Monday, June 25, 2012
Sunday, June 24, 2012
The Handmaids tale arrives in FL
Court-Ordered Care--A Complication of Pregnancy to Avoid
Julie D. Cantor, M.D., J.D.
N Engl J Med 2012; 366:2237-2240 June 14, 2012
Samantha Burton was 25 weeks pregnant when her membranes ruptured. Burton's obstetrician admitted her to Tallahassee Memorial Hospital (TMH) and prescribed continuous inpatient bed rest. But with two young children and a job to consider, Burton found the prospect of a 3-month hospital stay overwhelming. She decided to go home. When she tried to leave, authorities barred her exit.
Soon, the machinery of court-ordered care started rolling. TMH's outside counsel, deputized by the local state attorney to act on Florida's behalf, petitioned for judicial approval to force Burton to follow doctors' orders. Within hours, the court heard argument from the hospital, state attorney and testimony from the obstetrician, now considered the unborn child's attending physician.1 Burton testified by phone from the hospital, without counsel.
The next day, the judge gave TMH, any attending health care provider, and members and employees of the original obstetrician's practice permission to administer any care they deemed necessary to preserve the fetus's life and health.1 He ordered Burton to comply and denied her request to change hospitals. Within days, doctors delivered a dead fetus by cesarean section. . . .
Moreover, the due-process considerations are profound. Because these cases are usually heard on an emergency basis, judicial decisions are made without full briefing on relevant law, medicine, and policy. Unlike alleged criminals, patients have no Sixth Amendment right to counsel, and they cannot instantaneously find expert witnesses to testify on their behalf. And hospital lawyers acting as state attorneys have a clear conflict of interest: as even the Supreme Court of Florida has noted, it is inappropriate for a hospital to argue zealously against the wishes of its own patient, and it cannot act on behalf of the State to assert the state interests when a competent adult refuses care (Matter of Dubreuil).
Coerced care also devalues the inherent risks to maternal health and life. Cesarean sections and blood transfusions are not risk-free, and bed rest is neither benign nor evidence-based. Obstetricians aren't omniscient and may defer to culture over data. Forced care also ignores individuals' and families' values, reinforces inequality between the sexes, threatens to drive women from care, and condones a culture of coercion. And the notion that court-ordered care will insulate providers from litigation seems misguided -- courts should be unsympathetic to patients with refusal remorse, lest they eviscerate the concept of informed consent, and an informed refusal, unaccompanied by malpractice, should be a shield from civil and criminal liability. Of course, subjecting a patient to forced care, even court-ordered care, may lead to a lawsuit for violations of civil and constitutional rights.
Finally, there's the slippery slope. As a Florida Supreme Court justice explained, forced care that is designed to protect the health of the fetus creates its own universe of troubling questions. Should the State have the authority to prohibit a pregnant woman from smoking cigarettes or drinking alcohol, both legal activities with recognized health risks to the unborn? (In re Guardianship of J.D.S.). Should pregnant women be prosecuted for adverse outcomes when they reject medical care? Should they be jailed until delivery? Such cases have already arisen. . . .
In 1976, a man dying of aplastic anemia sued his cousin, asking a court to order the forcible extraction of his potentially matching and lifesaving bone marrow. The court refused and explained, For our law to compel defendant to submit to an intrusion of his body would change every concept and principle upon which our society is founded. To do so would defeat the sanctity of the individual and raise the spectre of the swastika and the Inquisition, reminiscent of the horrors this portends (McFall v. Shimp).
Those horrors are no less salient here. Forced interventions undermine the liberty, privacy, and equality of pregnant women. But they are far more insidious. Because they betray foundational legal principles of our free society, they endanger the liberty of us all.
Wednesday, June 20, 2012
Low-cost spay & neuter grants for cats! Hurry!
The Willamette Humane Society has received a grant to provide subsidized spay/neuter surgeries for 350 cats whose owners receive federal or state income assistance.The Handsel Foundation, a family foundation dedicated to providing financial support to organizations working in the area of animal welfare, awarded the grant.
Families or individuals in Marion and Polk counties who receive some form of government assistance are eligible for the subsidized surgery rate of $20 to spay and $10 to neuter. Appointments are required, and the subsidized surgeries are on a first-come first-served basis.
Regular prices are $35 for a male cat neuter and $55 for a female cat spay.
The Willamette Humane Society Spay & Neuter Clinic is at 4246 Turner Road SE.
To make an appointment, call (503) 480-7729.
Monday, June 18, 2012
Awesomely cool
We have a few spots left for GeerCrest Farm'sFarm Life Experience!
Our Farm Life Experience Program is open to children from ages 8 to 16
Rates: $395 per week, including lodging and all meals and snacks.
Space available in the Following Sessions:
July 9 - 13, 16- 20, 23 - 27, 30- Aug 3,
Aug. 20-24
Go to our Farm's education page
Watch a video of education programs at GeerCrest Farm
GeerCrest is reviving the traditional homestead farm, where the multi-generational farm family grows a diverse supply of food, shares its agrarian way of life with children and promotes the welfare of its community. The Farm-Life Experience at GeerCrest Farm is based on the belief that children need to experience the daily rhythm of farm life because it gives them a foundation on which to grow into productive members of society.
GeerCrest Farm 12390 Sunnyview Rd NE Salem, OR 97317
Wednesday, June 13, 2012
More on the Disaster in the Making (vaccination refusals)
1. VACCINATION: THERE IS NO INOCULATION AGAINST INCOMPETENCE.Bob should have mentioned the damage done by bogus vaccination programs, such as the US used to get intel on Bin-Ladin in his hideout. Like planting CIA agents among journalists and Peace Corps volunteers, getting intel from agents disguised as vaccination program staff does serious long-term damage to the program being used as cover. Every journalist, medical aid worker, and vaccination program is endangered by such efforts.
Vaccination programs prevent more human suffering than any other branch of medicine. Their success depends on public confidence in their safety. But according to a report released last Wednesday by the U.S. Department of Health, spot checks by the Office of the Inspector General finds that free vaccines, provided under the nationwide Vaccines for Children program, are often stored at the wrong temperature, which can render them ineffective.
The first generation to receive MMR vaccinations are now parents. They have been spared not only the direct misery of the illness, but also serious side effects that can show up many years later. They should be the first to demand strict standards of safety and effectiveness in administering vaccines. Someday perhaps, eradication of pathogenic diseases will be routine, but were not there yet. What prevents it?
2. ERADICATION: FIRST WE MUST CURE THE WORLD OF ITS SUPERSTITIONS.
In 1977, smallpox, the most deadly and persistent human pathogenic disease, was eradicated from Earth by the World Health Organization following an unprecedented agreement allowing quick-response teams to freely cross every a border to administer vaccine in case of an outbreak. It was a moving demonstration of what can be achieved by world cooperation, and was quickly followed by calls to eradicate poliomyelitis. Polio eradication was undertaken by WHO in 1988 with help from private organizations, but although the number of polio cases diagnosed each year has plummeted, final eradication remains elusive. Opposition by Muslim fundamentalists is said to be the major factor in the failure of polio immunization programs. In Pakistan and Afghanistan the Taliban issued fatwa opposing vaccination as an attempt to avert Allah's will, while others saw it as an American plot to sterilize Muslims. Some conservative Christian groups oppose vaccination for diseases that are transmitted spread by sexual contact, arguing that the possibility of disease deters risky sexual contact. It doesn’t.
Sunday, June 10, 2012
On reducing the shortage of donated organs available for transplant
I've been thinking about the terrible shortages of organs for some time, and I keep coming back to the question of whether we shouldn't do several things:
1) Pass laws making organ donation the default position for everyone in society -- that is, it is assumed that your organs are available for donation to whomever will benefit unless you take specific, positive action to refuse donating your organs when they are no longer doing you any good; AND
2) Revise the rules on who gets the donated organs to put adults who refuse the default position and their children at the bottom of recipient lists.
That is, if you are unwilling to donate your organs, you will only be given donated organs when there is no more suitable candidate for a transplant available who is also willing to be a donor for others. And if you have opted out your children, same rule applies -- children of those who exempt themselves from donating will only be given organs from a child donor if there is no more suitable child available who can benefit from those organs.It sounds terribly brutal or even bigoted to see it stated that way, though my intent is neither to be brutal nor to harm people of any religious group. But in a pluralistic society where there are far more people who need organ transplants than there are donors, something has to be done to increase the odds of people donating. It seems just (as in justice) to have organs preferentially given to those who have indicated a willingness, were the roles reversed, to be the donor as well as the donee. It doesn't matter whether your organs are medically fit such that they would be accepted, it's whether or not you positively opted out when you didn't know whether you would need them that matters.
More importantly, this avoids the whole "Why shouldn't we let the rich arrange with the poor to sell their organs?" problem that crops up now and again. The proposal above is even-handed and avoids any hint of privilege based on anything but your own willingness to contribute into the system that might benefit you in the same way that you might benefit.
Thoughts?
Coal is the enemy of the human race, the slow "screw the future" suicide system
This is an excellent post by Cliff Mass, UW meteorologist on his weather blog, on why coal trains are a REALLY BAD IDEA for the environment & human health.
Also, Professor Dan Jaffe, of UW Bothell, has documented the substantial contribution of Asian pollution to our background pollution levels (see here for one story on this). This is really scary stuff!
Here are some highlights. Want to see the coal dust blowing off a coal train? Click on this image to see a video of a coal train in British Columbia...you will see HUGE amounts of dust blowing off into a scenic river basin:
http://www.youtube.com/watch?v=jixOquzgNqk
Even worse...once the coal gets to China they burn it, producing all sorts of particulates and gases that then moves across the Pacific to worsen regional air quality problems here in the Northwest. In fact, Professor Dan Jaffe, of UW Bothell, has documented the substantial contribution of Asian pollution to our background pollution levels (see here for one story on this).
Saturday, June 9, 2012
Disaster in the Making: More Oregon parents not having kids vaccinated
The move among parents to resist vaccination for children is depressing on many levels. The worst part is realizing how, given that all too soon we're going to have plenty of problems getting the tax revenue necessary for maintaining first-world levels of public health in the first place, some parents are voluntarily creating non-vaccination issues to boot.
There's no easy answer. Our legal systems treat children as little more than pets, items of property. Thus, the property owners (aka parents) can refuse vaccinations of their "property" without consequence to themselves, but with plenty of consequence to others, and sometimes to the non-vaccinated children.
For good reasons, we've got seatbelt laws, and laws that forbid letting kids ride in the back of open pickup trucks. But the law makes it easy for parents to claim a religious scruple against vaccination of their children. What's the difference? There used to be lots of arguments about how seatbelts made certain crashes more dangerous. Of course, those arguments are mostly bunk, like the arguments about vaccinations. But if we let parents expose their kids to serious and occasionally fatal diseases through failure to vaccinate, why can't parents decide whether their kids should wear a seatbelt?
Friday, June 8, 2012
Two and three weeks out -- a great great ride and a great party benefiting a great place
Third Annual Hoedown & Silent AuctionSaturday: June 30, 2012
Join The Pagan Jug Band and Special Guests for the third Annual Farm Benefit with Silent Auction & Hoedown! Come out to the farm and camp for the weekend, bring your family, Bring An Instrument For Jams, definitely bring your dancin' feet ... biggest bonfire in town, camping under the stars, and of course music, music, music!!!
Local food and beverages will be available for purchase.
In the historic and (incredibly) scenic Waldo Hills!
- $5 -$20 donation per person, kids 12 and under free, camping available - (see below)
- Optional Sunday Brunch - (see below)
- Sorry, No Dogs Allowed
- 2:00 pm Gates open to campers - (see below)
- 3:00 pm Gates open to public, games and activities begin
- 4:00 pm Live music begins with WhistlePig, Route 41, and The Pagan Jug Band
- 5:00 pm Silent Auction begins
- 9:00 pm Silent Auction ends
- Bonfire begins at dusk.
$20.00 - Camping (tent)Please register your camping space in advance. Space is limited, and we cannot guarantee room will be available on the day of the event. To reserve a camping spot, please email us or call us at: 503-873-3406.
Note: We reserve the right to refuse campers that do not accommodate our family atmosphere.
- $20 camping fee (tent)
- $30 camping fee (trailer)
Brunch will be available between 9:00am - noon, and is a full menu, buffet-style brunch including beverages. Tickets for brunch must be purchased by Saturday before 9pm.
- $10 adults (13 and up)
- $6 kids aged 4-12
- FREE ages 3 and under
Petal Pedal
Saturday June 23, 2012
Cycle the Summer Solstice!
- A gourmet distance ride in the Willamette Valley.
- Blooming fields of flowers along serene, low traffic routes.
- Free Hopworks beer & gourmet dinner at the finish line.
- World class support from start to finish.
- On site boutique hotel amidst 80 acres of gardens.
- Campout under the stars at Historic GeerCrest farm!
Petal Pedal is a gourmet distance "Century" bike ride like no other. You'll journey along scenic, quiet roads along mostly flat routes (with a hilly option to visit Silver Falls) as you drift away to another world.
Description: The ride starts and ends at The Oregon Garden, Oregon's premier botanical garden with over 80 acres of specialty areas. Your ride pass includes
- breakfast
- lunch
- gourmet dinner
- free beer
- full support
- access to the garden.
Petal Pedal is a fully supported ride with three distances to choose from 100, 60 or 30 miles. You will enjoy riding on quiet rural roads, passing waterfalls and wineries, with friendly rest stops every 15 miles.
Plan to stay all weekend and explore Silverton, the friendliest town in Oregon, and the surrounding area.
Just $10 a night for camping or only $15 for both Friday & Saturday nights. Add $10 for Sunday Brunch ($5 for kids up through 12). Register via PayPal here.
Oil addiction generates denial | Energy Bulletin
A choice bit:
Little time left to deal with our addiction
Rising gasoline prices should ideally be welcomed as a warning of what is soon to come. One of the keenest observers of the geopolitics of oil and the precarious nature of our U.S. oil dependence is Michael Klare.
Because the American economy is so closely tied to oil, it is especially vulnerable to oil’s growing scarcity, price volatility, and the relative paucity of its suppliers. Consider this: at present, the United States obtains about 40% of its total energy supply from oil, far more than any other major economic power.We will now have to prepare for major economic changes and high gas prices. Oil and politically sensitive gasoline prices have receded in price the last month, but this is in no way a sign that our lives can return to the cheap oil era of the past. We are busily preparing to fight Iran. The energy wars are heating up globally . The hour is getting late.
Klare now calls on Obama to be honest about the true gravity of our current situation.
President Obama has to be honest with the public. There is no solution to high prices, other than a change in the behavior of our energy use, because there is no cheap oil left on the planet. We have to begin a process of converting to alternative forms of energy or alternative forms of transportation. And he has to be honest.