Medical Progress? It's in the Eye of the Beholder

We have seen the degradation of protections for legal abortion services over the years; states have used a number of methods to make it harder for women to get an abortion or or for an abortion clinic to operate, including regulations on the temperature of rooms at clinics, requiring providers to have admitting privileges at local hospitals to 'protect' the women, requiring other, usually unnecessary medical procedures, long waiting periods, multiple visits to clinics, and so on. And, anti-abortion protesters who pester women entering the clinics have been given wide latitude to 'educate' clinic patients on the error of their ways, regardless of what services they're aiming to receive.

As a century-old organization providing health care services, including  gynecological exams and mammographies, testing and counseling for STDs and yes, the country's largest provider of abortion services, Planned Parenthood is among the favorite targets of the benevolent lobbyists and legislators who aim to protect us women.  Things are about to get a whole lot worse, if the pro-birth extremists in Congress have their way, after a series of carefully edited videos (at least three so far) were released by the Center for Medical Progress (CMP), a 501(c)3 organization which self-describes as

...a group of citizen journalists dedicated to monitoring and reporting on medical ethics and advances. We are concerned about contemporary bioethical issues that impact human dignity, and we oppose interventions, procedures, and experiments that exploit the unequal legal status of human beings. We envision a world in which medical practice and biotechnology ally with and serve the goods of human nature and do not destroy, disfigure or work against them. 

The organization calls for defunding Planned Parenthood as the solution to these ethical issues. Under current law, it is illegal to use federal funds for abortion services, and Planned Parenthood does not receive any federal funding for those services.

The videos admittedly paint an unflattering picture of certain Planned Parenthood officials, for which the head of the organization has apologized, and will continue to apologize. They also paint a cold picture of the whole process by which organs and tissue are harvested, something that even supporters of fetal tissue donation, including me, don't necessarily want to think about or discuss.

If you check the CMP website, you'll find links to the undercover videos, as well as links to a lot of information related to 'selling baby parts' which is a carefully chosen, inflammatory and very ugly way of talking about the very legal practice of procuring fetal tissue for use in research. (Under federal law, fetal tissue can be donated, and the costs of procuring the tissue, preserving it, and getting the samples into the hands of researchers can be recovered. There are restrictions, of course -- selling the tissue, harvesting it from fetuses which were conceived expressly for the purpose of harvesting the tissue, or for a donation to a family member or other specified person. Planned Parenthood does none of these things.)

What you won't find on their website are undercover videos of citizen journalists speaking with medical professionals about things like this:

• coldly and matter-of-factly harvesting organs, such as hearts and eyes and lungs and livers and kidneys and skin and bones for transplantation or research by drug companies or universities, even when the deceased patient has never discussed organ donation with anyone
• callously hooking patients up to machines, artificially keeping them alive for days, weeks, months, or years, including people who show no brain activity, because their family (or the government) thinks this is in the patient's best interest (again, when the patient is incapable of consenting)
• brutally freezing egg and embryos for some off-in-the-future implantation, custody case, or destruction or donation if the embryos are not used
• withholding game-changing medical treatment, such as medical marijuana, from innocent children suffering from seizures, or other patients who would benefit from treatment

I don't think I have to go too far out on a limb here to guess that the "unequal legal status of human beings" the CMP talks about points to a belief that a fetus, at any stage, has the same 'rights' as we do. "Contemporary bioethical issues" apparently refers to using fetal tissue in research, and a "world in which medical practice and biotechnology ally with and serve the goods of human nature" means, quite simply, a world without abortion.

It does not mean a world where the ethics of practices such as those I describe above are covertly examined over cocktails and dinner via hidden camera videos, because that would be unnecessary. There's nothing ethically challenging about any of those things, right?

It does not mean a world where the government stays out of frequently painful and heartbreaking medical decisions, where the wishes of the patient, their representatives and their doctors take precedence over some bureaucrat or legislator sitting in an office somewhere. We all know, of course, that those pesky bureaucrats (and legislators who voted for the Affordable Care Act) are the bane of existence for the ACA's many detractors.

And it certainly does not mean a world where all women, regardless of income, ethnicity, or place of residence, have equal access to potentially life-saving health care services, including those offered by Planned Parenthood.

You can call it 'medical progress' if you like, but to me it would only be true progress if the same rules were applied across the board. Accordingly, I ask you to join me in calling on our elected representatives to demand for the immediate defunding of all medical facilities that offer any of the same health care services as are offered by Planned Parenthood.

Maybe then we'll see who really thinks this is 'medical progress.' 

Poll Watch: We're Out of Touch

There's been a lot of polling over the past year checking our overall sense of how much or little we approve of Congress or President Obama, and we know that for the most part those results have been abysmal. Congressional approval has been in the single digits, and POTUS has also been tagged with horrible numbers.

There are lots of other poll questions out there, though, that don't seem to get as much play.  Here are some recent results from one generally conservative polling organization I subscribe to that I thought were interesting:

• 66% of likely voters favor getting sexual assault cases out of the hands of commanders and into the hands of the military judge advocates. Recently, legislation related to this was voted down.
• Only 47% think that reducing taxes helps the economy (a six-year low for this polling agency), but  Republicans continue to champion that message and push legislation in that direction.
• By a 2-to-1 margin, voters disagree with the SCOTUS decision on McCutcheon, the case that was championed by the Republican National Committee and Mitch McConnell, minority leader of the Senate. Further, more than half of us think that Congress should regulate campaign contributions, and that our free speech rights are not violated if that regulation occurs. The most important thing, we think? Full disclosure of all contributions. 
• And then there's this: 59% of Republicans think Republicans in Congress are out of touch with the party's base, and 23% think the Rs in Congress are more conservative than the people.  
• On the other side, 27% of Dems think their folks in Congress are more liberal than the base, and 30% think the Dems are out of touch. 

Kind of makes you wonder, doesn't it?

Here in New York, one of the hot topics is whether we'll allow medical marijuana. Our Sonova Governor Andrew Cuomo included a proposal for testing this at a limited number of hospitals across the state in his State of the State address.  Polls have reflected different levels of approval, with a recent one showing New Yorkers approve by about 10-to-1, while others have reflected weaker support.  Will we get there this legislative term? Probably not.

And then there's the NY SAFE Act, the quite a bit reasonable/somewhat stupid gun legislation Cuomo was able to rush through last year. As we come up on one of the major deadlines -- April 15th for registering so-called assault weapons -- we have a significant majority of counties across the state officially disapproving of the law, and some counties and police jurisdictions indicating they won't enforce the law.

That contrasts with recent polling indicating that 63% of voters support the SAFE Act. a slight uptick from last year.  Geographically (and not surprisingly) support is strongest in NYC and downstate; upstate there is a slight majority opposed to the law. I did find it surprising that  a majority of whites and men support it, although in smaller numbers than do women and minorities.

So - at the federal level, the state level, and the local level, we can easily find a disconnect between what voters say they want and what their elected officials seem to be doing. So I've gotta ask, are you happy with your elected officials?  Do they have any sense at all what you're interested in, and what you think is important? Have you told them lately what's on your mind?

Maybe, they do what they want because they're smarter than we are, and realize better than we do what we want or need.  Maybe, they do what they do because of the 'you scratch my back, I'll scratch yours' process in which they work. Or maybe they do what they do because so few of us actually care enough to vote.

I wonder, are we more out of touch than they are?  

Fortune Favors the Bowl

Er, the bold. Not the bowl, fortune favors the bold, that's what I meant to say.

This'll be my last post in the Fortune Favors the Bold series focusing on Governor Cuomo's recent State of the State address.  I could keep going; I mean, he put a lot of stuff out there. But I've hit on the ones that struck a chord with me, or hit a CNY nerve.  Some of the rest of it -- taxes, for example -- I'm sure I'll get to a few dozen times in the coming weeks and months. Here's what the series covered:

• Part 1 gave a general overview of the speech;
• Part 2 talked about collaboration between jurisdictions, and how his most favorite example just hit a rough spot;
• Part 3 touched on Cuomo's move to 'Raise the Age' for juveniles in the adult justice system
• Part 4 was all about my favorite subject, money in politics. 

Today, I want to talk about medical marijuana and drugs.  Not the kind of drugs you typically buy on the street corner, but the kind you get from a licensed medical professional at a licensed hospital.  Because there's a difference, in my opinion between pot you smoke to get a buzz and pot you smoke to treat a medical condition.

In the SOTS, after talking about his administration's accomplishments, Cuomo went on to say

But my friends, even with all of that we still have more to do.  We have to make New York healthier.  Research suggests that medical marijuana can help manage the pain and and treatment of cancer and other serious illnesses.  Twenty states have already started to use it. We'll establish a program allowing up to 20 hospitals to prescribe medical marijuana, and we will monitor the program to evaluate the effectiveness and the feasibility of a medical marijuana system.

And with that, "stupid stoners" sucking our tax dollars on disability all across this great state sort of sat up, said "Wow, man" and tried to lift their bongs into the air, before collapsing into convulsions of laughter, quickly forgetting what they were laughing at.  Or so one doctor at SUNY Upstate would have you believe.

He's Dr. Brian Johnson; he's the director of addition psychiatry, and believes marijuana is a destructive drug. I'm suspect the article didn't have the full story, or at least I hope the doctor would have taken time to talk a little more about this, rather than providing a couple of soundbites. Here's what made it into print:

Hyping it as a medical treatment is ridiculous. You will end up with a bunch of stupid stoners in New York with lung disease who thing that maybe they should go out on disability because they don't want to get off the couch. 

The article notes that Doc sees correlations to the "right to pain treatment" movement back in the day that, in his view, opened the floodgates for the explosion of prescriptions for hydrocodone and other opioid pain killers - which (unlike marijuana) are highly addictive. He notes

People testified back then about the poor mother dying of cancer who could not get oxycodone. Since then opioid prescribing has tripled and accidental overdose deaths are more common than motor vehicle deaths. 

I agree with what he says about prescription painkillers - too many doctors are too willing to prescribe them to too many patients who are addicted to them, a fair number of whom manage to get multiple prescriptions from multiple physicians. Heck, even doctors get addicted to painkillers. We've had a few in our own back yard, including this guy.

Where I don't agree with him is on the overdose part, the addiction part, or the stupid stoner part. Because I don't think that AIDS patients, cancer patients, glaucoma patients, seizure patients, and others who typically might qualify as medical marijuana patients are 'stupid' and they don't become 'stoners' and frankly, even if they did, if it makes them comfortable while they're trying to deal with their illness, who the hell cares?

Some medical professionals (not necessarily this Dr. Johnson) seem to look down their noses at anything that is nontraditional, or not manufactured, or doesn't come with trinkets and junkets courtesy of drug companies; they deny years of theory, study, and practice, including those of native/indigenous peoples. There are thousands of years of records of 'medicine men' in Asian cultures, and hundreds of years of the same in newer countries like ours. Why ignore this, when it might bring relief to your patients?

And I have to wonder why someone would look down their nose at marijuana, whether smoked, vaporized, in pill form (although the pill form is somewhat less effective, I've read), when they are otherwise more than willing to direct a patient to take something that can cause this:

Belching; bruising; difficult or labored breathing; feeling of indigestion; headache; itching skin; large, flat blue or purplish patches in the skin; pain in the chest below the breastbone; shortness of breath; skin eruptions; swelling; tightness in the chest; wheezing, bloating; bloody or black, tarry stools; blurred or loss of vision; burning upper abdominal or stomach pain; cloudy urine' constipation; decrease in urine out put or decrease in urine-concentrating ability; disturbed color perception; double vision; fast, irregular pounding or racing heartbeat or pulse; halos around lights; indigestion; loss of appetite; nausea or vomiting; night blindness; over-bright appearance of lights; pale skin; pinpoint red or purple spots on the skin; severe and continuing nausea; severe stomach burning, cramping or pain; skin rash; swelling or inflammation of the mouth; troubled breathing with exertion; tunnel vision; unusual bleeding or bruising; unusual tiredness or weakness; vomiting of material that looks like coffee grounds; weight loss; anxiety; back or leg pains; bleeding gums; blindness; blistering, peeling or loosening of the skin' blood in the urine or stools' blue lips and fingernails; canker sores; change in the ability to see colors, especially blue or yellow; chest pain or discomfort; clay-colored stools; cold sweats; coma; confusion; cool, pale skin; cough or hoarseness; coughing that sometimes produces a pink frothy sputum; cracks in the skin; darkened urine; decreased vision; depression; diarrhea; difficult, burning or painful urination; difficult, fast, or noisy breathing; difficulty with swallowing; dilated neck veins; dizziness; dry cough; dry mouth; early appearance of redness, or swelling of the skin; excess air or gas in the stomach; extreme fatigue; eye pain; fainting; fever with or without chills; fluid-filled skin blisters; flushed, dry skin; frequent urination; fruit-like breath odor; greatly decreased frequency of urination or amount of urine; hair loss; high fever; hives; increased hunger; increased sensitivity of the skin to sunlight; increased sweating; increased thirst; increased urination; increased volume of pale, dilute urine; irregular breathing; joint or muscle pain; large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs,feet, or sex organs; late appearance of rash without or without weeping blisters that become crusted especially in sun-exposed areas of skin, may extend to unexposed areas; light-colored stools; lightheadedness; loss of heat from the body; lower back or side pain; nervousness; nightmares; no blood pressure; no breathing; no pulse, nosebleeds, numbness or tingling in the hands, feed, or lips; pain in the ankles or knees, pain or burning in the throat; pain or discomfort in the arms, jaw, back or neck; painful red lumps under the skin, mostly on the legs; pains in the stomach, side or abdomen, possibly radiating to the back; pale or blue lips, fingernails or skin; pounding in the ears; puffiness or swelling of the eyelids or around the eyes, face, lips or tongue; rapid shallow breathing; red, irritated eyes; red skin lesions, often with a purple center; red-green color-blindness; redness or other discoloration of the skin; redness, swelling or soreness of the tongue; scaly skin; seizures; severe sunburn; shakiness; skin thinness; slurred speech; sneezing; sore throat; sores, ulcers or white spots on the lips or tongue or inside the mouth; sores, welting or blisters; spots on your skin resembling a blister or pimple; stiff neck or back; stomach cramps or tenderness; stomach upset; swelling in the legs and ankles; swelling of the face, fingers, feet or lower legs; swollen, painful, or tender lymph glands in the neck, armpit or groin; tiny bumps on the inner lining of the eyelid; unexplained weight loss; unpleasant breath odor; watery or bloody diarrhea; weakness or heaviness of the legs; weight gain; yellow eyes or skin; bleeding under the sin; confusion about identity, place, and time; muscle tremors; restlessness, sleepiness; continuing ringing or buzzing or other unexplained noise in the ears; hearing loss; acid or sour stomach; change in hearing; feeling of constant movement of self or surroundings; passing gas; sensation of spinning; stomach soreness or discomfort; appetite changes; burning, crawling, itching, numbness pricking, "pins and needles' or tingling feelings; burning, dry or itching eyes; difficulty with moving; discharge, excessive tearing; general feeling of weakness; not able to concentrate; redness, pain or swelling of the eye, eyelid, or inner lining of the eyelid; seeing, hearing or feeling things that are not there; shakiness in the legs, arms, hands, or feet; sleeplessness; swollen joints; trembling or shaking of the hands or feet; trouble getting pregnant; trouble performing routine tasks; trouble sleeping; unable to sleep; unusual drowsiness, dullness, or feeling of sluggishness.

Folks, those are the side-effects, overdose symptoms, or general crap associated with naproxen, the main ingredient in Aleve, the over-the-counter pain medication I take on occasion.  See, you don't even have to look at prescription pain meds to have the crap scared out of you, and to wonder if we know what we're doing when it comes to medications, and to wonder if we should be looking at other options.

We are a nation of medicators - patients who demand doctors give them a pill or a shot for everything that ails them, and doctors who comply, whether out of sympathy, expediency or as a defensive medicine practice.

We're a society that has managed to convince ourselves that having an erection is a medical necessity that can be handled, pardon the pun, with a little blue pill and a cheap copay.

When we're that far in the weeds with priorities, how can we refuse a sick person a little weed of their own?