Tuesday, March 29, 2005

DeLay's Own Tragic Crossroads

Tom DeLay, who tried to intervene in the Schiavo case, allowed his comatose father to die in 1988.

Full story

What's Going On?

By PAUL KRUGMAN
Published: March 29, 2005

... The future seems all too likely to bring more intimidation in the name of God and more political intervention that undermines the rule of law.

But medical care is the cutting edge of extremism.

And it won't stop there. There is a nationwide trend toward "conscience" or "refusal" legislation. Laws in Illinois and Mississippi already allow doctors and other health providers to deny virtually any procedure to any patient. Again, think of how such laws expose doctors to pressure and intimidation.

Full Op-ed (reg req)

Free mirror

Schiavo Case Affirms the Rule of Law

My article "Schiavo Case Affirms the Rule of Law" is online at The Future of Freedom Foundation. I also recommend Jacob Hornberger's more detailed "The Schiavo Case Is Not Judicial Murder."

Monday, March 28, 2005

Pharmacists' Rights at Front Of New Debate

Pharmacists' Rights at Front Of New Debate
Because of Beliefs, Some Refuse To Fill Birth Control Prescriptions

By Rob Stein
Washington Post Staff Writer
Monday, March 28, 2005; Page A01

Some pharmacists across the country are refusing to fill prescriptions for birth control and morning-after pills, saying that dispensing the medications violates their personal moral or religious beliefs.

Full

Saturday, March 26, 2005

Patients who refuse food and fluids to hasten death

Patients who refuse food and fluids to hasten death.
Letter by Schaler, reply by Ganzini et al. This letter appeared in the October 30, 2003 issue of NEJM (349:18, pp. 1777-1779). Note the reply by authors. The study was cited in the opinion piece by Timothy Quill that appeared in the March 24, 2005 issue of NEJM.
At http://www.schaler.net/nejmcorrespondence.pdf

Friday, March 25, 2005

Pentagon Sees Aggressive Antidrug Effort in Afghanistan

Pentagon Sees Aggressive Antidrug Effort in Afghanistan

By THOM SHANKER

Published: March 25, 2005
The New York Times

WASHINGTON, March 24 - The American military will significantly increase its role in halting the production and sale of poppies, opium and heroin in Afghanistan, responding to bumper harvests that far exceed even the most alarming predictions, according to senior Pentagon officials.

Full

"A Massive and Rugged Intellectual Sanity"

Greetings:

The Editorial Institute at Boston University is pleased to announce "A Massive and Rugged Intellectual Sanity," a conference on the life and work of Sir James Fitzjames Stephen, to be held 8-10 April, 2005.

Sir James Fitzjames Stephen exerted a powerful force on nineteenth-century lawmaking in India, England, Canada, and the USA. His thinking on evidence and criminal responsibility underpins modern Anglo-American jurisprudence in these areas, as more generally does his three-volume History of the Criminal Law of England (1883). He was notable for his trenchant attack on John Stuart Mill's "unsound" liberalism, in Liberty, Equality, Fraternity (1873, revised edition 1874); and his ideas on all manner of other subjects, cultural, moral, political, social, were also propounded vigorously through his prolific journalism.

This conference inaugurates a Selected Edition of Stephen's major works and will explore Stephen's life in a series of papers and discussions from panels of international guest lecturers. To learn more about "A Massive and Rugged Intellectual Sanity," see the conference invitation (attached), or go to our website: http://www.bu.edu/editinst/news/index.html.

Please contact us if you would like to attend any or all of the sessions. The conference is free and open to students, faculty and the public. Thank you for your time.
Sincerely,Alex Effgen
--
^~^~^~^~^~^~^~^~^~^~^~^~^~^~^~

Alex Brink Effgen
Administrative Assistant
The Editorial Institute atBoston University
143 Bay State RoadBoston, MA 02113
Tel: 617-353-6631Fax: 617-353-6917
http://www.bu.edu/editinst/^~^~^~^~^~^~^~^~^~^~^~^~^~^~^~

Wednesday, March 23, 2005

The real tragedy of Terri Schiavo

This guy's view is incoherent. He believes in the medical model for bulimia and anorexia, but believes that obesity is a myth resistant to treatment. Lee

As I write these words, Terri Schiavo is being starved to death because she was once a chubby little girl.

Almost everyone has heard about how, 15 years ago, Schiavo's heart stopped for several minutes, causing massive brain damage that left her severely disabled.

What very few people are aware of, because it has gone largely unreported, is that Terri's heart stopped as a consequence of an eating disorder.

Full article

Tuesday, March 22, 2005

Early Release, The New England Journal of Medicine

The New England Journal of Medicine
March 22, 2005
Early Release
http://content.nejm.org/

“Culture of Life” Politics at the Bedside—The Case of Terri Schiavo
By George J. Annas, J.D., M.P.H.
http://content.nejm.org/cgi/reprint/NEJMlim050643v3.pdf

Perspective
Terri Schiavo—A Tragedy Compounded
Timothy E. Quill, MD
http://content.nejm.org/cgi/reprint/NEJMp058062v1.pdf

A Damaging Intervention

A Damaging Intervention
Washington Post editorial
Tuesday, March 22, 2005; Page A16

THE PROSPECT OF a disabled person slowly dying by virtue of a court order issued over the strenuous objections of her parents is enough to trouble even the most ardent advocate of the "right to die." So Congress's lightning-fast passage of special legislation to force the federal courts to review Terri Schiavo's case might make a certain intuitive sense. Certainly one can feel only sympathy for the relatives torn apart by this case. But Congress has an obligation to rise above sympathy and intuition. Its precipitous action this weekend, supported by President Bush, was damaging and unprincipled.

full

A Blow to the Rule of Law

New York Times
Editorial

If you are in a "persistent vegetative state" and there is a dispute about whether to keep you alive, your case will probably go no further than state court - unless you are Terri Schiavo. President Bush signed legislation yesterday giving Ms. Schiavo's parents a personal right to sue in federal court. The new law tramples on the principle that this is "a nation of laws, not of men," and it guts the power of the states. When the commotion over this one tragic woman is over, Congress and the president will have done real damage to the founders' careful plan for American democracy

full editorial here

Monday, March 21, 2005

Drug rehab: is it just another addiction?

The Times (London)

February 14, 2005

Drug rehab: is it just another addiction?

by

Michele Kirsch

A growing number of doctors and addicts believe that drug rehab is a waste of time
KATE MOSS’s rock star boyfriend, Pete Doherty, should at this moment be facing what has become a rite of passage for any self-respecting party boy: rehab. This is not the first time for the former Libertines frontman. Indeed, he is already something of a veteran.

Full story here

A Blow to the Rule of Law

My views on the Terri Schiavo case per se are known. (See here.) Nevertheless, I am appalled by the assault on the rule of law launched by the U.S. Congress. The case went through the Florida courts and was reviewed many times. I don't like how the law is written, but it is a bald-faced lie to say, as one Republican representative said, that Terri Schiavo was deprived of due process of law. The precedent Congress has set—by decreeing that a particular person may file a state legal matter in the federal courts—will surely come back to haunt us. That this travesty is perpetrated by the party professing dedication to small government and federalism makes it all the more outrageous. This is a sad day in more ways than one.

Sunday, March 20, 2005

Libertarianism and Mental Illness

Dr. Thomas Szasz is a prolific writer in the field of mental illness. His opinion on the matter is encapsulated in the title of his most famous book, “The Myth of Mental Illness.” Dr. Szasz is also well-known for his libertarian principles. This is exemplified by the terms “pharmacracy” and “the therapeutic state” coined by him.

To put it concisely, Dr. Szasz believes that:
1. mental illness does not exist;
2. the state should not interfere in health care or other personal matters.

As Dr. Szasz has written profusely on these two subjects, usually together, some people have jumped to the conclusion that rejecting the existence of mental illness and libertarianism are somehow connected. This is not necessarily so. A person can believe that mental illness does not exist, and yet not be a libertarian. On the other hand, in his recently published book “Faith in Freedom,” Dr. Szasz demonstrates that most famous people identified with libertarianism did/do, in fact, believe in the existence of mental illness.

The point that Dr. Szasz has dedicated his life to making, is that the concept of health and illness does not justify state interference. He endorses separation of Medicine and State, just as he endorses separation of Church and State.

So what does justify state interference? Does the concept of evil justify state interference? My opinion is that it does not. Good and evil are concepts borrowed from religion, even when they are used by atheists, just as health and illness are concepts borrowed from medicine, even when they are used by lay people. Neither concept is a valid base for coercion of individuals by the state, whether law-abiding or not.

Coercion by the state is justified only when someone has violated the freedom of another person, that is, violated the other person’s right to life, liberty, or property. This we call a crime. (A victimless act is not a crime, and should not be criminalized.) It is reasonable to assume that whoever commits such a violation may do it again, and must therefore be stopped, which requires coercion. Protecting the liberty of its non-criminal citizens is the state’s proper responsibility.

The state should not, and indeed cannot delve into the reason for the crime, except in the case of self-defense. Ascribing it to illness poses the risk that a violent criminal will be declared recovered, and released to strike again. Ascribing it to evil poses the risk that a violent criminal will be declared reformed, and released to strike again. Conversely, state recognition of illness or evil may criminalize acts that are not crimes. Furthermore, as illness and evil are concepts that are rightly separate from the state, a judge has no tools for determining them.

Criminals should be released only when they have completed their sentence. If the sentence was short, the crime must have been light, thus the released criminal does not pose a serious risk to others. When the crime was so grave that a life sentence is imposed, there should never be a release, whether recovered/reformed or not. It is wholly compatible with human rights to provide a convicted criminal with medical and/or spiritual assistance while he is serving his sentence, provided he asks for it. This then becomes a private matter between the convict and his doctor and/or spiritual advisor.

In summary, in my opinion both illness and evil are concepts borrowed from institutions which are, or should be, separate from the state, and therefore cannot be invoked either to absolve a person suspected of a crime or to convict him. Both concepts are irrelevant to the state.

Saturday, March 19, 2005

Begging the Question

Friday night, after it was announced that a career child molester had confessed to abducting and murdering a missing little girl from Florida, one of the cable-TV talking-head analysts (does it matter which one?) kept repeating, "We don't know how to treat these people." Will it ever occur to the analyst that child molesters don't need treatment because they aren't sick? Such evil doesn't call for treatment, but imprisonment.

The Terri Schiavo Case

The sad case of Terri Schiavo brings important medical-ethical issues to the fore. But this is not a hard case. As a general principle, when there is reasonable doubt about an incapacitated person's wishes regarding life-support and when someone is willing to pay for continued support, the presumption should be in favor of life and a spouse should not be able to terminate it. In this case, there is no written proof that Terri Schiavo expressed a wish not to be kept alive. All we have is her husband’s and one or two other persons' say so. Not good enough. In fact, according to Terri Schiavo’s parents, “When he [husband Michael Schiavo] promised the malpractice jury back in 1993 that he would take care of Terri for the rest of his life, Mr. Schiavo said nothing to the jury about Terri not wanting to be sustained on anything ‘artificial.’”

Not only was Michael Schiavo awarded money by a jury for her perpetual care, it has been reported that others have offered to pay for her life-support. Add to these facts that ten years ago Michael Schiavo commenced a romantic relationship with another woman whom he describes as his fiance, has had two children with that woman, and has announced that he has “moved on” with his life, and his wish to disconnect his wife from feeding and hydration tubes becomes suspect and indeed irrelevant. The Florida courts long ago should have excluded Michael Shiavo from the matter, declaring that he has a conflict of interest, and recognized Terri Schiavo’s parents as her guardians.

The fact is, we don't know what Terri Schiavo would say she wants if she could speak for herself. But there should be a presumption in favor of preserving life unless that presumption is overcome by an advance directive.

It might be argued that in her condition, Terri Schiavo is no longer a person and thus has no interests. But what is the difference between a former person (non-person) and a severely impaired person? Does the desired disposition dictate which term we use? Language is often more prescriptive than descriptive.

Friday, March 18, 2005

Of Minds and Heads

Saying someone has lost his mind is as true—and as false—as saying he has lost his head.

Thursday, March 17, 2005

Opal Petty, 86, Patient Held 51 Years Involuntarily in Texas, Dies

Opal Petty, 86, Patient Held 51 Years Involuntarily in Texas, Dies
March 17, 2005
New York Times

Obits.
By CHRISTOPHER LEHMANN-HAUPT
Opal Petty, whose lawsuit over her 51-year involuntary commitment in Texas mental institutions led to changes in state policy, died on March 10 in San Angelo, Tex. She was 86 and lived in Christoval, Tex.
The cause was pneumonia, said Linda Kauffman, the wife of Ms. Petty's nephew, Clint Denson.
Ms. Kauffman learned by chance at a 1986 reunion of her husband's family that Ms. Petty had been committed by her family to a state hospital in 1934, when she was 16. No one at the reunion knew exactly where she was at the time, Ms. Kauffman said in an interview, only that she was in some facility near where Ms. Kauffman lived. . .

Full article at http://www.nytimes.com/2005/03/17/national/17petty.html?

Don't Blame the Drugs by Paul Varnell

Don't Blame the Drugs
By Paul Varnell
First published February 23, 2005, in the Chicago Free Press.


Those of us who do not do drugs, and we are the majority, are getting pretty sick and tired of drugs — and more sick and tired of drug users. Get a life, guys — a real life, not an illusory one. . . .

Full article at the Independent Gay Forum here
http://www.indegayforum.org/authors/varnell/varnell145.html

Wednesday, March 16, 2005

To Lie or Not to Lie

From the Associated Press:
Bradenton, Florida—A Longboat Key psychologist has been sentenced to ten weekends in jail for lying on forms to involuntarily commit a griping neighbor who later died.

Holli Bodner had a yearlong feud with Jean Pierre Villar about street lights and dog poop before committing him to a mental health center in April 2003.

A prosecutor and Villar's family contend Bodner's action contributed to her 41-year-old neighbor's death from a blood clot last November. She pleaded no contest to a perjury charge and says she didn't mean any harm.

Erika Villar says her husband suffered from chronic pain after Manatee County sheriff's deputies aggravated a work-related back injury when they forced him into a squad car during the commitment process.

Question: What’s the difference between “lying” and not “lying” on a commitment form?

Hat tip: Joe Rose.

Tuesday, March 15, 2005

Was Howard Hughes Mentally Ill?

George Mason University economist Bryan Caplan, a self-described "big fan" of Thomas Szasz, recently blog-posted his reaction to the movie The Aviator: "Howard Hughes and the Economics of Mental Illness." He writes, in part, "What's so odd about Hughes? His biggest foible, which drastically increases during the story, is germophobia. No doubt today he'd be diagnosed with Obsessive-Compulsive Personality Disorder. I say, however, that this is just name-calling." Well worth reading. It also contains a link to download his paper "The Economics of Thomas Szasz."

Arnold Kling on Doctoring the Market

Worth checking out: "Doctoring the Market" by Arnold Kling at Tech Central Station. Here's a sample:

“Health care providers, unlike auto mechanics or computer salesmen, deal with life-or-death issues. However, that does not mean that the ethical dilemmas of the health care profession are more challenging than those in other fields. Most of the ethical dilemmas for doctors do not involve life-or-death decisions. An ethical issue might be whether to fudge a diagnosis for insurance purposes, whether to order an unnecessary procedure or follow-up visit in order to pad the bill, etc.”

Saturday, March 05, 2005

FDA halts distribution of Paxil

GlaxoSmithKline stopped distributing its Paxil CR antidepressant and Avandamet diabetes tablets after regulators seized the drugs Friday, saying manufacturing practices failed U.S. standards.

U.S. marshals seized lots of the two medications at manufacturing and distribution sites in Puerto Rico and Knoxville, Tennessee, the U.S. Food and Drug Administration said.

Paxil CR tablets could split apart and patients could receive a portion of the tablet that lacks active ingredients.

Neither of the products made by Glaxo, the biggest European drug maker, are medically necessary and alternatives are available, the agency said.

Full story

Soldier who reported abuse sent to psychiatrist

A US Army intelligence sergeant who accused fellow soldiers in Samarra of abusing detainees in 2003 was in turn accused by his commander of being delusional and ordered to undergo a psychiatric evaluation in Germany, despite a military psychiatrist's initial judgment that the man was stable, according to internal Army records released on Friday.

Full Story (reg.)

Full story (free)

Friday, March 04, 2005

New Freedom Commission on Mental Health

My article “Bush’s Brave New World” is now online at The Future of Freedom Foundation website. Originally appearing in the November issue of Freedom Daily, it examines the disturbing recommendations of the President’s New Freedom Commission on Mental Health.

Ritalin linked to chromosomal changes

In a small but startling preliminary new study, Texas researchers have found that after just three months, every one of a dozen children treated for attention deficit/hyperactivity disorder (ADHD) with the drug methylphenidate [Ritalin] experienced a threefold increase in levels of chromosome abnormalities-occurrences associated with increased risks of cancer and other adverse health effects.


Full Story


Cancer Letters Paper

Tuesday, March 01, 2005

The Medical-Insurance Scam

The heroic French liberal Frédéric Bastiat wrote that "The state is that great fictitious entity by which everyone seeks to live at the expense of everyone else” (Selected Essays on Political Economy, chapter 5, "The State"). Were he writing today he would surely extend his aphorism to include government-mandated/regulated medical insurance.