Wondering on Wednesday 12/14/22

 

Ready... Set... Wonder!

In no particular order, I'm wondering tonight about holiday parties. You know, the kind we host or attend, with family, or coworkers, or friends and neighbors. Or, you know, the kind attended by Associate SCOTUS Justice Brett Kavanaugh. The party in question was hosted by "far-right operative" Matt Schlapp, who runs the Conservative Political Action Committee (CPAC), the group that's hosted both Donald Trump flag-kissing events and Hungarian right-wing strongman Viktor Orban. 

In a planned leak of party attendees, Kavanaugh's name is at the top of the list; other names below his include some with business before the Court. The linked article provides some details on that, and also notes

If Kavanaugh was a judge in any other federal court, his attendance at Schlapp's party might have violated Cannon 2 of the Code of Conduct for United States Judges. Specifically, Kavanaugh is permitting Schlapp and others to, at a minimum, "convey the impression" that they have special access.  

A judge should neither lend the prestige of the judicial office to advance the private interests of the judge or others nor convey or permit others to convey the impression that they are in a special position to influence the judge.

We know Kavanaugh's not the only one, nor are the conservative justices alone on stuff like this. But with all the focus on Justice Clarence Thomas, his wife Ginni, Justice Samuel Alito and his parties, and the leaks, I can't help wondering why Kavanaugh didn't just find a quiet bar somewhere to share some holiday cheer. 

Speaking of "all the focus on" people, I'd be remiss if I didn't mention Brittney Griner, the WNBA star and world's most famous vaper. Griner, you know, was released from her Russian prison camp in an exchange for convicted international arms dealer Viktor Bout who had served more than half his 25-year sentence. Not released along with Griner? Former Marine Paul Whelan, who's been held in Russia on espionage charges. 

I don't know enough to talk intelligently about whether any trade for Bout would have been a good idea, and I certainly don't know diddly about the negotiations that led to the exchange. All I do know is lots of people were arguing about whether we should have brought home the vaping 'woke' black lesbian National Anthem protestor, or if we should have brought home the white former presumably straight presumably non-vaping Marine.

Noticeably missing from any of the arguments? The fact that Whelan was a staff sergeant in the Marines, until he was busted down to private, and was given a bad conduct discharge. I have to wonder this: if people were as aware of his military history as they are of her National Anthem history, would they think he was really all that much better a trade? 

And speaking of history, there's Texas, which has a long history of interjecting into things that the government doesn't really need to get involved in: keeping pregnant women on life support against their wishes, or providing bounties to folks who report women seeking health care, or wanting to investigate parents of trans children for child abuse, for example.  

And, we learned, the Lone Star State is still interested in interjecting where it doesn't need to be. As the WaPo reported, Texas AG Ken Paxton went looking for info on transgender Texans. 

“Need total number of changes from male to female and female to male for the last 24 months, broken down by month,” the chief of the DPS’s driver license division emailed colleagues in the department on June 30, according to a copy of a message obtained by The Washington Post through a public records request. “We won’t need DL/ID numbers at first but may need to have them later if we are required to manually look up documents.”

That's what Department of Public Safety staff were asked to provide, based on a verbal request from Paxton. And they found "more than 16,000 such instances," which led them to tell the AG they couldn't provide the data he asked for.

So, what's the wondering, you're wondering? Simply, this: what the actual hell is going on down there? What compelling government interest is there in having this data? Is it because their plan to charge parents got shot down, so they're going to attack adults instead? Or is it because Paxton's a Texas-sized jerk? 

What's got you wondering these days?

Another Heartbreaking Case from Texas

Health care is a very touchy subject under the best of circumstances - ask any politician who's had to vote on giving or taking away any kind of health care itself, or, more often, giving or taking away health insurance. Ask a judge who has to rule on any case related to either health care or health insurance - there's no fun there, as we've seen. 

For folks in Texas, though, the issue seems even more fraught than usual - again. Here's some history on the twisting, turning journey that can be health care in the Lone Star State. 

In April of last year, I posted about the host of bills before the Texas legislature that would allow people with deeply held beliefs to not provide care to LGBTQ Texans. Here's a snippet.

...would allow state-licensed professionals to refuse to serve LGBTQ people if they cite their religion has advanced out of committee in the Texas senate.  Senate Bill 17 would prevent state licensing agencies from denying or revoking licenses from professionals - including doctors, lawyers, pharmacists, and even barbers - if they claim to be following a "sincerely held religious belief."

I noted that, while the bill protected some folks from having to violate their beliefs, that protection didn't extend to everyone.

It's OK though - apparently law enforcement officers have to keep their religious beliefs in check, and even doctors will have to set their beliefs aside for "life-or-death" situations.

And remember, the same Texas that wants to make all of these discriminatory protections for some of their residents and against others, is the Texas that already discriminates against the moral convictions of people, based I guess on the deeply held beliefs of the state, not even the beliefs of an actual person.

That's right: Texas already discriminates against people who want to control health care decisions for family members - but they can't do that if the patient is pregnant. Here's a snippet from my post in 2014 on the horrific case of the Munoz family. 

Marlise Munoz, a mother in her 30's and an EMT, was found unresponsive by her husband Erick, who's also an EMT. He did what he could to try and revive her, as did folks at the hospital, but ultimately the were unsuccessful and Marlise has been on life support since November 26^th, after suffering what doctors believe was a pulmonary embolism. She's being kept alive mechanically, even though her husband has indicated that he and his wife had specifically discussed not wanting to be kept alive on machines; her parents agree. 

And yet, there she lies, brainwaves flat, machine-supported. 

Why? Because Mrs. Munoz was pregnant – 14 weeks at the time of her collapse, now nineteen weeks or so - and under Texas law, life support cannot be withdrawn from a pregnant person. 

That case was the subject of a documentary, 62 Days, covering the family's fight to change the laws that were used to wreak havoc on them. 

And now we have another Texas case full of conflict. I can't decide if this one's worse than the Munoz case, or if it's merely just as horrifying. Here's some info from the WaPo article that brought this one to my attention, about a child named Tinslee Lewis.

Inside a Texas children’s hospital, an 11-month-old girl lies paralyzed and in constant pain. She can breathe only with a ventilator. A suite of medications keeps her alive. 

Tinslee’s condition, doctors say, will never improve. 

The article also notes that every medical procedure performed "causes more suffering," even changing her diaper - and, perhaps most horrifying,

Tinslee also experiences "dying events" that require aggressive intervention two or three times per day. 

The hospital has tried to find another facility that will take her, but so far more than 20 have refused, saying they couldn't correct her condition; the hospital now wants to end life support. A judge has refused to approve an injunction  to continue her care, a decision the baby's mom, Trinity Lewis, is planning to appeal. 

The article points out that this case, like the others, goes beyond what's legal and into what's ethical - something that we - regular folks, politicians, and activists on both sides of the 'life' issue - apparently don't agree on.

Texas AG Ken Paxton argued in a letter to the court that "the Texas law that allows doctors to discontinue treatment violates patients’ constitutional right to due process." On the other hand, though, "The Texas Catholic Conference of Bishops and the Coalition of Texans With Disabilities, among other groups, are backing the hospital." There's also some disagreement on the part of the anti-abortion folks. 

While Texas Right to Life took Lewis’s side, the Texas Alliance for Life and the Texans for Life Coalition have said they agree with the doctors. 

Even folks in the medical ethics field are not aligned, it seems. There's a conflict between what doctors say - and how they say it - and what parents hear from the doctors, see in their child, or what they want to hear and see. The first comment below is from Charlie Camosy, a theology professor at Fordham. The second is from Ann Mongoven, associate director of the Markkula Center for Applied Ethics at Santa Clara University., again from the same article.

Two things get conflated here: One is the medical expertise of the doctors, in which case, they do know best. But determining whether this baby has a life that's worth living have very little to do with your medical expertise. It's an ethical question.  

They're not saying that [Tinslee's] life isn't worth living. What they're saying is, 'I am making her suffering worse, and my job is supposed to be the opposite.'

Professor Camosy leans towards letting the patient or their surrogate make the decision, rather than letting it fall to the medical experts. Mongoven pointed out that "the heart of the matter" gets obscured, no matter who makes the decision, and that

These cases get framed as political battles, when in fact there's a tragedy at the heart of the case that could pull people together. 

The tragedy would be there whether Texas had laws on the books for cases like this one, or the Munoz case from a few years ago, or that allow a practitioner to withhold services from a patient based on a 'deeply held belief'.'  The ethical questions would also be there, with or without any related laws.

But the question is, do the laws help in any way, or do they only make these situations worse? 

The Doctor-Politician-Patient Relationship

What is it with politicians, that they simply can't seem to keep themselves from getting in the way of things that really should be up to individuals to decide?

We've heard for years about how the government doesn't belong in the middle of the doctor-patient relationship, at least not as far as anything related to the Affordable Care Act is concerned, right? Except, of course, when we need the government to get in the way, we're led to believe.

We've gone through the battle on paying for contraception, even making legitimate allowances for actual religious organizations such as churches and their affiliates to not have to directly provide and pay for contraception, but leaving that up to insurance companies. And that hasn't been good enough.

And we've had the fight to make sure that companies that sell picture frames and baskets and similar decorative items also don't have to provide the full array of contraceptive methods to their employees because, well, because Republicans. And because corporations are people too, of course. We mustn't forget that.

The reason we have had the latter battles, the ones over contraception, are clear. Well, kind of,  Then-Representative (now House Speaker). Paul Ryan said back in 2012 that, when it comes to Catholics at least, what's constitutional is not up for discussion by mere mortals in the executive, legislative and judicial branches of our government - someone else owns that decision. Here's Ryan talking about covering contraception under the Affordable Care Act,after the religious opt-out was implemented:

The question is, can the government mandate that people violate their religious teaching, their conscience, their freedom of religion. Look, I can tell you as a Catholic the charities, and the hospitals, they don't enforce doctrine, they don't interpret it. It's the bishops and they're very clear in saying this is a violation of our constitutional rights. So it's an issue of constitutional rights and the government having the kind of power to trump them.

Seems we need the government to get in the way when the religious leaders tell us to, I guess, to help us understand what our constitution means. Except, of course, when the religious leaders say things that the politicians don't like, then all bets are off.

We've had the battle over paying for discussions about end-of-life care decisions - you know, health care proxies, DNRs, living wills, and MOLST and POLST forms, and things like that. We've learned how those critical documents, designed to ensure that a person has the right to define their own wishes and courses of treatment - and that others must honor those wishes - became death panels.

And we need a government to insert itself between patient and doctor in other cases too, such as keeping a person on life support - or taking them off - against medical advice or against patient and family wishes.

In this post from January 2014, we have both sides of that coin. On the one hand, we have a woman who was kept on life support against her wishes, because she was pregnant and in Texas. Because in Texas, where everything is bigger including their smaller government, it's illegal to remove life support from a pregnant woman, no matter the circumstances. The courts eventually ordered life support to end, after what I would only describe as eight weeks of torture for the family. I later found out that it's not just Texas where this type of 'pregnancy' exclusion applies.

On the other hand, we have a teenager who suffered complications during surgery to help relieve her sleep apnea, and was declared dead with no brain activity. In this case, the family believed their child was not dead, even though a host of medical professionals hired by the hospital, the family and the courts concluded she was. The court eventually allowed the family to move their daughter to a facility in another state where she could be 'treated', if that's the right word. Today, she is still 'alive' on machines. Legal actions drag on.

And now, it seems, we need a government to interject itself between the doctor and patient again, specifically when we're talking about a different type of end-of-life care.

Washington DC passed a bill allowing assisted suicide, the Death with Dignity Act. Under the rules, Congress has 30 days to overturn anything DC passes, but it was unable to get the overturn votes and a Trump signature in time. The DC bill survives -- for now -- as do bills in a handful of states that have made assisted suicide legal, allowing patients to truly and finally control their own destiny.

I can't help thinking we won't have to wait long belong before the next time the politicians will come into the examining room with us again. Because, as I noted above, they simply can't help themselves.