Health and Medicine

An O. Henry Story Comes To Life

/ Jack Marshall / 2 Comments

James Verone, a.k.a. " the Rosa Parks of health care," a.k.a. "Soapy"

The media thoroughly disgraced itself by hyping the stupid story of James Verone, an out-of-work 59-year-old man with health problems who robbed a bank in Gastonia, N.C., for $1,  and then  waited patiently for the cops to arrest him.“When you receive this a bank robbery will have been committed by me. This robbery is being committed by me for one dollar. I am of sound mind but not so much sound body,”read the note that Verone handed the bank clerk.

Verone grabbed his 15 minutes of fame with gusto, telling the local TV station that he became a thief out of sheer desperation. He needed health care, he said, and had no other way to get it than through the free care provided in jail. The problem with this is that he had plenty of better options than turning to intentionally unsuccessful crime. A hospital in Gastonia, Gaston Memorial Hospital, offers discounts up to 100% to low-income patients. There is also a free health clinic five miles from the bank Verone robbed, and more in nearby Charlotte. Or Verone could have received treatment from of the state-of-the-art medical facilities at the University of North Carolina, whose mandate is to provide “medically necessary health care to the citizens of North Carolina, regardless of their ability to pay.”

Naturally, few of the media reports, calculated to use this idiot’s stunt to shill for government-financed health care, bothered to report any of this. Continue reading →

When Business Rejects Ethics: the Sorabella Story

/ Jack Marshall / 9 Comments

"So sorry about your wife's cancer, Carl. Let me know if there's anything we can do. Oh, by the way...you're fired."

I usually feel that organized labor rhetoric about cruel and heartless employers is archaic and exaggerated for political effect. This story, however, is almost enough to make me pick up a sign and start picketing.

Carl Sorabella, 43, got a merit raise in November for Haynes Management,  a real estate company in Wellesley, Mass., where he has worked as an accountant for almost 14 years. Then he learned that his wife, Kathy, had been diagnosed with advanced cancer. Told that the likelihood was that she had only months to live, Carl approached his boss. Sorabella explained that his wife’s illness would require him to have flexible hours as he supported her during her tests and treatment. He assured her that he would do whatever was necessary to keep his work up-to-date and complete his duties.

She fired him anyway. Continue reading →

Sorrell v. IMS Health: Legal, Ethical, and Unjust

/ Jack Marshall / 1 Comment

The case of Sorrell v. IMS Health, which the Supreme Court decided yesterday, sharply focuses the philosophical disagreement over the role of the courts in public policy. The legal question was rather straightforward; the ethical issues are complex. Is it the Court’s duty to make bad—but constitutional— laws work, or is its duty to follow the laws, and leave it to the legislature to fix their flaws?

This was a case about incompetent  lawmaking. Gladys Mensing and Julie Demahy had sued Pliva and other generic drug manufacturers in  Louisiana and Minnesota over the labels for metoclopramide, the generic version of Reglan. The drug, used to treat acid reflux, had caused them to develop a neurological movement disorder called tardive dyskinesia. None of the generic drug’s manufacturers and distributors included warnings on the labels about the danger of extended use of the medication, even though the risk was known to them. Neither did the manufacturers of the brand-name drug. The problem was that the state statutes required generic drug manufacturers to included warnings about dangerous side effects, while federal regulations required generic drugs to carry the exact same label information as their brand name equivalent.  Continue reading →

The FDA’s Disgust Offensive: Manipulative and Wrong

/ Jack Marshall / 27 Comments

Why stop at this?

I’ve never smoked.  My wife is a smoker and I am worried about her; I also think the tobacco industry is more or less despicable. Nevertheless, I find the new disgust-initiative by the FDA on cigarette package labeling  troubling. If it’s ethical, it only passes muster in a utilitarian balancing formula, and even then I think it opens the door to government abuse.

Thanks to a 2009 law, cigarette makers must add large, graphic warning labels depicting diseased lungs, a man exhaling smoke through a hole in his neck, a baby near a cloud of smoke, a dead body, a man wearing a black t-shirt with “I Quit” written across the chest and three other ugly images to packaging and advertising in the U.S. by October 2012. These will be accompanied by warning labels with messages like “Smoking can kill you” and “Cigarettes cause cancer.” In full, stomach-turning color, the new labels must occupy the top half of the front and back of  cigarette packs, and 20% of any cigarette ad’s space. The labels must also include the number of a national quit line and the current warning labels.

All this, yet the government allows the stuff to be sold. I don’t get it, frankly. If cigarettes are so bad that the FDA feels it has to use tactics this extreme, then it should have the courage to just ban them, like they ban other harmful substances. Continue reading →

Return to a Sore Subject

/ Jack Marshall / 1 Comment

"Does anybody care?"

[NOTE: An unusually busy travel schedule combined with terrible hotel WiFi and a week that was already stuffed with juicy and provocative ethics stories resulted in my not fulfilling my duties very well the last three days, for which I apologize sincerely. I’m going to make every effort to catch up this weekend.]

Rep. Weiner resigned at last, noting that his district and its constituents deserved to have a fully functioning representative in Congress, and that he could no longer fulfill that role. True enough, though one has to ask (or at least I do): if the people of Queens and Brooklyn deserve better representation than a hard-working, if dishonest, obsessed and twisted, pariah can offer, what about the people of the 8th District of Arizona, who have a representative who can’t funtion in her post at all?

I was going to wait until the six-month mark in Gaby Giffords’ rehabilitation to raise this matter again, since that will mark a full 25% of the Congresswoman’s term that she has been unable to serve, but the combination of Weiner’s resignation and the news of Giffords being released from the hospital created too much dissonance for me to ignore. I fully expect that I will be writing some version of this post 18 months hence, after Rep. Giffords’ entire Congressional term has passed without her voting on a bill or answering a constituent’s letter. To quote the singing John Adams in “1776,”: “Is anybody there? Does anybody care?”

Reports from various medical personnel enthused that Giffords has made remarkable progress, and “seems” to understand “most’ of what is being said to her, though she still has trouble articulating responses. That is great progress for someone who has some of her brain blown away by a gunshot at close range, but it sure doesn’t sound like someone who is going to be making a persuasive argument on the House floor any time soon, or ever. So are we serious about this running the country stuff, or aren’t we? Continue reading →

Hateful, Vicious and Wrong…Constitutional or Not

/ Jack Marshall / 11 Comments

In New Mexico, Greg Fultz has responded to the loss of the baby he almost fathered with  his ex-girlfriend by putting up a billboard along the Alamogordo, NM. thoroughfare that shows him holding the outline of an infant, accompanied by text that reads, “This Would Have Been A Picture Of My 2-Month Old Baby If The Mother Had Decided To Not KILL Our Child!”

His ex-  has taken him to court for harassment and violation of privacy, demanding that the billboard be removed.  Fultz and his attorney are not giving in, and argue the order violates Fultz’s free speech rights.

Fultz may have a good case. I could see him prevailing in a First Amendment analysis that places free speech above the breach of privacy and the embarrassment such a billboard would cause. If his girlfriend really did have an abortion (she claims it was a miscarriage), I can also understand how many would sympathize with his claim of father’s rights.

It doesn’t matter. The billboard is ethically indefensible. It is motivated by hate and anger, and designed only to humiliate and hurt. Putting it up is a mean-spirited act of vengeance, with no redeeming virtues at all. I sure wouldn’t want to be the kid that had a man who would do something like this as a father, and I can certainly understand why the ex-mother is also an ex-girlfriend.

The only good thing about the billboard is that it doesn’t have a picture of any portion of Congressman Weiner.

Toronto: Religious Bullies Distort the Alcoholics Anonymous Mission

/ Jack Marshall / 20 Comments

In Toronto, two Alcoholics Anonymous groups that specifically removed reference to God and religion in their version of the Twelve Steps have been de-listed by the central organization there, a straight exhibition of the abuse of power and a breach of integrity in the pursuit of selfish ends.

Alcoholics Anonymous, as anyone who has listened to Charlie Sheen’s anti-AA rants knows, employs repeated evocations of God and “a higher power” in its formula for treating alcoholism.  But while many have successfully turned to faith in their journeys to sobriety, most individual AA chapters neither insist on religious belief nor preach it, leaving it to each member to decide what his or “her higher power” is. To many, it is a God, and to many it is the fellowship of AA itself. The point of the higher power is to help an alcoholic discover the spiritual strength and resolve to conquer a pernicious and powerful disease with no known cure. the objective of AA, however, is not to seek to strengthen religion. Continue reading →

“Grow Your Own Marrow Donor” Ethics and Consequentialism: The Ayala Family Saga

/ Jack Marshall / 24 Comments

Anissa Ayala and her custom-made bone marrow donor

Once again, the fans of that ethically corrosive twin of  “the ends justifies the means,” consequentialism, were holding court in the mass media, as the “Today Show” revisited a two-decade old ethical outrage to declare that it was all perfectly fine after all…because it worked.

Thus does television, itself dominated by ethically-dim writers, producers and stars, corrupt the public. So here we go again:

Does the fact (if it indeed is a fact) that Osama bin Laden capture and execution was facilitated by torture make torture less ethically wrong?

No.

Do the fortuitous results of any action that was unethical from its inception change the nature of that conduct from unethical to ethical.

Again, no.

Is conceiving a child solely to provide donor bone marrow to her cancer-stricken older sister ethically acceptable as long as the sister’s cancer is cured?

Absolutely not!  But to listen to the “Today Show,” and revoltingly, the “Today Show’s” resident medical correspondent Dr. Nancy Snyderman, it is not only ethically acceptable but laudable. Because it worked.

Twenty years ago, Abe and Mary Ayala were desperate because Anissa, their 16-year-old daughter, had been diagnosed with leukemia. Chemotheraphy proved ineffective, and neither the Ayalas nor their son was a compatible bone marrow donor. The Ayalas had long before decided that two children were enough; Abe had a vasectomy. But then Mary came up with the idea of having another child in the hopes that it would be a bone marrow donor who could save Anissa’s life. Continue reading →

Ethics Malpractice from “Dear Margo”: The Tale of Witchy, Tubby and Sue

/ Jack Marshall / 3 Comments

"Well sure---his inner qualities are much more important to me now that he's so hot!"

I read a lot of advice columns, which often involve ethical issues and very often expose the ethical incompetence of the supposed experts who write them. Some advice columnists are ethically spot-on with regularity, like The Washington Post’s Carolyn Hax. Some, like the past and present”Ethicists” of the New York Times, are off-base almost as often as they are on. Then there are the advice mavins like “Margo,” in the Boston Globe. I don’t know how such people get to be advice columnists, but I suspect it either involves picking names out of a hat or the exchange of sexual favors. [Full disclosure: I give out personal ethics advice myself over at AllExperts.com, when a legitimate questioner can find me—ethics isn’t listed as one of the site’s topics—and when the question isn’t a thinly veiled homework question, which it usually is.]

As an example of ethics malpractice, consider this question posed to Margo. “Sue” wrote that she had broken up with her ex-boyfriend over arguments about his weight and eating habits, which “grossed her out.” Eight months later, he’s fit and fabulous, and has a new girlfriend.  “I really would like him back because he’s hot and slim,” Sue writes, plaintively. “How can I step on his witchy new girlfriend so I can get him back?” Continue reading →

No Excuses and No Mercy For Lance Armstrong

/ Jack Marshall / 9 Comments

Sorry, Lance…good guys don’t cheat.

Back when Barry Bonds was still playing baseball, a sportswriter mused about why it was that everyone assumed  Bonds was a performance-enhancing drug cheater despite his protestations to the contrary, while most Americans and sports journalists brushed away similar allegations regarding Lance Armstrong. Both competed in sports with acknowledged steroid abuse problems; indeed, the problem in bicycle racing was presumed to be more pervasive than in baseball. (A few years later, with the banning of multiple Tour winners, the presumption became a certainty.) Both athletes had improbable late career improvements in their performance to reach previously unimaginable dominance in their respective sports. Both had to explain or deflect multiple credible accusations of cheating and circumstantial evidence that suggested that they were doping. Both claimed they had never failed drug tests, and there were good reasons to doubt the denials.

So why was Bonds a villain by consensus and Lance an untouchable hero? The sportswriter explored many theories (Apologies: I cannot locate the article. If someone can, please send it), among them the greater popularity of baseball over cycling, Bond’s startling physical transformation into a behemoth while Armstrong remained cyclist-sinewy,  Armstrong’s inspiring story as a cancer survivor, Armstrong’s philanthropic work,and the fact that Bonds, unlike Armstrong, was black. The biggest difference, however, and to the writer the key one, was that Armstrong acted the role of a hero, while Bonds refused to. Armstrong was friendly and accommodating, while Bonds was angry, intimidating and antagonistic. Armstrong seemed like someone who played by the rules, and who lived his ethical values. Bonds seemed like a rebel, one who wouldn’t hesitate to break the rules for his own benefit. In short, the public wanted Armstrong to be the hero he seemed to be, so they ignored the evidence linking him to performance-enhancing drugs.

After last Sunday, the disparate public perception of Bonds and Armstrong, always illogical, became unsustainable. Continue reading →