Sunday, June 23, 2013

Will Doctors Finally Stand Up For Good Medicine?

Will doctors finally refuse to play the "enforcer"?























Reposting this March 2012 essay because the (usually Republican) war on women's reproductive rights has actually accelerated since then. (quelle surprise!) That's the bad news. The good news is that, unlike when I wrote the article below, a few doctors are finally beginning to speak out publicly against being compelled by state legislatures into the role of enforcers of ideologically-driven, unconstitutional, medically unnecessary and unethical laws. Very few individuals are willing, yet, to bring down upon themselves the wrath of powerful religious and political elites, but there are notable exceptions. Usually it is a small group of doctors, rather than individuals, speaking up, probably because there is some sense of security in numbers.

The war on women is continuing apace. Nearly all of the hard-earned protections that women fought for and won in the latter half of the 20th century have been gutted:
How much more will doctors take?

Since the rise of the Tea Party movement, the Right has found stunning success in its attempts to turn back decades of gains in the rights and status of women. The efforts to turn back the clock on American women focus on reproductive rights but also attack the changing roles in the workplace, in the family and in government that reproductive rights have helped to allow women to assume.

Anti-woman proposals that have been percolating in the right-wing fringe for years – such as “personhood” measures – are suddenly supported by mainstream presidential candidates. Rights that women have come to take for granted – like the right to access birth control – have suddenly come under attack for the first time in decades. How the War on Women Became Mainstream: Turning Back the Clock in Tea Party America, People for the American Way, 2012.

There was a time when the very idea that a U.S. state legislature might pass laws compelling doctors to literally lie to patients because of a religious, ideological agenda would only have been imaginable within the realm of fiction. Today, the shocking reality is that states really do force doctors to lie to patients, telling them that safe, legal procedures can lead to cancer or other serious health complications in order to coerce them to acquiesce to the dictates of Christian authoritarianism.

People are being forced by government to lie to other people about potentially life-changing, even life-threatening medical care. It hardly seems possible, but this is our bizarre reality in a country where one group's religious beliefs are now being forced upon all citizens. It's going to take a united effort of millions of ethical individuals to push back against the well-organized, highly lucrative religious/political machine that has been riding roughshod over women's freedom and humanity for the past couple of decades.

Previously posted in March 2012:

Recently, a doctor stepped forward to call government intrusion into the private decisions of female citizens the outrage that it is. I think that doctor's statement bears reposting. Writing anonymously, the doctor made a case for principled medicine, and provided some tips on how doctors should practice civil disobedience in states where these ghastly laws are in effect. The essay was originally posted on the blog Whatever.  Also anonymously. I think that is disturbing.

Christian terrorism is rarely called
out by a cowed and cowardly media.
When citizens feel they can only speak out "anonymously", the chilling irony should not be lost on us - it should be ringing alarm bells. Loudly. People who still believe in the principles of equality and freedom, even if they do not agree that it might be a good idea to consult experts before writing terrible laws, ought to be worried when free speech is suppressed through intimidation. People who value a free society should be horrified that there are citizens among them who are too frightened to speak openly when they disagree with the government.

Some doctors are angry about being used by the government to intimidate a subset of its citizens. They are rightly aghast at being compelled to be the brutal enforcers of this Republican governmental violation of women's most basic human dignity - doctors being forced by law to commit state-mandated rape as a method of anti-abortion rights coercion - when there is no medical reason for compulsory testing of this kind prior to an abortion. Some have begun to realize that part of the anti-abortion strategy is to undermine both their authority as medical experts and their trusted position in society. But most of these doctors remain silent.  And the very few who do speak out, tend to do so anonymously. Why?

Christian jubilation after the
murder of Dr. Tiller sends a clearly
threatening message to doctors.
One reason is pressure from within the profession. Some doctors are perfectly happy to put religious ideology over the welfare of their female patients and may privately support laws that force their peers to bow to church authority.  Many other doctors are understandably alarmed by the violent rhetoric and physical harassment directed at pro-choice doctors by anti-choice groups, so they pressure their peers not to offer the full range of women's health services, not to speak out about the immorality of withholding appropriate medical care, not to make waves which could endanger them all. The few doctors who dare to protest unconstitutional laws based on religious ideology are intimidated into anonymity by threats to their livelihoods and reputations and even threats to their physical safety. They are presented with an ethical catch-22 situation: they know that invasive procedures - including vaginal penetration with an ultrasound wand against a patient's will and for no legitimate medical reason - goes against everything most doctors say they believe about doing no harm to a patient, but those who try to apply those ethics to women patients are threatened with prosecution if they disobey these draconian anti-woman laws.

Already wealthy, tax-exempt churches
lobbied for access to federal funds to
duplicate secular public services. The churches
can  supplement their grants with cash
from their own fat reserves and wait patiently
for the cash-strapped secular agencies
 to starve and shut down, leaving the field
clear for a total church takeover.
The intimidation of doctors is just the latest in a steady round of attacks on traditionally respected professions by an unholy alliance of religious and corporate elites and their political arm, the Republican party. Their long term strategy is to replace the current political system in the United States - democratic republicanism - with an authoritarian theocratic regime: a Bible-based government, led by godly men and answerable only to God (whose "commands" are, conveniently, communicated only through those same godly men). That strategy has relied heavily on the tactic of stirring up fear, suspicion and resentment to undermine public confidence in an array of once-trusted professions while simultaneously planting and building churches around the country. The targeted groups have long been hated by religious hardliners and wealthy, powerful elites because of their relative inability to control the information coming from these sources. The goal is to replace the secular resources that serve society with church-controlled resources.

Republican candidates like
Rick Santorum vied for the title
of "most devout Christian"
to the delight of the
religious elites.
Republican strategists capitalized on the natural (but usually milder) anti-intellectualism that is common in a population that believes it can point to its own physical strength, raw ingenuity and dogged determination for the country's success as much as, if not more than, the work of highly educated, high-falutin' "experts". When tough economic times hit the middle class hard in the late 70's and again in the early 90's, those smoldering resentments were all too easily fanned into the raging flames of a culture war. Government agencies (It's not Uncle Sam, it's big brother!), scientists (godless evilutionists!), teachers (lazy, freeloading glorified babysitters!) and journalists (It's not the free press, it's the commie, liberal media!) were the first casualties of the manufactured "populist" rejection of formerly respected experts and secular representatives of peoples' interests. Political operatives worked hard to sow doubt, distrust and contempt for the essential human resources upon which a civil society relies and they have succeeded to an alarming degree. Where once a public servant's religious views were a non-issue, today virtually any candidate for public office in the USA must pass a religious test - specifically must display Christian bona fides - to have any hope of winning a nomination.

The attack on medical doctors - probably the most trusted profession in the modern era - is a part of this series of attacks on the secular foundations of American society. It is not accidental that doctors have joined scientists, teachers and journalists in the crosshairs of Republican operatives. Like scientists and journalists before them, doctors as a group were once able to work fairly independent of ideological influences. Individual doctors brought their own beliefs to their practices, of course, but the profession as a whole was not under pressure to conform to a particular politicized religious ideology.

This state of affairs could not be permitted by the Republicans or their powerful backers. Authoritarian political systems demand ideological purity and social conformity, so doctors - like journalists and scientists before them - posed a threat to the political ambitions of the Republican party, especially in terms of their strategy to use abortion as the rallying "cause" which could impassion voters enough to vote blindly against their own interests. If left unthreatened, doctors might challenge the lying propaganda that the anti-abortion movement was spreading and puncture the bubble of misguided passion the religious right had so carefully blown up. If permitted to retain their respected and trusted position in society, doctors might undermine the attempts of religious political operatives to replace trusted public resources with private Christian agendas.

Prison for doctors?
Hence the push for legislation which targets doctors as well as women. When pressed to say what penalty abortion should bring to a "guilty party" should their dream of criminalizing abortion be realized, anti-abortion leaders usually shy away from suggesting a punishment for the women involved (probably sensing that it would be a loser at the polls), but nearly all declare that, as the "butchers" who "kill babies", doctors should be thrown into prison for murder. Sensing the target on their backs, doctors have fallen silent as wave after wave of unconstitutional and medically unsound legislation has been passed, heaping untold misery upon women.

Thus, the goals of the Republican party may soon be achieved. Doctors may be rightly disrespected for standing silently by as the medical ethics they claim to believe in are violated by these laws: as women are grossly mistreated, legal medical procedures are withheld - even in potentially life-threatening situations - and patients are harmed by bad medical practices. Furthermore, doctors may be rightly distrusted by women (and many men) for many of the same reasons, in addition to the betrayal of doctor-patient trust upon which competent health care must rest.

If principled doctors fail to act to stop this looming crisis of public confidence, the consequences for society extend far beyond the impact on doctors and women. The public confidence in the media, in teachers and in scientists has been successfully undermined with predictably terrible results. Religious conservatives may claim that their holy books can provide all of the answers to the needs of humankind, but even science's most vindictive critics turn to medical science for help when a health crisis occurs or - irony of ironies! when they need assisted reproduction using technology developed through evolutionary science - while they work tirelessly to deny that opportunity to others. Should they, and other hypocrites like them, succeed in convincing enough people that doctors, like teachers and scientists, are not respectable authorities who can be trusted, then to whom will the people be able to turn when they need real assistance?

Keeping a low profile and hoping that this madness is only a temporary cultural spasm fueled by a fringe group of religious fanatics will be a mistake. It did not work for scientists, teachers or journalists.  It did not work for the people who believed such radical theocrats could never seriously win elections and form governments. It has not been working - with frightening consequences - and the situation will only get worse as long as professionals shrink back fearfully from challenging the lies and disinformation that are being deliberately disseminated to undermine public confidence in them. I am encouraged by the letter I linked to at the top of this post, but it sure would be nice to see many more doctors stand up and say "Enough is enough!".

The manipulation of public trust in doctors, scientists, teachers, the media, and even their elected representatives is a dangerous power play by the conservative right wing. Destroying trust in the resources best-equipped to provide the public with the services it needs is a strategy which has had terrible consequences for millions of people, and ultimately could tear apart the very fabric of our civil society.  That is a game that should never have been played by anyone who loves this country and all it stands for. But the thing few people acknowledge is that the self-labelled Christian "patriots" deeply despise this country and all it stands for. They deny that the country was ever what it was, and they intend to - they are actively fighting to - destroy the American dream and replace it with a theocratic nightmare. It is a sectarian insurgency.

Are you going to stand by and let that happen?


Saturday, June 22, 2013

FTB CONscience!!



























Exciting news!  FreeThoughtBlogs announced this week that they will be hosting an online conference:


"FtBCon is a free, online conference organized by the Freethought Blogs network. It will take place on July 19-21 and will focus on social justice, technology and the future of the freethought movement. Without travel, registration, or hotel costs, FtBCon will be accessible to freethinkers around the world. Conference sessions will be held through Google+ hangouts, and attendees will have the opportunity to interact with each other in chat rooms and to submit questions to moderators.

We are currently assembling our schedule. If you or your organization are interested in participating, submit your session ideas for consideration by e-mailing PZ Myers with a proposal."

It's free! It will be packed with fantastic speakers and contributors! It will be interactive!

This might just be the best news you'll read all day. Mark your calendars, NiftyReaders!



Friday, June 21, 2013

Sweet Summer!





























At 5:04 GMT (12:04 CST),  our planet arrived at that point in its elliptical journey around the sun when our north pole is tilted as closely as it ever tilts - about 23.5 degrees - toward our life-sustaining star.  It is officially summertime!

The northern solstice (or June solstice) occurs on either the 20, 21 or 22 of June. It marks the peak of the lengthening hours of daylight that began with the March equinox. On this date, northerners will experience the greatest number of hours and minutes of daylight in all of 2013. For those in the southern hemisphere, the opposite is true - their day will be the shortest of the year. 

I was going to post a poem about midsummer night full of fairies and magic, or about flowers and breezes and the smell of freshly mowed grass. But this poem pushed its way to the front of the line: I think in its own way, this poem communicates a warmer, more human affirmation of life than more conventional metaphors of growing things and magic.


Summer Solstice, New York City
by Sharon Olds

By the end of the longest day of the year he could not stand it,
he went up the iron stairs through the roof of the building
and over the soft, tarry surface
to the edge, put one leg over the complex green tin cornice
and said if they came a step closer that was it.
Then the huge machinery of the earth began to work for his life,
the cops came in their suits blue-grey as the sky on a cloudy evening,
and one put on a bullet-proof vest, a
black shell around his own life,
life of his children's father, in case
the man was armed, and one, slung with a
rope like the sign of his bounden duty,
came up out of a hole in the top of the neighboring building
like the gold hole they say is in the top of the head,
and began to lurk toward the man who wanted to die.
The tallest cop approached him directly,
softly, slowly, talking to him, talking, talking,
while the man's leg hung over the lip of the next world
and the crowd gathered in the street, silent, and the
hairy net with its implacable grid was
unfolded near the curb and spread out and
stretched as the sheet is prepared to receive a birth.
Then they all came a little closer
where he squatted next to his death, his shirt
glowing its milky glow like something
growing in a dish at night in the dark in a lab and then
everything stopped
as his body jerked and he
stepped down from the parapet and went toward them
and they closed on him, I thought they were going to
beat him up, as a mother whose child has been
lost will scream at the child when its found, they
took him by the arms and held him up and
leaned him against the wall of the chimney and the
tall cop lit a cigarette
in his own mouth, and gave it to him, and
then they all lit cigarettes, and the
red, glowing ends burned like the
tiny campfires we lit at night
back at the beginning of the world.


For your musical inspiration on the brightest day of the year, here is Julia Fischer accompanied by the Academy of St. Martin in the Fields playing Vivaldi's Summer from his violin concerto The Four Seasons. The performance was recorded at the National Botanical Garden in Wales.

Thursday, June 6, 2013

Isn't That Just Ducky!





























Hello there!

I am helping Nanny!

I am helping her to write!

I make Nanny laugh and laugh because I am so helpful!

I help her take breaks. I help her to play!

You know, playing is much
more funner than work!
Let's play, Nanny!

Let's play now! Right now!

Let's play right now this minute!

Tap, tap, snuffle. Tap, tap, snort.

Let's play!

<sigh> <snort> <tap, tap, tap, tap...>

OK, I think I have helped enough today!

Isn't that just Ducky!


Mother Doesn't Want a Dog

Mother doesn't want a dog.
Mother says they smell,
And never sit when you say sit,
You know, Nanny, it really
could be worse!
Or even when you yell.
And when you come home late at night
And there is ice and snow,
You have to go back out because
The dumb dog has to go.

Mother doesn't want a dog.
Mother says they shed,
And always let the strangers in
And bark at friends instead,
And do disgraceful things on rugs,
And track mud on the floor,
And flop upon your bed at night
And snore their doggy snore.

Mother doesn't want a dog.
She's making a mistake.
Because, more than a dog, I think
She will not want this snake.

-  Judith Viorst

Tuesday, June 4, 2013

Beatriz Is Still In Danger



























Yesterday in El Salvador, after months of life-threatening delay, a seriously ill young woman was finally delivered of a non-viable fetus by cesarean section.  Beatriz's fetus was diagnosed with anencephaly early in the pregnancy and could not survive. The baby died within hours of its delivery, as expected.

For many people who have been watching this story, there was a collective sigh of relief; Beatriz's life has been saved!  Over here at NiftyIdeas I am relieved, yes, that one part of this woman's horror story has come to an end, but I am angry because the story does not end there.

 Beatriz is finally free of a doomed pregnancy.
 She now faces the difficult recovery from 
major abdominal surgery as well as from 
the physical and psychological fallout 
of having been made a reproductive prisoner 
of the state for several months.
One woman in El Salvador was forced to pay the price of a government bowing to political pressure and ruling that all of its citizens must obey the dictates of religious conservatives.

One woman in El Salvador was denied the right to freedom from reproductive slavery; was denied the right to "stand her ground" and defend herself from the threat of physical harm and even death.

One woman in El Salvador is a symbol for millions of women all over the world who have suffered a similar fate - or worse - and the millions more who will continue to suffer from state-sanctioned reproductive slavery and even murder.

Because she was a pregnant woman, Beatriz was denied a basic human right: the right not to have any part of her body - or her whole body - forcibly used by the state to serve the needs of another human being. That is a form of slavery. No man can legally be forced to give up control of his organs or blood to keep another human being alive - not even if that other human being is his own innocent child. Even non-pregnant women are usually permitted to protect their own bodily autonomy in the same way. The ideology called "sanctity of human life" which urges states to force pregnant women into giving up bodily autonomy no matter what the risk to themselves disappears in a puff of smoke once a fetus emerges from a womb as a living baby. Then, it can go to the devil as far as "pro-lifers" are concerned. They fight to deny babies life-saving health care, food and education after birth equally as hard as they fight to force their mothers into giving birth in the first place.

The cesarean section that Beatriz underwent yesterday was not a satisfying conclusion to a dramatic political and religious fight. The sighs of relief are premature and misplaced. Except for the long-overdue ending of her doomed pregnancy, Beatriz has suffered as horribly as it was possible to suffer because of her country's sick theocratic laws and she is still not out of danger. Beatriz was at risk for every kind of regular pregnancy injury and she has certainly suffered several. She has almost certainly suffered severe and permanent damage to her health, too and she could very likely have died. She could still die as a direct result of the chain of health repercussions that this forced pregnancy has caused.

Beatriz was forced to endure months of high risk pregnancy as a slave to other peoples' ideological demands. Like every woman who has experienced pregnancy, Beatriz will have lifelong effects to her body and her health due to the stress that even a normal, healthy pregnancy would have had on her body. Unlike most healthy women, however, Beatriz has undoubtedly suffered major repercussions which will negatively impact her health for the rest of her life. Kidney failure is not a minor, easily reversible thing which will magically disappear now that she is no longer pregnant. She may or may not ever recover from that. The triggering of a severe autoimmune disease flare up is not a minor thing which will disappear now that she is no longer pregnant. Autoimmune disorders are like a genie in a bottle - once that cork is popped and the evil genie escapes, the repercussions spiral outward from there; there is no stuffing it back inside the bottle.
Beatriz's fetus suffered from a 
fatal birth defect: anencephaly
It's brain and parts of its skull
were missing
 It could not survive.

Finally, the cesarean section itself was major abdominal surgery involving cutting through the densely muscled abdominal wall, cutting into an organ - the uterus - and removing the fetus. It should always be the last resort in normal healthy women because the risk of harm to the woman is so high. Beatriz should never have been forced to endure a doomed pregnancy for so long that her only medical option in the end was to face even more risk to her health and life by undergoing a major surgical procedure.  It was unnecessary for Beatriz to have ever been forced into that situation, and I contend that it was criminal for her government - and the theocrats who control her government - to have persistently harmed her in this way.

The risks of pregnancy have been minimized and dismissed by proponents of forced birth, to the point where the general population is almost completely ignorant of facts. The average man on the street actually believes that because it is both "natural" and commonplace, pregnancy is no big deal - that it has only trivial deleterious effects on a woman's life and health - and that labor and vaginal birth or even cesarean section are likewise no big deal, either. Pregnancy is indeed, "natural" - as are many biological functions which may exact a very high cost on the functioning organism - but it is by no means a trivial matter.

Illness, injury and even death
caused by pregnancy is a reality,
as are lost wages, high medical bills
and countless other hardships
suffered by women but ignored
or minimized by society.
Every pregnancy causes lifelong negative changes in a woman's body. No mother escapes that. These range from the universally-experienced, relatively benign, but still psychologically painful (stretch marks, loss of youthful tone in the body) to the frequently-experienced, moderately serious and both physically and psychologically devastating (permanent loss of bladder control; vaginal and perineum tearing resulting in permanent scarring, damage and pain; damage to the abdominal wall resulting in lifelong weakness and risk of hernia) to the rare, but significant number who suffer serious pregnancy harm (massive blood loss and organ failure causing lengthy and incomplete recovery; months of debilitating pregnancy complications requiring expensive, bankrupting medical care; loss of ability to work and earn a living or care for other children; loss of life).

The reality of c-section is that
it is a major surgery carrying
a risk of major complications
and months-long recovery.
Statistics for these harms are difficult to pin down because the popular narrative discourages reporting of pregnancy-related harm, and in fact many pregnancy or childbirth-related injuries and deaths are recorded as caused by whatever secondary cause stemming from the pregnancy actually killed the woman. In other words, if a woman's organs shut down due to massive blood loss in delivery, her death might be recorded as " catastrophic organ failure" and never be factored into any statistical analysis pointing to risks of pregnancy and delivery. Further, hospitals in most places are not required to report maternal injury or death statistics as a separate database.

These flaws in reporting help to conceal the extent of the risk that women take on when pregnant and it helps to perpetuate the false narrative that pregnancy is a natural, easy "choice" which is always better for a woman as well as an embryo. In fact, pregnancy is never objectively better for a woman than either abortion or never conceiving in the first place. It is much worse for her in every way - physically, psychologically, economically and legally. Obviously, human beings still wish to reproduce and many women wish to become mothers so they voluntarily risk these hardships. The problem is when society compels them to undertake these risks.

Sadly, Savita Halappanavar
did not survive her state's
determination to murder her.
When a pregnancy is voluntary, most women willingly take on the health risks even when they are properly informed about the potential seriousness of those risks because they choose to be pregnant. Often however women are not informed of the risks of pregnancy because the narrative has been controlled by anti-choice activists who promote the minimization of pregnancy risks and dismissal of the huge impact pregnancy makes on a woman's life. Because of deliberate miseducation, many women voluntarily become pregnant without understanding the full range of risks they are taking, and if the pregnancy later causes or uncovers a serious health issue, these women are put into a horrific quandary. Furthermore, whether women understand the risks or not, their ability to choose whether or not to take on the risks of pregnancy is being more and more reduced, even in so-called "progressive" countries where constitutionally-protected abortion rights still exist at least in theory.

Beatriz will never be the same again. If she survives the surgery and its aftermath, she will still endure a lifetime of severely diminished health and strength as a direct result of the actions of the Salvadoran state. She was forcibly harmed by the Salvadoran state, through its religiously-mandated laws and its theocratically-controlled government. I'm going down on record to say that the fact that this can still happen to any woman in the 21st century is an outrageous affront to human morality and a terrifying miscarriage of justice.

As the Republican party - representing the extreme religious right wing of society - continues to push anti-choice legislation through state legislatures and Congress, the safety and human rights of women
The 2012 Republican-dominated
Congress put policing women's
health before jobs, in spite of the
promises that got them elected.
even in the USA is in jeopardy. Access to safe legal abortion might be denied to women in a modern, democratic country is no longer guaranteed. In fact, in many states it is nearly impossible for a woman who needs an abortion to get the health care she needs and in most other states, it is increasingly difficult. What happened to Beatriz and Savita is already happening here, and has been happening for years. One reason why the stories are not publicized is because of false reporting of the causes of injury or death as noted above. But it is the implacable resistance in society to the notion that pregnancy might pose dangers to women which fuels willful blindness. In the USA and Canada, people don't know that many women every year are denied the healthcare they need, because they do not want to know.

Women are at risk of reproductive slavery and medical malpractice all over the world including in the "progressive" west. Instead of prioritizing women's health, increasing access to effective contraception for every woman and abortion services for women who need them, societies romanticize pregnancy and childbirth, fight against comprehensive sexual education for young people, limit access to healthcare, force pregnancy and childbirth and then saddle women with all of the physical and economic costs of involuntary parenthood. Men and women who value justice and human rights ought to be paying attention. Tomorrow we may be reading about a Beatriz or Savita in our own hometowns.





Monday, June 3, 2013

Monday Music - Broadway's Not Just For Gays Anymore!



The Tony Awards will be presented this coming Sunday, June 9 at Radio City Music Hall in New York City.

Theater! Music! Dancing! On that glittering evening, we will be treated to a taste of the best of all three for 2013. Maybe if we're lucky, there will even be a little dollop of humor to spice things up.

So break out the popcorn and get comfortable (What? There has to be some upside to not having a snowball's chance in hell of actually attending a star-studded event like this in person. We get to eat popcorn, so eat your hearts out celebrities!). Here is a warmup for NiftyReaders!

For your Monday Music, Neil Patrick Harris and company at the 2011 Tony Awards.