These charges are very serious and in response, University of Wisconsin School of Medicine and Public Health and University of Wisconsin Medical Foundation, the UW Health entities that employ the physicians, have immediately launched an investigation of the reported behavior.
It's good politics and good public relations to take this seriously, of course, but I think the outcome is predictable.
The investigation will identify which UW Health physicians were involved and whether their behavior constituted violations of medical ethics or University of Wisconsin and UW Health policies and work rules....
I don't know the details of the rules or medical ethics, nor do I have any inside information about the way my university handles such things. But I know how the doctors defended themselves when I confronted them, and I think their explanation will be accepted.
They said they were really "seeing" the individuals who asked for notes, and they individually listened to their "patients" reports about what their symptoms were. I had a longer conversation with a second doctor and, like the one I interview on camera, he had his approach to ethics down pat: Doctors providing notes for employees accept their patients' statements about what their symptoms are all the time, and the people they spoke to on the street really did mention symptoms, such as headache, diarrhea, insomnia, and — notably — stress (including stress from the budget plan and the protests). This puts this within the range of something doctors routinely do.
I'm not saying that's the right resolution, but I predict that will be the result of the investigation, perhaps with a public-appeasing, forward-looking statement that doctors ought to avoid the appearance of impropriety by refraining from this activity in the future.
"But 'social justice' is frequently just a euphemism for a socialist political agenda of leftist politics, redistribution of wealth, and heavy state controls over the marketplace."
Says Paul Hsieh (via Instapundit) in the context of explaining those Wisconsin doctors writing excuses for protesters — and tweaking our anxieties about Obamacare.
The Wisconsin protests have shown how some doctors are seemingly willing to subvert their professional integrity to serve the political ends of government special interest groups. Under ObamaCare, when similarly trained doctors have to choose between practicing in their patient’s medical interests or in the political interests of their government paymasters, which side will they choose? And will you want this new breed of doctor taking care of you when you’re sick?
Interesting questions, but to be fair, the doctors handing out the notes were helping individuals, not burdening the individuals for the sake of the greater good. Hsieh links to me and says:
University of Wisconsin law professor Ann Althouse spoke with one of these doctors who was completely unapologetic for his actions, saying that it was “not dishonest” but rather “an ok thing to do” because it was in the interest of “social activism.”
To be extra accurate: I ask the man if what he's doing is "dishonest," and he says, "It's not dishonest. It might be a little social, oh, gosh, what do you call it?" I say "Activism?" He seems about to say one thing, the stops himself and says "It's an okay thing to do" then goes on to talk about how teachers matter a lot to him. He notes that he is genuinely "seeing" the patients (on the street corner) and they do have their symptoms. It's not the most explicit embrace and promotion of social activism. Indeed, he may very well be motivated by nothing more than a desire to help the nice teachers so they won't get in trouble at their jobs.
That said, I'm concerned about the general trend of medical ethics in the form of "social justice" ideology, if that's really what is going on. Is it?
I saw these people myself today. At first I thought it was some sort of comic street theater, but it was, apparently, real doctors, defending what they were doing. I'll have my video interview up soon. I asked if it was dishonest or unethical, and the answer was that everyone has symptoms, perhaps a migraine, diarrhea, or insomnia. I suggested "activitis."
UPDATE: My video:
UPDATE 2: I spoke to another doctor — I assume he's a doctor — and I asked him whether he was worried, with all the cameras here, about his reputation. He said no. But he didn't use a political defense. He didn't say he supported the protesters and wanted to help them. He said people really do have symptoms, and it's a normal thing for doctors to believe patients who report symptoms and to write excuse notes for them. People call doctors all the time to get the required notes, and doctors trust the patients to report their symptoms properly. He ticked off the symptoms I've listed above.
Furthermore, if papal organs were donated, they would become relics in other bodies if he were eventually made a saint.
I don't know enough Catholic theology to understand what's wrong with a saint's relic functioning in someone else's body. Saints are supposed to help us out only in ways that that are unachievable by ordinary dead people?
Many hospitals allow and even encourage recording because modern cameras, particularly those taking video, are so unobtrusive. But that same technology has introduced a wild card into a fraught scene that could shock a jury — with the mother screaming and staff responding (or not) to what may look like an emergency — all of which can be edited to misrepresent what actually took place....
“When we had people videotaping, it got to be a bit of a media circus,” Dr. Tracy said, adding that the banning of cameras evolved through general practice rather than a written policy. “I want to be 100 percent focused on the medical care, and in this litigious atmosphere, where ads are on TV every 30 seconds about suing, it makes physicians gun shy.”...
Dr. Elliott Main, chairman of obstetrics and gynecology at California Pacific Medical Center in San Francisco, which also allows filming of births, said, “The modern approach is not to ban cameras but to do drills and practice.”
“Where you get into trouble is where people panic or don’t know what to do next and have blank looks on their faces,” he said. Videotaping simulated births, he said, can help the medical staff adjust their behavior.
Now, part of medical training is: Acting!
Look like you're doing the right thing, even when you're confused and you know you're hurting someone. That would be a good approach even without the cameras, but medical personnel — like politicians — need to adjust their demeanor and expression for the world of YouTube.
1. In the Boston Globe, a Harvard nanophysics researcher named Mike Stopa says the term "death panels" "persists... because it denotes, in a pithy way, the economic realities of scarcity inherent in nationalizing a rapidly developing, high-technology industry on which people’s lives depend in a rather immediate way."
2. The NYT reports that "The Obama administration has become so concerned about the slowing pace of new drugs coming out of the pharmaceutical industry that officials have decided to start a billion-dollar government drug development center to help create medicines."
Life and death — it's economics, and the government is here to help.
Here's a discussion point for the comments: Is "First, do no harm" a good conservative principle, making this flag something other than mockery of the liberal's call to civility? Or does the presentation of government as medicine work as a critique of liberalism?
The couple, who have three sons and still grieve for a daughter they lost soon after birth, are going to the Victorian Civil and Administrative Tribunal to win the right to select sex by IVF treatment....
The man said: "After what we have been through we are due for a bit of luck. We want to be given the opportunity to have a girl."
The woman, who is consumed by grief over the daughter who died soon after birth, admits she has become obsessed with having a daughter and it has become vital to her psychological health.
Victoria's Assisted Reproductive Treatment Act 2008 bans sex selection unless it is necessary to avoid the risk of transmission of a genetic abnormality or genetic disease to a child.
How would you analyze this question? Abortion is legal there, and the woman has already used abortion as a method of sex selection. The case is about who may have access to advanced treatments.
The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.
Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves....
Get ready to be prompted to sign a document that will sound helpful and reasonable. The advance directive. Don't you want the autonomy and control that comes from deciding in advance that you don't want people to try to save your life?
“While we are very happy with the result, we won’t be shouting it from the rooftops because we aren’t out of the woods yet,” [said the office Representative Earl Blumenauer of Oregon*] in an e-mail in early November to people working with him on the issue. “This regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the ‘death panel’ myth.”
Moreover, the e-mail said: “We would ask that you not broadcast this accomplishment out to any of your lists, even if they are ‘supporters’ — e-mails can too easily be forwarded.”
The email said email can be too easily forwarded. Ha ha ha. And now, here it is, quoted in the NYT, cut and pasted into blogs.
The e-mail continued: “Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response. The longer this goes unnoticed, the better our chances of keeping it.”
In the interview, Mr. Blumenauer said, “Lies can go viral if people use them for political purposes.”
But it's not a lie. You may not like the label — no labels! — attached to the policy, but the policy itself is understood — understood and presented in an inflammatory way that precisely counterbalances the soothing, lulling tones used by people who like it.
Sarah Palin, the 2008 Republican vice-presidential candidate, and Representative John A. Boehner of Ohio, the House Republican leader, led the criticism in the summer of 2009. Ms. Palin said “Obama’s death panel” would decide who was worthy of health care. Mr. Boehner, who is in line to become speaker, said, “This provision may start us down a treacherous path toward government-encouraged euthanasia.” Forced onto the defensive, Mr. Obama said that nothing in the bill would “pull the plug on grandma.”
Well, you will pull the plug on grandma, but only after grandma has signed the document the doctor explained to her long before she got into the situation she's in now, back when it seemed like autonomy and control.
“Using unwanted procedures in terminal illness is a form of assault,” [said Dr. Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Service].
The question is what do patients want and how what they want will be determined. It seems to me that the effort is to get people to commit in advance to death-hastening choices, by getting everyone to sign these documents. Now, all the new regulation seems to do is to authorize Medicare reimbursements for the time health care professionals spend counseling patients about the value and importance of signing the document. It's hard to see what's wrong with that. If treatments are covered but advice about forgoing treatment is not covered, then there's an incentive to do expensive things.
In a recent study of 3,700 people near the end of life, Dr. Maria J. Silveira of the University of Michigan found that many had “treatable, life-threatening conditions” but lacked decision-making capacity in their final days. With the new Medicare coverage, doctors can learn a patient’s wishes before a crisis occurs.
Treatable? You have a condition that can be treated, but you can't think well enough anymore to decide whether you'd prefer to die? If you've signed the document, the answer is you'd rather let the condition kill you, because you allowed the doctors to "learn [your] wishes before" this "crisis" occurred. You didn't know what the crisis would be or how you would feel when it happened, but you had "wishes" then and these will be taken as your "wishes" now.
"I looked the doctor in the eye, and I said, 'Am I going to die?'?" Jessica recalls.
"He looked at me and didn't say anything. That terrified me. I thought to myself, Is this it? It can't be. I have my whole life ahead of me. When you're 16, the last thing you think is that you're going to be facing you own mortality."...
Jessica needed an immediate heart transplant, but no matching hearts were available, so surgeons implanted a device into her abdomen to pump for the decimated left side of her heart. The left ventricular assist device (or LVAD) connected to a battery pack outside of her body. It would keep Jessica alive during the nine-month wait for a heart.
Still, she was determined to live the life of a normal teenager. With a prosthetic left leg and carrying the LVAD, she went back to school in November.
"One of my biggest fears is missing out on life and not making the most of it," she says. "I wanted to participate in as many high school activities as I possibly could, and my friends and my family and my community rallied around me."
She was a lead in the school musical "How to Succeed in Business Without Really Trying." She went on the choir trip to Disney World, was secretary of the school's glee club and made National Honor Society. Her classmates named her prom queen that spring.
On page 2, at the link, you can see the beautiful prom-queen picture. That's with the LVAD and the prosthetic leg, not long before the donor heart became available.
I was touched by this story. (There's also an angle about the coach having Lou Gehrig's disease, and her team won the state championship only because she finished.) But I wonder if officials should allow a kid who's collapsed to keep going.
[A]n assistant coach... said that if [Holland] Reynolds had appeared to be in immediate danger, he would not have let her continue. “I would have picked her up and carried her straight to the ambulance,” he said. “But she was able to make eye contact with me. Her body was tired, but she was mentally all there.”
Is that medically right? If a kid collapses playing sports but makes eye contact, she's not in immediate danger?
Check the video. The breakdown begins at 19:30. Should this be celebrated in the national press, or should we worry that encouraging kids to this point risks death or serious injury?
Police in Idaho have arrested a woman who impersonated a plastic surgeon so she could carry out breast exams to random strangers....
The victims said they believed [Kristina] Ross because she used medical vocabulary.
She said Ross even gave them a phone number to an actual plastic surgeon's office in order for them to make follow-up appointments.
Ross is charged with a felony — "practising medicine without a licence." Oh, blech, it's the Daily Mail. Why do I keep reading that lurid trash! The charge is practicing medicine without a license. Oh, what bullshit. She wasn't practicing medicine. She was lying to ladies in a bar.
The Daily Mail also makes a big deal out of the fact that Ross's "gender category" is "male to female."
I love the way the paragraph I took that quote from has one hot link — you know those links the NYT throws in that take you to other NYT articles? — and the link is on the word "marijuana." I know and you know what marijuana is, but what about Marfa? Eh. You either get the joke or you get that it is a joke... and move on.
Move on to the odd news about what would otherwise not be news — that you can make a lot of money growing and selling marijuana. But look! There's art in there. And pretty people. And it's medical marijuana...
At a going wholesale rate of $200 or more an ounce in the Bay Area for high-quality medical marijuana, it’s a lot simpler than raising money the traditional way, the project’s organizers point out. And — except for the nagging fact that selling marijuana remains a crime under federal law — it even feels more honest to the people behind Life Is Art. They see it as a way of supporting the cause with physical labor and the fruits of the land instead of the wheedling of donors, an especially appealing prospect in an economy where raising money has become more difficult than ever.
The nagging fact that selling marijuana remains a crime under federal law... which is so unenforced that pretty people pose in the New York Times with their pitchforks in American Gothic japery in the company of their big, sunlit marijuana plant. Tell me, how will it ever be possible to enforce those laws again? And if they are not going to be enforced, how can we accept the continual degradation of respect for the idea that it means something for an activity to be a crime?
