“Belgian Docs Give Selves OK to Kill ICU Patients”

The Journal of Critical Care Medicine has published a statement by the Belgian Society of Critical Care Medicine giving ICU docs the right to kill patients–even though euthanasia in the country is supposed to only be consensual.

Under the document, futile care impositions of withdrawing or withholding care are up to the medical team–whatever a patient or family may want.

via National Review Online.

“Assisted suicide” is legal in Belgium.

And, despite published statements by doctors who have admitted to breaking the rules, apparently the oversight designed to protect against abuses has not found a single case worthy of prosecution.

So is the next step the part where the patient’s wishes become irrelevant? This blog post seems to think this is exactly what is happening – that the goal this paper is arguing for involves killing patients (even children, and “even in the absence of discomfort”), whether the patients want it or not.

It’s only logical: Once killing is accepted as an answer to human suffering, what constitutes “suffering” expands like an elastic band to include that of society and the hospital having to care for lives defined as meaningless. And it can even include termination when patient suffering isn’t present.

As for choice: What’s that got to do with anything? Efficiency!

You simply cannot trust a doctor if that doctor’s mission is compromised. Either doctors heal or doctors kill people who go over-budget. They can’t do both.

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“What Was the Point of Obamacare?”

Last week, the Washington Post delivered a bombshell report: “Only one in 10 uninsured people who qualify for private plans through the new marketplaces enrolled as of last month.” Instead, the overwhelming majority of those who are enrolling in insurance plans on the ObamaCare exchanges already had insurance.

The lie of the year for 2013 was President Obama’s promise that, “if you like your plan, you can keep it.” The lie of the year for 2014 is going to be the claim that ObamaCare would insure the uninsured.

ObamaCare has failed to attract those who lack health insurance, seemingly because they have decided that the premiums are too high for the bare-bones coverage the exchanges offer. In other words, the Affordable Care Act has failed to offer affordable care. Instead, most of ObamaCare’s sign-ups are merely migrating over from an existing health-insurance plan—in many cases involuntarily, after their plans were canceled for failing to comply with new ObamaCare regulations.

via The Federalist

The “point” of Obamacare seems to have been to get Americans’ health care under government control, so that the NSA and their buddies would have more data and the government could force nuns to pay for birth control – out of sheer malice.

Am I oversimplifying? Sorry – feeling cynical lately, as people quite seriously argue whether Christians ought to be formally scapegoated for the sins of the world (all in the name of “tolerance” and “diversity”, of course) or even allowed to exist at all.

Did we ever come up with a good reason why a law disliked by voters of both parties – and now proved wildly ineffective – “cannot” be repealed?

“Golden Rice Opponents Should Be Held Accountable for Health Problems Linked to Vitamain A Deficiency”

Except for the regulatory approval process, Golden Rice was ready to start saving millions of lives and preventing tens of millions of cases of blindness in people around the world who suffer from Vitamin A deficiency.

It’s still not in use anywhere, however, because of the opposition to GM technology.
via Scientific American

Sure – we can arrest people for interfering with scientists’ right to save the world, because scientists are so expert that they know what they’re doing and can absolutely guarantee that everything will work as promised…so that means if they’re wrong, they can be held liable for manslaughter if anyone dies, right?

Right?

Whaddya mean “that’s not how science works”?

Baby born to a mother who had taken thalidomide while pregnant. Image via wikipedia.

Baby born to a mother who had taken thalidomide while pregnant. Image via Wikipedia.

Authority means accountability. If scientists want the one, they should be ready to accept the other.

And that doesn’t even touch the issue of whether they are taking too much license with the environment we all share. I hate saying that, because I am not at all a fan of environmentalists, and I hate sounding like them. To me the question is not environment vs. science, but rather the correct way to handle risk. The history of science is full of projects that crashed first and only learned to fly after examining what went wrong the first three or seven or fifty times. Scientists don’t own the environment. We all do. That is why the correct way to win debates over whether or not there is such a thing as “genetic pollution” or whether cross-pollination issues are potentially of concern is by persuading the voters – not by punishing thoughtcrimes, as this writer advocates, by making people criminally liable for invented crimes just because those people and their hard-to-rebut arguments happen to be politically inconvenient.

…or just because the scientific community doesn’t know how to effectively rebut a valid point?

…or just because the scientific community doesn’t want to even try, because they think people should just obey?

Maybe if scientists want to go back to the good old days – when people still trusted them – they could start with an apologize for their own past lack of accountability (which is why people stopped trusting them, after all). Blind obedience hasn’t worked out very well for too many of us.

Milgram Experiment advertisement. Image via Wikipedia.

Milgram Experiment advertisement. Volunteers were treated unethically. Image via Wikipedia.

The history of science is littered with experiments that were supposed to be safe but wemt wrong. A disturbing number of these science-gone-wrong stories have occurred in the third world. Scientists have a long and ugly history of using developing-world populations as their personal guinea pigs. For example, most people have heard of the Tuskegee syphilis experiment – but how many people know that after it was exposed and shut down, the scientists moved it overseas?

The Commission confirms that despite knowledge that it was unethical, US government medical scientists PURPOSELY infected  “at least 1,300 who were exposed to the sexually transmitted diseases syphilis, gonorrhea and chancroid” to study the effects of penicillin. At least 83 subjects died.”

Reading this article, it seems that wanting to experiment on third world populations is what this is all about. Poverty isn’t caused by lack of resources. It’s caused by corruption and other political problems. We already have more than enough food to feed the world. So don’t fall for the guy using Third World poverty-stricken people as meat shields: this is not about solving the problems of the poor. It’s about the question of whether scientists promising awesome things have the right to bypass that part of the political process where they have to prove their awesome products are safe and worthwhile – to our satisfaction, not their own.

In other words, it’s about self-governance (as opposed to top-down experts telling us what to want, think, feel, need, desire, use, and not use).

And the people who want the right to override our political processes – because they are quote-unquote ‘experts’ – have a history of being ethically stunted people who view the developing world as their own personal sandbox for exploitative experimentation.

But medical ethicists say that even if today’s research is not as egregious as the Guatemala experiment, American companies are still testing drugs on poor, sometimes unknowing populations in the developing world.

Many, like Markel, note that experimenting with AIDS drugs in Africa and other pharmaceutical trials in Third World countries, “goes on every day.”

“It’s not good enough, in my opinion, to protect only people who live in the developed world — but all human beings,” he said.

via ABC

Scientists have relied on bullying to artificially manipulate outcomes – in the case of GMO foods, they have forced people to falsely equate GMO foods with lower-risk foods. Yes, lower risk. There is a risk in GMO foods, and the scientists want us to behave as if there isn’t. That’s the heart of the matter right there – that is what they want, but they are not willing to do what they have to do to earn the outcome; they want to manipulate the outcome dishonestly. They want to deny the existence of real issues that could or do exist. They want to skip the part where they have to persuade us, and their preferred method for doing this is to replace self-governance with top-down bullying – using the three-step “impending doom” song-and-dance beloved of “progressives” everywhere:

  1. Make optimistic promises about how great the results of the proposed policy will be, then treat those promises as if they’re fact. (How could you be against ending world hunger?)
  2. Make dire predictions of impending doom if the policy is not implemented, and act as if criticizing (or even evaluating) the policy equals wanting that horrible doom to fall. (You don’t just want to end world hunger, but you want everyone to starve and die!)
  3. Ignore or, if necessary, deny the consequences if these grossly exaggerated and highly improbable predictions are incorrect.

There is always risk in science – that is why we don’t hold scientists accountable for the deaths their mistakes cause, even though science has caused a steady stream of death and mutilation. We know that science is frequently wrong. The flip side of this is acknowledging that scientists don’t really know, and aren’t honestly in a position to guarantee safety or certainty. Some of the worst atrocities in the history of science come from scientists losing their objectivity – forgetting that they don’t really know. Getting carried away.

It is accurate and correct to perceive GMO products as risky – potentially very risky – to both health and the environment. It isn’t “anti-science” to point out that risk warrants caution. We don’t actually know they’re safe. Note that the people insisting that we should accept they are safe are people who want all the profits while we are stuck with all the risk. (Normally risk and reward go together, but of course it’s always nicer if you can keep the reward and give some other poor slob the risk.)

The honest way to handle it would be to admit that consumers have good reason to prefer non-manipulated foods – and to price GMO foods less, accordingly. But they don’t want to do that. They want to make it so that you can’t tell if a food is GMO or not. They want to replace non-GMO foods with GMO foods.They want to own the food supply.

And, no, the fact that they’re willing to forego profits doesn’t mean anything – not when you’re talking about a product with the power to foster dependency and create market dominance. Remember when Nestle gave away baby formula? WHOOPS!

If their real goal were to prevent vitamin A deficiency, it wouldn’t be hard to dispense vitamin A to all at-risk populations without forcing farmers into accepting crops that may be wonderful or may cause serious problems.

Two Separate Questions

So what are we to make of the divisions that emerged in the course of Arizona’s consideration of its version of a Religious Freedom Restoration Act, and the responses it inspired? I think it comes down to a matter of priorities, and to the broad-based willingness to let personal inclinations about what society ought to look like overwhelm a reasonable understanding of the ramifications of giving government the power to shape that society.

via The Federalist

Two question:

  1. “What society should look like” – that is, we should or shouldn’t limit Christian power, and/or we should or shouldn’t limit gay rights, or whatever.
    (In other words, the ends that may or may not justify the means.)
  2. Question #2: Should government have the power to shape society into (1)?

Are people even thinking at all about how it might change our world to change our structure of governance – changing the right to be free from governmental coercion into the right to use government to coerce the other guy?

Rule Of Law?

[I]t’s time to concede that no one has been more adept or aggressive about delaying and defanging Obamacare than Obama himself. Systematically and with an eye toward his party’s immediate political troubles, Obama has reshaped, photo-shopped, reimagined, and reengineered Obamacare. It all sounds techy and cool and flexible—at least to the administration. To those who must live with and live under the law, the arbitrary is the norm. The only pattern is chaos. Obamacare’s worst enemy is Obama.

The New York Times has compiled a helpful list of recent changes to the Affordable Care Act—13 in just over a year. That comes out to more than one substantive change to policy or legislated deadlines per month. This, in a landmark law nearing its fourth birthday.

via NationalJournal.com.

A Twofer

A former waitress has settled her lawsuit against Hooters, the restaurant that gave her a toy Yoda doll instead of the Toyota she thought she had won.

Jodee Berry, 27, won a beer sales contest last May at the Panama City Beach Hooters. She believed she had won a new Toyota and happily was escorted to the restaurant’s parking lot in a blindfold.

But when the blindfold was removed, she found she had won a new toy Yoda — the little green character from the Star Wars movies.

via USATODAY.com

Amazingly – given the way Hooters does its best to protect itself from the consequences of its management practices – Berry appears to have gotten what she wanted out of Gulf Coast Wings, Inc.:

“She’s satisfied with it,” said the attorney, David Noll. He did say that Berry can now go to a local car dealership and “pick out whatever type of Toyota she wants.”

[…]

“I think that’s a recognition of the fact that there’s been such an amazing amount of attention focused on this case,” he said. “There’s not a whole lot of reason to try to hide its existence.”

via Free Republic

There are two reasons why this joke as originally perpetrated “isn’t funny” (and, no, I don’t hate pranks – I absolutely adore this April Fool’s joke. And this one, too.)

1. Jokes are not an excuse to humiliate those over whom you have authority.

Jokes should be perpetrated against peers – those equal in power. Greater in power is okay – if the employees had pranked the manager, that would be a legit joke – but scamming an employee isn’t good clean fun. It’s abuse of authority.

It’s also a breach of trust. People need to be able to trust their employers or else they can’t effectively hold a job. Trust brings with it certain responsibilities. Joke or no joke, don’t humiliate the people who work for you. Especially not for doing exceptionally good work.

I think manager Jared Blair may find future employers are not eager to hire him. He cost Hooters more than just money.

2. Jokes are not an excuse to profit at the expense of someone’s hard work.

If the ‘contest’ had involved something totally random, that would be a joke. Making someone put in extra effort at work – to create profit for yourself, rather than her – is not a joke; it is fraud.

The Real Story

What’s really interesting & far more important  – and yet not being given wide press by those bothering to report this story – is this:

On Monday, Circuit Judge Glenn Hess heard a motion to dismiss the lawsuit based on an employee handbook Berry signed when hired. The handbook says employees and the company must try to settle disputes through mediation or arbitration before going to lawsuits.

Hooters attorney Casey Rodgers argued that the suit should be taken out of the courts and sent to arbitration, or dismissed outright.

But Hess sided with Berry’s lawyer, Stephen West, who argued that the agreement wasn’t a contract, wasn’t binding and shouldn’t be enforced.

West pointed out that the handbook itself states that it isn’t a contract and is “subject to change by (Hooters) without notices.”

“Hooters has retained for itself the right not to be bound by the terms of its own arbitration agreement,” West told the judge. “They can’t have a contract when it favors them and not have a contract when it doesn’t favor them.”

Hess cited procedural and fairness issues in coming to his decision. He said most contracts are agreements between equals with the same power to “dicker” in their best interests.

Hooters’ handbook, on the other hand, is a “take or leave it” agreement in which an employee’s refusal to sign would probably lead to an employment offer being withdrawn. Berry, Hess wrote, was at an unfair disadvantage.

Hess wrote that Hooters now wants Berry held to an agreement that was never intended to bind the company.

“The long-standing rule of law is that unconscionable contracts will not be given effect,” Hess wrote. “The defendant’s motion, therefore, is denied.”

via Free Republic

Contracts that “bind you but not me” are a real pet peeve of mine.  I am glad to see one thrown out as “unconscionable”.

“Doctors on social media share embarrassing photos, details of patients”

Some doctors have misgivings about employing social media in the service of patient care: “What if one finds something that is not warm and fuzzy?” frets resident physician Haider Javed Warraich in a post this week on the New York Times’ Well blog. Despite his reservations, Warraich defends the practice, pointing out that doctors have used online intel to gauge suicide risk, discover relevant undisclosed criminal histories, and contact the families of unresponsive patients.

Social networking was also helpful on the day of the Boston Marathon bombing. Doctors near the finish line tweeted accounts of the attack to local emergency personnel six minutes before official announcements were made, giving staff critical time to prepare for the arrival of victims.

But until the utility of online sharing in health care contexts becomes obvious to hospital operatives, they’ll continue to view it the way the rest of us regard twerking—if we ignore it long enough, surely it will just go away. Nearly 60 percent of the health care professionals surveyed by InCrowd report having no social media access in clinical settings at work.

The American Nurses Association, American Medical Association, and other trade groups have tried to soften administrators’ hard line by setting standards for social media use in the workplace. They’ve published guidelines packed with nuggets like “Pause before you post” and “Be aware that any information [you] post on a social networking site may be disseminated (whether intended or not) to a larger audience.”

via Slate

This really isn’t as difficult as Slate makes it seem.

Social media employing any potentially identifying information should be permissable if and only if there is a clear benefit to the patient, and privacy precautions are taken.

It’s really that simple.

There’s no reason why doctors need to be digging around or worrying about patients’ undisclosed criminal history, and there’s certainly no reason why we ought to view privacy violations as inevitable.

The life-saving nature of certain types of tweet (for example, the doctors who seek help in assessing suicide risk) may suggest that some types of privacy violations may seem justifiable, but there is no reason why professionals should not be held to roughly the same standards as other life-saving professional ethical codes with regards to judgment calls, and full privacy protections should only be waived if for some reason adhering to them might cause serious harm.

Professionals who don’t take privacy seriously should lose their license and face criminal charges. If the profession won’t police itself, the entire profession will suffer a loss of credibility – patients will rightfully lose faith and trust in doctors.

The issue seems somehow more complicated than this in the Slate article because they use examples that border on dishonesty: why would they even include the Boston Marathon bombing incident? What possible reason could they have for treating that situation as if it were somehow in the same category as the incident with the nurses who posted private patient photos on their Facebook pages? The Boston Marathon case could not have involved privacy violations, since the tweeters were writing about what they’d observed in a public situation.

Under no circumstances should patient information be uploaded to any site for reasons that are not beneficial to the patient. Nobody should be afraid to seek medical help for fear that he will end up on a Facebook page, ridiculed by the so-called professionals.

A good rule of thumb might go like this:  if you would be embarrassed, ashamed, or afraid of what people might think if the person whose information you posted found out what you did, you are probably committing a crime.

In 1999 the California HealthCare Foundation issued a report titled “The Future of the Internet in Health Care: Five-Year Forecast,” by Robert Mittman and Mary Cain of the Institute for the Future… overall, the forecast proved remarkably prescient. Its conclusions about online privacy foreshadow the equilibrium most contemporary patients and providers have reached: “[T]here will inevitably be several well-publicized incidents of people being harmed by public releases of their health care information—those exceptional cases will shape the debate,” the report predicts. “[I]n the end, people and organizations will have to learn to live with a less-than-perfect combination of technologies and policies.”

There’s “less than perfect”, and then there’s just professionals who aren’t behaving according to professional standards.

“Should Facebook, Yahoo, and Twitter really judge what’s news?”

Where did you first learn about Amazon’s crazy plan to deliver packages via drone? “60 Minutes”? The New York Times? Increasingly, the answer is likely to be Twitter, Facebook or Yahoo, and that’s just how the online giants like it.

Those companies aren’t news providers in any traditional sense, but they’re trying harder to become the go-to place where their users learn about current events. It opens up new streams of revenue for the companies, but some experts wonder what it will mean for how we consume news.

”Facebook’s algorithms don’t spring out of nowhere,” said Jeremy Gilbert, who teaches media product design at Northwestern University’s Medill School of Journalism. “Why does Google favor one source over another?”

They are not necessarily malevolent forces, but Internet companies’ power to influence what citizens read and see—and what they don’t—is becoming greater.

via PCWorld.

An education problem – when now even many teachers don’t understand why Wikipedia isn’t the same as a credible source, when Encyclopedia Britannica has almost as many errors, and the mainstream news sources have cut back on reporters in favor of more reliance on press releases, unsourced stories, and even outright op-ed masquerading as news….do we even have any such thing as a credible source?

The problem is that access to reliable information is necessary to a functioning civilization – it is necessary for economic growth, for political well-being, and for social cohesion.