Wednesday, December 16, 2009

British Medicine Has A Religion Problem Too.

A battle has been raging in British Parliament since Debby Purdy won her case this summer that allows spouses or others to assist terminally ill patients to travel to other countries for aid in dying. Aid in dying (assisted suicide, euthanasia) is illegal in Britain but the court decision has forced the Director of Public Prosecutions to revise the laws and what can only be called a culture war has raged on ever since.

Lord Joffe, a member of the House of Lords, pens an article for Times Online that criticizes religious advocates for imposing their doctrine on the country's lawmakers and patients.

For the mirror-view of how the USCCB is working in the US to shape health care reform - because they can and because they are the second largest deliverer of medical services in the US - Britain's current struggle is a great study.

In the US, patients' rights have never been successfully defended on religious grounds, only privacy grounds, despite the fact that opposition to such services as contraception, abortion, sterilizations, fertilization services, counseling for STDs and AIDS is primarily religious. It's a sad state of our health care delivery that the courts haven't mustered the frankness to protect the millions of women, gays, men and elders each year who are subjected to religious discrimination and denied their rights.

Here are replies to the article. Note the second one comes from Care Not Killing, an anti-aid in dying activist group.

Here's Joffe's article:

It came as no surprise that there was the usual outcry against the interim report on prosecution in respect of cases of assisted suicide by the Director of Public Prosecutions. Headlines appeared saying, “Assisted suicide proposals ‘unacceptable in a civilised society’ — Roman Catholic bishops”, while last month a letter to The Times from Lord Mackay of Clashfern, et al, accused the policy of placing people at risk, and directed readers to the response of the alliance Care Not Killing (CNK).

The CNK is an organisation created to oppose assisted suicide. Its core members include the Church of England, the Catholic Bishops’ Conference and most other faith-based organisations, all of which are implacably opposed to assisted suicide. The alliance demands that the policy be restructured using a provision in the code for crown prosecutors that says prosecution should take place unless public interest weighs against it. Lord Brown of Eaton-under-Heywood, in his judgment on the Debbie Purdy case, criticised the unhelpfulness of the code itself as any sort of guide in cases of assisted suicide.

The CNK’s response also makes no reference to public opinion. As Baroness Hale of Richmond said in her judgment: “The British public have consistently supported assisted dying for people with a painful or unbearable incurable disease from which they will die.” Meanwhile, a survey conducted by The Times in July found 74 per cent in support of assisted suicide for the terminally ill and only 23 per cent against.

Looked at as a whole, the CNK response clearly aims to reduce to the very minimum those who will not be prosecuted for assisted dying.

Those who base their views on their faith have no alternative other than to oppose it. They regard suicide as a sin. So when the DPP assesses the responses to the consultation, he should be aware that many will come from the relatively small minority who base their views on their faith, and have been encouraged by their religious leaders to write to him. Meanwhile, most of the silent majority who support assisted dying and, it can be assumed, would also support the policy, either do not know of the consultation or have not had the same kind of face-to-face encouragement to respond.

As it now stands, the policy complies exactly with the law lords’ interpretation of the law and provides the necessary factors, in precise and clear language, that will enable both the public and prosecutors to make their decisions over this difficult subject.

Lord Joffe has introduced Bills on assisted dying to the House of Lords

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The AMA Monopolizing Patient Access to Other Providers.

From Earth Times, an article on how the Coalition for Patients Rights is working to ensure that patients can access cheaper, effective health care professions other than MDs. The AMA has a stranglehold on not only medical training but licensing, they represent a strong lobby that pressures states to qualify the scope of what other medical professions may provide. It's an old story, big pushy association works to make it's members only game in town.

Here's a clip from the article:

“There is an abundance of evidence that shows patients achieve equal or better health outcomes at lower cost to themselves and the health care system when they fully incorporate a range of health care professionals in their delivery system,” said Maureen Shekleton, PhD, RN, FAAN, a spokesperson for the Coalition for Patients’ Rights™ (CPR). CPR is comprised of more than 35 member organizations representing a variety of licensed health care professionals who provide a diverse array of safe, effective and affordable health care services to millions of patients each year.

There are numerous studies that show the high quality and cost-effectiveness of the care provided by professionals other than MDs/DOs. Collectively, these data substantiate the likelihood for more cost-effective care. Highlights include:

States are charged with overseeing each profession’s scope of practice and ensuring it is safe based on the education and training of the professionals. While research backs the clinical value of promoting access to health care providers besides MDs/DOs, state regulations can hinder access for patients. There are significant lobbying and advocacy efforts under way by some of the physician community to seek restrictions to the scope of practice of other health care professionals. For example, the American Medical Association (AMA) is actively working on advocacy documents that question, despite clear evidence to the contrary, the quality of care delivered by health care professionals who provide some of the same services as physicians.

“These efforts to lobby lawmakers and regulators are not only wasteful and divisive, but do a disservice to the public who have been benefitting from the care of these practitioners for decades,” said Shekleton. “Our health care system is already overburdened with shortages of qualified practitioners. As the oldest professional health care society in the United States, the AMA should be fostering a collaborative environment that meets the needs of patients, not looking to restrict the practice of qualified licensed practitioners and trying to prevent patients from seeing the provider of their choice.”

CPR members are dedicated to achieving optimal health outcomes for patients in a cost-effective way. As policymakers address how to control costs and expand insurance coverage, it will be critical to include all qualified health care professionals. “Ensuring and promoting the rights of patients to choose this kind of care is good for patients and it’s good for our health care system overall,” said Shekleton. “If we can be prudent with our financial resources and still ensure good outcomes for patients - it’s a win-win situation that policymakers should support.”

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Colorado Hospital Merger Will Expand USCCB Patient Discrimination.

From Law Week Colorado, a report on the continuing struggle in Denver to prevent the Roman Catholic Church from overtaking two existing non-profit hospitals and imposing discriminating religious policies on the community.

As you know if you stop by here often, the Catholic Church is the second largest deliverer of health care in the US after Veterans' Affairs. All their entities -hospitals, hospitals, HMOs - are governed by Ethical and Religious Directives which violate the separation of church and state by delivering care to non-Catholic patients according to USCCB written and approved guidelines.

These ERDs discriminate against women, gays, the elderly - essentially entire communities. When Catholic hospitals merge with secular ones, the USCCB expands their non-profit, tax-exempt, 50% publicly funded imposition of ERDs onto those who are not Catholic.

Read my articles to the right to learn more about patient discrimination at Catholic hospitals.

Critics of the proposed sale of two non-Catholic area hospitals to a Roman Catholic hospital system said Tuesday that the transfer would be a “monolithic abomination” to the state’s health care system.
Frances Koncilja, a usually subdued attorney who is challenging the sale of two Exempla Healthcare hospitals to the Sisters of Charity of Leavenworth, said the sale would restrict patients’ rights by denying medical services deemed unethical by the Catholic church. She spoke Tuesday before the City Club of Denver with a spark to her speech.
“For the last two years, Dean (Heizer) and I have been battling this monolithic abomination that is going on,” said a candid Koncilja, who spoke only feet away from James P. Tatten, lobbyist for the sale and former Director of State Advocacy for Catholic Health Initiatives.
The transfer agreement to purchase Lutheran Medical Center in Wheat Ridge and Good Samaritan Medical Center in Lafayette calls for eliminating controversial patient services, including abortions, tubal ligation and vasectomies. With Lutheran Medical being the only general hospital in Jefferson County, controversy has mounted.
The long litigious battle over money, medicine and ethics has been going on for years.
The original deal called for the Community First Foundation to receive $311 million from the Sisters of Charity of Leavenworth and for sponsorship to be transferred. In 2007, Republican Attorney General John Suthers issued an opinion that gave the go-ahead for the sale. But an arbitrator earlier this year blocked the deal, ruling that assets stemming from the sale belong to the community — not to the hospitals’ non-profit co-sponsors.
During that time, Exempla itself filed a lawsuit against the Sisters of Charity, Community First and Suthers to stop the transfer.
Another deal was later struck this year in which sole sponsorship was promised, but no money would change hands. Critics say details of the latest deal have not been released and they object to the lack of transparency.
The lawsuit filed by Koncilja and Heizer argues that Community First entered into an illegal agreement because it diverts the two hospitals from their original purpose of providing non-sectarian health care.
Questions were also raised by opponents Tuesday as to where $50 million of the $311 million went that was promised for community services. In a follow-up interview with the Denver Daily News following the event Tuesday, Tatten could not answer the question.
“We don’t know. That’s one of the challenges with this kind of issue,” said Tatten. “Ya know, you’re talking about some really high level moral, theological and health care issues, and then trying to allow that at an operational level from a health care perspective. So, I don’t know.”
Of great concern to opponents is the implementation of ethical and religious directives for the Catholic hospital system. There are dozens of directives that limit medical services provided by doctors at hospitals within the system.
One of the directives goes as far as to require an attempt to baptize newly born at-risk infants.
“Newly born infants in danger of death, including those miscarried, should be baptized if this is possible,” states the directive. “In case of emergency, if a priest or a deacon is not available, anyone can validly baptize.”
Critics were dealt a blow last month when Suthers issued an opinion that the state does not need to hold hearings on the agreement. Suthers’ opinion came even as a new state law requires such public hearings over hospital mergers that affect the community’s best interest.
Meanwhile, Koncilja Tuesday cited a list of both Republicans and Democrats she believes let the community down by not fighting for greater transparency. At the top of the list was Suthers. Also on the list was Denver publicist Jean Galloway, spokeswoman for Community First Foundation, who was in attendance Tuesday as Koncilja read her name off the hit list.
Koncilja and her supporters believe the issue hasn’t gotten the attention it deserves, arguing that if it was anything but a Catholic hospital system requiring directives, more eyebrows would be raised.“I would submit that if a mosque had purchased an interest in this hospital and said that women, if they wanted to get treated, had to have burqas on before they were allowed to be registered as patients, we would all be outraged,” she said.
Tatten did little to defend the Catholic hospital system, instead arguing that the greater issue is national health reform. But after the event, he told the Denver Daily that perhaps more could have been done in the area of transparency, such as holding voluntary public hearings. That being said, Tatten said the sale has been so complicated that public hearings likely wouldn’t have been helpful.
“Often times with public hearings people feel that if they participate and they share their view, that someone will consider it and they have an impact on an outcome,” he said. “But, I think in this type of situation, it was so structured and so legalistic.”

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LGBT Patients' Rights at Fresno Hospital.

One fantastic little victory! From eNews Park Forest, a story of how it took a threatened law suit for one hospital to establish equal rights for LGBT patients. Now if only the ACLU and NCLR could find others to come out about discrimination at other hospitals.

The only way it seems that patients' rights can be established is often via lawsuits, which can be an enormous burden on the privacy and challenge patients face. This great news story emphasizes for us how discriminating routine care is, and how vulnerable women, gays and elder patients are when they don't have civil rights organizations at their back.

December 16, 2009. Community Regional Medical Center in Fresno has agreed to make policy changes and conduct staff trainings to ensure that the rights of its LGBT patients and family members are properly respected. The changes are in response to a demand letter by American Civil Liberties Union and the National Center for Lesbian Rights on behalf of a lesbian who was barred from visiting her partner and giving advice about her treatment at the hospital.

“We are very pleased that Community Regional is taking seriously its obligations to respect the rights of its LGBT patients and family members,” said Elizabeth Gill, a staff attorney with the ACLU of Northern California. “While it’s unfortunate that a couple had to suffer in order to make the hospital take notice, it’s commendable that Community Medical is taking such important steps to ensure that this kind of mistreatment doesn’t happen again.”

On May 29, 2009, Kristin Orbin was rushed to the emergency room after suffering from an epileptic seizure. She and her partner of four years, Teresa Rowe, had traveled from the Bay Area to Fresno to attend a rally in support of marriage for same-sex couples. Although Rowe, who grew up in nearby Clovis, California, was well aware of Orbin’s medical history and how she responded to various medications, hospital staff refused to allow her to speak with the doctors treating Orbin or to visit with her. As a result, Orbin was given the drug Ativan that she didn’t need and which caused her unnecessary pain. After the couple had been separated for several hours, Orbin finally saw her doctor. She complained to him, and Rowe was eventually allowed to be with her.

“While an apology would have been nice, we are pleased that this incident will help put an end to unfair treatment of LGBT patients and their family members,” said Rowe. “But while the policy changes are extremely welcome and necessary, this incident has also underscored that, ultimately, allowing same-sex couples to marry is the only way to guarantee the respect and recognition that will prevent this kind of treatment.”

According to the letter Community Medical Centers sent to the ACLU and NCLR, the hospital is in the early stages of reviewing all its policies dealing with LGBT patients and foresees further changes in addition to the promised training and policy changes. It has also agreed to keep the ACLU and NCLR apprised of its progress.

“We’re very pleased that Community Medical has decided to do right by its LGBT patients,” said James Beaudreau, Education and Policy Director of the Gay and Lesbian Medical Association (GLMA). “Providing equal treatment and care for all persons, regardless of sexual orientation and gender identity, should be of paramount importance to any hospital. It creates an environment in which all patients feel safe and comfortable receiving treatment, which results in a higher quality of patient care.”

A copy of the demand letter and its response is available here.

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Bobby Schindler's Fight.

It's incredibly sad and telling that this story about the custody battle of a woman for her persistent vegetative state husband is framed as an impressive career move for the "pro-life" activist Bobby Schindler. Is it not enough that the legacy of Terri Schiavo has been over-employed as a religious tool to oppose patients' rights? Now all persistent vegetative state patients are working for Terri's Fight as well?

Bobby Schindler watched his sister die in one of the most publicized end-of-life cases in the nation’s history.
Now, he’s hoping a similar case in Chemung County has a different ending.
Schindler, the brother of Terri Schiavo, was in Elmira Monday to show his support for Sara Harvey, who is attempting to regain custody of her injured husband, Gary Harvey.
“We’re trying to support her efforts to bring her husband home,” Schindler said.


Like Sara Harvey, Schindler and his family did not have guardianship of Terri Schiavo, whose husband was her guardian.
Terri Schiavo, who had been in a persistent vegetative state since 1990, died March 31, 2005, in Florida after her feeding tube was removed by a court order, a move requested and backed by her husband, Michael Schiavo.
Her death culminated years of bitter legal fights between the Schindlers and Michael Schiavo.
“There are animals that got treated better than my sister,” Schindler said. “All life is really sacred.”
Schindler said Chemung County should allow Sara Harvey to regain guardianship and let Gary Harvey live.
“Gary Harvey is not dying,” Schindler said. “There is no reason care (should be) denied.”
Schindler, who visited Gary Harvey on Monday at St. Joseph’s Hospital in Elmira, said the county is bullying Sara Harvey.
“It’s horrible how they are treating this woman,” he said.
Sara Harvey is allowed only supervised visits with her husband.
“I went through hell, and I’m still going through hell,” she said. “The government owns my husband.”
Schindler, who has an uncle who lives in Corning, helps run a foundation that advocates for people in situations similar to Sara Harvey’s. The foundation’s Web site is

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Health Care Reform and the Conscience Clause.

Check out this fact sheet created by the Center for Reproductive Rights on what a balanced conscience clause in the health care bill would do.

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The Culture of Death Is A Wave.

Oh dear. Where to begin. From Catholic Culture, an article by Dr. Jeff Mirus, who has apparently taken his language from last century, titled "A Barren Beach," so poorly framed and informed I'll take it on paragraph by paragraph:

I confess it: I just don’t see how it is possible for a good Catholic to favor the Federal takeover of health care. This is so obvious that we shouldn’t even have to be debating it. Completely apart from funding for abortion, each bishop in the United States should see the problem with a clarity so pure and crystalline as to hurt his eyes. (For just a few of the reasons, see Phil Lawler’s The Catholic case against health-care reform.)

Government regulation of patients' rights to affordable healthcare is hardly a take over. And particularly now that the health care bill has been stripped of any regulatory benefits that will effect meaningful change on the preying medical industry. The bishops have an agenda which exacts religious ideology over all patients - and as the second largest provider, after Veterans Affairs, of health care, they've been flexing their muscle to prevent any government intrusion whatsoever, theological claims to care for the "least of these" be damned.

Look: Anyone who understands the secularist trajectories of contemporary American polity, the increasing tendency in the West toward totalitarianism, the violation of human freedom and dignity which necessarily follows the abandonment of subsidiarity, and the dramatic push toward a culture of death by Western culture in general, and by the American courts and Democratic Party over the last generation in particular—well, anybody with even an inkling of the factors in play, if he has significant Christian values at all, should be running as far away from Federally-controlled health care as possible

Subsidiarity, one tenet of Catholic social teaching, does not prevent enforcement of plurality of belief nor protection of rights. It simply states that what can be done fairly at the local level should be. Unfortunately, those who adhere to a "free market" for health care have failed to acknowledge the discrimination, subjugation, and lack of access that the current system has imposed on society. There's no loss of freedom, liberty, dignity, or any other glorious democratic objective by requiring that health care providers meet the needs of their consumers. Other industries have experienced such regulation - no toys with lead, for instance - without collapsing. And that we should all have Christian values is a blatant denial of the necessary separation of church and state. We're not all Christian, by fact, and nor will requiring that we all adhere to a "Christian" (as conceived by the bishops or anyone else) bring about religious freedom.

The new world that anyone with eyes should see coming is a world in which genuinely religious people, who take Revelation seriously rather than making it all up as they go along, will be increasingly marginalized; where extreme moral evils will not only be permitted but protected by law, and not only protected by law but required; where the bulk of those evils are bioethical and therefore inescapably medical; and where those who object to such evils must either participate in them or lose the right to practice their profession, to remain at liberty, or even to remain alive.

There is no marginalization of Christians demanded by society and nor is there any going on. This is the expression of a persecution complex that feeds Christian justification for imposition of doctrine through social services like health care, education, and aid. Because missionizing is built into the faith, and because that missionizing is best exacted on the suffering, I understand Catholic and evangelical disagreement with removal of that robust market by government regulation. But play it if you must, Doctor, to explain your declining congregations and the growing social acceptance of actions and lifestyles that lie beyond your draconian and antiquated line of acceptable "morals."

We have been through wave after wave of this sort of thing since faith and reason were divorced in the eighteenth century: first the French Revolution and the Terror, then the rise of Communism and Nazism, and now the increasingly ideological progressions of the European Union and the American judicial system. Every one of these manifestations of the secular rationalist state has been greeted as beneficial to mankind by a significant number of citizens, who have fervently blessed slavery as freedom, and called black white.

What is referred to here is decline of the dominance of one faith over society. Enslavement according to race was finally and belatedly determined discrimination, a violation of rights on a minority population, just as society is slowly waking to the discrimination exacted on other segments of society by government in the name of "morals" and religion.

If the effort to put health care fully under Federal control is not, under contemporary circumstances, a major step along this path, then I am incapable of analytical thought. Does anyone seriously believe this will not amplify and multiply the full range of horrendous bioethical evils which afflict our dying culture? Does anyone really believe it will not strengthen the culture of death, ultimately punishing those who oppose it? How is any other interpretation possible? Whence comes a realistic hope that the result could be something other than this? Where are the historical trends to support such a vanity?

I'll let that first sentence answer itself. There is no culture of death, just as there wasn't one 50 years ago when the first heart transplant was proclaimed "playing god." There is scientific and technological advancement that continues to roll back death from disease and lengthen lives. Refusing to acknowledge that advancement comes has kept the church in the dark, employing advancement where it wishes and denying it elsewhere according to small-minded and unscientific fears. With regard to medicine, allowing one woman to have an abortion in no way diminishes another's faith; it only acknowledges that we live in a pluralistic society where all have rights, not just a favored some. The last sentence I will let stand for itself as well.

And what infuriates me is that so many, including many who claim the Catholic name, still purport not to see this; still claim they can support it with complete consistency as Christians; still dissemble; or, at best, still convince themselves that by riding this new wave of power they can escape the ultimate

drowning of their own souls.

Take that up with your church which has failed to adjust its policies to eradicate discrimination, has denied science, and has consistently and detrimentally exerted its own power for its own sake.

Ah! See them riding that monstrous wave, boasting as if seizing a higher and firmer ground! Observe the teeming insignificance of so much life swept below! Pause to watch the mighty water as it arches and froths, and hear presently their exultant shouts turn to terror as the wave curls and crashes, spilling even the mightiest into its shimmering maw. Listen at last to the diminishing roar as the wave recedes, revealed only now as the ebb tide of history, leaving its dead upon the barren beach.

Flowery but quite removed from reality.

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Krauthammer, Global Warming, and "The New Socialism."

I usually stay away from Charles Krauthammer's columns, finding them often the skilled work of a spoiled child who wants more chocolate and has refused the fact that the colorful box is empty - because he's eaten them all.

But his December 11 column make unfounded claims that can't be ignored; his display of willful ignorance regarding international politics, empty phrases like "socialism," denial of global warming, and blatant adherence to disproven policies (and historical analysis) is an enormous disservice, via syndication, to a nation that is once again trying to find its way in the world with conscience.

Before I get to the krapola he asserts, I think it's worth noting that Krauthammer is from another era, like the sweet old lady who still uses the word "gay" to mean happy and romanticizes, for instance, a time when society was moral and just. The world has gone to heck, he asserts. People just aren't good and honest - like Thatcher and Reagan - any more. No matter than they never were; no matter that ideologies the individual adheres to have been disproven by time and history.

Krauthammer represents the Cato Institute ideologues of the 1980s and 90s. Though they still spew out their dated concepts in a contrived "fresh" fashion, their simplistic positions are obsolete, disproven and meaningless in a world that has proven to be more complicated than the one they want(ed) it to be. Quoting Ayn Rand is not even quaint any more; it is self-deceptive, and destructive at that.

Because Krauthammer is, in this latest blinder, discussing what one could call world entitlements, let me quote a hideous article from the Cato in 1998 by David Kelley. I think it demonstrates what I'm getting at:

...human beings have only recently, in certain parts of the world, taken definite actions to create wealth. Against the backdrop of millennia of human history, it is wealth that stands out and calls for explanation. Poverty is simply the absence of wealth. It is the natural human condition, which persists in the absence of efforts to overcome it.

Kelley asserts that the West has essentially won the wealth race because those in the developing world have been lazy, coddled, become accustomed to hand outs. And like others on the deluded Right, unwilling to acknowledge the privilege from which he makes this observation. Now hear Krauthammer:

The idea of essentially taxing hard-working citizens of the democracies in order to fill the treasuries of Third World kleptocracies went nowhere, thanks mainly to Ronald Reagan and Margaret Thatcher (and the debt crisis of the early '80s). They put a stake through the enterprise.

But such dreams never die. The raid on the Western treasuries is on again, but today with a new rationale to fit current ideological fashion. With socialism dead, the gigantic heist is now proposed as a sacred service of the newest religion: environmentalism.

That environmentalism is a ruse (a religion) to suck as much wealth out of the West as possible, "the new Socialism," is a new Right saw. It denies the existence of damaging climate change and ignores why that change has come about. It demonizes non-Western countries for being subject to Western excess - essentially blaming the victims. Statistically, the West continues to suck resources out of undeveloped countries (uh, that was the purpose of colonialism, constructed by empires and now maintained by corporations) and gives back pollution, paternalistic dictates, guns for more violence, and ignorance.

"Third world kleptocracies" indeed have worked to capitalize on Western aid - and why not? Often non-relief aid is offered in ways that are benign and meaningless to populations ravaged by war, corrupt governments, and monopolization. What incentive does a dictator have to educate his population, to manage incoming aid, to develop "wealth-creating" industry, or to distribute wealth (beyond the vote-culling goat now and then) when money flows in and keeps him fat?

And because of the corrupting effects of capitalism, his subjected people admire the accumulated wealth at their expense. Oh he has two Mercedes Benz, he has been so smart to get so much from the West. He's a big, rich man who deserves his wealth.

The West has pursued and instated dictators for its own purposes - easy control, access of industry, even "insurance" against the spread of communism, markets for second rate products and other regulated items like weapons - with little consideration for the rights of citizens. Instead of blaming foreign policy for the poverty and lack of development in these countries, Krauthammer ignores their modern history and the West's role in it.

He's an egregious mouth-piece for the excesses, privilege, and discriminatory paternalism that have guided Western foreign policy for more than two centuries. Arguing that some cultures contribute more to world society - nee, our Western society - is to see the world from a shoe box, having never moved out into it. Unfortunately, Krauthammer speaks to an audience that as well is susceptible to such rantings. As the national economic crisis squeezes more Americans and encourages them to look for a bogeyman, "the other" has always been a good target. Isolationism has been proven a disaster, but it continues to rebound. The "free-market" has delivered none of it's promises and, without necessary regulation, has proven a perpetrator on individual freedom and wealth both here and abroad, yet some still scream for deregulation. And socialism, as Krauthammer uses the term, stands for communism; yes a failed system but as performed, never socialistic in any way.

I'm actually surprised that he continues to get leverage for the Socialism claims any more. As he uses the term, it never existed. As the EU enacts the term, it has proven a superior form of raising quality of life for even "the least of" citizens. Application of the term to both Communism and, say, Medicaid, is a stretch beyond understanding. But socialism is an old straw man for the myopic Right, bound to get a rise out of those who don't know better.

In short, the governing structures that Krauthammer hangs the flaccid skin of his rant on are hollow definitions, emotionally disturbing to those who don't know better and are under economic constraints, looking for a source of blame.

This column is an excessive example of irresponsibility. Ignore the horrors and damaging legacies of colonialism (by both empire and industry); deny the watershed of facts about global change that will, of course, destroy first those living unprotected in developing countries; pretend that those dirty little countries have no influence on the global environment nor economy; forget the discriminatory role the West has played in installing and supporting corrupt governments around the world; and prey on the insecurities of challenged Americans.

It's a win, win, win, win argument, unless you wish to exert a proper and honest analysis of Western foreign policy and science. And that's, well, beyond Krauthammer's reinforced and small-minded objective. He's got a column to write and emotions to stir, facts be damned.

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What Is A Patients' Right?

At the end of life, sedating a patient properly to make certain they are without pain is difficult. Drugs can be disorienting, often the patient is not fully conscious, communication can be muddled and difficult to understand. The influence of concerned family members and attending staff can all filter into an untranslatable request or denial of services. Patient requests are easy to ignore.

So too, it seems, that patients during routine procedures are often difficult to understand, according to the doctor in a case in Florida who followed through on a colonoscopy even after the patient's sedation wore off. She has charged that she was under intense pain and wanted the doctor to stop the procedure. He has testified that he thought completing the procedure was in the patient's best interest.

If a doctor's already started a procedure, then the patient begs him to stop, does he have to?

Apparently not, attorneys for the Florida Department of Health say, if the patient signed a consent form giving permission for the procedure.

Health News Florida reports that after a Pasco County patient complained that happened to her during a colonoscopy performed by gastroenterologist Kozhimala John last year, DOH lawyers looked for some clause in the Medical Practice Act that would apply.

They initially filed a complaint under the wrong-side or wrong-procedure statute, reasoning that the patient consented to a colonoscopy with anesthesia, not one without it. But the doctor's attorney said that wouldn't fly, and they decided he was right.

"There was unnecessary suffering inflicted," DOH prosecutor Robert A. Milne told the Florida Board of Medicine "but we had to (drop the charges) for legal reasons."

In the end the Zephyrhills doctor, who is board-certified in internal medicine and gastroenterology, was charged only with inadequate record-keeping for failing to document the many ways the colonoscopy went awry.

When the Board of Medicine heard his case in Orlando earlier this month, some members fumed about the state dropping the more serious accusation.

Donald Mullins, one of three non-physicians on the 15-member board, spoke sharply to John.

"It's her body. She needed to make the decision. These were not your decisions to make I'm disgusted that we're going to (accept the settlement). I just can't believe it!"

Miami pediatrician Onelia Lage also said John displayed too little regard for the wishes of his patient. "Regardless of the legalities, when the patient screamed and said, 'No!,"You needed to listen."

But John's attorney, Bruce Lamb of Tampa, pointed out that the state could not prevail if it took the case to a formal hearing. Lamb, a former DOH prosecutor turned defense counsel, noted that the settlement agreement on the record-keeping charge was unusually strict.

In it, John neither admitted nor denied violation of the law but accepted a reprimand and $15,000 fine. He agreed to perform 100 hours of community service and take a course on "risk management."

A description of the May 2008 day of the colonoscopy is contained in DOH's investigative records. They show the colonoscopy was under way when the sedation, a common mix of Versed and Fentanyl, wore off. The patient told John he was hurting her and pleaded for him to stop, the records show.

He tried to increase the sedation, but there were problems with the IV. "Please stop!" the patient kept insisting, while the nurse tried to shush her, the file shows.

The doctor didn't stop until he was done, he told the investigator, because he thought he was acting in the patient's best interests. He was almost done, he said, and he wasn't sure whether she was thinking clearly because of the drugs. He said he didn't want to put her through it again, since patients say the worst part of a colonoscopy is the preparation for it — drinking large amounts of chalky liquid and many hours in the bathroom to clean the colon for a sharp image.

But the patient was unhappy that her protest went unheeded. She filed a complaint with DOH.

John said the reason the scope was difficult to push through was the scar tissue in the patient's abdomen left after several surgeries. He said that the patient's perception that the nurse was holding her down may have been a misunderstanding, since he asked the nurse to apply pressure to the abdomen.

He had trouble administering more sedation because the intravenous line kept infiltrating the vein and he couldn't find other usable veins, John said.

He concluded: "Most people would say: 'I didn't really mean for you to stop the procedure even though I told you to...' She was under sedation. I couldn't take her words for sure."

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