced surgery while she begs me to stop. However . . .
We weren’t there and don’t know from this report the condition of the baby or the mother at the time that they wheeled them into the operating room.
It appears that they did wait “several hours.”
We have precedent that mothers in labor may not make life-changing and -threatening decisions. For instance, the law doesn’t allow Medicaid to be billed unless a mother consents to tubal ligation at least 4 weeks prior to delivery. Even with private insurance or cash-pay, few doctors will perform a sterilization without consent obtained in advance. (I understand that the purpose of this law is to prevent coercion and eugenics, but the one-size-fits-all seems patronizing to all mothers.)
I’ve assisted several women who became hysterical at the end of labor. (One woman stood up on the gurney several times, even as her baby was “crowning” and we were trying to prep her for the imminent delivery. I was a resident in training, and my supervisor ordered the sedation and restraints to protect her from falling from the bed, and the baby from a free-fall delivery from over our heads. She delivered her baby almost immediately after the last time we got her on her back – before the restraining orders could be followed.)
The mother in this story did present herself at the hospital, implying (and possibly signing) consent to the treatment by her attending obstetrician. If she had stayed home for the delivery, there would be no dispute in the first place.
Down the slippery slope, we have a “throuple,” a three-woman marriage, performed in Massachusetts in August of last year. One of the women is now expecting a baby.
All men and women may take advantage of the “benefit’ of marriage. However, it required a redefinition of marriage for a man to marry a man or a woman to marry a woman. Such a redefinition was never required to allow the black man and woman to drink from the water fountain or for a black man to marry a white woman or a black woman to marry a white man.
Once the redefinition began, what is there to stop anyone from making their own meaning?
I agree that freedom and the recognition of rights means that I will live among people who don’t agree with me. I’ve been married to my high school sweetheart for over forty years; I know that reality very well! However, I don’t have to sit quietly while throuples and others change laws to force me to involuntarily subsidize their choices. It is the duty of the ones desiring change to prove it beneficial or harmless *prior* to the change. Instead, we saw illegal acts by the mayors of San Francisco and other cities, lawsuit after lawsuit, after lawsuit . . . And suddenly: “it’s the law of the land!”
Edited – Added that last paragraph – BBN
We are beginning to hear how great for the State of Texas it is that Leticia San Miguel Van De Putte will be the Democrat nominee for Lieutenant Governor in November. The story is that she will cause more Latinos to register to vote in the hopes that she will represent the 38% of Texas voters better than the Anglo man who will be nominated by the Republican Party.
Think so? I don’t.
Democrat Senator Judith Zaphirini nominated Senator Leticia Van de Putte for Senate President Pro Tempore on the opening day of the Texas 83rd Legislature on January 8, 2013:
Move the cursor to 45 minutes in, when Senator Zaphirini introduces Leticia Van de Putte’s children and grandchildren. Listen to the words, watch the faces around her.
“Six children, six grandchildren! What blessings! I’m not sure at what point in time Senator Van De Putte became such an advocate for Planned Parenthood, but her children are so glad that it wasn’t earlier than it actually was.”
Just after posting the article about Great Britain’s new official exclusion of pro-life doctors, I received an email from AAPLOG, the American Association of Pro-life OB/Gyns, referring to this article:
“In medicine, the vast majority of conscientious objection (CO) is exercised within the reproductive healthcare field – particularly for abortion and contraception. Current laws and practices in various countries around CO in reproductive healthcare show that it is unworkable and frequently abused, with harmful impacts on women’s healthcare and rights. CO in medicine is supposedly analogous to CO in the military, but in fact the two have little in common.
This paper argues that CO in reproductive health is not actually Conscientious Objection, but Dishonourable Disobedience (DD) to laws and ethical codes.”
Read the rest for more about the “dishonorable doctors” who follow their consciences and well over 2000 years of “First, do no harm.”
Edited: BBN to add corrected url,
The Royal College of Obstetricians and Gynecologists in Great Britain have determined that any nurses or doctors who oppose any form of contraception may not complete training and will not receive certification in the specialty:
Doctors who oppose morning-after pill on conscience grounds face qualifications bar
Guidelines confirm that doctors and nurses who oppose controversial emergency contraception on ‘moral or religious’ grounds cannot receive key specialist qualifications
This is very possible in the US. Take a look here at some fairly recent history of attempts to keep docs from practicing with a conscience.
I wrote a very difficult letter today. I resigned from the organization that is supposed to support Family Physicians in our education, practice management and good medical care of our patients. Instead, the American Academy of Family Physicians too often strays toward forcing its members to be complicit with controversial policies such as condoning gun control and over-the-counter contraceptive drugs, and condemnation of “reparative therapy” for homosexual patients, even when those patients are unhappy with their sexuality. I write about my main conflicts and the “final straw” in the letter:
It is with great regret that I write this letter as notice that I have decided not to renew either my Texas or American Academy of Family Practice membership. While I am still a family doctor, neither the Texas Academy of Family Practice (TAFP) nor the American Academy of Family Practice (AAFP) represent my political or ethical views.
The political, social and ethical controversies were the main reason I remained in the Academy for the last few years since I left full time practice. I hoped that I could make a difference by volunteering my time and money as an active participant in the Texas Academy, the National Conference of Special Constituencies, the AAFP list serves, the Academy Legislative meetings in DC and our annual AAFP Congress of Delegates.
From the time of Hillary Clinton’s closed meetings on healthcare to the endorsement of the passage of the ACA before it was written, the political actions of the AAFP leaders has disappointed me in Washington, DC. Our practice hassle factors have grown and grown, too often with the blessings of – and sometimes due to the experiments with alternative methods of practice by – the Academy.
The AAFP advocated for elective abortion before I joined as a Student member and I accepted that the burden of persuasion was on those of us who disagreed.
However, the Academy’s decision to advocate for the redefinition of marriage in 2012 and the refusal to reconsider the extracted Resolution on marriage neutrality at the 2013 Congress of Delegates in San Diego were the final proof that there’s no tolerance for family doctors who hold conservative politics or traditional ethics in the Academy.
Unfortunately, our TAFP spokesperson to the 2013 AAFP Reference Committee on Advocacy misrepresented the Texas Delegation’s instructions from the Directors on marriage. As I remember the discussion and vote, the intention was to allow the Texas delegates wide latitude in voting on any final form of the Resolution.
I hereby resign from the Texas Academy of Family Physicians, the American Academy of Family Physicians and as a Fellow of the AAFP.
I waited to resign after nearly 30-year membership until the last minute before being dropped (for lack of paying my annual dues). There were several reasons for my hesitancy. For one thing, I didn’t want to be an undue influence on other members when they considered whether or not to write that hefty annual check to the Academy. For another, while I will continue to work with the AAFP and the Christian Medical and Dental Association to protect the right to life, marriage, the conscience rights of doctors within the profession of medicine and the specialty of Family Medicine, I do believe that it is important to work to persuade from within the organization. The biggest problem with finally writing the letter was that I was looking for a way to somehow keep my integrity while allowing the Academy to claim to represent me.
However, now that I’ve resigned, please consider sharing my letter with your family doctor. Many of them are unaware of the policies that our professional organizations push on good doctors of today and the students and residents who will be our doctors of tomorrow.
Libertarians within the Republican Party and Republicans who are called “moderate” because they aren’t social Conservatives claim that we will win over more voters and that it’s hypocritical of small-government Conservatives to use government to define or license marriage.
Radio talk show host and commentator Dennis Prager destroyed the claim that Republicans could win elections by dropping our social conservative platform planks in his recent essay :
“To respond to the first argument, it is hard to believe that most people who call themselves fiscal conservatives and vote Democrat would abandon the Democratic Party if the Republican Party embraced same-sex marriage and abortion.
“The left and its political party will always create social issues that make Republicans and conservatives look “reactionary” on social issues. Today it is same-sex marriage, the next day it is the Republican “war on women,” and tomorrow it will be ending the objective male-female designation of Americans (Children should have the right to determine their gender and not have their parents and their genitalia determine it, even at birth). Or it will be animal rights, race-based affirmative action or an environmentalist issue.”
Contrary to the claims of those libertarians, traditional marriage of one man and one woman encourages smaller, not larger, government. State marriage licenses prevent the need for a formal legal contract (and a lawyer) before marriage in order to clarify the mutual duties and rights of spouses, inheritance, and a myriad of paternity/maternity rights within intact marriages, at death, and on dissolution of the marriage. Recognizing that not all marriages result in children, the laws do recognize the State’s “compelling interest” in defending the child’s right to life, liberty and property.
While some (on the Right, as well as the Left) might favor laws making entering into a marriage as burdensome and expensive as divorce, many people would simply cohabit. When they go their separate ways – or if one dies – without a marriage license, the Courts will still determine the separation of property and child custody. At best, the new burden will be added to the old. Or, more likely, whole new layers of court rulings and State or Federal legislation would have to be added to replace current law.
There are strong historic, biologic and societal reasons behind the support for defending the Conservative definition of marriage. The new definition is not clear-cut and has very little history. However, the proponents of gay marriage are seeking not only all of the legal – government – benefits and protections afforded traditional marriage, as well as special protection from those same governments to coerce everyone with a business license into participating in their nuptials. There’s nothing “small government” about “getting the State out of the marriage.”