Politics

Opponents of SB303 Promote Doctors Without Conscience

The opponents of Senate Bill 303 may not realize it, but they are promoting the very thing they claim to oppose: elevating the patient’s right to determine his own care above the doctor’s conscience will result in doctors who practice medicine without consciences.

The consequences of elevating autonomy above non-maleficence (“first do not harm”)  go to the very heart of medical ethics. In fact, the promotion of patient autonomy is the common justification for euthanasia and elective abortion on demand.

The doctor is the one whose hands, conscience, and medical judgment will be writing the orders for or actually carrying out the resuscitation. Just as it’s not ethical to force doctors to cause the death of patients, it’s not ethical to demand that doctors write orders and perform interventions when their medical judgment indicates that the intervention will not be successful and will increase pain and suffering while prolonging the process of death.

As ethicist Gilbert Meilaendar noted at the President’s Bioethics Council Meeting in September 12, 2008,

[T]he reason for a physician being willing to risk his life in an epidemic was precisely that he didn’t think staying alive was the most important thing, that there was something else that was morally more compelling and obligatory even than preserving his existence. And that would have something to do with the personal integrity that you seem willing to think may be — one should be willing to set aside in embracing what one thinks is evil.

Why Ethics? | LifeEthics.org

If there’s no such thing as right and wrong or good and evil, why are we arguing in the first place?

If you crack the egg of a bird on the Endangered Species List, it won’t matter that the bird was a fetus or embryo. You’ve still broken Federal law. Why is the species of an (unhatched) animal so clear cut under law, but human embryos have no protection under current law? Legal follies such as this underscore our lack of seriousness and consistency when contemplating our children of tomorrow. My concern is that we are not teaching them why they should treat us kindly, much less giving them a good example.

Bioethics dilemmas and most political disputes may seem to be new problems, but they’re not. Every “new” problem is another facet of the potential to deny the existence of right and wrong or to infringe on the inalienable rights of our fellow humans. Knowledge of the basics can guide decisions and actions.

If there’s no such thing as right and wrong or good and evil, why are we arguing in the first place? These truths transcend relative social considerations and laws, including religious beliefs, ideology, or the wants and wishes of the powerful or majority. They even transcend time and space: if you take a close look at the big debates, the speakers aren’t simply talking to each other: we’re arguing with the great thinkers of the past and trying to convince people who come along after us.

The unique nature of the species Homo sapiens sapiens is the source and the definition of “human dignity,” and the reason that all members of the species and our offspring are human beings who should be valued equally, without discrimination.

And of course, we are unique, since It looks like we’re the only species having this conversation. We’re the only species that, when an individual has safety, food and sex, doesn’t just go to sleep. Our species makes art, records history, and argues about the nature of the universe. Humans seem to naturally “know” “that’s not fair,” even at 3 or 4 years old. We seek Unconditional Justice, Truth, Love, Beauty and Knowledge. And we value Unconditional Love most of all.

The Negative rights to Life, Liberty and Property are owned and endowed upon individuals; they are not the property of or gift of societies or governments. These exist in a necessary order; a hierarchy of importance and power to call on society for protection. The right not to be killed trumps the right not to be enslaved, which precedes the right not to have your property taken from you by force or fraud. If they can kill you, there are no limits on how much they can enslave you or take from you. We must be secure that others won’t take our property against our will, because earning and owning property is how we avoid enslavement to others and how we make plans and lay by the staples of life to support the lives of ourselves and our families, both immediately while we can earn, and later when we are unable to work.

Society and government must protect these “inalienable” rights of individuals, but only as far as to ensure equality of opportunity, not the equality of outcome. These are protections against the actions of others, not against words or thoughts. It is not protection or promotion of someone’s personal tastes and not the right to not be offended. We must be very, very careful when we tax and even more careful if we presume to force the actions of others.

Good politics and science cannot exist in a moral vacuum. The powerful, the majority, the surging mob. the man with the biggest gun or governments cannot do good when their actions infringe on the life, liberty or property of the individual. To claim that people must act or give up property indefinitely for the greater good – Utilitarianism – ends in domination without measurable or objective limits.

And yet, to function in society carries responsibilities. Extraordinary privileges like those given to lawmakers, doctors, and scientists to do good, may also result in extraordinary power to do evil through abuse of unequal power of weapons, tools, numbers or even knowledge and skill. This is where conscience and the first principle of “first do no harm” come in. The right of conscience is a function of the liberty of an individual not to be forced to act against his understanding of good and evil, right and wrong.

Medicine and science have held a unique position to advocate for the protection of human rights, at least since Hippocrates, who formalized the now 2500 year old oath to “heal when possible, but First, do no harm” Non-maleficence, or not acting in order to avoid harm, must precede and be incorporated in the desire to do good or beneficence.

Once again, we come back to that first point: all of our offspring, descendants deserve the same value and protection of their rights to life, liberty and property without discrimination. It’s possible that we already have offspring among us who are not of our species. Science has created human embryos with more than two biological parents and others who have been the subject of genetic manipulation. Also out there are is the Humanity+ or Transhumanism movement in all its permutations, along with more accessible enhancement of the human mind and body through technology, medicine, machines, and manipulation at the nano-level.

We must consider how our children of tomorrow will consider us. It is true that humans aren’t perfect, we will make mistakes, and some humans will purposefully infringe on the rights of others. However, what values and principles will the pattern of our governments and individual action reflect? Will it be our respect and love for one another? Will they respect and love us or will they look back in horror or disgust?

(I want to thank Robert Spitzer, who wrote “Healing the Culture,” one of the best Ethics books in existence.)

This is a March, 2011 post from LifeEthics. org. Why Ethics? | LifeEthics. Edited 5/10/13 to move to top of the list.

American Academy of Family Practice quotes me on Plan B without restrictions

Should all girls “of child bearing age” be able to walk into the corner pharmacy and buy Plan B without ID, age restrictions or parental supervision? I don’t think so!

However, my professional organization, the American Academy of Family Practice, issued a statement this week advocating for just that. Our online newsletter included my comments in an article published today:

On the other hand, family physician Beverly Nuckols, M.D., of New Braunfels, Texas, said she has issues with the Academy statement because it is inconsistent with its own Family Medicine, Scope and Philosophical Statement.

“Family physicians not only treat the patient within the context of her family, we also strive to treat the whole patient — ‘biological, behavioral (and) social,'” Nuckols said. “In this case, the ‘disease’ we are trying to prevent is the high-risk behavior of unprotected sex. Parental involvement is vital to the health of children and is the best prevention for high-risk behavior, including adolescent sexual activity.

“The AAFP normally and correctly advocates parental involvement and intervention to prevent other high-risk activity, such as driving without a license, the use of guns without adult supervision, smoking, or overeating, etc.,” she said. “What is the rationale for treating adolescent sexual activity any differently than we would treat other risky behavior or preventable risk factor?”

Nuckols, who serves as chair of the Christian Medical & Dental Association’s Family Medicine Section, said she also has concerns about OTC Plan B One-Step because there are few controlled, randomized studies that prove levonorgestrel to be medically safe and effective for adolescents at the dosage given.

“The published data on emergency contraception don’t break out the numbers of adolescent girls, but the numbers appear to be low,” she said. “The closest I’ve found are small studies for treatment of menstrual disorders and inherited bleeding disorders by chronic use of oral or intrauterine levonorgestrel, with the youngest age at 14.”

via AAFP Disagrees With Justice Department Blockade of OTC Access to Plan B One-Step — AAFP News Now — AAFP.

(BTW, The author quoted my written statement, exactly, so any errors are mine.  I goofed in identifying myself to the author: Much to my relief, our CMDA Family Medicine Section elected a new Chair and I’m now the Past-Chair. I didn’t realize we had passed the turn-over date. Oh, and “data” really is plural, so “data … don’t” is not terrible grammar, just awkward.)

Dying, Naturally, in the Emergency Department

Here’s an excellent professional article about end of life care for patients that’s relevant to our discussion about SB 303.

Two Roads to Death

Two major pathways to death have been described: The easy and the difficult road Figure 1. Depending on the road a patient takes, the intensity of ED management may vary significantly. For instance, some patients are highly symptomatic at the EOL, requiring intravenous medications and even continuous drips to maintain comfort while others can be managed by relatively simple oral regimens in the home setting, with the support of hospice services.For symptoms like pain, the EM skill set proves sufficient as the management of healthy patients and those at the EOL is similar. EM treatment algorithms are less relevant, however, for symptoms like dehydration, delirium and dyspnea in the dying patient. For this reason, we will focus our attention on the unique approach to these common and often troublesome EOL issues.

via Dying, Naturally, in the Emergency Department.

Texas Tops Site Selection’s Most Competitive States of 2012 (from @GovernorPerry)

Texas has taken the top spot in another of Site Selection Magazine’s annual rankings – this time in the magazine’s ranking of the most competitive states in 2012. Earlier this year, Texas was awarded Site Selection’s 2012 Governor’s Cup for the most new and expanded corporate facilities announced over the year.

The magazine highlighted Texas’ commitment to maintaining a strong job creation climate and reducing the tax burden on employers, specifically through Gov. Perry’s $1.6 billion tax relief proposal.

Site Selection considered a number of criteria for the ranking, including total new and expanded facilities in 2012, total new jobs created in 2012, rank in the corporate real estate executive portion of the 2012 Site Selection Business Climate Ranking, state tax climate as ranked by the Tax Foundation, performance in the Beacon Hill Institute’s State Competitiveness Index, and the number of National Career Readiness Certificates per 1,000 residents aged 18-64.

To view the full article, please visit http://www.siteselection.com/issues/2013/may/top-comp-states.cfm.

via Office of the Governor Rick Perry – [Press Release] Texas Tops Site Selection’s Most Competitive States of 2012.

New brain research shows two parents may be better than one

More evidence that we shouldn’t treat our children of tomorrow like lab rats by redefining marriage:

A team of researchers at the University of Calgary’s Hotchkiss Brain Institute (HBI) have discovered that adult brain cell production might be determined, in part, by the early parental environment. The study suggests that dual parenting may be more beneficial than single parenting.

Scientists studied mouse pups that were raised by either dual or single parents and found that adult cell production in the brain might be triggered by early life experiences. The scientists also found that the increased adult brain cell production varied based on gender. Specifically, female pups raised by two parents had enhanced white matter production as adults, increasing motor coordination and sociability. Male pups raised by dual parents displayed more grey matter production as an adult, which improves learning and memory.

“Our new work adds to a growing body of knowledge, which indicates that early, supportive experiences have long lasting, positive impact on adult brain function,” says Samuel Weiss, PhD, senior author of the study and director of the HBI.

Surprisingly, the advantages of dual parenting were also passed along when these two groups reproduced, even if their offspring were raised by one female. The advantages of dual parenting were thus passed along to the next generation.

To conduct the study, scientists divided mice into three groups i) pups raised to adulthood by one female ii) pups raised to adulthood by one female and one male and iii) pups raised to adulthood by two females. Researchers then waited for the offspring to reach adulthood to find out if there was any impact on brain cell production.

Scientists say that this research provides evidence that, in the mouse model, parenting and the environment directly impact adult brain cell production. While it’s not known at this point, it is possible that similar effects could be seen in other mammals, such as humans. The study is published in the May 1 edition of PLOS ONE. It was funded by the Canadian Institutes of Health Research (CIHR).

The research paper can be read online: http://dx.plos.org/10.1371/journal.pone.0062701.

Don’t Experiment with Marriage (children aren’t guinea pigs)

Government could decree that “East” is now “North.” After all, they’re just arbitrary names for concepts, right? However, until all the old signs and maps (and compasses!) are replaced and gone forever, a lot of people will be lost and possibly hurt in transportation accidents.

Changing the family structure by government laws and regulations on marriage is reckless social experimentation, more like changing “up” to “down,” than “East” to “North.”

Rand Paul, (small-l)ibertarian Republican junior Senator from Kentucky and the son of perennial Presidential candidate Ron Paul, told the National Review that the Republican Party’s “problem” with gay marriage could be solved by changes eliminating references (and benefits) to marriage in the tax codes.

However, as an editorial in The Hill commentary noted,

Paul did not address in the interview how he might deal with other advantage and privileges extended to legally wed heterosexual couples, like federal spousal benefits, pension plans, health care, and Social Security survivors benefits.

And Paul ignores the societal consequences on our children of tomorrow.

Research confirms that the best environment for children is to live in a home with their married biological parents. When the ideal is not possible, statistics still favor stable, traditional marriage and the 2 parent home for the successful adult child of blended families and adoption. Please take a look at peer-reviewed studies published on the effects of stable families on children, here and here.

Want proof that government interference can change society for the worse? Look at the harm government has done to lower income families all those years when benefits were denied to families when the father was in the home. Or the negative influence of housing subsidies on marriage. (I can email the full article.)
Society and government ignore facts at the risk of harming the life, liberty, and pursuit of happiness of future generations. Don’t expect me to vote for or pay for dangerous societal experimentation – or even to sit quietly while someone outlines his intention to play social engineer.

Update: see this post from May 5, 2013, showing more evidence for the benefit to children of being reared in the home with their biological parents.

Vermont House passes aid-in-dying bill – News – Boston.com

The House rejected an amendment to allow the people of Vermont to vote on a referendum. The Vermont Senate has not passed the Bill.

MONTPELIER, Vt. (AP) — After a second long day of debate, the Vermont House gave final approval Wednesday to a bill that would allow terminally ill patients to ask their doctors for a lethal dose of medication.

via Vermont House passes aid-in-dying bill – News – Boston.com.

Hippocratic Oath and Lawyers at the End of Life

Doctors don’t swear oaths as part of our training anymore; and certainly not the Hippocratic Oath. After all, the Hippocratic doctor swears to follow his conscience, even when the patient disagrees. He must refuse to give women medicine or devices to cause abortion or to give poisons to kill patients, no matter who asks for it.

Neither doctors nor hospitals killed Terri Schiavo. Terri Schiavo was killed by her husband’s lawyers and the probate judge who forbade food and water by mouth and by IV or feeding tube.

Plan B, Minors, and the Obama FDA Appeal

Just after I hit “publish” on yesterday’s effort to explain the mechanism of Plan B and why we still shouldn’t allow minor girls to buy it over the counter, I found the news that the Obama Administration has decided that the FDA will appeal the ruling by a New York Federal Judge Edward Korman that gave the FDA 30 days to remove all age restrictions on Plan B, the “morning after pill.” This will not change this week’s decision to move the age requirement down to 15 years of age, it is a good, if minor, move.

USA Today has an article that’s typical for those who object to the appeal, written by Cecile Richards, the former National president of Planned Parenthood (and the daughter of the late Texas Governor Ann Richards).

The comments on CBS News’ coverage of the appeal point out one big problem that teens who have unplanned sex may also have: the “emergency” aspect of “emergency contraception.” One person suggests that Plan B should be available in vending machines and restrooms, as condoms often are. Several readers are concerned that teens who have unprotected sex plan won’t ahead or be able to find a pharmacy open when they need it..

Obviously, the writer of that comment doesn’t understand that the pill can be useful up to 5 days — and is still very effective (if it’s going to be) for at least a day or two. As I responded, there is a difference between a condom and Plan B: the latter is ingested and will have an effect, however small, on the hormonal balance of whoever takes it. Condoms don’t make people nauseous or throw up!

Plan B appeal angers W.H. allies – Kathryn Smith – POLITICO.com

I didn’t expect this!

President Barack Obama’s administration on Wednesday angered allies in women’s groups by appealing a judge’s ruling that the morning-after pill must be available over the counter to girls of all ages.

The administration has argued that the pill should not be readily available to young teens, so the appeal is consistent with that position.

via Plan B appeal angers W.H. allies – Kathryn Smith – POLITICO.com.

Plan B and Minors (Updated!)

Update 5/02/13: The Obama Administration has decided to appeal the judge’s ruling that the age restrictions must be removed completely from Plan B sales.

Because of a ruling by a Court in New York on April 5, 2013 and the April 30, 2013 announcement that the Obama Administration has published its intent to allow 15 year olds to buy Plan B over the counter without a prescription or adult supervision, the news is full of the controversy about whether or not Plan B is an abortifacient because it kills the embryo or blocks implantation.

(How about that: she’s old enough to buy over the counter emergency contraception, but she’s still young enough for her parents to buy her insurance until she’s 26!)

There is quite a lot of evidence that Plan B does not interfere with the embryo if fertilization occurs and none that it does. If, as the evidence supports,  it doesn’t cause the death of the human embryo, before or after implantation, Plan B is not an “abortion pill.”

But it still shouldn’t be sold over the counter to minors.

I don’t know anyone who thinks it’s healthy for 12, 14 or 15 years olds to have sex – whether boys or girls. While Texas does have the “Romeo and Juliet” defense ( when there’s no force, both are over 14 years old, opposite sex and within 3 years of the same age), 15 year olds can’t legally consent to sex. Texas law deems it a “crime of indecency” to have sex with a minor under 17.  Our State has also decided that 15 year olds can’t drink alcohol, can’t buy tobacco or Sudafed, and they usually can’t get a driver’s license.

We do this to protect them, because we know that they are not prepared to make good decisions. Their brains are not mature enough and they don’t have the experience and knowledge to adequately judge the difference between immediate gratification and future benefit. The fact is that most parents are their children’s best protectors and advocates. We are legally responsible for our children, but we are also morally responsible for them. We love them and don’t want them to hurt!

Parents need – and have the right – to know what our dependent children are doing and what medicines they are taking. By changing these regulations, the Federal government is moving between the parent and child — a much more sacred relationship than “a woman and her doctor.”

There is very strong evidence from good scientific experiments published in the last 10 years that Plan B does not interfere with the implantation or development of an embryo.

Plan B only works, when it works, by preventing fertilization for 4-5 days in the middle of the month – before ovulation – it delays ovulation so there is no egg to fertilize and by preventing the sperm from getting to the egg.

Plan B is a high dose of progesterone, the main hormone produced by the ovaries during the second half of a woman’s monthly cycle. Before ovulation, Progesterone or Plan B delays ovulation (the release of the egg from the ovary) and makes it difficult for the sperm to get to the egg.  At or after ovulation,   progesterone appears to slow the sperm’s travel to the egg (prevents fertilization) In nature, this prevents fertilization of an old egg – and its effect is one of the signs used by women who use “Natural Family Planning.”   Progesterone normally encourages the development of the lining of the womb after ovulation. In fact, doctors sometimes give Progesterone to women who have repeated miscarriages.

 It wouldn’t be ethical to conduct experiments on women who are ovulating and having sex, because those women might be carrying a human embryo that hasn’t implanted or who could be harmed. While it is true that there have been no experiments on women who might be pregnant, there are good studies which were done on ovulating women who have their tubes tied or who agree to abstain from sex during the experiment. Then, they were studied by checking repeat exams, blood work, ultrasounds and biopsies of the womb.  No evidence that Plan B interferes with implantation or damages the embryo has been found.

Current evidence is that Plan B decreases the risk of pregnancy for those women who take it properly, Plan B cuts the risk of pregnancy by 50- 70%. At the population level, it does not decrease either the pregnancy rate or the abortion rate. In fact, even women who have the pills in their medicine cabinet – who don’t have to pay $45 when they have unprotected sex – don’t use the pills consistently. This is true in countries like Scotland, the UK and Jamaica where teen girls can obtain the medication without a prescription or are provided the medication in advance of need.

I am a pro-life doctor who, like Texas law, believes that the individual begins at fertilization. I spend much of my time advocating for laws that protect the human right not to be killed and for traditional medical ethics. Yes, I am a Christian , but I prefer to make my arguments from the science side because I’m convinced that science will prove me right in the long run. After all, the “Nature’s Creator “ cited in the Declaration of Independence created science!

For the science, see these articles:

Added 8:00 PM 5/2/13 One of the best and oldest. I can email a copy of the entire article to anyone who needs it http://www.contraceptionjournal.org/article/S0010-7824%2805%2900045-4/abstract

• http://www.ncbi.nlm.nih.gov/pubmed/20670097
• http://humrep.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=17537781
• http://linkinghub.elsevier.com/retrieve/pii/S0010-7824(12)00100-X
• http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1726-46342010000200010&lng=en&nrm=iso&tlng=en
• http://linkinghub.elsevier.com/retrieve/pii/S0010-7824(11)00106-5
• http://www.webmd.com/sex/birth-control/news/20070417/plan-b-doesnt-cut-pregnancy-rates
• http://jama.jamanetwork.com/article.aspx?articleid=200095

Update on the Texas Advance Directive Act (SB 303)

The Texas Advance Directive Act of 1999 (TADA) describes “Advance Directives to Physicians” (what most people would call a “Living Will”) and contains Section 166.046, an attempt to outline the procedure for resolving a disagreement between a doctor and patients or their surrogates about what is medically appropriate treatment.
The law currently in effect requires the doctor to notify the patient or the surrogate when he or she believes that their request is medically appropriate. If there is still a disagreement, the doctor asks the hospital to convene a meeting of their ethics committee. If the committee agree agrees with the doctor, and no other doctor is willing to take over the care of the patient, the treatment in question can be withheld or withdrawn. TADA doesn’t allow “Physician Assisted Suicide” and certainly doesn’t allow euthanasia, where the patient might be killed on purpose.

The Texas Senate passed Senator Bob Duell’s Senate Bill 303, which significantly improves current law.  SB 303

• Requires the doctor to notify the patient or his surrogate before writing a “Do Not Attempt Resuscitation” order,
• Prohibits the withdrawal of artificially administered hydration and nutrition except in extreme circumstances and
• Gives families 5 days instead of 2 to prepare for the ethics committee meeting and 21 days instead of 10 before the patient must transfer care to another doctor,
• Outlines the duties of the hospital to  treat all patients the same, regardless of age, disability, or ability to pay, to provide a trained liaison to assist the family, and requires timely copies of the medical records.

Because SB 303 still needs to pass in the House, Texas Alliance for Life asked me to help them make a video explaining how it reforms current law.

If you agree that SB 303 is a pro-life reform Bill please call your State Representative at 512-463-4630 and ask him or her to support SB 303.

My “Ethics 101” on the law: “Back to Basics on Texas Advance Directive Act”

Video Scrutinizes Late-Term Abortion Practices at Bronx Clinic – NYTimes.com

Caution: very graphic story. The video by Live Action is not for the unprepared, so I’m not going to embed it here.

Live Action has released another of their under-cover videos, this one focusing on a woman who is 23 weeks pregnant who claims to be seeking an abortion at 23 weeks pregnancy. Live Action is a non-profit, pro-life group that is notorious for videos that expose Planned Parenthood and other abortionists’ attitudes toward abortion as birth control, late term abortion, gender selection, prostitution and even race-selective abortions.

A  New York Times article, points out the different roles of the two women representing the clinic. But still, both women were matter of fact about the methods and results of a 23 week abortion.

Lila Rose, president of Live Action, said the group would release more videos as part of its campaign against late-term abortions. Sunday’s video was shot at the Dr. Emily Women’s Health Center on Southern Boulevard in the Bronx. The release comes as Gov. Andrew M. Cuomo, a Democrat, has thrown his support behind legislation that will guarantee a woman’s right to an abortion after 24 weeks of pregnancy, if her health is in danger or if the fetus is not viable. The current law permits abortion after 24 weeks only if a woman’s life is in danger, although it is not enforced because federal court rulings have allowed less restrictive late-term abortions.

via Video Scrutinizes Late-Term Abortion Practices at Bronx Clinic – NYTimes.com.

Thank your Texas Senators for a Good Bill!

From Texas Alliance for Life:

 

Texas Senate Passes Pro-Life SB 303 to Help Families

Protect Loved Ones Near the End of Life

 

Lt. Governor David Dewhurst and Sen. Donna Campbell M.D. Deserve Thanks!

 

April 24, 2013

 

Dear Larry and Beverly:

 

Very good news! Last week the Texas Senate passed SB 303, a strong pro-life bill that will change current law to help families protect their loved ones near the end of life. Supported by pro-life Lt. Governor David Dewhurst and authored by Sen. Bob Deuell (R-Greenville), the full Senate passed SB 303 on a decisive 24-6 vote.

Your Texas state senator, Sen. Donna Campbell M.D., voted to support SB 303, a pro-life vote. Please thank Lt. Governor Dewhurst and Sen. Campbell for their support. See sample messages below.

SB 303 is strongly supported by broad coalition of pro-life and provider organizations including Texas Alliance for Life, the Texas Catholic Conference of Bishops, and the Texas Baptist Christian Life Commission. 

 

Voting for SB 303 were: Campbell, Carona, Davis, Deuell, Duncan, Ellis, Eltife, Estes, Fraser, Garcia, Hinojosa, Huffman, Lucio, Nelson, Nichols, Rodriguez, Schwertner, Seliger, Uresti, Van de Putte, Watson, West, Whitmire, and Zaffirini.Voting against SB 303 were: Hancock, Hegar, Patrick, Paxton, Taylor, and Williams. Senator Brian Birdwell was absent.

 

(snip)

Sequester vs. Waste and Fraud

In Washington, DC, today, the House and Senate voted to end the furloughs on Transportation Safety Administration employees and then, skipped town.   I wish they’d stuck around a little longer to deal with the growing Federal budget by cutting at least some of the tax waste and fraud in the news.

I know that much of the problem is due to State grants and poor over-site, like the Texas braces scandal, but the money comes from the Federal taxes. As long as they’re dealing with one sequelae of the “sequester,” why not deal with waste and fraud? There have been hearings, but where are the Federal laws and charges — or actual changes in regulation?

Today, the New York Times reported that New York State has suspended enrollment in their adult day care centers because of fraud and abuse (at the cost of $93 per person, per day):

Not a wheelchair or walker was in sight at these so-called social adult day care centers. Yet the cost of attendance was indirectly being paid by Medicaid, under Gov. Andrew M. Cuomo’s sweeping redesign of $2 billion in spending on long-term care meant for the impaired elderly and those with disabilities.

The National Institutes of Health was under the microscope last month, where grants were criticized for being politically motivated  (WingRight wrote on tobacco and tea party “astroturf”) and/or wasteful (why lesbians drink too much).

(Here’s a list of a few more examples of “Obscene Government Waste”:

— The government spends $1.7 billion for maintenance on empty buildings it owns, although some sources put the figure at closer to $25 billion. The Office of Management and Budget estimates that 55,000 properties are underutilized or entirely vacant.

— The federal government owns approximately one-third of all U.S. land. It does not need more land and it could be argued that it should not own 80% of Nevada and Alaska, and more than half of Idaho. That said, it wants to spend $2.3 billion to purchase more land and the National park Service currently has a backlog of maintenance tasks totaling $5 billion. These include parks that the Obama administration was saying would all have to be closed down because of a sequester reduction of a mere 1.2% of all federal spending.

— Homeland Security’s Janet Napolitano was issuing statements about the sequestration cuts to her department, but according to Tom Schatz, president of Citizens Against Government Waste, the department has $9 billion in unspent preparedness funds. How much of that will be spent on purchasing more DHS ammunition? They have already purchased enough to shoot every American five times.

— Republican lawmakers in Congress took the sequester fear-mongering as an opportunity to note, as Rep. Tom Price (R-GA) said, “There are pots of money sitting in different departments across the federal government, that have been authorized over either a number of months or years.”

— Rep. Tom Coburn (R-OK) is a leading budget hawk who identified programs to fund a space ship to another solar system, funds for advancements in beef jerky from France, and $6 billion for research to find out what lessons about democracy and decision-making can be learned—from fish!

— While you’re trying to figure out how to pay your 2012 taxes, give a thought to the National Science Foundation $350,000 grant to Perdue University researchers on how to improve your golf game.

— Not to be outspent, the National Institutes of Health gave a $940,000 grant to researchers who found that the production of pheromones in—wait for it—fruit flies, declines over time. Turns out that male fruit flies were more attracted to younger female fruit flies. The NIH also paid researchers to find out why gay men in Argentina engage in risky sexual behavior when they’re drunk and spent $800,000 in “stimulus funds” to study the impact of a “genital-washing” program on men in South Africa. You can’t make up this stuff.

— For reasons that defy sanity, various elements of the government have spent $3 million for research on video games; $2.6 million to train Chinese prostitutes to drink responsibly; a whopping $500 million on a program that would, among other things, try to figure out why five-year-olds “can’t sit still” in a kindergarten classroom; and grants such as $1.8 million on a “museum of neon signs” in Las Vegas, Nevada.

— Sanity does not apply to the $2 billion given annually to U.S. farmers to not farm their land. Don’t even ask about the Defense Department. It has long been famous for waste.

While all this has been going on, in 2010 the Office of Management and Budget determined that $47.9 billion was spent on fraudulent or improper payments in Medicare and the problem still hasn’t been fixed, though the cost is now up to $62 billion. There’s been $2.7 billion in fraud and mismanagement of the food-stamp program.

Dems divided on congressional Obamacare changes – Jake Sherman – POLITICO.com

Democrats are seeking to exempt Congress and their staffers from Obamacare.

http://www.politico.com/story/2013/04/dems-divided-on-congressional-obamacare-changes-90648.html

Texas Catholic Bishops Conference Rebukes “Texas Right to Life”

Using words such as “egregious,” “cynical,” “outrageous,” and “deceive,” the Texas Catholic Bishops Conference have published the letter that they sent to Texas Legislators concerning the actions of Texas Right to Life concerning Senate Bill 303 and its companion, House Bill 1444 on April 15, 2013.

Since employees and representatives of TRL continue to “stoke fear through ridiculous claims,” (and to harass those who support the Bills)  here’s the letter (I’ve reproduced the emphasis is in the original):

The Texas Catholic Conference is compelled to publicly correct the misstatements and fabrications that continue to be perpetuated by the Texas Right to Life organization against legislation to improve end-of-life care by reforming the Texas Advance Directives Act.

It has been said that all is fair in love, war and Texas politics. However, the actions of Texas Right to Life have been so egregious and cynical, especially when comes to misrepresenting the moral and theological doctrine of the Catholic Church, that the TCC cannot stay silent.

Texas’ Advance Directives Act needs reform. Current law lacks clarity given the complexity of end-of-life care, contains definitions that could permit the withdrawal of care for patients – including food and water – and permits unilateral Do Not Resuscitate Orders without the permission of, or even consultation with, the family.

Senate Bill 303 and House Bill 1444 are based on Catholic moral principles and reasonable medical standards for defending human life and protecting the conscience of both families and physicians. Both billsprevent unilateral DNRs, improve communication between medical providers and families, ensure a clear and balanced process for resolving differences, and give families the right to challenge Do Not Resuscitate Orders before a medical ethics committee.

In both its materials and communications with legislative offices and staff, Texas Right to Life has tried to stoke fear through ridiculous claims of nonexistent “death panels” and assertions that doctors are “secretly trying to kill patients.” Both claims are absurd. The truth is, many factors are involved in the sausage-grinding process of public policymaking. Some have less to do with making good laws and more about individual personalities and fundraising opportunities of organizations.

It is outrageous that an organization purportedly committed to the rights and dignity of life would resort to such disingenuous tactics that deceive honest and caring people. What is worse is doing so in a way that perpetuates current law and may cause unnecessary patient suffering.

Texas Right to Life has no authority to articulate Catholic moral teaching, and certainly does not have permission to represent the views of the Roman Catholic Bishops of Texas. If you have any questions, please feel free to contact us at the Texas Catholic Conference. We are more than happy to answer any questions or provide the Texas Catholic Bishops’ position on any issue before the Legislature.

 

(Edited for spelling and grammar, 4/25/13 BBN)

NIH funded study: “the tobacco industry and the Tea Party”

How reliable is a US government funded study that uses the term, “astroturf?”

Research using your tax dollars is under scrutiny – once again – and the subject of recent hearings in Congress. The National Cancer Institute, a wing of the National Institutes of Health, paid for this “study.” It was published in a “peer reviewed” journal, Tobacco Control, one of the “BMJ Group” (British Medical Journal) publications.

Discussion

The tobacco companies have refined their astroturf tactics since at least the 1980s and leveraged their resources to support and sustain a network of organisations that have developed into some of the Tea Party organisations of 2012.

***

 

What this paper adds

Rather than being a grassroots movement that spontaneously developed in 2009, the Tea Party organisations have had connections to the tobacco companies since the 1980s. The cigarette companies funded and worked through Citizens for a Sound Economy (CSE), the predecessor of Tea Party organisations, Americans for Prosperity and FreedomWorks, to accomplish their economic and political agenda. There has been continuity of some key players, strategies and messages from these groups to Americans for Prosperity, FreedomWorks and other Tea Party-related organisations.

***

• Funding This research was funded by National Cancer Institute grants CA-113710 and CA-087472. The funding agency played no role in the selection of the research topic, conduct of the research or preparation of the manuscript. SAG is American Legacy Foundation Distinguished Professor in Tobacco Control.

• Competing interests None.

• Provenance and peer review Not commissioned; externally peer reviewed.

via ‘To quarterback behind the scenes, third-party efforts’: the tobacco industry and the Tea Party — Fallin et al. — Tobacco Control.

Border Patrol now counts getaways – Beaumont Enterprise

Note the estimated 85,000 who escaped the Border Patrol in 2011. Secure the border, first, then we can talk about how to get a Green Card. (Hint: it begins by getting in line legally and in their own country.)
A recent Government Accountability Office report cites Border Patrol data from fiscal 2011, the latest available, that 61 percent of estimated illegal crossings on the southern border resulted in capture, 23 percent turn back to Mexico and 16 percent got away.

Of the 85,467 who got away, 70,980 (83 percent) were counted by sign-cutting, with nearly all the rest from cameras and plain sightings.

Despite such precise tallies, Border Patrol Chief Mike

via Under pressure, Border Patrol now counts getaways – Beaumont Enterprise.

Dr. Donna Campbell at San Antonio Tea Party

Big crowd!

Lieutenant Governor David Dewhurst at San Antonio Tea Party

Dr. Donna Campbell at San Antonio Tea Party

Big crowd!

Obama Gives $13 Million Grant to Texas Planned Parenthood! @txprolife

We’ve all been hearing about the supposed “War on Women” by Conservative law makers – and, by extension, voters – in Texas. Well, President Obama and Secretary of Health Kathleen Sebellius just fired another shot in the war against Texas and State’s rights.

UPDATE: In an emailed statement, Texas Department of State Health Services spokeswoman Carrie Williams says that the agency just received notice that it will lose the Title X grant and is “reviewing the information to get a sense of the full impact.” The agency hopes the transition is smooth and the provider base remains strong, she wrote.
EARLIER: The federal government has pulled from the state of Texas millions in family planning funding, granting the money instead to a coalition led by the Women’s Health and Family Planning Association of Texas, which says it can serve a greater number of women with the available funds.
For more than four decades, federal Title X funding has been dedicated to funding family planning services and covering clinics’ infrastructure costs. The funds are generally granted to providers (like Planned Parenthood) and/or to state health agencies. In Texas since 1980, the majority of the funding has been administered by the Department of State Health Services — roughly $18 million in 2012, for example; since 2009, DSHS has been the sole grantor of Title X funds.

(Edit, maybe it’s only half of that.)

A Little History

Before this year, Federal tax dollars came back to Texas in two major funds: the Women’s Health Program and Family Planning, or Title X funds. Texas “matched” a certain amount and the Texas Department of Health and Human Services administered the dispersion of the money. Because the money paid for or freed up other funds for staff, marketing, and “infrastructure” or office overhead, PP was helped to keep their abortion clinics running. The overall effect was that State matching tax dollars helped PP to funnel patients, if not dollars, to their abortion clinics.

Texas was forced to make severe Budget cuts across the board in 2011, including Family Planning funds. This led to prioritizing what little money we had:

“State lawmakers cut funding for family planning services by two-thirds in the last legislative session, dropping the two-year family planning budget from $111 million to $37.9 million for the 2012-13 biennium. They also approved a tiered budget system for family planning funds, which gives funding priority to public health clinics, such as federally qualified health centers and comprehensive clinics that provide primary and preventative care over clinics that only provide family planning services.”

Texas Tribune

Options gang ready to go home

We’ve been in Joplin, Missouri, learning how to run an STI (sexually transmitted diseases) clinic. Now, we’re going home!

Finance Chairman Representative Jeb Henserling of Texas

SPEAKING to National Pawnbrokers Association in Washington, School.

Our Texas Senators Cornyn and Cruz at Capitol

The Senators spoke to a group including Larry Nuckols and I, who were in DC representing the National Pawnbrokers Association.

Trial shows abortion’s ‘coarsening’ impact

http://m.bpnews.net/bpnews.asp?id=40078

I’m quoted on Abortion and Breast Cancer Risk

Several media outlets sort of quoted my testimony against HB 2945 in the Texas State House Affairs Committee on Wednesday. However, they proved Mark Twain’s assertion that there are “lies, damned lies, and statistics.”

In my testimony against HB 2945, I also pointed to the National Cancer Institute’s webpage, “Reproductive History and Breast Cancer Risk,” which outlines the protective effect of pregnancy. After all, the only women and girls receiving this information are pregnant women and girls!

Unfortunately, Representative Farrar focused on the “peer review” status of the Mabye article (“Did it go through the Medline or PubMed?”), ignoring the NCI data.

In that (yes, Jessica, it’s “peer reviewed”) New England Journal of Medicine article, the authors note that, while their study found no increased risk overall, there is a protective effect of pregnancy and an increased risk for some women: “Induced abortion had no overall effect on the risk of breast cancer, but we found a statistically significant increase in risk among women with a history of second-trimester abortion.” This was a small number of cases, but it was also in spite of the authors’ acknowledging that unknown thousands of unrecorded abortions ( those before 1973 computerization of records) were probably not accounted for.

From the Texas Tribune:

Dr. Beverly Nuckols, a family doctor from New Braunfels and board member of Texas Alliance for Life, testified against the bill. She cited a study published by the New England Journal of Medicine in 1997 that showed pregnancy decreases the risk of breast cancer.

“No one would prescribe pregnancy to prevent breast cancer,” Nuckols said. “We’re just letting them know that if they have a risk factor in their family, this pregnancy may cut their risk of breast cancer in half.”

via House Panel Debates Changes to Booklet on Abortion | The Texas Tribune.

Others:

Austin Chronicle, “A Woman’s Right to Know the Truth”

Statistics and “Peer Review”

Typical of the reporting on the connection between abortion and breast cancer, a blogger at “RhealityCheck,” only reports half a sentence – the half that she likes.

I don’t know how long my comments will stay up, so here’s my part:

The author only quoted half a sentence. The article clearly states, “Induced abortion had no overall effect on the risk of breast cancer, but we found a statistically significant increase in risk among women with a history of second-trimester abortion.”

and

And here’s the link to the article in question. Please note that even this research must adjust for the age at first pregnancy and for number of pregnancies.

My testimony begins at 1 hour, 12 minutes in on the video of the hearing. I actually focused on the protective effect of pregnancy, especially early pregnancy, according to the National Cancer Institute. This information is only given to women and girls who are already pregnant, after all.

Interestingly, we learned how little the Committee members understood about scientific research and resources. Follow the hours of testimony on HB 2945 and HB 2365 and Rep.Jessica Farrar’s obsession and apparent slow realization about the meaning and significance of “peer review” and “PubMed” and “Medline.“At one point, 1:26, Ms. Farrar, who admits that she “barely got through biology,” asks whether the research was “peer reviewed” by “the Medline or PubMed.”

As the day went on, it seems that Farrar was educated that peer review is conducted by the Journals themselves, and that PubMed and Medline are merely indexes of scientifc literature.