Politics

Miracles in a predictable universe

We are blessed with a universe that’s predictable and testable, yet we pray for miracles. And we pray for miracles, but act as though human actions can block them. Is the will of the Creator Who spoke the physical laws into existence limited by humans if they act as though the universe is predictable and testable?

Those of us who practice medicine are limited by the physical laws, the predictable and testable, with an emphasis on the tested. Our education and experience is based on these tested predictions and guide our decisions, and we’re watched and sometimes redirected by our colleagues, patients, laws and the community.

And then, there’s the best test of all: time.

In fact, I once noted that a patient who outlived the “10 Day Rule” might have proved the doctor (who instigated the process from the Texas Advanced Directive Act) wrong. There might have been a few cases like this, just as I believe there have been miracles. 

However, can you tell me how to measure these events and predict their occurrences, much less practice medicine based on them?

In the majority of TADA cases when treatments weren’t withdrawn, the patient died in the exact manner the doctors predicted, after the same interventions -and sometimes more invasive and tortuous “treatments” than the ones the doctor originally objected to. 

Doing to, not for (Baby Tinslee & TADA)

“We’re doing things to her. Not for her.” (Wini King, spokesperson for Cook’s Children’s Hospital, January 3, 2020) This may be the best description of a very sad case. 

Tinslee Lewis was born prematurely on February 1, 2019, with severe heart and lung defects. She had cardiogenic shock and was admitted to the Cardiac ICU at Cook’s Children’s Hospital immediately. ♡(See Cardiac Pathology ♡below.)

Even after three open heart surgeries, a fourth to close her sternum, a short time on ECMO (essentially, heart-lung bypass) and constant ventilator since July, of 2019, Tinslee’s enlarged heart and small, damaged lungs can’t keep up with the necessary blood circulation and exchange of oxygen and carbon dioxide, even with the assistance of multiple blood pressure medicines, diuretics and the ventilator on high, except when she’s still and quiet with the help of sedating and paralyzing drugs.

In response to a lawsuit against Cook’s Children’s Hospital,  where Tinslee has been in the CICU since birth, Tinslee’s medical records were submitted to the Court.  I’ve been able to review approximately 200 pages that are now public record, describing the constant,  repetitive interventions necessary to keep Tinslee alive on the ventilator.  

Tinslee’s doctors (and, the notes show, the nurses and staff) believe that they are being forced to cause Tinslee pain and suffering, while keeping her paralyzed and sedated. They report increasing difficulty with managing the ventilator so that her damaged heart & lungs can maintain oxygenation. She requires repetitive heart, lung and blood tests to guide adjustment of meds & treatments and has had several infections requiring treatment. In contrast to my earlier presumption, the notes in the records show that the ventilator and all its required meds and manipulations are indeed causing undesired problems, including fluid overload, infections and cardiopulmonary distress, in addition to her underlying lung disease. Even the baby’s growth, something we usually celebrate, increases her risk of cardiopulmonary insufficiency. 

Those records also contain notes from many attempts to explain and council Trinity Lewis,  Tinslee’s mother,  about her baby’s underlying problems and prognosis and the reasoning behind, in contrast to some past media reports.

Ignoring the fact that doctors, not hospitals, practice medicine in Texas, Texas Right to Life Lawyer Joe Nixon is quoted, claiming that the “hospital ” has decided to withdraw treatment. Texas Attorney General, Ken Paxton, is shown to have Tweeted that the problem is a “legal issue,” rather than an ethics and justice matter of forcing doctors (and by their orders, nurses and other staff) to cause pain and suffering for a little girl who is dying as her body fails to heal, in spite of every intervention possible.

Many people, out of compassion, object that “the family ” should decide when to withdraw life support. Yet, the family  members aren’t watching the oxygen levels drop while they rinse Tinslee’s airways with a bicarbonate solution to keep her lungs clear. And it’s certainly not the lawyers that are probing, injecting, measuring and adjusting constant, innumerable hourly interventions done to a baby who must be sedated and paralyzed to prevent cardiac and respiratory distress. 

In spite of the diligent  complicated interventions and care of the doctors and nurses at Cook’s, there have been comments in blogs and social media that the “hospital” wants to “kill” Tinslee. Startlingly,  AG Paxton called the latest Court ordered, indefinite hold on removal of life support  a “Stay,” as though the doctors, not her multiple medical problems, would kill Tinslee. He also misrepresents the process that Cook’s Children’s Hospital and Tinslee’s doctors followed,

“The statute fails to require that physicians provide an explanation of why they refused life-sustaining treatment and provide the patient’s family with adequate notice and opportunity to argue their position prior to the committee reaching a decision, effectively allowing the government to deny an individual’s right to his or her own life and to do so without due process.”

In fact, though, it is the lawyers, particularly at Texas Right to Life, who are turning a little girl’s tragedy into a continuation of their legal battle against the Texas Advance Directive Act. I’ve covered the benefits of and the struggle to improve the Act – repeatedly blocked by TRTL and their lawyers – for years on both WingRight.org and Lifeethics.org

The Act, TADA, was hammered out in 1999 by a group of stakeholders   including  patient and disability advocates, hospitals, doctors, ethicists and lawyers. Texas’ prolife organizations,  including TRTL and the organization for which I served on the Board of Directors for 15 years, Texas Alliance for Life, and for whom I wrote this essay.  

Briefly, TADA allows a balance and legal options when there’s a difference in opinion between a patient’s desire for a given treatment and the medical judgment (a combination of education, experience, and the standard of care) of the doctors who are tasked with the most difficult medical and surgical cases. 

I’ll admit that it’s my opinion – and only my opinion – that the lawyers hate that TADA provides a safe haven from lawsuits if doctors follow the law (!). I slowly came to this conclusion over the years because at virtually every Legislative hearing and stakeholders’ meeting about any changes to the Act, the lawyers bemoan the fact that doctors don’t have to go to court over each of these cases and that they face no legal penalty or “liability.” 

Poor Tinslee Lewis will most likely never leave the hospital alive. Disease and death don’t respect “due process,” but, they are predictable and an inevitable part of life. Hopefully,  we will see her mother and those who love her come to find peace with her death, celebrating the time they’ve had to be with her, especially these last 2 months. However, I fear that the lawsuits will continue for years, adding to their grief.

Edited 1/19/2020 for a typographical error: in the secondparagraph, “cardiogenic” replaced “carcinogenic.” BBN

♡Ebstein Anomaly – Cardiac Pathology 101, about as simple as I can make it (and understand,  too);

Babies born with Ebstein Anomaly have a malformed right and atrium and ventricle and misplaced (tricuspid) valves between the right sided ventricle and atrium. The larger right ventricle can’t pump efficiently. 

In addition,  the blood the right ventricle tries to pump into the lungs leaks/flows/churns (risking blood clots) back into the right atrium, which grows even bigger, with even thicker walls. The ventricle also grows bigger. When the  muscle fibers of the chamber walls get stretched apart enough, they are less inefficient. (Think of two hands gripping at the fingers. The farther out the grip, palm > 1st joint  > fingertips,  the less strength and pull on the opposite hand.) (For the geeks: Frank-Starling law.

The lungs aren’t efficiently filled with blood, they don’t expand, the pressure builds up in them and efficient exchange of gasses doesn’t take place. 

In the meantime, the blood backs up in the body, the liver, kidneys and extremities & eventually the left side of the heart, which can hypertrophy , too. 

The enlarged heart puts pressure on the lungs and nearby soft tissue,  including the blood vessels coming to the heart.

The combination of leaking high pressure blood vessels and the body’s increasing fluid in order to try to pump what oxygen there is, leads to edema or swelling of the body.

Sometimes,  the fetal atrial-septal defect stays open, allowing mixing of the un-oxygenated blood from the right, with the oxygenated blood. This malfunction can help, temporarily. 

With the high pressure, poor flow, and actual physical damage due to the mass of the heart, none of the organs can function well. Increased activity, stress, and growth will increase the demand for oxygen, kidney & lung function.

Texas transgender (7 yo) case

I don’t believe it’s appropriate for a child to undergo transition at such an early age, but there’s a few gaps in this story.

There is very little media coverage of the case, with opinion from only one side published online. I picked the report about the court decision that’s most comprehensive, even with some errors.

Mostly, this appears to be an especially ugly divorce battle. The dispute about transition has been going on since the child was 3 years old.

The child is one of two twins conceived by in vitro fertilization using the father’s sperm and a donor egg. The mother carried the two to term and delivered.

The mother filed the suit to end joint custody, but the father demanded that the jury decide custody, rather than the judge.

The jury was charged with 2 questions: should one parent have sole custody and should that parent be Mr Younger. They answered yes and no: one should have sole custody, but it shouldn’t be the father. The judge will rule this week on who gets custody & conditions.

I’m not sure, but I’m reading that there’s no immediate plans for puberty blockers & finding quite a bit of info that the blockers aren’t permanent.

I can’t help but hope there’s more to this story, because I still can’t accept a decision like this, at this age.

Eat the Rich (with the rest of us for desert)

Dems used to just act as though government owns your current and future earnings. Now, they want to know the value of your wedding ring, grandma’s China, the homestead, & your golden parachute. The plan is to tax them *every year* until you have to sell them (to them?) to pay those taxes.

Replace male statues in Central Park with women?

If everyone gets a trophy, why should anyone get a statue? Especially men?

Yes, here’s the next woke thing:

The New York Post reports that a City commissioner proposes to “Replace male statues in Central Park with women.”

“”A member of the commission that oversees art and architecture on city property suggested Monday that instead of simply adding statues of historical female figures to Central Park, the panel yank out some of the male ones first.

““There are what, five or six [male] statues that I think could easily be replaced by individual statues of each of these women,” said Hank Willis Thomas, a painter who serves on the Public Design Commission, at a hearing at City Hall.

“Thomas appeared to be specifically fingering statues including that of Scottish poet Robert Burns, in the park’s Literary Row, and the one of Christopher Columbus in the park, near the famed second one of the explorer in Columbus Circle, for removal.”

Goodbye Columbus indeed!

Texas Governor Abbott on “Suspicious Activity”

Texas’ Governor Greg Abbott ( @GovAbbott ) isn’t trying to change Texas law with last week’s Executive Order – in contrast to the claims I’ve seen on my Facebook news feed.

Instead, he called for law enforcement agencies under the executive branch to establish policies and training, and financial incentives to encourage “improving reporting channels and closing ‘information gaps’ when members of the public or law enforcement agencies worry that a person might be a threat to commit violence.“

The last three mass shootings in Texas tell us that we need to improve how our law enforcement and agencies follow current law on following up on reports and investigations.

The Sutherland Springs Church shooter in South Texas should have been rejected at point of sale background check because of his prior conviction and incarceration for domestic violence crimes while in the military. Unfortunately, he was never reported to the Federal database. (And so, Texas law probably couldn’t have made any difference.)

However, the Odessa shooter threatened and brandished a weapon at his neighbor, but local Law Enforcement Officers didn’t follow up because his house wasn’t on their GPS maps and was difficult to find!

The El Paso shooter’s mother tried to report him, but the LEO who spoke to her on the phone dismissed her concerns. No record of the call was made, according to the Allen police department.

I’m not sure that current laws would have (or should have) allowed any action against the (future) shooter by authorities, but it looks like that question and reporting procedures are what Governor Abbott wants clarified. From the Executive Order:

“”Within thirty days of this order, the Texas Department of Public Safety shall develop standardized intake questions that can be used by all Texas law-enforcement agencies to better identify whether a person calling the agency has information that should be reported to the Texas Suspicious Activity Reporting Network.

Within thirty days of this order, the Department of Public Safety shall develop clear guidance, based on the appropriate legal standard, for when and how Texas law-enforcement agencies should submit Suspicious Activity Reports.”‘

The question should be whether the “standardized questions” and reporting processes might have made a difference. Unfortunately, I’m not reading questions: I’m reading accusations that the Governor wants to impose “red flag laws” and confiscation of guns without due process of law.

The Governor previously directed the Texas Department of Public Safety to implement the “iWatch app” in June, 2018, allowing the public to report suspicious activity. There was no outcry then, and there doesn’t appear to be any “red flag” incidents because of this initiative.

Why do people think the Governor wants gun control now?

There’s no change in citizenship! None!

OIG finds Comey violations. No big deal?

Children born overseas (No change)

The “Highlights:”

Not the hype you’re reading about in the news.

Edit: Penultimate sentence: “18” instead of “28.” On September 3, 2019. BBN

Washington Post attacks Life via Texas

Leftist liars gonna lie about abortion –

‘“It’s not the baby’s fault for the sin of the father, or of the mother,” King said.‘

Remember this statement when you read or hear that Congressman Stephen King “defended” rape and incest.

In reality, he “defended” every child at risk of being killed because they are the result of a pregnancy after rape or incest.

And all the descendents of past pregnancies due to rape or incest.

Politicians and laymen alike should beware when publicly supporting the ethical position that all humans are, indeed, human at all stages of life and that they shouldn’t be killed: The Leftist liars will attack. In force.

Representative King wasn’t just defending the children of tomorrow: he was defenfing all of their descendents.

“What if we went back through all the family trees and just pulled out anyone who was a product of rape or incest?” King told a breakfast meeting in Urbandale, Iowa. “Would there be any population of the world left if we did that? Considering all the wars and all the rapes and pillages that happened throughout all these different nations, I know that I can’t say that I was not a part of a product of that.”

King was obviously referring to retroactive killing. After all, elective interventional abortion is the ending of a human’s life by intentional acts that are licensed and regulated under the medical codes of the various States.

Regardless of how they were conceived, every human is created equal and endowed with inalienable #HumanRights.

The faithful Left can’t tolerate equal rights endowed on all humans. They will invariably takeba any firm statement against their sacrament of abortion and their tools in the media will pull out sections, ignore the context, and turn it inside out, to spread the big lie.

So much the more if they can twist their lie into a defense of one of their own. Congresswoman Ilhan Omar cited the lying reports as proof of Republican “filth.”

(Nevermind that her own hometown paper, the Minnesota Star Tribune and her Somalian communityare the ones accusing her of biggamy as well as marrying her own brother to commit immigration fraud. Or that she’s been fined for filing false tax returnswith one of her husband’s. Y’all move along, there’s nothing to see, here.)

So tell me: how many people would be left alive if we killed every person who has an ancestors who was conceived in rape or incest?

New Political Party?

Claiming that ” ‘conservative’ and ‘Republican’ are now mere team names that have lost all meaning,” pseudo-Conservatives are trying to start a new movement, possibly a new Party. However, their #PrinciplesFirst aren’t Conservative.

The Principles have at least two fatal flaws.

1. They’re based on man-made law & artificial designations of “persons”& “citizens,” not on inalienable rights endowed on “all men” (humans).

The Constitution of the United States is an unique, exemplary document. But its strength and legitimacy depends on the concept of inalienable rights of humans that are not endowed by laws, men or any powers that be of this world. The Constitution can be amended. Human rights can only be infringed.

2. The list also errs in supporting “Each and every family unit – regardless of its shape.”

Would these families include those shaped by polygamy? Why not?

The Republican Platform can be downloaded for reading, here.

The Platform confirms most of the items in the Principles First list. However, the Preamble of the Republican Platform is clear on its origin:

“”We affirm — as did the Declaration of Independence: that all are created equal, endowed by their Creator with inalienable rights of life, liberty, and the pursuit of happiness.”

And equally clear on the”shape” of the family:

“”It is the foundation of civil society, and the cornerstone of the family is natural marriage, the union of TT man and one woman.””

Correct these errors, and the “new” Principles would be indistinguishable from that of the Republican Party Platform. The effort should be to hold our elected officials to the Platform, to strengthen our Party, maintain and expand our Seniority in the Senate, win both back in the House. It’s certainly not Conservative to tear down. #FirstPrinciples

Texas’ reaction

At least 22 people are dead and another 20 to 40 wounded in El Paso, Texas, due to a planned, murderous rampageby a man who drove 650+ miles to reach the site. He carried a semi-automatic rifle and wore both eye and ear protection.

The killings alone are enough to prove the killers are evil and full of hate, but their history and social media portray individuals focused on hate, erasing all doubt. It appears that the Texas shooter identified with white supremacists white supremacists while also professing to be anti-government and anti-corporation, while concerned about the environment. The Ohio shooter was known to be obsessed with guns, had participated while armed in a counter-protest against white supremacists and was politically left-leaning. The motives of the California shooter aren’t clear at all.

“””The age to purchase a firearm is 21. The state requires gun owners to obtain licenses and face background checks as well as imposing waiting periods on firearms purchases. Judges can take guns away from owners who are deemed to be a threat to themselves or others. And recent legislation aims to begin a fingerprinting database of all gun owners in the state.””

“””Apparently it doesn’t work like that. (Someone should tell our elected leaders.)””

Evil will find a way.

What will Texas response be?

In Texas, the result will probably be more guns.

Candace Owens, Steve Bannon, future of the Republican Party

@SteveBannon: More bartenders and fewer lawyers, not the donor-class candidates.

@RealCandaceO; Mock the Left, be cultural, not so staid.

Here’s the video, https://youtu.be/qC-r0izU4j0

Me: Use the energy and frustration and STOP tearing each other down!

The interview started out covering the grass roots efforts to build a border wall using private money, but these two talk about even deeper issues.

Here in Texas, we have some perfect examples: MQS and Speaker Bonnen, the”Freedom Caucus” vs. the Republican Caucus and the division in the pro-life, pro-family community are prime examples of their position.

Since 2012 at least, the various factions in our own Republican Party of Texas are fast losing our sense of cameraderie, and have already lost our sense of humor. In order to prove our uber-conservatism has been engaged in “Ready, Fire, Aim,” a circular firing squad.

Take the Strickland vs. Geren cookie incident:

https://www.texastribune.org/2015/05/03/stickland-and-texas-house/

Sure, Gerens’ joke was a little mean spirited, but it was funny. Strickland would have been so much better laughing it off, perhaps offering Green some Grecian Formula in response.

I’ve compared our factions to the sanctimonious deacon who loudly and critically disapproves of the prodigal church members who show up on Mother’s Day or Easter Sunday. Rather than making them welcome and encouraging them to come back next week.

I know I’d rather debate an atheist on issues than some of our faithful. Both sides might tell me to go to hell, but it’s a lot more damning when the believers give you directions.

Consider: Is it true, is it really importantis it necessary, and will it make the situation better or turn the frustration back on our own side? Why not look for a way to turn the debate around to unite Conservatives in a win/win deal?

Arguing Abortion on YouTube

I usually agree with this doctor. But not about abortion. ZDoggMD, Zubin Damania, has a sense of humor and a sense of balance. But today, he demands that we to “come to the center” because 1 in 4 women in the US have an abortion by age 45. “It happens.”

Well, according to the 1860 US Census, approximately 25% of families owned slaves. “It happen(ed).” Common ground was hard to find there, too.

I reconsider conspiracy theories

“.#NYTimeline: Pelosi declares a “cover up,” goes directly to meet @POTUS & it’s all “Trump Blows Up Meeting,” “tempestuous clash” & waging “war.” @NYT” (My tweet, this morning)

I’m not into conspiracy theories, because I’ve always doubted that 2 people can keep secrets. But evidently, a larger number can, if motivated like the WaPo, NYT, Brennan, Comey, State Dept., and the adulterous gang McCabe didn’t lead. For a while, at least…

The collusion, if you will, between the media and the Intelligence Community (IC) is pretty obvious and becoming more so by the day.

So, in contrast to my usual skepticism:

I’ll bet that the early 2017 media clique skipped over reports that the President was objecting to the counter investigation. They couldn’t know – or admit to knowing – about the information classified by the Obama administration before the inauguration. Those that might have heard – in all the leaks and reports that “came over the transom” – instead preferred to harp on the President’s denial about the Russian election interference.

It’s no surprise (now) that he was doubting the Intelligence Community from early on: he was hearing about “collusion” at the same briefings where he heard about the Russian election interference. If the IC was lying about one, why not the other?

Where are the BuzzFeed-like exposés about the investigations, the leaks?

There’s a good chance that, as happened here in Texas in the 2018 Senate race, media simply decided to withhold some of the”news that’s fit to print” and spread a little “darkness” (WaPo’s motto) of their own.

Updated information on TRTL, end of life, and money

One Texas Right to Life (TRTL) lawyer has posted an update on Facebook about the “rescue” of Mrs Carolyn Jones. I’m afraid that, as with the declaration that another patient was “slain,” TRTL is gaming the Medicare funding and Texas medical systems for political purposes.

Emily Cook, General Council for TRTL, wrote that she worried that “funny business clinically would happen as we moved her” from the hospital where Mrs. Jones has been admitted for over 6 months, where the docs had weaned her off the ventilator and wanted her to transfer to a more appropriate level of care facility over 2 months ago.

Emily says TRTL spent their own money (*see my last paragraph) to put her in a private ambulance and take Mrs. Jones to another hospital ER. That hospital couldn’t provide dialysis, so they in turn transferred her via ambulance somewhere else, to yet another hospital until admission can be arranged at the nursing home.

Cook-ing the system

Why does TRTL lie? (UPDATE)

Life Ethics

Western classical liberal ethics has favored “deciding” that all humans are human-enough to possess human rights. 1.Are they human? 2.Can we kill them? The answers have been increasingly 1. Yes, & 2. No. That’s not #Patriarchy. It’s a good basis for a #sentient, civil society.

HatTip to a FB poster, Clint Stutts, for the questions.

False story about Texas Advance Directives Act (TADA)

There’s also a quote from Mrs. Jones’ daughter, repeated from the earlier article: ““My mom is going to die on Monday because of a law that saves hospitals money.”

It turns out that money and Medicaid paperwork is actually what is keeping the family from allowing Mrs. Jones to be transferred to another doctor and facility. The family is concerned that they (rather than the hospital) will be responsible for the costs of Mrs. Jones’ care.

This is in spite of the fact that when a patient first goes on dialysis, she becomes immediately and automatically eligible to apply for Medicare and Social Security Disability.

Depending on assets and income, patients unable to work on dialysis also qualify for Medicaid and other State benefits in Texas. Medicaid will even pay bills retroactively for three months.

Have they no decency?

Now, Texas Right to Life is blatantly lying, posting an article on their website entitled “American hero slain two days before Christmas …”

“slain?”

Far down in the piece, there’s this:

“Chris passed away naturally on December 23, 2015 – two days before Christmas.”

Mr. Dunn died from his metastatic pancreas cancer, on full medical treatments. His mother, Mrs. Kelly actually thanked those who cared for him at the hospital.

Every article on TRTL’s website has a “Donate” button at the top, prioritizing money over the people whose stories they use to raise money and influence the Texas Legislature. Now, we see this completely dishonest caption.

Just what is their mission and how can we trust them?

Hurting patients and families

End of life or end of hospital stay?

What a tragic story!

While I only know what I’ve seen online, in my experience, it appears that the dispute about Mrs. Carolyn Jones is over continued hospitalization at this hospital, versus transfer to care at another facility.

(See this television news report.)

I’m the first to say that hospitals are scary places and to sympathize with families struggling to cope with the bureaucracy and protocols. However the current news, press releases, and pro-life blogs are reporting several errors and omissions about Texas’s law and legislation up for consideration in Austin.

The obvious errors in this report include:
1. First. It’s not correct that Mrs Jones will die on Monday, even if the ventilator is turned off at the hospital. She’s not intubated through the mouth or nose. Instead, there’s a tracheostomy and a feeding tube in place. Supplemental oxygen could be provided many different ways, at home or in a nursing home.
2. Mr. Jones has testified at the Texas Senate Health and Human Services Committee meeting (EDIT: the video is here, at 52 minutes in) on 4/10/19 and elsewhere that Mrs Jones had been weaned off the ventilator, needing it only occasionally, at night.
2. She should be able to speak and swallow with training.
3. Texas Advance Directives Act doesn’t require that the doctor declare the treatment be “futile.” Instead, the doctor must declare that he refuses to follow a certain treatment decision that the patient or family demands .
4. Kidney dialysis is paid for by the Federal government, so the problem isn’t only funding.

In my admittedly limited knowledge about this particular case – it appears that Mr. Jones disagrees that it’s time to move from the hospital to home or nursing home, even after 5 months (not 10 days).

At least since 2005, legislation has been introduced at the State to increase the timeframe to as long as a month. Texas Right to Life refuses to agree to anything other than indefinite treatment, with the doctor forced to act against his will, violating his conscience and ignoring his medical judgement.

TRTL has even clashed with other pro-life organizations and Texas’s Catholic Bishops and “primaried” several conservative Legislators, although they are the only Texas pro-life group that opposes the law.

It would be good to add more time – I don’t know of anyone who disagrees. But there needs to be a limit to how long a doctor is forced to act against his conscience. One Bill that was rumored this year would change the “10 days” to 21 days and add a week to the notification period before the Ethics committee meets. Unfortunately, it never got past the Powers That Be.

For more on the ethics of the Texas Advance Directives Act, see this WingRight post.

The most urgent need is communication with families, correcting misunderstandings like those outlined here.

(Edited May 10, 2019 at 12:22 AST, to correct the Link to the testimony of Mr. Jones. BBN)

Emergency: Liberty Right Infringement

Texas Right to Life General Counsel Emily Cook is attacking Texas Medical Association on Facebook, even though virtually every other pro-life, medical, nursing, hospital, and disability group in Texas oppose SB 2089 by Hughes, that would change the “Texas Advance Directive Act, “TADA” will harm patients and attack the right of doctors to refuse to act against our conscience.

We’ve worked to fix other problems: Artificially administered food and water, even full IV feedings, can‘t be removed. Texas law didn’t even mention DNRs, but last session, we passed an amendment with explicit procedures and informed consent language.

SB 2089 specifically says anyone can file a lawsuit in any Court in the County, the Court can’t charge the patient (or surrogates) any fees, and the judge is required to rule in 5 days.

Another kind of lawyer joke

“[T]he doctor/bioethics committee thinks the patient should die.” Wesley J. Smith, Esq., Texas Senate Health and Human Services Committee, 4/10/2019 LifeNews.com

Wesley Smith is a rarity among the many lawyers who chased bioethics to the bedside late in the last century: he actually believes in the sanctity of human life and in the right of conscience. I’ve attended and reported on his debates and encounters with proponents of intentional euthanasia. And even happily defended him.

Unfortunately, Lawyer Smith was not above spinning the truth this month when he came from California to once again misrepresent the Texas Advance Directive Act (“TADA,” “the Act,” or “166.___”), an attempt to balance conflicting rights when doctors disagree with a patient or his surrogates about actual medical procedures and treatments that the doctor believes harms the patient.

On April 10, 2019 Mr. Smith gave invited testimony to the Senate Health and Human Services Committee in favor of SB 2089 (Hughes) and
SB 2129 (Creighton). LifeNews.com published part of his testimony online, under the title, “Texas Rule Allows Hospitals to Essentially Euthananize Patients After a 10-Day Notification.”

Mr. Smith doesn’t just contradict multiple Supreme Court rulings since Cruzan (1990) affirming that withholding or withdrawing treatment is not equivalent to euthanasia. Paradoxically, he echoes arguments that anti-conscience activists use to justify abortion on demand, Physician Assisted Suicide and intentional euthanasia by a third party by claiming that the principle of autonomy supercedes “First, do no harm,” or non-malevelence, and the right to conscience.

(You can watch all of Part I and Part II of the April 10, 2019 Health and Human Services Committee meeting addressing SB 2089 by Senator Bryan Hughes and SB 2129 by Senator Brandon Creighton online. Part I includes Mr. Smith’s testimony beginning at 33:00/1:01:10.)

We’ll skip Mr. Smith’s assertion that there is a right to force others to provide everyone medical care in general, not just in emergencies or at the end of life. I’ve covered these assertions and his attacks on the Texas Conference of Catholic Bishops I’m, back in 2007.

Today, let’s just look at his spin on the current version of TADA.

Lawyer Smith uses emotionally weighted terms that aren’t in TADA, such as, “life-extending,” “futile care,” “permitting the institution to force its will on patients and families,” “invidious discrimination,” and “inappropriate care.” He contrasts patient’s “rights” with doctor’s “values,” and is the first that day to raise the specter of doctors willing to kill when patients are “expensive.” And, reflected in the LifeNews.com headline, Mr. Smith flatly says that TADA allows euthanasia – intentional acts to kill patients – equivalent to the administration of injections or medications that he wrote about this week.

As I’ve stated so many times in past WingRight.org and LifeEthics.org posts, TADA doesn’t allow us to remove or withhold care for patients, only treatments that are “medically inappropriate.” There are no futile patients, only futile treatments that cause harm to the patient over and over, without any expectation of reversing organ failure after organ failure.

Mr. Smith also ignores the multiple attempts by the medical and pro-life community and Legislature to improve the law’s timeframe and communication, much as Senator Creighton’s Bill. One example from 2007, SB 439 by Senator Bob Deuell, would have required written notice and an offer of a private ethics consult to take place at least seven days before the hospital committee meeting. That Bill had a schedule for giving the patient or surrogates written information about the dispute process, copies of medical records, and lists of resources. The family would have been given access to the committee meeting, with their own advocates. When the committee agreed that the treatment requested was inappropriate, the family would have receive assistance in searching for7⅞ another doctor or facility for at least another 21 days. I believe that the Bill bogged down in the House because of opposition from Texas Right to Life to any Bill that did not include liability for doctors and the indefinite “treatment until transfer” in this year’s SB 2089.

In the last five minutes of the Part I video, another lawyer, Texas Right to Life General Council Emily Cook, gave us the best clue about the ultimate goal of her organization: “judicial review.”

Ms. Cook and Mr. Smith would have every one of these disputes settled by a Court. This is the Texas trial lawyers’ dream: a huge weapon against our State’s tort reform.

Today, the law specifically allows an appeal to a County probate judge when the Committee agrees with the doctor’s decision. SB 2129 allows a request for an injunction in any Court in the County, enabling “judge shopping.” Since it also prohibits the County from charging the patient or his surrogates any fees, the costs would fall solely on the County.

Ultimately, SB 2129 would make it much, much easier to sue the doctor and the hospital, moving Medical decision-making into the courtroom.

Most of the “stakeholders” for patient rights in Texas (including Texas Alliance for Life, Texas Baptist Christian Life Commission, Coalition of Texans With Disabilities, Texas Medical Association, Texas Hospital Association, Catholic Hospital Association, Texas Nurses Association, and the Texas Conference of Catholic Bishops and many others) oppose both of the Bills that Mr. Smith favored. Since SB 2129 would mandate that the County pick up any Court costs and that the judge make his ruling within five days, don’t be surprised if we hear objections from representatives of these parties, too.

So what’s the “joke?”

It could be the ridiculous notion that Lawyer Smith is a mind reader, able to discern the “invidious” motives for the “discrimination” he feels doctors and hospitals routinely practice:

“To fully comprehend the unjust nature of Texas law in this regard, realize that these “futile care” or “inappropriate care” decisions do not terminate treatment because it won’t work, but because it does. It is keeping the patient alive when the doctor/bioethics committee thinks the patient should die.” (Emphasis from LifeNews.com’s transcript.)

He repeatedly comments that physician’s decisions about medically appropriate treatment are subjective and that they (we) might “project their fears and their desires onto the patient” based on our “values,” rather than medical judgement based on repeated, at least once a day examination of the patient, reports by the nurses and staff and our education and experience.

The joke might be that Lawyer Smith volunteered that the indefinite, repeated evaluation and medical decision-making against the medical judgement of doctors would not be “slavery.” I would like to know what Lawyer Smith calls the legal requirement to use one’s body and brain to carry out actions, including writing orders for nurses and other medical staff, against your will.

It might be tragically funny to watch “judicial review” end up with the two sides hiring expert witnesses – doctors – to give the judge opposing views. There’s dark humor in the realization that ultimately the judge would order the original doctor to use her medical judgement to provide treatment – against her best medical judgement.

But the real joke is that “judicial review” risks the unintended consequence of decisions made by judges like the late t Judge George Greer, who Mr. Smith wrote about in this article.

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Texas Advance Directive Act 2019 Legislature

“(22) in complying with the procedures outlined in Sections 166.045iand 166.046, Health and Safety Code, fails to make a reasonable effort to transfer a patient to a physician who is willing to comply with a directive.

Amendment No. 5

Representative Toth offered the following amendment to Amendment No. 4:

Amend Amendment No.4 by Toth to CSHB 1504 on page 3, line 25, between “Code,” and “fails”, insert “willfully”.””

Prenatal manslaughter?

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

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

My answer:

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

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

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

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

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

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

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HB 896 Abolish abortion in Texas

#HB896 @TxLeg

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

You can watch the testimony in the House Broadcast Archives.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Immunologist denies Imunology (Vaccines)

Here’s a review and critique (with live links, by Skeptical Raptor) on one of the anti-vaxx advocates, an “immunologist” who exaggerated her credentials, makes her money through the big-money scam “Vaxxed,” and who wrote this ridiculous lie:

“”Immunology does not attempt to study and therefore cannot provide understanding of natural diseases and immunity that follows them.””

Banned by prolife website

I’ve sat on this for 4 days, hoping for a response to the questions I sent to 2 of the ‘co-founders” and an editor of the website. (They only use those online forms, so I can’t follow up by email.)

So far, no response from any of the 3.

I’m not going to link to the website, but the address is in the photo.

Unfortunately, the division in the Texas prolife community is deep. The article I attempted to comment on quotes – and disputes – an article I wrote for Texas Alliance for Life a few years ago.

All I wanted to say was that I hope the readers will read that article.

Praying for peace.

(BTW, that case ruling came down in favor of Houston’s Methodist Hospital and the Texas First Court of Appeals refused to declare the Texas Advance Directive Act unconstitutional.)