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?
(Photo of the men’s bathhouse at Pompeii, in contradiction to the claim that gender-segregated facilities are a modern concept.)
The Texas Senate State Affairs has another long day ahead, as testimony will be heard today on SB6, the so-called “Bathroom Bill.”
Here’s a rebuttal that I wrote in response to a facetious op-ed that appeared in the Austin American Statesman last month. The Opinion editor told me a shorter version would be published, but I haven’t seen it.
Obviously, John Kelso isn’t a survivor of male on female sexual abuse or harassment.
Many survivors (like me, at 3 years old) have strong reactions to the idea – the threat – of a man in the enclosed space of even a “public” bathroom. Just as as I worry about the safety of children, I also want a “safe space,” where I am not likely to be confronted by a male.
If the transgendered individual doesn’t trigger that fear – and I have no doubt that I’ve shared bathrooms with some who didn’t – then no problem. However, their ability to do so is no justification to engage in sweeping social experiments.
Representative Schaefer and Lieutenant Governor Patrick didn’t start this controversy. Individuals making policy decisions in cities, school districts and the Federal government did, sometimes with the weight, fines, and penalties of law.
The fact is that at least 1 in 5 women have been sexually abused before the age of 18. (In my experience as a Family Physician, I would have expected the percentages to be higher.) More than 90% of those assaults are committed by males who prey on females. While “only” 20% or so are perpetrated by strangers, isn’t that enough?
And yes, some of us do consider innocence a value to be protected and wish to protect girls from involuntary exposure to the physical characteristics of anatomical males. Thus, our objection to co-ed bathrooms and the Obama Administration’s Department of Education guide lines that included locker rooms and overnight accommodations on school trips.
Significantly, Kelso claims to be ignorant of multiple abuses of by straight males, dressed as females or otherwise, who take advantage of the opportunity to exploit newly accessible, formerly same-sex, hygiene facilities. I suggest at least a bit of online research.
How dare commenters mock women’s “worry” and “FEAR(sic)?” Isn’t fear of assault the reason most often given to justify “gender neutral” policies?
It’s very rarely good medicine to encourage a symptom of disease, especially one that leads to harm. I don’t help raise a patient’s temperature when they have a fever. I treat the infection and to keep the temperature from going up to dangerous levels.
In every case of cutting and self harm that I saw in my practice, the several girls and one boy had already been the victim of sexual abuse and were also abusing alcohol or drugs. The cutting was a symptom of depression, post-traumatic stress and the victimization that started the cascade.
And yet, the Journal of Medical Ethics has published an article arguing that since cutters are going to cut, doctors should aide them by providing sterile knives or razors.
The Journal is actually a forum for public arguments on controversial topics in bioethics, rather than a policy manual or review of facts and best practices. However, far too often the subjects are treated with respect and support those same controversial ideas.
The online bioethics newsletter, Mercatornet, disputes this normalization of pathology and outlines the history of support and opposition to the concept of “safe” self harm.
Indeed, the argument for limiting harm is often given as the reason for elective abortion, physician assisted death and other forms of euthanasia.
Please, apply the suicide or cutting to illegal drug use. Does the rationale follow through? If a person is only happy after heroin, should we assist him by allowing and providing a cleaner, more pure product – as well as the needles so many State laws have made possible?
Cook sarcastically sums up with an imaginary Tweet:
“Bioethics is broken. Doctors respecting patients who make really BAD decisions. All because of AUTONOMY. DUMB!!! Back to human dignity!!!”
I have long described Bioethics as “the formal study of who we can kill.” Now, we can add, “and aid in harming.”
While we were distracted by whether Kellyanne Conway was “lying” about “alternative facts” and how mean Bannon and Spicer are, the FBI quietly lifted the gag order on National Security Letters issued by them during the previous Administration.
Now, I’m not a lawyer, so the following is a lay explanation.
These “Letters” are in fact, subpoenas issued by a government agency. They don’t require a judge or FISA Court review or warrant.
Get this: the laws authorizing the NSLs are called “Patriot” and ” Privacy” Acts and the gag order provisions have been vetted by the Ninth Circuit of Appeals:
However, the government appealed to the Ninth Circuit Court of Appeals, which vacated her ruling and sent the case back to the district court. Last month that court ruled that the gag order challenge was no longer relevant because the USA Freedom Act had successfully addressed the issue of gag orders.
Google, Twitter, Facebook, and others reported the release from the gag order during the last couple of months. Yahoo, along with the others, has been fighting in court and some of the Letters have been disclosed to the targets:
I sincerely thought that all of these sorts of subpoenas were required to eventually go through approval of a FISA Court judge. Hopefully, the Trump Administration will not continue the Obama Administration’s abuse of these Letters and that Congress will correct the law.
Cuomo wants no co-pays, no deductibles, and abortion business doctors to decide whether the abortion is “medically necessary.” And there are lots of taxes on the poor, as well as the rich, to pay for it.
What a perfect example to give as a rebuttal to those who tell me that as a Christian, I have to support every social spending plan by government.
That duty to help the poor is my personal duty to Christ. I don’t see any command to turn it over to someone else.
The US Government spends and taxes – doesn’t even dedicate Medicare and Social Security taxes for the supposed purposes – and hasn’t proven a trustworthy steward for my duty to Christ. In fact, Jesus said to give Caesar what is Caesar’s. He didn’t tell us to take from our neighbors to give to Caesar!
But there are many scriptures addressing our duty to use well what we are given and to give credit to the One Who blessed us. And many more admonishing us to protect our fellow humans.
Proverbs 24:11 Rescue those who are being taken away to death; hold back those who are stumbling to the slaughter.
Ridiculous! It’s a plant. Which literally grows like a weed – or house plant – and doesn’t require manufacturing or processing to use. What business does government have in outlawing a plant?
Marijuana laws are in the news in Texas, once again. I hear and read plans to make money from taxes and autocratic demands to”protect” people from the plants. The same Republicans who demand legalization of the sale of raw milk and think gambling dollars should stay in the State argue against any decriminalization of marijuana.
Even if you don’t have sympathy for the thousands jailed for use while the plant is illegal, the raids on gardens, seizures of farms or the arrests of people because owners are suspected of growing illegal *plants* should make you consider the harm from draconian narcotics laws.
In fact, my trouble getting poppy seeds for the hard, back in the’90’s is what changed my mind about these laws. The Clinton Administration was arresting people for selling seeds and dried pods used in crafts:
“Somniferum is the only poppy species mentioned in the federal Controlled Substances Act of 1970, where it is listed as a Schedule II drug, the same as cocaine. The entire poppy plant, not just the opium that oozes from its green seedpod, is considered contraband.
Republicans are advocates of personal responsibility and remind others about the words in the Declaration of Independence. We should know that legitimate laws are intended to protect us from the infringement of inalienable rights by third parties — and the government. Laws are not meant to protect us from ourselves.
In a liberty-minded, Republican-controlled State and Nation, there shouldn’t be any laws against growing seeds from your grandmother’s heritage poppies or your new neighbors’ marijuana plants.
Addendum: a 1992 article about poppies at Thomas Jefferson’s Monticello:
“Thomas Jefferson planted white opium poppies at Monticello. They grew in the historic garden near Charlottesville, Va., until last June, when they were yanked up.
“The center even sold the seeds. Until its governing board — “which has a mania for being legal,” Mr. Fitzpatrick said — decided to press the issue.”
The consensus of media pundits and bloggers, as well as quite a few liberal and even Conservative op-ed authors, is that Donald J.Trump was elected President out of some misguided national populism and anger at Congress, fueled with a lot of racism, misogyny and hate. The fact that those same voters elected a Republican majority in the House and Senate – sending virtually every eligible Republican incumbent back to DC – is glossed over.
The idea that Conservatives really believe in small government and equal opportunity supported by personal responsibility is rarely voiced. That we might actually vote, not only for President but consistently down ballot, in order to defend the Bill of Rights and the right to life is ignored while we are accused of xeno-, homo-, and poly-whatever-phobia. I read that I am “afraid” of other lifestyles, religions, and losing my “privilege” based on being a White Christian.
Personally, I approve of most of the Republican Platform, especially where it addresses core Conservative issues, such as low taxes and equal treatment under the law. I want a Legislature that will uphold the Constitution as it’s written and defend against the infringement of inalienable rights. I don’t want activist judges nominated or confirmed at any level of the Federal Court system, especially the Supreme Court. I hope President Trump and the Republican Congress majority will decrease the hassle factors and threats placed on the practice of medicine and business in general by an overreaching Federal bureaucracy.
And, yes, my sense of fairness hopes that our existing immigration laws will finally be enforced, as an outcome of the”equal treatment under the law.”
Instead of facile clichés fed by cherry-picked sound bites and the latest talking points from the Left, try looking at and listening to the 59 Million voters across the country who elected a Republican candidate for President, and ensured a Republican majority including all those “establishment” candidates in both the House and Senate.
It’s the Republican platform and Conservative policy that we Conservatives voted for, not one man.
November 6, 2016 – a Sunday afternoon – FBI Director Comey announced that his agency’s investigation of Hillary Clinton’s selfie-server is closed, still without recommendation to charge the former Secretary of State. He destroyed any confidence that the United States is a nation of laws.
From the New York Post:
” From within the SCIF, Santos — who had no clearance — “collected documents from the secure facsimile machine for Clinton,” the FBI notes revealed.:
“Just how sensitive were the papers Santos presumably handled? The FBI noted Clinton periodically received the Presidential Daily Brief — a top-secret document prepared by the CIA and other US intelligence agencies — via the secure fax.”
Among the FBI notes on their investigation into those once-deleted emails from Clinton’s selfie-server were some indicating that Clinton regularly required her Washington, DC maid to print out official State Department documents, including classified information.
That’s right: her maid, a woman without any security clearance at all.
Again, while these emails and the access by the maid present new information to most of us, the FBI knew that they existed and that they were among the 30,000+ emails that were deleted *after* Congress had served Clinton with a subpoena.
We can assume that the emails had been marked as personal by the (again, no-security-clearance-) lawyers to whom Clinton delegated the task of dividing the contents of the selfie-server into those that were not and those that were State Department business. Clinton claimed that neither group of emails contained classified documents, so she saw nothing wrong with turning over a memory stick containing the emails to the lawyers.
Media Matters covered the maid stories. The point that they made was strictly on Conservative bias and the timing of when the classified emails became classified. There was no coverage about the President’s morning briefing from intelligence sources or on the illegality of giving access to the SCIF. There was certainly no insight into the fact that the documents could later be determined to be classified is the EXACT reason that a person without the appropriate clearance should not be given access!
I’m disgusted. I’m angry. I want to commit felonies of my own – felonies yet to be determined, but of my choice and according to my own schedule.
But since I do believe in the Rule of Law and its benefits, I want to know what my Senators Cruz and Cornyn and my Congressman Lamar Smith intend to do clean house in the Federal government.
And I don’t mean, “with, like a cloth.”
(Edited @ 7:05 PM on November 7, to add comments on Media Matters and to correct the cloth comment. 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
There is only one candidate on the November ballot for President this year who states that he is pro-life. Even if Donald Trump is inconsistent – and he is, I’ll admit – the fact is that Hillary Clinton and Gary Johnson are very consistent in their advocacy for legal elective abortion. Trump may have said that Planned Parenthood does good work, but Clinton campaigns with Cecile Richards.
RedState has lost all relevance as a reliable source for conservative commentary, in their zeal to defeat Donald Trump.
First, the moderators began banning commenters who simply questioned RS authors during the Primary. Now, Discus and comments have disappeared entirely from the site, and any public feedback is moved to the ephemera on Facebook.
Yes, Pro-life Bills are often weak, incremental compromises. We face the reality of needing to win at least some Dem votes and the probability of vetoes. The Press invariably paints usas evil. As Wolf pointed out – and the Supreme Court ruling on Texas’ HB2 clearly showed – the current Courts are stacked against us.
One of my friends acknowledged the weak Bills and compromises that our legislative efforts sometimes become, likening our efforts to lifeboats. Rather than big, shiny, well-crewed ships to use to rescue the unborn, we are forced to borrow any thing that floats. Our crafts are ugly and leak, and we constantly have to worry that we will sink. This is all we have, but we go back again and again, to rescue as many as we can without each trip.
Leon Wolf just shot a few new holes in our efforts, from his safe harbor at RedState.
Tell me why I should believe that “Latinos” are a big homeogeneous blob who don’t care about anything else except immigration, including law and order?
The news yesterday was full of “Latinos” declaring that they have turned away from voting for Donald Trump after his speech on immigration in Phoenix.
These people on the “news channels” and social networks claimed that an entire group of people, all lumped together because of who their parents are or what language they speak, are of the same mindset, and will vote as a block to ensure that some people – dare I say “their people” – are treated differently under the law from everyone else
There’s no justice in ignoring the law. On the contrary, inconsistent enforcement of the law is injustice: it infringes on everyone’s rights. Everyone’s liberty is placed at risk by inconsistent enforcement at the whim of whoever has the biggest gun, the most votes or the latest appointees to the US Distric Attorneys offices and Federal Courts. Whoever has power gets to decide which of us is “more equal.”
Illegal aliens have at least committed a misdemeanor for the first offense. If they’re working, they are probably using false Social Security numbers, possibly committing identity theft – not a victimless crime, even if you believe the reports that illegal aliens contribute more than they cost society.
So, here’s my “Modest Proposal,” with apologies to Vicar Swift.
If you think we should just let illegal aliens hide out for 10 years, then self-report (yeah, sure) , sign up for fines and an English as a Second Language class, how about treating every equivalent infringement the same?
Let us each pick our own tort or crime, to be determined at our convenience. Give everyone a year or 10 – after the fact – to self-report, pay a fine, take a class and go on.
Start with other cases of identity theft, then move on to Federal offenses like voter fraud, money laundering, Medicare and Medicaid fraud and abuse, on to failure to pay the IRS, bank fraud, embezzlement.
After all, it’s only fair.
About 300 delegates to the RPT weren’t Republican.The Platform of the Republican Party of Texas is online under “Platform,” here: http://www.texasgop.org/2016-convention/ . The numbering in this version of the Platform is awkward, but the plank-by-plank votes are reported at the 3rd link, below.
110 even voted against Principle #5, “Personal accountability and responsibility”
Just under 300 voted consistently against what should be non-controversial issues, such as the plank against human trafficking.
(Numbering appears to be a typographical error, hopefully soon corrected. The hard copies we had were much clearer.)
TRump is a very recently converted –well, mostly converted, except for big government, taxes and tariffs, government healthcare, and using government agencies to pick and choose winners and losers and courts to threaten others – Democrat.
It’s not as though he changed any donation habits more recently than the last two years.
It’s not even as though he’s voted in a Republican primary since 1988.
He believes money and lawsuits are weapons and he is a bully.
He can not or will not give more than anecdotal evidence for any of his other conversion experiences.
He lied as recently as the steak incident – an entirely unnecessary lie, easily discovered.
He has no conservative credentials and does not pretend to apologize for it, even to God.
But he says that a simple majority is “a random number” and demands that the Republicans ignore our Convention rules and let him make up his own.
TRump still lies, redefines words, ignores the rules and history and makes threats when he doesn’t get his way.
Newbie Republican still acts like a Dem.
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How human is human enough for human rights?
Justice Taney on slavery, in the ruling on the Dred Scott case:
The question before us is, whether the class of persons described in the plea in abatement [people of Aftican ancestry] compose a portion of this people, and are constituent members of this sovereignty? We think they are not, and that they are not included, and were not intended to be included, under the word “citizens” in the Constitution, and can therefore claim none of the rights and privileges which that instrument provides for and secures to citizens of the United States. On the contrary, they were at that time considered as a subordinate and inferior class of beings, who had been subjugated by the dominant race, and, whether emancipated or not, yet remained subject to their authority, and had no rights or privileges but such as those who held the power and the Government might choose to grant them. “
Nevertheless, today’s Supreme Court hearing didn’t deal with the question of whether the zygote/embryo /fetus is human enough. It dealt with the regulations for abortion businesses and the doctors who work for them. These are essentially the same rules imposed on Federally Qualified Healthcare Centers.
Doctors must offer continuing care and the buildings should allow safe egress and sanitary standards of care. The challenge is against State protections for the women who have chosen abortion.
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By 7 PM, there was a line of people setting up to spend the night in front of the Supreme Court of the United States building. They hope to be able to watch the Court proceedings on Wednesday when the Texas abortion law, HB2.
Here’s the coverage from Brian Rosenthal of the Houston Chronicle, about Texans, like me, who travelled to DC for the hearing. I’m quoted as ‘helpful about the future of the law in the last few paragraphs.
Beverly Nuckols, 60, a New Braunfels family doctor who flew in for the arguments, said she was happy that a long and just process finally could be coming to an end.
Nuckols said was hopeful about the ruling because she was confident in the law.
“I believe we will get a tie,” she said.
“”Ronald Reagan made us believe that it was morning in America again, and it was. Now, the children of Reagan are ready to assume the mantle of leadership. . . Those of us who grew up when it was morning in America and Ronald Reagan was in the White House are ready to do for the next generation what Ronald Reagan did for ours!””
Someone named Rich DeOtte has written a Facebook piece attacking friends of mine. Rich mocks Dr. Joe Pojman as “a rocket scientist” and “knucklehead” (needless to say, that’s not popular in the Nuckols household) and takes a slap at Kyleen Wright, of Texans for Life Coalition and the Texas Medical Association.
Dr. Joe Pojman, Ph.D., is indeed a “rocket scientist,” who gave up his original career path of aerospace engineering to sacrifice as founder and Executive Director of Texas Alliance for Life, an organization I’m proud to support and serve as a Board member.
Joe wrote the op-ed that Rich attacks in direct response to the “misrepresentations” in another, political op-ed piece by Emily Kebedeaux Cook on the Texas Right to Life Website. Joe only wrote about issues, and did not engage in name calling or derision. The only reason Emily and TRTL are mentioned is because she’s the author of the political opinion piece about the “decline in the Texas Legislature’s efforts to protect human Life.”
As Joe points out, the very document to which Emily refers refutes her position: Texas was named one of three “Life List All-Stars” for 2016 by the Americans United for Life.
Joe laid out the case that our Texas Legislature’s pro-life laws are most definitely not at a standstill: we are ahead of the Nation. Joe’s position that Texas leaders gave us many successes in the 2015 84th Legislature is supported by the similar list of “Wins” reported by the Texas Catholic Conference, representing the Bishops of Texas. In an earlier letter, TCC notes that many of the criticisms Emily makes in her February 8th blog post were not previously scored “equitably” by TRTL. For instance, Senator Bob Deuell received no credit for authoring much of what became HB2.
In fact, Texas’ Legislative leadership in passing pro-life laws is why many of us are going to Washington, DC on March 2nd to bear witness when the Supreme Court hears testimony on the abortion facility regulations in HB2.
Emily and Rich focus most of their criticism on the efforts of pro-life groups, including doctors like me, to reform end of life care and the Texas Advance Directive Act (TADA). Session after session since it was passed, we in the pro-life community have had our efforts repeatedly blocked by the “death panel” accusations Rich makes and the demands in Emily’s op-ed.
I was one of the doctors appointed to the Texas Medical Association ad hoc committee that evaluated last sessions’ end of life Bills for TMA approval. Our group of doctors agreed to and helped fine tune HB 3074, what Emily called a “modest protection”: prohibiting the removal of Artificially Administered Nutrition and Hydration, including food and water by invasive medical methods like IV’s and “Total Parenteral Nutrition.” We were called anti-life and pro-“death panel” (Rich’s words) for including medical exceptions for the rare circumstances when the patient can’t process the AANH and/or when it actually caused harm.
Those “three strongest Pro-Life bills” that Emily mentioned were included in the “Wins” listed by the TCC. The Bills not only would have forced doctors to continue to indefinitely perform acts that we believe are not medically appropriate as long as a patient or his family demands it. They would have forced all disputes between the doctors practicing medicine and patients or their families into court and add “liability”(civil and criminal penalties) for the doctor.
Forget if you can, that if all disputes go to court judges would be required to determine medical care – to practice medicine – probably based on the testimony of dueling, paid medical expert doctors. Malpractice rates will go up for doctors taking on the most vulnerable patients – the elderly, the trauma victims and the victims of cancer. Those doctors will spend more time in courts, rather than in the ICU. And so will more grieving families.
We found out what happens when malpractice goes up in Texas, before tort reform was passed. Because of the malpractice crisis, there were no neurosurgeons west and south of San Antonio and Houston – none at all in El Paso or all of South Texas. We were losing obstetricians and family doctors willing to deliver babies and offer prenatal care, all over the State.
I don’t know how to translate past physician shortages directly into the possible shortage of doctors providing end of life care. However, I will predict that fewer family doctors, internists, pulmonologists and the ICU intensivists will be able to afford to practice in the ICU. Just as a patient had to be flown to Dallas, San Antonio or Houston from most of Texas for a head injury, only the tertiary medical centers in those cities will be able to staff their ICU’s properly.
Physicians, not hospitals – and certainly not courts – practice medicine in Texas. Doctors must be allowed to practice medicine according to our medical judgment, which is a combination of education and experience, under the watchful eye of the community; not “death panels,” but fellow physicians, nurses, ethicists, lawyers (who may be any of the former) and lay people. In the end, if you force the hands and minds of doctors against their judgment, you will end up with doctors practicing without judgment, and humans with inalienable rights forced to act against our will and in violation of our conscience.
And, now, back to Rich’s Facebook post. Think twice when you read political posts full of personal attacks and name calling. We should be able to discuss politics without, as Emily said in her blog post, “unnecessary, vicious, and vindictive fights inside the Republican Party.”
Edited to fix a name glitch – BBN
I’ve never done this before, but …
I hope Texas – and especially Comal County – voters will wait to vote. The State elections and the Presidential race are full of dirty tricks and deceptive ads and flyers.
People I once trusted are so fearful of a couple of powerful Lobbyist groups in Texas, and at least one lying campaign management firm, that they are making ill-advised endorsements. Those people most likely will not benefit the way they think they will.
Wait. Watch. Election day is March 1st.
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For every one who still claims that Republicans should have shut down the government last year rather than pass any budget that included funds for Planned Parenthood, read what National Right to Life had to say at the time. Even if the government had shut down over the budget, PP would have continued to receive funds!
“Additionally, as LifeNews.com reported recently, a study by the Congressional Research Service found that the majority of federal funds flowing to Planned Parenthood would not even be temporarily interrupted if the government shut down over this issue, because the funds flow through “entitlement” programs such as Medicaid – and those entitlement programs do not do not depend on enactment of the annual funding bills.
“It is also important to understand that federal spending bills do not include any “line items” that specifically designate money for Planned Parenthood. Rather, Planned Parenthood affiliates tap into funds from big programs like Medicaid and Title X. In order to deny Planned Parenthood such funds, a new law must be enacted to specifically prevent such funding. But for Congress to approve such a law will require 60 votes in the U.S. Senate, to overcome the filibuster.”
Remember this the next time you read or hear that nothing has come from a Republican majority in the House and Senate because Congress passed a budget September, 2015.
Then, ask the writer or speaker what kind of budget we would have had if Pelosi and Reid had been in charge.
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Edited for formatting -BBN
Unpledged delegates exist really to make sure that party leaders and elected officials don’t have to be in a position where they are running against grass-roots activists. (Democratic National Committee Chair Debbie Wasserman-Schultz, February 11, 2016)
The Washington Post reports on an interview with Wasserman-Schultz in which she is asked by CNN’s Jake Tapper to explain why Hillary Clinton received as many delegates in the New Hampshire Democratic (NOT) Primary as Bernie Sanders, who beat her by 22 percentage points.
For all those who declare other Republicans “establishment,” the Dem’s superdelegates are the true establishment of power by the Powers-That-Be of the Party. You only have to win your delegates, not 2/3 of the vote and then, again, 1/3 of Party officials. (Or lobbyists and donors.)
I’m “Establishment” if you believe what others say about me. The “friendly fire” isn’t accurate in this case, if the goal is to defeat the Democrats in not only the Presidential race, but to keep our majority in the House and Senate.
I remember when conservatives were against “liberals” and liberals called us the establishment. Liberals and conservatives were clearly divided into Democrats and Republicans. Today, Republicans are just as likely to deride other Republicans as being “establishment” as they are to use the equally variably defined “RINO” name-calling. At least with “RINO,” there was once an attempt to point out where the Republican-In-Name-Only differed from our core values. There’s no similar definition or list somewhere about what it is to be, or even as why it’s bad to be “establishment.”
The “establishment” designation is reminiscent of the tactic from the ’60’s: “Don’t trust anyone over 30.” It’s also classic Alinsky: “Pick the target, freeze it, personalize it, and polarize it.”
Besides being a distraction (time spent denying or defending that ephemeral “establishment”), it attacks the person addressed, rather than the issue at hand. By assigning the other as “other,” the name-caller can assume he is free to entirely skip any consideration about the other person’s thought process.
It takes more time to discuss issues and facts than to declare someone with differing views as a part of a mindless group, rather than as individuals who think and reason. It was much easier for President Obama to accuse Conservatives of being led by Fox News and Rush Limbaugh or for Hillary Clinton to assign us all to the “Right-Wing Conspiracy” than to confront us as individuals with reasons to oppose government-run and -owned medicine or higher taxes.
The Republican Party is a very diverse group of individuals, who generally agree that individual liberty is better achieved under a small constitutional government with a strong national defense. Individuals within the Party can disagree on priorities and tactics and we can definitely disagree on personalities. We should not simply shut out fellow Republicans with name-calling.
The National Review has a page online of non-endorsements for @therealdonald. They are worth reading. Here’s a few excerpts:
From Erick Erickson, radio talk show host and formerly of RedState.com, this reminder:
“Nonetheless, I will not be voting for Donald Trump in the primary. I take my conservatism seriously, and I also take Saint Paul seriously. In setting out the qualifications for overseers, or bishops, Saint Paul admonished Timothy, ‘If anyone aspires to the office of overseer . . . he must not be a recent convert, or he may become puffed up with conceit and fall into the condemnation of the devil’ (1 Timothy 3:1,6).”
From Yuval Levin, editor of National Affairs and author (I stole his line about Pope Benedict for my email signature, “I have a mustard seed and I’m not afraid to use it.”), observes:
American conservatism is an inherently skeptical political outlook. It assumes that no one can be fully trusted with public power and that self-government in a free society demands that we reject the siren song of politics-as-management. A shortage of such skepticism is how we ended up with the problems Trump so bluntly laments. Repeating that mistake is no way to solve these problems. To address them, we need to begin by rejecting what Trump stands for, as much as what he stands against.
“Why is there a double standard when it comes to evaluating Donald Trump? Why are other politicians excoriated when they change their minds — as, for example, Rick Perry did on the question of whether HPV vaccinations in Texas should be compulsory — but when Trump suddenly says he’s pro-life, the claim is accepted uncritically? Why is it unconscionable for Ted Cruz to take and repay a loan from Goldman Sachs to help win a tough Senate race but acceptable for Donald Trump to take money from George Soros? Why is vetting Trump, as we do any other candidate, considered “bashing”? Aren’t these fair questions?”
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
Texas Right to Life turned Mr. Dunn’s imminent death from metastatic pancreatic cancer into a crusade against the Texas Advance Directive Act (TADA or the Act). The Act is invoked by the attending doctor – not the hospital or ethics committee – when family members demand that he or she perform acts that go against the conscience because they are medically inappropriate, causing the patient to suffer without changing his course.
In this case, the mother and father disagreed with one another about the care plan and the patient was unable to make legally binding decisions. The father agreed with Mr. Dunn’s doctors that the treatment was causing suffering, objected to surgery to place a tracheostomy, and wanted hospice and comfort care. The mother wanted dangerous, painful procedures performed that would not change the medical outlook except to possibly hasten death.
And, unless you read the court records, you wouldn’t know that the judge ruled that Chris was not mentally competent to make his own medical decisions, that the hospital never wanted guardianship and had voluntarily promised to continue care until the guardianship could be settled. In fact all the lawyers, including the Texas Right to Life representatives, signed off on an agreement acknowledging this promise on December 4th. ( The official court records are available to view free of charge online at the Harris County District Clerk’s website as protected pdf images. See Family case number 2015- 69681.)
Inflammatory headlines falsely claimed that “the hospital” had imposed a “death sentence,” and was actively trying to kill Mr. Dunn by refusing to diagnose, treat or even give a prognosis. That same blog post mentioned non-standard treatments that some in the family were demanding.
First of all, of course there was a diagnosis. Several, in fact. From the signed affidavit of Mr. Dunn’s attending physician, filed December 2, 2015 in response to the law suit:
“Based on my education, training, experience, as well as my care of Mr. Dunn, I, and members of my team, have advised his family members that Mr. Dunn suffers from end stage liver disease, the presence of a pancreatic mass suspected to be malignant with metastasis to the liver and complications of gastric outlet obstruction secondary to his pancreatic mass. Further, he suffers from hepatic encephalopathy, acute renal failure, sepsis, acute respiratory failure, multi-organ failure, and gastrointestestinal bleed. I have advised members of Mr. Dunn’s family that it is my clinical opinion that Mr. Dunn’s present condition is irreversible and progressively terminal.”
The primary diagnosis was metastatic pancreatic cancer. The cancer was a mass that blocked the ducts and blood vessels coming from the liver as well as the normal function of the intestines. As liver excretions backed up into the liver and the blood pressure in the liver increased, Mr. Dunn suffered a life-threatening gastrointestinal bleed, fluid buildup in the abdomen and lungs, and sepsis (an overwhelming infection). All of these would aggravate respiratory failure, the necessity of a ventilator and lead to the kidney damage. Liver failure often results in hepatic encephalopathy and variable delirium.
There was definitely treatment given, including tube and IV feedings, antibiotics, the ventilator, and periodic removal of the abdominal fluid. Again, this was all publicly documented in Court documents, in the media and even on the Texas Right to Life blog that claimed that “Houston Methodist has invested no time or effort in Chris’s health, instead exerting their energies into trying to kill him instead.” [sic]
The Intensive Care doctors as well as the Biomedical Ethics Committee, met with the parents to explain Mr. Dunn’s condition and his prognosis. The family was given notice before the Committee hearing and met with the (not at all “nameless” or “faceless”) Committee to discuss their (differing) wants. Thirty days’ worth of medical records, a hospital case worker and assistance in finding alternative care were made available to the family.
Then, there’s the complaint about the limits on visitors and videotaping. It is not unusual to limit Intensive Care Unit visits to specific times and to allow only close family, especially when the patient can’t consent and there is contention among family members. It is certainly standard to prohibit filming in the Unit, since patients are visible from one area to the next, in various states of undress and undergoing constant or frequent *intensive* treatments.
(BTW, one of the lawyers in the TRTL ICU video proves the basis for the rules: he is not compliant with the usual isolation procedures. Former Senator Joe Nixon didn’t wear the protective gown at all correctly, risking the introduction of infectious contamination into the room and/or taking germs home with him.)
It’s very unusual for patients on a ventilator to be conscious because of the severe discomfort associated with the foreign body – the breathing tube – that is necessary in the airways. It’s difficult to believe that anyone would complain about sedating Mr. Dunn in order to bypass his gag reflex.
Finally, the standard of care in advanced metastatic pancreatic cancer is pain relief and palliative support. The surgery to remove a pancreas is extremely dangerous for even healthier patients. As Mr. Dunn had already had an episode of bleeding and both liver and kidney failure, it’s likely that even a biopsy of the pancreatic mass or liver, much less surgery, would have caused more life-threatening bleeding. With liver and kidney damage, he wouldn’t have been able to tolerate trials of radiation or chemotherapy, either.
In fact, the doctors and nurses gave excellent treatment all along, as shown by his survival beyond the average for patients who presented in such a precarious state and acknowledged by Mrs. Kelly in her statement after Chris’ death.
The truth is that Methodist never made plans to “kill” Mr. Dunn. Mr. Dunn was never in danger of the hospital “pulling the plug.” The real problem was a disagreement between Mr. Dunn’s divorced parents over who would legally make medical decisions. That rift is bound to have been made worse by TRTL and the lawyers turning Chris’ illness into a public political battle. The accusations about euthanasia, killing and murder may cause other future patients harm, if they are reluctant to seek care because of these stories.
Today, the Conservative grassroots are shouting raw emotions, masses feeding off headlines, “Shares,” and “Likes,” rather than the meat of the story.
Paul Waldman, in “Why have so many GOP governor’s fizzled out in the 2016 race?”online at “The Week,” astutely describes the insanity that has gripped the Party formerly consisting of Conservatives, but which is now infested with destructive anti’s.
From the article,
Over the past few years, the party’s grass roots have been gripped by an anti-politics fervor that values quixotic crusades over substantive victories, and equates actually accomplishing anything through ordinary political processes with betrayal.”
“That’s why someone like Ted Cruz, a senator who has never written a law and who, if you ask him what he has accomplished, will tell you about the times he “stood up” and failed to stop Barack Obama and his own party’s leaders from keeping the government open or not defaulting on America’s debts, can still be considered unsullied and thus potentially worthy of the nomination. And those like Donald Trump and Ben Carson, their minds uncluttered by even the remotest understanding of how government works, are the most popular of all.”
Brutal. Truth. Insanity, where failure equals stature and inexperience and ignorance are lauded as qualifications.
Can we re-use the Know Nothing name for our party?
Once upon a time, the grassroots of the Republican Party, especially Conservatives, were researchers, well informed, and capable of reason. It was a joke among us that the real news was hidden in the penultimate paragraph of any news story.
Yet, 14 years of Governor Rick Perry’s Conservative leadership in Texas is mocked amid comments about glasses and his performance over a few months in 2011. Governor Scott Walker won and re-won elections in a Blue State and braved for-hire Union mobs willing to break windows in the Wisconsin State Capitol, but he was simply ignored. Each were treated more seriously by crooked Dem Prosecutors than by Conservatives.
There’s no way this latest crop could have exposed the Clinton’s of the 1990’s – or will be able to do so in the last half of the 2010s. Sticking out the month long re-count in Florida, or defending the Governor’s Mansion in Austin?
Not while dragging that couch they supposedly got off of in 2009 and Tweeting about the “Establishment.”
I’m not being flippant when I say, God help us!
James Taranto’s Best of the Web Today distinguishes between the comments of Donald Trump and Marco Rubio and the “reporters” that covered them. The truth is worse than a set of “When did you stop beating your wife” questions: the reporters inserted words and assertions that weren’t voiced by the candidates.
From November 20th’s “More Hillary than Hitler:”
Further, the atrocious idea of “a database or system that tracks Muslims in this country” didn’t come from Trump but from either Hillyard or Yahoo! News’s Hunter Walker.
ThinkProgress’s headline: “Rubio Trumps Trump: Shut Down Any Place Muslims Gather to Be ‘Inspired’—Not Just Mosques.” But Rubio didn’t say Muslims, he said radicals. ThinkProgress thereby takes the position that there is no distinction between radicals and Muslims more generally.
I’ve seen high praise and strong condemnation for both men, based on the falsehoods “reported” in the news – or in the headlines of articles slanted by those “reporters.” I’m not surprised at the bias from sites such as “ThinkProgress” or even “Yahoo.” However, I’m deeply disappointed in the voters and, especially, the conservative bloggers and voters who take the headlines at face value.
It is the duty of *our* government to protect *our* inalienable rights. We, the people, *are* the government and we have no business taking from our neighbors to give to another. We cannot ethically put others in danger for our purposes.
As the Governor of Texas wrote, there is absolutely no way to vet the current crop of refugees. Have you seen the make up of the groups? Largely, single men who should be defending their own land, not coming here so completely dependent on charity.
Good hearted people are claiming that we are hypocrits and false Christians if we don’t accept Syrian refugees with open arms ( and State tax coffers.
The good Samaritan analogy is not equivalent. The Samaritan self-sacrificed, both financially and with time. He didn’t tax anyone else to pay for his good deads, but covered the expenses from his own pocket.
And he didn’t put himself — much less his dependents and innocent bystanders — in harm’s way.
If you feel this way, you might consider sponsorship of an alien someday. However, we can’t afford the money as a State, to bring in these people who will need total care and we certainly can’t afford to risk that even one is a terrorist.
(As someone asked: If I hand you a bunch of grapes, telling you that 1% may be poisoned, but I can’t test –Are you going yo eat any of them?)
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Please read the link – or at least the entire quote I’ve pasted here – before commenting.
The immigration debate and its ability to divide the Republican Party and split the Conservative vote is not new. Here’s a commentary about the dispute in light of the 2012 Presidential election, written in 2011. (Scroll down the page to “On Immigration,” Saturday, May 21, 2011.)
Dr. Jerry Pournelle has served our Nation in many capacities (including serving in the Army during the Korean War), but he’s probably best known, to those who know his name at all, as the author of Science Fiction written from a conservative, libertarian-leaning viewpoint. I strongly recommend his essays, including this one from 2011:
“We aren’t going to deport them all, and no Congress or President will do that, nor could even if it were thought desirable. The United States is not going to erect detention camps nor will we herd people into boxcars. We can’t even get the southern border closed. Despite President Obama’s mocking speech, we have not built the security fence mandated a long time ago. We probably could get Congress to approve a moat and alligators, although there are likely more effective means. We can and should insist on closing the borders. That we can and must do. It won’t be easy or simple, but it’s going to be a lot easier than deporting 20 million illegals. Get the borders closed. We can all agree on that.
“That leaves the problem of the illegal aliens amongst us. We can and should do more to enforce employment laws; but do we really want police coming around to demand “your papers” from our gardeners and fry cooks and homemakers?”
This is not a trivial point. I advocate for the necessity of identifying illegal aliens and would prefer that the process begin in the country of origin. However, in practical terms, how would the “Maria” Dr. Pournelle describes, who was brought here as a child, “begin the process?”
Defense and security requires that we secure the border and that we identify as many who are here illegally as possible. A first step would be to better track people who enter on Visas: what are all those computers at border entry spots for?? We should also cease the fiction that our schools don’t know which families with children are undocumented. We should hold employers accountable, but be very careful about instituting new government papers and government computer lists of eligible workers.
We must determine common ground for the sake of success. As pointed out four years ago by Dr. Pournelle, errors will be used against us, with the hard cases like “Maria” will be splashed across media and social networks. Without common ground, and with emotional demands to “deport them all,” we’ll still be debating this four years from now. And our citizens – and the illegal aliens – will remain at risk from the violent and criminal, if not from the terrorist.
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.)
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