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

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

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

There’s a lot to like about this idea.

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

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

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

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

Rick Perry revives hope for tort reform

While maintaining our strong protections from the 2005 Texas tort reform, the Governor advanced a new law this year that will further protect everyone in Texas. With the new “loser pays” law, we should see fewer frivolous lawsuits and the monetary judgements from genuine litigation against wrong-doers will not be eaten up by legitimate legal expenses.

 

Imagine this: Emily, whose right kidney has failed, goes to the hospital for a transplant. Instead of replacing her right kidney, the surgeons mistakenly replace her left kidney. Left with her failed kidney and an uncertain transplant, Emily sues for medical malpractice. After months of costly litigation, Emily’s original damage claims are swallowed up by the cost of her legal fees.

Should she, the injured party, bear the costs of litigation?

This example demonstrates the problem of the “American Rule,” which is nearly universal in the American legal system with regard to torts. The American Rule requires each party to pay its own litigation costs, regardless of outcome. Most other Western democracies use the “English Rule,” or “loser pays,” which quite literally means that the loser pays the costs of litigation for all involved parties.

via Rick Perry revives hope for tort reform | Washington Times Communities.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

and, from page 50:

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

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

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

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

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

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

Doing the work skilled providers won’t

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

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

Critique of Judge Sam Sparks’ Texas Ultrasound Opinion

I’m a doctor, not a lawyer, so I may not understand all of the words and references in the opinion, but I’m shocked that any self-respecting Federal Judge would allow such a frankly biased opinion out of his office. Perhaps Sparks doesn’t mind burning his chances of ever being appointed to another Court, and is quite happy with his life time appointment in the Federal Court at Austin.

I’m halfway through the ruling and thought I’d post some thoughts before these comments got too long.

Sparks decided that it’s not really important for the Plaintiffs to be someone actually harmed by the Law in order to have standing in his Court. He approved the class action suit filed by a New York State corporation, The Center for Reproductive Rights, who filed a class action suit on behalf of all the abortionists in Texas, supported by affidavits from three abortionists:

1. 1. Alan Braid, MD is the only one  of the three who lives and works in Texas. He owns a privately owned abortion clinic in San Antonio, Reproductive Services, S.A. http://www.reproductiveservicessa.com/
2. 2. David A. Grimes, MD, inventor of the partial birth abortion and instructor in “family planning and OBGyn at the University of North Carolina. In 1995, Grimes testified in favor of forcing residency programs and residents to perform and  train doctors in abortion http://www.nchla.org/issues.asp?ID=28  “Making abortion training a routine part of any residency…will put abortion back in the mainstream of medicine.”
3. 3.  Anne D. Lyerly, MD, from the University of North Carolina at Chapell Hill, who was once the chair of the ethics committee of the American College of Obstetricians and Gynecologists. She testified *against* conscience rights before the Bush President’s Bioethics Council in 2006.

If R. v. W. isn’t found to be gross misconduct, this ruling should be. Sparks can’t resist a revealing his prejudice and mocking the legislature.

Citing Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833, 846 (1992), a US Supreme Court ruling on abortion limitations and Equal Protection, Sparks not only has to admit that the Texas law is legitimate under prior law and Court rulings, but that:

“This legitimate interest obviously justifies “singling out” abortion providers and the patients thereof, because they pose a serious potential risk to “the life of the fetus that may become a child.”’

However, he goes on to admit his prior bias:

“The Court has grave doubts about the wisdom of the Act, but that is no legal basis for invalidating it. The Act’s onerous requirements will surely dissuade or prevent many competent doctors from performing abortions, making it significantly more difficult for pregnant women to

obtain abortions. Forcing pregnant women to receive medical treatment from less-skilled providers certainly seems to be at odds with “protecting the physical and psychological health and well-being of pregnant women,” one of the Act’s stated purposes. H.B. 15, Sec. 12(1). However, rational basis review requires this Court to accept even tenuous rationales for the advancement of a legitimate government interest.

In short, if the Texas Legislature wishes to prioritize an ideological agenda (2) over the health and safety of women, the Equal Protection Clause does not prevent it from doing so under these circumstances. Accordingly, the Court must reject Plaintiffs’ Equal Protection arguments. (p. 20/55)

That footnote (2) ?

“2 It is ironic that many of the same people who zealously defend the state’s righteous duty to become intimately involved in a woman’s decision to get an abortion are also positively scandalized at the government’s gross overreaching in the area of health care.”

S

“(It) is difficult to avoid the troubling conclusion the Texas Legislature either wants to permanently brand women who choose to get abortions, or views these certifications as potential evidence to be used against physicians and women,” Sparks wrote.

Text of Sparks’ Ultrasound Ruling available

Here’s the ruling in pdf. More after I’ve read it.

The larger order with explanations is here. (update at 7:25 PM, BBN)

Update, 7:07 PM

Okay, it appears that he’s placed an injunction on any enforcement of the law at all.

However, in addition to the histrionic statement the the State would “permanently brand women” for signing informed consent forms that would be placed in their private medical records, the Judge shows further poor judgement by this section:

IT IS FURTHER ORDERED that Defendants are ENJOINED from enforcing the penalty provisions of the Act against either a physician  or a pregnant woman if the physician does not place the sonogram images where the pregnant woman may view them, or does not make audible the heart auscultation, if the pregnant woman elects not to view the images or hear the heart auscultation;

There is, of course, no penalty in the law for women if the abortionist “does not place the sonogram images where the pregnant woman may view them,” etc.

For years in Texas, we have had formalized, scripted informed consent for hysterectomies, sterilizations, radiation therapy and electroshock therapy. And yet, no one notices or cares.

Does anyone claim that a patient is being “branded” if his doctor explains his cardiac ultrasound? Would you go to surgery if he didn’t have a conversation with you after the echocardiogram and before the procedure?

Federal Judge Sparks places injunction on Texas Ultrasound Bill

The news reports so far only contain very brief statements which appear to be from the same press release. More as soon as I can find the actual ruling.

However, all the reports tell us that Judge Sparks said Texas ultrasound bill will ” “permanently brand women who choose to get an abortion.” Aren’t medical records private? How histrionic can this judge be? The woman’s statement will be part of her medical record. No one will see it except the abortionist.

He also said something to the effect that the doctor’s “First amendment rights” are infringed by State mandated informed consent. Please tell that to all of the doctors who have followed a strict Texas law on informed consent for hysterectomies, sterilization, radiation therapy and electric shock therapy.

It doesn’t look as though the judge struck down the part that requires a doctor to perform the informed consent himself, 24 hours before the procedure. Good. By requiring the same standard of informed consent that most of us would expect from our heart doc before a catheterization or by-pass, the law will be enough to make elective abortions prohibitively expensive for the mills to make any profit.

Politics at Texas Medical Board

Dr. David Stevens, CEO of the Christian Medical and Dental Association believes that the Texas Medical Board’s review and limitations on adult stem cell treatments is politically motivated.

It does appear that the Board is responding to politics.

“Meanwhile, Stevens believes criticism of Governor Perry’s recent adult stem cell procedure is politically motivated. (Listen to audio report)

The Republican presidential candidate had back surgery July 1, where his own stem cells were removed and injected back into his body. But shortly after, the Associated Press published a story in which several doctors criticized the decision as too “experimental” and “risky.” But Stevens believes those doctors are playing more politics than they are science. He points out that Perry consulted with his orthopedist, Dr. Stanley Jones, who is a well-respected physician.”

The Board heard the proposal on Friday, August 26. The Board would impose Federal regulations and a formal ethics board oversight for “off label” or experimental use of medications or treatments.

We doctors use our judgement at times to treat our patients using medications, procedures and equipment in ways that are considered “off label.” (For instance, the “morning after pill” therapies were at first unofficial use of oral contraceptives, long before Plan B was on the market.)

The Board should adjust their criteria to whether or not the patient gave full, proper informed consent obtained and is the treatment inherently ethical in likely outcome and goal?

55% Say Abortion Morally Wrong Most of the Time – Rasmussen Reports™

Slightly more voters continue to classify themselves as pro-choice rather than pro-life when it comes to abortion, but a majority still believes it is morally wrong.

The latest Rasmussen Reports national telephone survey finds that 48% of Likely U.S. Voters say, generally speaking, on the issue of abortion, they consider themselves pro-choice. Forty-three percent (43%) describe themselves as pro-life. (To see survey question wording, click here.)

Pro-choice voters have slightly outnumbered pro-lifers in surveys for several years.

Still, 55% believe abortion is morally wrong most of the time, a finding that shows little change since April 2007. Thirty percent (30%) think abortion is morally acceptable in the majority of cases, while 15% are undecided.

via 55% Say Abortion Morally Wrong Most of the Time – Rasmussen Reports™.

Vaccines don’t cause autism, but aren’t perfect:Institute of Medicine

A new review, more support for long term safety of vaccines along with evidence that anything that has an effect can have a side effect.

The Institute says its vaccine report is its first comprehensive safety review in 17 years, prompted by the government’s Vaccine Injury Compensation program that pays damages to people injured by vaccines.”Vaccines are important tools in preventing serious infectious disease across the lifespan,” Clayton said. “All health care interventions, however, carry the possibility of risk and vaccines are no exception.”The report cleared flu shots’ suspected link to Bell’s palsy and asthma and examined more than 100 other possible side effects, only to find “convincing evidence” of the following 14 side effects linked to vaccines: Fever-triggered seizures from the measles-mumps-rubella, or MMR, vaccine – which rarely cause long-term consequences Brain inflammation in some people with immune problems, also from MMR Viral infection from the chickenpox varicella vaccine resulting in widespread chickenpox or its painful relative, shingles. Pneumonia, hepatitis or meningitis, occasionally results from varicella vaccine Severe allergic reactions known as anaphylaxis from six vaccines: MMR, chickenpox, hepatitis B, meningococcal and tetanus. Fainting or a type of shoulder inflammation also generally linked to vaccinesThere’s also evidence of short-term joint pain in some women and children from the MMR vaccine, and anaphylaxis from the human papillomavirus, or HPV, vaccine – but the Institute says there’s no proof.

via Vaccines don’t cause autism, but aren’t perfect: Report – HealthPop – CBS News.

Murder and medical ethics – Viewpoint

What do we risk when we give serious consideration to the argument that some humans may not be human enough to be protected by society?

From a Ph.D. student:

Perhaps neither of these situations is particularly plausible. But more plausible, I think, is a third: imagine again that abortion is murder and that my first student avoids pregnancy in medical school. She becomes an obstetrician and spends a career delivering healthy babies to happy parents. Only intermittently do those parents ask her, instead, to abort their children. When they ask this of her, she first remembers the principles that she learned as a child — but she then remembers the many arguments that I taught her. She remembers that she is a doctor, a woman of the world, and that whatever seems to be black and white is always, in the end, many shades of gray. Surely, she thinks, abortion cannot be as bad as they say: it is distasteful, certainly, but hardly evil. It is a thing to be done and forgotten.

And so she kills. Not often, and not gladly. But she kills nonetheless. And the blood that spills is, at least partly, on my hands.

This, then, is my fear. When I voiced it to a fellow graduate student, he reassured me that our students do not listen to us anyway. Which may well be true. But it is better not to take the chance if the stakes are as high as we take them to be — if, for example, abortion really is murder. Consider a parallel case: we teach our children, before we send them off to college, that murder is wrong. We would never allow them to take, much less demand that they take, a course that would seriously question this — that would, so to speak, look at both sides of the murder debate. What would be the point? Even if said course did not manipulate them into the pro-death camp, presenting that camp as though it were a legitimate option — as though intelligent and responsible students sometimes concluded that murder is permissible, or even a human right — could only serve to weaken their resolve: if the best philosophers cannot agree that murder is wrong, they might think in a moment of rage, who can blame them for murdering?

via Murder and medical ethics – Viewpoint – The Observer – University of Notre Dame and Saint Mary’s College.

Governor Perry signs pro-life pledge

The move to sign the Susan B. Anthony List’s pledge is completely in line with the Governor’s actions while in office here in Texas. He has advocated for parental consent, for informed consent, and for the prenatal protection law we passed in 2005.

This year, he put the “ultrasound bill” on the fast track by naming it as an emergency bill. We also moved our family planning money to hospitals and docs who provide comprehensive, continuing care rather tna limiting services to “family planning,” and ensured that local hospital and health districts that wish to receive State funds will cease performing elective abortions. (The Travis County Health Department paid for 750 elective abortions last year, but recently voted to immediately comply with the new law, surprising some.)

FOR IMMEDIATE RELEASE:August 24, 2011
Contact: Ciara Matthews, (202) 630-7067

Perry Becomes Seventh Candidate to Sign SBA List Presidential Pledge

WASHINGTON, D.C.  – The Susan B. Anthony List announced today that Republican Presidential candidate Governor Rick Perry has signed its Pro-Life Presidential Leadership Pledge, making him the seventh Republican candidate for President to do so.

“Governor Perry has been a long-time friend of, and leader for, the pro-life community,” said SBA List President Marjorie Dannenfelser. “His signature on our pledge is more than welcome and we applaud him for his commitment to continue to fight for women and unborn children.”

The Pro-Life Presidential Leadership Pledge developed by the SBA List is what has been defined as a “minimum standard” of what is expected of the next pro-life President. The Pledge contains four principles to which its signers are expected to adhere:

FIRST, to nominate to the U.S. federal bench judges who are committed to restraint and applying the original meaning of the Constitution, not legislating from the bench;

SECOND, to select only pro-life appointees for relevant Cabinet and Executive Branch positions, in particular the head of National Institutes of Health, the Department of Justice, and the Department of Health & Human Services;

THIRD, to advance pro-life legislation to permanently end all taxpayer funding of abortion in all domestic and international spending programs, and defund Planned Parenthood and all other contractors and recipients of federal funds with affiliates that perform or fund abortions;

FOURTH, advance and sign into law a Pain-Capable Unborn Child Protection Act to protect unborn children who are capable of feeling pain from abortion.

Politico.com is confused by the fact that Governor Perry endorsed Rudy Guiliani in 2008. Mayor Guiliani had promised to only nominate strict constructionist judges.

By ALEXANDER BURNS | 8/24/11 10:16 AM EDT Updated: 8/24/11 10:39 AM EDT

Read more: http://www.politico.com/news/stories/0811/61982.html#ixzz1VxxeQKTX

Governor Rick Perry on VP Joe Biden and China One Child Policy

Statement by Texas Gov. Rick Perry on VP Joe Biden’s Comment Regarding China’s One Child Policy

Print

Posted on August 23rd, 2011

Doctors screen for cervical cancer too often

Most women only need a test every 3 years after a couple of normal tests in row (yeay!):

“There’s really no advantage to annual screening compared to screening every two or three years,” lead author Katherine Roland told Reuters Health.

Guidelines from the American Cancer Society and other organizations recommend that women age 30 and older are screened using Pap smears and tests for the human papillomavirus, or HPV. (For younger women, the ACS recommends starting testing at age 21 or three years after beginning sexual activity.)

If both tests are normal, those guidelines call for a three-year wait before the next screening. That’s because HPV — which causes changes in the cervix that can lead to cancer — may take a decade to progress to that point.

“No test is perfect,” said Philip Castle, an HPV expert at the American Society for Clinical Pathology in Chicago. But, he added, “a single negative HPV test is very good at ruling out disease.”

Even when doctors use just a Pap test, Roland said, a woman who has had a few normal tests in a row can go two or three years before her next screening.

via Doctors screen for cervical cancer too often | Reuters.

No Deaths Due to Gardasil

I’m still getting emails from people warning about deaths due to Gardasil and there are repetitive false reports in the “lame-stream media” and by bloggers repeating the same lies.

One email and an “alert” on one of the big forums has no link to real data, but does link to a law firm in Florida that is looking for cases to use in a suit against Merck. Unfortunately for them, the trial lawyers link to the CDC web page showing that they have no case.

In contrast, the reports given by the FDA and CDC show no connection to deaths and no connection to any serious reactions. All of the reported events happen at the same rate that they do in the general population, whether or not the people were vaccinated.

From the CDC page linked by that trial lawyer:

As of June 22, 2011 there have been a total 68 VAERS reports of death among those who have received Gardasil® . There were 54 reports among females, 3 were among males, and 11 were reports of unknown gender. Thirty two of the total death reports have been confirmed and 36 remain unconfirmed due to no identifiable patient information in the report such as a name and contact information to confirm the report. A death report is confirmed (verified) after a medical doctor reviews the report and any associated records. In the 32 reports confirmed, there was no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine and some reports indicated a cause of death unrelated to vaccination.

From the FDA page:

Concerns have been raised about reports of deaths occurring in individuals after receiving Gardasil.  As of December 31, 2008, 32 deaths had been reported to VAERS.  There was not a common pattern to the deaths that would suggest they were caused by the vaccine.  In the majority of cases with available autopsy, death certificate and medical records, the cause of death was explained by factors other than the vaccine.

There have been about 40 Million doses given in the US, closer to 60 million in the world, since 2001. There is no connection to deaths due to the vaccine. The Vaccine Adverse Events Reports confirm a death rate less than that of the general population (around 60/100,000).

There are multiple post-marketing studies going on all over the world, since at least 2001 and yet there are no “red flags.”

I’ve covered this much more extensively elsewhere on WingRight, along with some of the examples of the non-confirmed reports and instructions as to how to look up the VAERS reports for yourself.

Do you believe in legalized euthanasia?

How do you feel about legalized euthanasia, the intentional killing of your fellow humans? Here’s a yahoo.com poll that indicates the majority answering the poll (we don’t know who they are) are in favor.

For more on legalized euthanasia in the news over the last few years, look at LifeEthics.org.

Doctors wary of Perry’s stem cell treatment – The Boston Globe

Yeah, Daley destroys human embryos to harvest stem cells, even made a few designer embryos with the intention of destroying them. The International Stem Cell Research group fawned all over the faux Korean cloner.

These people to be have no business talking about ethics or “wise decisions.”

[S]ome scientists are questioning the safety and wisdom of Perry’s treatment, especially because it was not part of a clinical trial in which unproven therapies are tested in a way that helps protect patients and advances medical knowledge.

Perry “exercised poor judgment’’ to try it, said Dr. George Q. Daley of Children’s Hospital Boston and the Harvard Stem Cell Institute. “As a highly influential person of power, Perry’s actions have the unfortunate potential to push desperate patients into the clinics of quacks’’ who are selling unproven treatments “for everything from Alzheimer’s to autism.’’

Daley is past president of the International Society for Stem Cell Research, a group of 3,000 scientists and others in the field. He favors stem cell research. But of Perry’s treatment he said: “I would never in a million years accept for one of my family members to undergo this.’’

via Doctors wary of Perry’s stem cell treatment – The Boston Globe.

The Facts on Gardasil and Perry: Right Wing vs. WingRight

Do you really want to frustrate me? Publish an opinion piece online, but restrict comments so that I can’t tell you where you’re wrong. Sure, it’s your site, and you make the rules. Well! Since I have my own blog  . . .

The mainstream media has rediscovered Executive Order RP65 that Governor Perry issued in February, 2007. I wrote a “A Dose of Reason, Perry and Gardasil” to answer some of the gobbledygook in the media.

Unfortunately, some of the pundits we normally consider conservative are just as mixed up and fail just as miserably in their research and conclusions.

Michelle Malkin (michellemalkin.com ) won’t take new subscribers or comments from the public at all. She has written a disorganized rant calling Governor Perry “Obama-like.”  She claimed that the Governor went over the heads of the Legislature, calls the opt-out clause “bogus,” without researching what it was before the Governor’s EO, and is evidently completely unaware of the funding of vaccines in the US.  I was able to comment at the column’s syndication site, Creators.com,   copying and pasting my coverage of these concerns in “A Dose of Reason, Perry and Gardasil.”

RedState’s  Bill Streiff and Erick Ericson have posted their own articles That site won’t take comments from new subscribers. Ericson reposted his 2007 missive that compared the Executive Order to eugenics and focused on the possibility of corruption due to Merck’s lobbying.

Streiff’s two pieces, here , and  here,  cover the de-bunked corruption charges and provide a succinct list of ethical objections that are less subjective and a bit more organized. Here’s my reply:

1. The recommendation did not include males, though males can carry and transmit HPV. This oversight made the creation of “herd immunity” impossible. This, definitionally, means the vaccine could have only a limited effect in combatting HPV.

The vaccine had not been recommended for boys at the time. The reasoning is that the vaccine prevented cancer. Society was not ready to talk about anal sex and males having sex with males, so there was a delay in adding boys. Since that time, the recommendations have changed to include boys.

2. Not all strains of HPV linked to cancer were affected by the vaccine. While doing something is better than doing nothing… generally… no one knows what the impact will be of creating a better evolutionary environment for the others strains by eliminating competing versions of the virus.

We knew at the time that the vaccines covered the viruses that caused 70% of cervical cancers (16 and 18) and 90% of the strains that cause genital warts (6 and 11). The preventive effect for these strains was 96% to 100%. according to the British Journal of Cancer article on the 5 year follow-up, published in December, 2006. (It was on-line November, 2006 and I accessed it for review today, August 18, 2011.)

We already had evidence, since confirmed, that there might be some cross-immunity for other strains.

3.Requiring people to receive a vaccine against diseases which they may very well never encounter is a very queasy ethical area. Unlike diseases like measles, whooping cough, etc., HPV is not spread through casual contact.

True. But 50% of people will be infected at sometime in their lives. The true cost is all of those abnormal pap smears – the cellular changes are all – 99.7% due to HPV.  It’s also true that we vaccinate for tetanus – what we used to call “lock jaw” – even though it’s not contagious, and for Hepatitis B, which is only spread through blood and body fluids.

4. Clinical trials were conducted on women aged 16-26 leaving everyone to presume that Gardasil was safe and efficacious in 10 year-olds even though there was zero data pertaining to that age group.

Completely false. Both the 2007 Gardasil insert (no longer available online, but I saved a copy on my computer) and the current insert contain information about early testing on boys and girls 9-15. 1122 girls ages 9-15 received the vaccine during trials to test the immunogenicity, demonstrating the production of antibodies.
There. I feel better, don’t you?

Wonderful news on Conscience from Arizona

Without a conscience, what is a doctor, nurse, or pharmacist except a technician willing to follow the whims of law?

(Again, this is not sound-bite material!)  I received an e-mail from the American Defense Fund concerning the lawsuit against the State of Arizona by Planned Parenthood over a law to protect those of us in medicine who have consciences.

The ruling overturned a two year old injunction that prevented quite a few limitations placed on abortion in the State, including informed consent, parental consent, and the requirement that doctors, not nurses, perform abortions as well as the conscience issue.

Over the last decade, there have been several deliberate attacks against the right of medical professionals to obey our consciences and to refuse to provide services that we do not believe are “medical care.” I’ve tried to cover them at LifeEthics.org., even though I had a hard time keeping my promise to avoid politics and religion on that blog.

The articles at LifeEthics.org include this one from the American Journal of Bioethics, this one by a lawyer writing in the New England Journal of Medicine, and this one from this year about the Obama Administration’s refusal to protect the conscience.

Here’s the update, dated August 11, 2011:

A litigation update:

The Arizona Court of Appeals issued an opinion today on conscience rights.

In a case litigated partially by the State, partially by the Speaker of the Arizona House, and partially by ADF, BDF, and CAP on behalf of a variety of pro-life medical groups (Ave Maria Pharmacy, Christian Medical and Dental Associations, Christian Pharmacists Fellowship International, American Association of Pro-Life Obstetricians and Gynecologists, and Catholic Medical Association) . . . . . . the Court upheld Arizona’s state conscience protection statute Ariz. Rev. Stat. § 36-2154, against a challenge by Planned Parenthood of Arizona. The Court also upheld the right of the aforementioned pro-life groups to intervene in the case to defend the conscience law.

Here is the opinion,http://azcourts.gov/Portals/89/opinionfiles/CV/CV090748.pdf and below I provide some highlights.

The conscience statute protects hospitals, physicians, and staff from being involved in abortion, and all of the above plus pharmacists and pharmacy employees from being involved in any abortive or anti-implantive drug or device. The Court of Appeals’ decision reverses an injunction that Planned Parenthood had obtained below in the Arizona trial court, which had enjoined not only conscience protections but a bunch of pro-life provisions of Arizona law (including laws about parental involvement in abortion, prohibiting non-doctors from performing them, and other pro-life measures).

PP threw the kitchen sink of anti-conscience arguments against this conscience statute, and the Court specifically addresses PP’s arguments on pages 32-37, saying some very helpful things against some of the popular “access” arguments we all hear against conscience rights. (The Court does unfortunately characterize the conscience statute as “refusal provisions.”)

Among the arguments the court smacked down are the following:

• The Court rejected PP’s argument that conscience protections violate a woman’s right to access abortion. The Court gave several reasons. First, in a previous case the Court had upheld an Arizona law prohibiting abortions at state university hospitals, saying “Even as plaintiff does not have an absolute right to an abortion on demand, she also does not have the right to select any public facility she chooses for an abortion.” By extension, therefore, the Court held that since “Even a state actor can refuse to facilitate an abortion,” it is even more true that private actors can refuse.
• In addition, the Court declared that the conscience law protecting private individuals and institutions can’t possibly violate a woman’s constitutional rights because “any reproductive rights that might exist under [the Arizona Constitution] can only be asserted against governmental acts, not the decisions of private individuals. . . . Therefore a woman’s right to an abortion or to contraception does not compel a private person or entity to facilitate either.”
• The Court further noted: “In its arguments below, PPAZ also contended the statutes would ‘thwart women’s ability to chart their own medical course.’ As explained above, whatever right a woman may have to ‘chart her own medical course,’ it cannot compel a health-care provider to provide her chosen care.”
• The Court rejected PP’s argument that the conscience law “allows medical professionals to abandon their patients, even in an emergency.” The Court pointed out that because the Arizona Constitution protects common law medical malpractice actions from being abrogated by statute, the conscience statute therefore does prevent a woman from suing any physician for denying her the standard of care, whatever that might be. A woman’s ability to impose malpractice liability therefore defeats the argument that the conscience statute allows abandonment in an emergency.
• The Court rejected PP’s argument that the conscience statute “justif[es] practices inconsistent with the peace and safety of the state.”
• First, “no authority suggests that permitting individuals to choose whether to facilitate abortions places the peace and safety of the state at risk.”
• Second, the Arizona Constitution says that constitutional protections for conscience do not protect violations of peace and safety, but it does not prohibit the legislature from protecting conscience even more than the constitution happens to do.
• Third, the “peace and safety” limitation is merely a limit on how far judges are supposed to interpret the constitutional protections; it does not allow private citizens to sue to contend that too much conscience is being protected.
• Notably, the Court observed that the conscience statute may well protect employees of Planned Parenthood who object to involvement in abortion, but it went on to reject PP’s above arguments anyway.

Presumably PP will appeal this case to the Arizona Supreme Court, but the Court has discretionary review so it could simply deny the petition. In any event, the case will go back down to the trial court for final proceedings (to the same judge who issued the injunction), because this was just a “preliminary” decision.

Ultrasound law due September 1

The Texas Tribune, as part of its “31 Days, 31 Ways”  series of articles has a video interview with Dr. David Spear, an Austin abortionist and director of Planned Parenthood, concerning the soon to be enforced law requiring the doctor to meet with women before an abortion, and give her the information available from her pre-abortion ultrasound.

“The law is currently being challenged in federal court. U.S. District Judge Sam Sparks has said he plans to rule on the case by September. The New York-based Center for Reproductive Rights filed the suit in June, before requesting an injunction to prevent the law from going into effect on Sept. 1. In the suit, Texas Medical Providers Performing Abortion Services v. Department of State Health Services Commissioner David Lakey, the group argues that the law violates the equal protection clause by “subjecting [women] to paternalistic ‘protections’ not imposed on men” and the First Amendment rights of doctors by “forcing physicians to deliver politically-motivated communications” to their patients.”

Dr. Spear confirms that the ultrasound is standard of care as we heard that over and over in testimony at the Lege. The woman pays for the Ultrasound, already. It is her medical information.

No responsible doctor would introduce an instrument into the uterus without an ultrasound these days. It’s common practice to do this a couple of days before the abortion, although Dr. Spears implies that it is done the same day as the procedure. If it is true that it’s done the same day, is that before or after sedation and/or is the woman given the chance to evaluate her medical information while clothed, eye to eye with the doctor, or is she in a gown, feet up in the stirrups?

No one complains about other informed consent laws. There’s already law describing the informed consent for electric shock therapy, radiation therapy, sterilization and hysterectomy. Hysterectomy was the first such law. These (and the mandatory waiting period before Medicaid will pay for sterilization) came about because of a patronizing “doctor knows best” attitude of the past.

There’s nothing either political or religions about informing women about the ultrasound. There’s certainly noting political or religious about expecting the doctor to give informed consent – can you imagine if this conversation were about the heart catheterization and the heart ultrasound (echo-cardiogram)?

Part of the law includes the requirement to give information about the father;s responsibilities and about aide that is available locally for pregnancy and after the birth. These lists have been printed by the State and paid for by licensing fees for abortion clinics since 2005.

Common State Abortion Restrictions Spark Mixed Reviews

Why would anyone want doctors to be forced to perform elective, interventional procedures that they find morally wrong?

Gallup typically finds few differences between men’s and women’s attitudes about the legality of abortion in general. Consistent with that, the new poll shows relatively minor gender differences in views about the seven specific restrictions tested.

Partisan differences are much greater, although majorities of Democrats as well as most Republicans favor informed consent, parental consent, 24-hour waiting periods, and a ban on “partial birth abortion.”

By contrast, Republicans and Democrats are on opposite sides when it comes to opt-out provisions and withholding federal funds from abortion providers.

via Common State Abortion Restrictions Spark Mixed Reviews.

Doggett layoff author opposes Perry

Big surprise: Lloyd Doggett doesn’t like Perry. I guess he’s given up on winning his primary against one of the Castro twins (I can’t tell them apart), so he’s going to spend time campaigning against the Governor who wouldn’t lie for money.

ABC.news has a blog entry explaining the details, here.

Doggett’s the creator of the Doggett layoff, causing school districts all over the Nation to layoff teachers. Doggett was the author of the amendment to part of a stimulus bill, refusing money to Texas education by setting specific, individual requirements for Texas that no other State must meet and that go against Texas’ Constitution. Doggett repeatedly claimed at the time that claiming the Governor could lie and violate the State Constitution if he wanted the money badly enough.Doggett kept repeating that the requirements weren’t “unConstitutional.”

Last year, I met with this man with a group of doctors about graduate medical education, identifying as a doctor interested in primary care, not as a Republican. He assumed he could talk freely to us and literally shook with fury when he criticized Conservatives and the Tea Party. Claims Republicans don’t think for ourselves and only listen to Fox news and Limbaugh.

And yet, here I am reading ABC.news and there he is spouting his hate for conservatives. Well, he won’t be unopposed this election – and he’ll have a great panel of Conservatives vying to run against him on the Republican ticket, too.

Dose of Reason: Perry and Gardasil

Bear with me, this isn’t a “sound bite” subject.

(Edit 8/23/11: The opt out is for 2 years, not 1. BBN )

The Human Papilloma Virus is an infection, and should not be a moral issue. In contrast, the vaccine against four strains of the virus, Gardasil, has become a political issue, even though the Federal Food and Drug Administration (FDA) now recommends it for all boys and girls.

Governor Rick Perry has been criticized for his February, 2007 Executive Order that made the vaccine mandatory for girls before entering the 6^th grade. Very little is said about the part of the EO that affirmed the right of and facilitated parents who wish to “opt out” of not only Gardasil, but other vaccines as well.

We expect the Governor to direct the people that he appoints, right?  The Governor is responsible for management of the Executive Branch, including the Department of State Health Services. He appoints the head of the DSHS, who supervises the people who decide which vaccines will be mandatory. Texas’ Legislature modified Chapter 38.001 of the Texas Education Code over the years to mandate certain vaccines and allow the DSHS to add other mandated vaccines without Legislative oversight.  Just before the Gardasil controversy, the Department had mandated Chicken Pox and Hepatitis A, which are both manufactured using cultures of human fetal tissue obtained at an abortion.

The Governor’s Executive Order (RP 65) that caused all the controversy also ordered the director of DSHS to make it easier for parents to opt out of vaccines. The Legislature had changed the law from “opt in” to a requirement to “opt out” once for all the school years. Next, they changed to a two year limit on the opt out, and then in 2005, the Legislature restricted the period to one year and required a new State form bearing a “seal.” Parents had to go to Austin or start early in the summer. There were bureaucrats who maintained that the only way to get the form with the seal was to go to Austin, find the right office and make the request in person.  Perry used his EO to tell the Director of DSHS to make the request (and the seal) available on-line, making it easier to “opt out.”

In fact, the reason for the Executive Order was to speed up private insurance coverage and to make it easier for parents to exercise their right to opt out.

The Federal government doesn’t have the authority to mandate vaccines in the States.  Not yet, not exactly. However, thirty days after the National Advisory Committee on Immunization Practices (ACIP) recommended the vaccine, Texas was required by Federal law to buy and distribute the vaccine in the “Vaccines for Children” program.  The program provides vaccines without cost to uninsured children up to age 21, those who are insured by Medicaid, and those whose private insurance does not pay for vaccines at all. In effect, the only families who have to pay for Gardasil – for whom the State of Texas will not pay, anyway, under Federal law – are those whose private insurance will only pay for mandated vaccines.

Gardasil is manufactured the same way that insulin for diabetics is made these days: using recombinant DNA. In this case, common bakers’ yeast makes the proteins that cause the immune response. Gardasil had been thoroughly studied even in 2007, and is not only included in the Vaccines for Children program, it is the most-requested vaccine for girls. We are even seeing cross-protection from other strains.  It has recently been recommended for boys. The recommended time to give the HPV vaccine is at 11 or 12 years old, when children are scheduled to receive other shots (tetanus and MMR boosters) and before they were likely to be infected.

The only reason that we do “Pap smears” (the papanicolaou test) is to look for changes in the cell nuclear DNA of the cervix, the opening to the uterus or womb. Over the last 15 years, we have found that 99.7% of these changes are due to HPV infections. In the US, 70% of cervical cancers are caused by HPV 16 and 18. (50% by HPV 16.) These are the two types of HPV that result in the most damage and cost, due to repeat paps and the subsequent biopsies, freezing, “LEEP,” or other treatments in which the surface of the cervix (the opening to the uterus or womb) is burned off to remove cancerous and pre-cancerous cells. These treatments lead to infertility and premature births.

Because 15% of girls begin sex before age 15 and half of girls who have sex before 20 say their first time was involuntary, the first trial of Gardasil involved 1200 girls between the ages of 9 and 15. The girls 15 and under had a better response to the vaccine than the older girls and women 16 and above. The researchers compared blood levels of antibodies. The research ethics committee ensured that no paps or pelvics were done on the young girls. (Every one of the young women under the age of 21 when I sent them for colposcopy for cancerous changes had been raped before they were 15 years old.)

The reports of deaths and injuries from Gardasil are poorly documented. The great majority of the adverse effects in the reports include pain, redness, and tingling at the injection site and fainting and headaches. People often faint and complain of headaches after seeing a needle, even without being stuck. It looks awful sometimes, like a seizure. The FDA has ruled that none of the deaths that have been confirmed were caused by the vaccine. In addition, this article from the Canadian Medical Association Journal contains a table showing the numbers of serious events and the numbers of deaths in several studies on the use of the HPV vaccine.

Remember your statistics classes. With 33 million doses, there are bound to be deaths that coincide with the timing of the vaccine use. The teen death rate from all causes is 62 per 100,000 across the US. Most of those are boys, but still: In 10 million girls, 30 deaths are not outside the rate for the age group. They are tragic, but consistent with life on this Earth.

More likely the girls who had severe reactions or death had other risk factors, due to the population presenting to clinics giving the vaccine: those who present with worries about STD’s, the newly sexually active and those entering college. The records show that many were given new scripts at the same visit for birth control pills and other vaccines and medicines, according to the analyses in the medical literature. (Also, remember the silicon, SSRI, and the general vaccine scares that have been blown out of proportion through the years and later proven to be untrue.)

The reports on the possible vaccine-related deaths are available for viewing at” the “Vaccine Adverse Event Report Site” (VAERS),(drop down to the table at the middle of the Page, option #3) using “HPV4” (This is the Merck vaccine), at Option#4, check “YES” at “life threatening” (or you could check “death”) and (top of page)”Sort by submission date.”

Here’s a few examples:

    Administered by: Unknown  Purchased by: Unknown Symptoms: Adverse reaction Write-up: It was reported from an article, published on 29-JUN-2009 that there were “hundreds” of life-threatening reactions said to be associated with GARDASIL. This is one of several reports received from the same source. Attempts are being made to obtain additional identifying information to distinguish the individual patients mentioned in this report. Additional information will be provided if available.

Another:

FINAL DX: Hodgkins lymphoma, nodular sclerosing, stage IIA. Records reveal patient was pale & had firm left clavicular lymph node. Excisional biopsy done 7/23/09 revealed diagnosis. Tx w/chemotherapy & possibly radiation tx when chemo completed.

And another:

    Write-up: Vaccine was administered, patient became dizzy 30 seconds after shot. Patient was pale, diaphoretic & nauseous. Symptoms lasted about 45 minutes. BP dropped to 90/50 & pulse to 50/min. 8/20/09 PCP note received DOS 8/4/09. After shots pt became naseated, pale, diaphoretic, dizzy and had difficulty breathing. BP dropped to 90/50 and pulse into the 50’s. Sx lasted ~45 minutes with return to baseline. Vax record states pt “passed out.”

New Right to Government Funding?

“Americans will be thrilled to know that the courts have invented a new “right” to government money.”

These are points that need to be clarified: How much control do the people of the State have when money passes from the taxpayers to the Feds, and then back through the State’s Treasury under the State Legislature and does any entity have a “right” to tax funds? In other words (borrowed from something I read somewhere from Justice Rehnquist) are the courts to decide the big issues and only allow the Legislatures to decide small, inconsequential issues?

Today’s Washington Update, an e-mail newsletter from Tony Perkins and the Family Research Council, reviews a recent legal ruling in a Kansas Court.

The Judge indulged in political speech, himself (“The purpose of the statute was to single out, punish, and exclude Planned Parenthood.”) but he may have a point that Kansas Legislators might not have legal standing to limit the use of Federal Title X (“Title Ten”) family planning funds that come out of Medicaid appropriations. This is a point that needs to be clarified: How much control do the people of the State have when money passes from the taxpayers to the Feds, and then back through the State’s Treasury under the State Legislature?

Here in Texas, there haven’t been any challenges against our new laws that will eventually limit tax payer funds that will go to PP. We worked on Texas’ family planning funds rather than Federal money. We prioritized funds going to hospitals, county health and federally qualified health clinics that provide comprehensive and continuing care for more than one body system. We also tightened up law prohibiting State tax funds from going to any organization or clinic that performs abortions.

Supreme Court: Higher First Amendment Hurdles for Public Health Regulation

From the New England Journal of Medicine:

Vermont’s statute had a fatal self-inflicted wound. By prominently announcing that the state intended to tip the balance in the “marketplace for ideas” against drug companies, the law dug itself into a constitutional hole: state interference with that marketplace was likely to provoke the ire of a majority of the Supreme Court. Writing for the Court, Justice Anthony Kennedy stated, “[t]he more benign and, many would say, beneficial speech of pharmaceutical marketing is also entitled to the protection of the First Amendment.”

Instead of dealing with this statute under existing precedent, Kennedy seized the opportunity to expand the First Amendment’s reach and power to strike down government regulation of health care information. The Court’s opinion raises serious questions for some public health rules and the regulation of drug marketing. Justice Stephen Breyer, writing in dissent, charged that the Court added an unprecedented constitutional standard that would hinder consumer-protection regulations, including Food and Drug Administration (FDA) restrictions against off-label marketing.

Although the First Amendment’s core is the protection of religious freedom and political speech, in recent decades, federal courts have expanded its application to business-related or “commercial” speech. In the 1970s, the Court used the commercial speech doctrine to reach state laws prohibiting advertising by professionals such as lawyers, accountants, pharmacists, and physicians. These professions had been self-regulating, following ethical rules that limited market competition. The Supreme Court struck down the prohibitions, using a standard of review that reserved some deference to the state legislature. By 1980, this “intermediate-scrutiny” standard was encapsulated in the Central Hudson decision, and until now, the Central Hudson test — whereby it’s considered constitutional to regulate commercial speech only if doing so “directly advances” a “substantial” government interest in a way that “is not more extensive than is necessary” — has been the operative standard.

Kennedy applied a more stringent “heightened-scrutiny” standard to the Vermont law, seeing the additional burden as justified because the law regulated specific conduct (drug marketing) and specific persons (data miners and drug companies). Under this standard, the Court didn’t carefully weigh the health care cost savings described by Vermont and gave short shrift to physicians’ confidentiality in patient-related decision making, claiming that prescriber-identifiable information was widely available in the marketplace. The majority dismissed Vermont’s concerns about data mining as “nothing more than a difference of opinion,” without considering seriously the peer-reviewed evidence on marketing’s effect on prescribing choices. Indeed, experts’ testimony to the Vermont legislature was offered as evidence of the state’s bias.

via Higher First Amendment Hurdles for Public Health Regulation | Health Policy and Reform.

Partisan disagreement over Health Care Law

Which way will those Independents vote in 2012?

Data Watch | Health Policy and Reform.

The Brief: Top Texas News for Aug. 4, 2011 — Texas News | The Texas Tribune

Governor Rick Perry is quoted as saying, “You know I don’t mind being the first. I like it.”

The Brief: Top Texas News for Aug. 4, 2011 — Texas News | The Texas Tribune.

Perry’s Surgery Included Experimental Stem Cell Therapy — Rick Perry | The Texas Tribune

I’ll admit it: this is just cool!  Notice the political and ethical comments from the Texas Tribune:

The governor’s procedure did not involve embryonic stem cells, which he and many other conservatives ardently oppose using for medical research on both religious and moral grounds. His treatment involved removing his own adult stem cells from healthy tissue and injecting them back into his body at the time of surgery, with the belief that the cells would assist tissue regeneration and speed recovery.

via Perry’s Surgery Included Experimental Stem Cell Therapy — Rick Perry | The Texas Tribune.

The FDA, which is in litigation over its authority to regulate new stem cell clinics, has not approved the use of adult stem cells for anything other than bone marrow transplants, which have been used for decades to treat cancer and sickle cell anemia patients. This has largely kept doctors from openly advertising these stem cell injections, but not from capitalizing on them by offering the therapy to their patients.

It also hasn’t stopped Perry from pushing for adult stem cell research and industry in Texas. During the governor’s 2009 State of the State address, he called on state leaders to invest in adult stem cell companies. Later that year, his Emerging Technology Fund awarded a $5 million grant to the Texas A&M Health Science Center Institute of Regenerative Medicine and $2.5 million to Helotes-based America Stem Cell to develop new adult stem cell technology.

Last month, three weeks after his adult stem cell treatment, Perry wrote a letter to the Texas Medical Board, which is considering new rules regarding adult stem cells, saying that he hoped Texas would “become the world’s leader in the research and use of adult stem cells.” He asked board members to “recognize the revolutionary potential that adult stem cell research and therapies have on our nation’s health, quality of life and economy.”

In the weeks since the procedure, the governor has traded his cowboy boots for orthopedic shoes and donned a back brace, raising questions that his recovery may be slow-going. Still, he has traveled extensively; in an interview with The Associated Press last week, Perry said he felt 80 percent recovered and was swimming and using the treadmill.

As for the high cost of such stem cell injections, Miner said that whatever health insurance didn’t pay for, “Perry did.”

In Perry’s procedure, his doctor, Houston orthopedic spine surgeon Stanley Jones, said he pulled stem cells from fatty tissue in the governor’s hip, left the cells to expand in culture for several weeks at a Sugar Land lab, then injected the cells back into the governor during his back surgery, into the spine and into Perry’s blood stream.