Saturday, January 30, 2010
Op-Ed on CBS "Pro-Life" Superbowl Ad.
Those opposed to legal abortions have learned a lot about reaching out to the many Americans who can't make up their minds about the issue. Many of these people don't want abortion to be illegal but believe that too many such procedures take place in this country. Conservative groups, such as Focus on the Family, have gotten that message. They know to save the fire and brimstone for their hardcore base; for Super Bowl Sunday, you appeal to people's hearts with a smiling baby -- or Tim Tebow and his mom. Presenting Americans with a challenge of personal sacrifice, especially if the person who has to sacrifice is a woman, is a convincing sell.
Women's and choice groups responding to the Tebow ad should take a page from the Focus on the Family playbook. Erin Matson, the National Organization for Women's new vice president, called the Tebow spot "hate masquerading as love." That kind of comment may play well in the choice choir, but to others, it makes no sense, at best; at worst, it's seen as the kind of stridency that reinforces the view that pro-choice simply means pro-abortion.
We have seen a dramatic shift in attitudes toward "pro-life" and "pro-choice." In 1995 Gallup asked respondents for the first time whether they considered themselves "to be pro-choice or pro-life." Only 33 percent took on the pro-life label. In 2009, 51 percent considered themselves pro-life, and pro-choice had dropped from a high of 56 percent to 44 percent.
Demential and Mammograms: Addressing Futile Care in the Elderly.
In order to help our patients avoid care that is more likely to hurt them than help them, it is important all of us be able to explain to our colleagues why mammograms are not a good idea in women with dementia. Here is a brief outline of that explanation:
- Mammography frequently finds abnormalities that are not cancer and need further evaluation. The fear caused by these findings, and the stress from the evaluation can be debilitating for healthy women. For women with dementia, the anxiety and stress can be debilitating. And with dementia, this stress is also felt by overworked caregivers.
- However, contrary to common perceptions, the most serious harm from mammography in women with dementia is not false positives, but actually finding a clinically insignificant cancer. The concept of clinically insignificant cancer is not understood by the public. A clinically insignificant cancer is a tumor that if undiagnosed would never cause symptoms in the patient's lifetime. The type of tumors for which mammograms are beneficial will generally be clinically insignificant in women with dementia. Without mammography they will go undetected and not cause problems. But if found, these women will often be given surgery and other invasive therapy. To subject someone with dementia to invasive therapy that has little chance of benefiting them is very unfortunate. Dr. Walter has previously shown that in some cases, this treatment leads to devastating complications, including one case report of a non healing wound infection, and another case of a post-operative stroke.
Perhaps the most fundamental problems with ordering screening mammograms in women with dementia is that it suggests check box medicine is being provided, and therefore the real needs of the patient and her caregiver are not being attended to.
- Perhaps most concerning is that time spent focusing on nonhelpful care diverts focus from the type of care women with dementia really need. At GeriPal, we have previously discussed how primary care physicians are uncomfortable caring for patients with dementia. It is well established that the quality of care for people with dementia is poor. Interventions that could improve functioning and quality of life are often not done. As we have also discussed, the needs of caregivers get ignored.
Our health system fails frail elders with dementia. There is so much more that needs to be done for them. Contrary to those who raise the Rationing charge when it is suggested that women with dementia not get mammograms, this is actually about doing more for these patients, not less. We can start by not doing tests that are more likely to hurt our patients than help, and focusing on what these patients and their caregivers really need.
GeriPal: What a Nursing Assistant Will Tell Us If We Ask.
How Saintly Was Mother Teresa and Does She Deserve a Stamp?
Forget about the Presidential Medal of Freedom and that little thing called the Nobel Peace Prize. (Okay, bad example…) But it’s obvious, at least to the folks at theFreedom From Religion Foundation, that the Postal Service has no business putting super-humanitarian and all around do-gooder Mother Teresa of Calcutta on a stamp.
Why? It’s the nun thing.
Freedom from Religion Foundation spokeswoman Annie Laurie Gaylor told Fox News that issuing the stamp runs against Postal Service regulations because, quite simply,
Mother Teresa is principally known as a religious figure who ran a religious institution. You can’t really separate her being a nun and being a Roman Catholic from everything she did.
…There’s this knee jerk response that everything she did was humanitarian, and I think many people would differ that what she was doing was to promote religion, and what she wanted to do was baptize people before they die, and that doesn’t have a secular purpose for a stamp.
The Postal Service, of course, disagrees. As far as they’re concerned, the Mother Teresa commemorative stamp has nothing to do with her religion. As Postal Service spokesman explained:
Mother Teresa is not being honored because of her religion, she’s being honored for her work with the poor and her acts of humanitarian relief,” Betts told FoxNews.com.
“Her contribution to the world as a humanitarian speaks for itself and is unprecedented,” he added.
Growing Catholic Church Schism, The Call for Remonstrance.
Why is Catholic remonstrance necessary? Here are a few compelling reasons.
First, remonstrance is a form of dissent. Any institution, whether it be a national government or a religious hierarchy, needs to hear about potential problems before they become major problems. Listening and hearing such dissent is essential to institutional health. Arguably: No dissent, no health.
Dissent also draws attention to vital new ideas even if they were treated with scorn upon arrival. For example, a reconsideration of natural law principles in light of knowledge acquired since St. Thomas Aquinas in the thirteenth century offers strong arguments in support of artificial birth control and embryonic stem cell research while establishing homosexuality is not the aberration Church fathers believe it to be. Even the great Aristotelian thinker, St. Thomas Aquinas was treated as a heretic and excommunicated shortly after his death. And yet his ideas came to greatly influence Catholic theology.
Remonstrance also allows more the esoteric economic agendas of the Catholic Right to be exposed.
Reactionaries now control much of the structure of Church governance. For example, Archbishop Raymond Burke is now the current Perfect of Supreme Tribunal of the Apostolic Signatura, roughly the equivalent of a Vatican Supreme Court. Additionally, Pope Benedict XVI is expanding the ranks of conservatism in the Church by reaching out to the anti-modernist, anti-SemiticSociety of Saint Pius X (SSPX) and attempting bring socially conservative Anglicans into the fold.
Although he also recently issued the economically progressive encyclical Caritas in Veritate, he is appointing and elevating economically regressive bishops and cardinals -- especially in the United States. The very anti-health care reform Kansas City, Kansas Archbishop Joseph F. Naumann, as well as Kansas City - St. Joseph Bishop Robert W. Finn, Cardinal Justin Rigali of Philadelphia and Bishop R. Walker Nickless, of the Diocese of Sioux City, Iowa immediately come to mind. Many of these church princes cavort with Catholic neocons whose political agenda for the church has more to do with comforting the wealthy and extending empire than with Jesus's concern for the oppressed, the marginalized, the vulnerable, and the despised.
Finally, Catholicism risks transformation as an appendage not only of neconic oligarchy but opposition to pluralism as espoused by traditionalists. Some such as Tradition, Family, Property, are downright scornful of modern democracy. To that end, these folks often abuse the Catholic notion of obedience. In their hands it is transformed from the idea of living a life in compliance with God's will to one of blind obedience to those who abuse their hierarchical authority to violate other key components of natural law such as distributive justice. To people like these, dissent is a dangerous thing.
It is not difficult to see where this goes. If the faithful can be bullied into religious compliance by dint of damnation anxiety, then they can be an effective tool for oligarchs who join with traditionalists in equating dissent with disobedience to God.
That is why mainstream Catholics must now offer remonstrance; and refute the substitution of Caesar for God; both in the pew and in the public square.
Labels: catholic church
British Nurses Tackle End of Life Care.
At Nursing Times, Joan Morgan reports on a new study designed to improve end of life care in Britain, based on the Liverpool Care Pathway.
Being responsible for planning and implementing change in practice/behaviour involves bringing about a major cultural shift. As end of life care in critical care is possibly more varied and complex than other areas of the hospital, this will take time, from both a personal and professional perspective.
It is imperative to have a thorough understanding of the legal and ethical issues involved. In the UK, the legal practice of withholding and withdrawing treatment is determined by doctors, although usually carried out after a consensual decision making process involving other professionals and family members. Moreover, we now live and work in a multicultural and ethnically diverse society, which requires greater understanding and sensitivity.
It was therefore necessary to conduct a literature review to understand current practice surrounding end of life care in critical care. This review reinforced the notion that deep seated beliefs affect care of dying people (Morgan, 2008).