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Sunday Open Thread

It's too sunny to stay at the computer today, so here's an open thread for you. I'll be back tonight.

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    Medical Conscience Rule (5.00 / 1) (#1)
    by lobary on Sun Dec 21, 2008 at 12:21:27 PM EST
    Can any of you lawyers settle a disagreement I've had with a friend about the HHS rule Bush proposed this week.

    Is the rule meant to apply only in the context of sexual reproductive rights, or can it be more broadly used to allow any "medical services provider" receiving federal funds to refuse to treat a person on the basis of that treatment violating the provider's conscience?

    If anyone is interested, the rule can be read in its entirety here:

    http://edocket.access.gpo.gov/2008/E8-30134.htm

     

    Would it also extend to refusing to treat (none / 0) (#4)
    by nycstray on Sun Dec 21, 2008 at 01:01:51 PM EST
    someone because they were gay?

    Or what about orders of DNR? Pre-Schiavo situations?

    Parent

    Thanks (5.00 / 1) (#6)
    by nycstray on Sun Dec 21, 2008 at 01:23:43 PM EST
    Yeah, lawsuits do tend to make a line in the sand for some. Forgot about those  :)

    I'm the one who's supposed to make decisions for my parents if they can't, so now it looks like I have to check out all medical staff unless this rule gets overturned (or whatever they do). I can't remember, are they required to tell you if they have religion issues up front?

    Parent

    Shouldn't be an issue (5.00 / 1) (#11)
    by gyrfalcon on Sun Dec 21, 2008 at 02:17:02 PM EST
    in a hospital of any size.  Medical staff who object to a DNR or whatever it might be just get excused from care responsibility for that particular patient, whether it's a tech, a nurse, a doc, surgeon, anesthesiologist.

    Might make sense to have that conversation, though, with whoever at the hospital is in charge of your parent's care on a day-to-day basis, which is most often a resident, since it's easier all the way around if you and he/she are in basic agreement.

    In addition to abortion, the other controversial biggie is the issue of feeding tubes, and it would be a good idea to have that conversation in detail with parents and get their wishes in writing and signed, notarized, etc., particularly for the benefit of other family members who may object to whichever way your parents want it handled.

    I had a friend who got caught in that one once with her very elderly and non compos mentis father at the end of his life.  She knew his very, very strong wishes from numerous earlier discussions, but the rest of her family and some of his friends went totally ballistic when she carried out what she absolutely knew he had wanted and refused a feeding tube for him and just had palliative care for his remaining days.

    Parent

    One of my concerns would be (none / 0) (#15)
    by nycstray on Sun Dec 21, 2008 at 02:39:21 PM EST
    if say a Dr had religion issues that effected the advice s/he gave re treatment and care.

    We'll have to go over the "in writing" issues again. The Schiavo incident was an opportunity for some good conversation. My mother was just horrified by it. Luckily, no one in the family has religion issues that I would have to deal with.
    I'll double check on the feeding tube. Thanks for bringing that up.

    What a mess.

    Parent

    The new HHS rules should be (none / 0) (#8)
    by oculus on Sun Dec 21, 2008 at 01:31:52 PM EST
    the subject of a full-page petition, addressed to President-elect Obama in the NYT, LAT, and other newspapers of nationwide circulation.

    Parent
    They should also publish the rule(s) (none / 0) (#9)
    by nycstray on Sun Dec 21, 2008 at 01:48:22 PM EST
    in simple english so people are aware what it effects and what is required of medical professionals in the way of disclosure.

    Parent
    Heh (none / 0) (#10)
    by lobary on Sun Dec 21, 2008 at 01:55:42 PM EST
    Even simple English is not so simple in the administrative law context.

    Parent
    From personal experience (none / 0) (#18)
    by Cream City on Sun Dec 21, 2008 at 06:27:55 PM EST
    make arrangements that, if your parents have living wills that say they want to be let go rather than put through months of pain -- they will NOT be taken to a Catholic hospital.

    My father's living will was not respected for months, until we finally arranged to get all the sibs together with the docs -- sibs including a doc and a couple of lawyers.  It still took a lot of work and agony, mainly for my father. . . .

    Parent

    Not so sure, Dalton. (none / 0) (#17)
    by caseyOR on Sun Dec 21, 2008 at 03:15:26 PM EST
    This rule change is very broad. It even covers janitors and billing clerks. And there is no provision requiring doctors to inform patients of all medical options, even the ones that violate the doctor's conscience, nor any requirement that doctors refer patients to someone without the conscience problems.

    My understanding is that, yes, an LGBT person could be denied care if the provider objected to their sexual orientation. Remember, federal law does not prohibit discrimination against LGBT people. Hopefully, trauma care will not be affected

    This impacts not just abortion. Providers can refuse to tell rape victims about emergency contraception; refuse to write prescriptions for, or fill prescriptions for, birth control.

    Catholic hospitals are already looking at refusing to honor DNR and other end of life concerns like ending or declining feeding tubes.

    My question for the lawyers: many states now have laws requiring that rape victims been offered emergency contraception. State also have laws requiring insurance companies that cover prescriptions to also cover birth control. Can a federal rule, not a law passed by Congress, overrule state law?

    Parent

    Barney Frank blasts Obama choice (5.00 / 1) (#20)
    by Cream City on Sun Dec 21, 2008 at 06:31:27 PM EST
    of anti-choice-on-everything Rick Warren, from CNN tonight:

    WASHINGTON (AP) -- The longest-serving openly gay member of Congress said Sunday it was a mistake for President-elect Barack Obama to invite the Rev. Rick Warren to deliver the invocation at his inauguration.

    "Mr. Warren compared same-sex couples to incest. I found that deeply offensive and unfair," Rep. Barney Frank, D-Mass., said in a broadcast interview.

    "If he was inviting the Rev. Warren to participate in a forum and to make a speech, that would be a good thing," Frank said. "But being singled out to give the prayer at the inauguration is a high honor. It has traditionally given as a mark of great respect. And, yes, I think it was wrong to single him out for this mark of respect."

    Exactly.  

    Still waiting to hear from Pelosi (none / 0) (#22)
    by caseyOR on Sun Dec 21, 2008 at 08:56:30 PM EST
    So far nothing from the congressperson representing San Francisco. And, while I am glad the Barney spoke out, we should have heard from many members of Congress about this. It should not fall to one of the few LGBT members of Congress to call Obama out on this egregious invitation.

    So, where is the outrage, Nancy? And where is the rebuke from my own congressperson, Earl Blumenauer? Why have we heard nothing from any senators? Boxer? Wyden? Schumer?

    Parent

    8" Of Snow (none / 0) (#2)
    by CDN Ctzn on Sun Dec 21, 2008 at 12:36:51 PM EST
    yesterday, freezing rain last night, and more snow and freezing rain today. No, this is not Minneapolis, this is Portland, OR. Go figure!

    This is Vermont (5.00 / 1) (#14)
    by gyrfalcon on Sun Dec 21, 2008 at 02:27:08 PM EST
    and we're getting our third foot of snow in just over a week.  Vast amounts of shoveling, but at least it's incredibly light and fluffy dry snow.

    No wind at all this afternoon and reasonable temps in low 20s, so it's just magically beautiful out.

    Outdoorscat Marco insisted on going out, and when I opened the door, he raced giddily down the path with his tail humped, turned and leaped into a drift, leaped back out and raced back up the path and in the door with his eyes bright and happy and feeling very full of himself.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    


    Parent

    Happy to hear you had a reprieve (none / 0) (#25)
    by cal1942 on Sun Dec 21, 2008 at 10:49:48 PM EST
    We were spared last night and only got an additional 2 inches.  

    Today it's sunny but it's 8 degrees with 30 mile per hour winds gusting to 40.

    Back out again with snow blower and shovel to clear drifts. Running out of room in some places to pile up additional snow.

    Still no plow.  The longer without the plow, the higher the wall blocking the driveway.

    Parent

    Are you new to the area? n/t (none / 0) (#12)
    by MoveThatBus on Sun Dec 21, 2008 at 02:18:20 PM EST
    Palin baby overdue (none / 0) (#13)
    by wrisky on Sun Dec 21, 2008 at 02:18:45 PM EST
    It was due yesterday on the 20th. I just can't help wondering when the little tyke will arrive. Not much word on how her confinement is proceeding.

      One would think a friendly shout out to all the well-wishers among her mom's supporters would be in good taste.
     

    Women awaiting birth don't (none / 0) (#16)
    by oculus on Sun Dec 21, 2008 at 03:15:22 PM EST
    seem very "confined" to me.  Many work until the baby is born.

    Parent
    Uh, by the end . . . (none / 0) (#19)
    by Cream City on Sun Dec 21, 2008 at 06:30:00 PM EST
    I recall feeling quite confined -- not only by all those pounds but also by the need for my bladder to be no more than a minute from a restroom. :-)

    Parent
    I felt "contricted" driving our VW (none / 0) (#23)
    by oculus on Sun Dec 21, 2008 at 09:21:10 PM EST
    bug; that's for certain.

    Parent
    My internal organs (none / 0) (#21)
    by Fabian on Sun Dec 21, 2008 at 07:48:34 PM EST
    still remember feeling very "confined".  I was lucky that neither my lungs nor my bladder were seriously affected.

    Parent
    For the lawyers out there (none / 0) (#24)
    by CoralGables on Sun Dec 21, 2008 at 09:22:58 PM EST

     Gov. Charlie Crist promoted Palm Beach Judge Jorge Labarga to a seat on a South Florida appellate court last week despite Labarga's comments from the bench last year that judges will get even with lawyers who cross them, even if it takes years.

    ''When you pick a fight with a judge, ultimately, you are gonna lose. Not today, but five years from now, 10 years from now, six years from now. That judge is going to remember you, always, always,'' Labarga said.