Health and Medicine

Few Political Stories Make Me Angry. This One Makes Me Angry. And Frightened.

/ Jack Marshall / 16 Comments

brideg-collapse

In these three posts—Blame Everyone for Infrastructure Ruin: Unethical, Irresponsible Priorities from Reagan to Obama (2010); Ethics Heads-Up: When the President Talks About “Investment in Infrastructure,” Pay Attention (2011); Hole-in-the-Roof Ethics: If Obama Asks For Massive Infrastructure Renewal, the GOP Must Support It. (2011), I laid out the unanswerable case for making national infrastructure renewal a priority. Let me just quote from the three, to save me typing time…

In the early Eighties, I oversaw an independent study funded by the Highway Users Federation and the National Chamber Foundation called “Transport Tomorrow,” exploring the immediate need for transportation infrastructure repair and expansion in all modes of transportation: roads, railway, waterway, and airports. In the process of learning how dire the need for massive construction and repair was if America’s future commercial needs were to be met, the study commission made a disturbing discovery: urban water and sewer systems were crumbling too. There was literally not enough money to fix all the roads, bridges, tunnels, water mains and sewer pipes that had to be fixed, and the consequences of not doing so would be economic paralysis and worse, disease and even social unrest.In the face of this looming and undeniably real disaster, the Reagan Administration did—pretty much nothing. Neither did the Bush, Clinton and Bush II administrations…

Seldom is a solution to a problem so obvious, and so conducive to bi-partisanship. It is a solution to two problems, really: America’s dangerously rotting infrastructure, and the nation’s dismal unemployment rate. Spend the money, trillions if necessary, to repair and replace existing roads, railway beds, waterways, sewer systems, airports and bridges.  It still won’t get us where we need to be, but we’ll be much better off than if we let the current deterioration continue, and we’ll save money in the long run, too—real savings, not phony health care reform savings that evaporate once reality kicks in.

There is no justification not to do this, nor is there any legitimate excuse for any elected official not to vote for it. (And no, not wanting to give the President a victory is not legitimate…or ethical, or patriotic.) Repairing the infrastructure isn’t “discretionary spending,” it is essential, unavoidable and cost-effective spending, unless it is diverted into new boondoggles and pork. No new structures, unless they replace unrepairable old ones. No light rail systems or bullet trains; what is needed is basic maintenance and repair….everywhere. It is already late, but “better late than never” has seldom been as appropriate.Will fixing the infrastructure add to the deficit? Not really, because it already is an expense that we know will have to be made, or else. If the sewer systems and waterworks break down, we start dying. If bridges collapse, we die too. That isn’t even mentioning the increasing costs in energy and commerce caused by a decaying transportation system. The sooner we pay for it, the less it will cost, so sooner is per se better for the economy, and it is perfect timing given the employment crisis.

Yes, Obama better have a way to pay for it, with real budget cuts and reasonable taxes. If he plays politics with the proposal by making it impossible for the GOP to support (as some pundits, like the Post’s Eugene Robinson, have advised), shame on him. This has to be paid for, but it also has to be done…If Obama puts a fair, reasonable, relatively pork-free proposal on the table, Republicans would be despicably unethical to reject it.

As we now know, the Obama Administration proposed, and the GOP Congress opposed. This is a long-term bi-partisan failure, but it must be remembered that Obama had no credibility on this issue, and he never did propose a a way to pay for it “with real budget cuts and reasonable taxes.”

I was reminded of this issue when I read yesterday about how engineers have concluded that over 9% of the nation’s bridges are structurally deficient. Bridges are just part of the infrastructure disaster to come—just wait until the 200-year old sewer and water systems in some cities start breaking down, and we have Flint, Michigan times a thousand—but they are illustrative of our government’s failure. Continue reading →

Two Unethical And Unconstitutional Laws On Guns, One From The Right, One From the Left, Bite The Dust. Good.

/ Jack Marshall / 11 Comments

guns4

I.

As last year’s flat-out demagoguery about banning gun ownership for citizens placed on the FBI’s no-fly list proved, Democrats will never let the Constitution get in the way of an emotion-based attack on gun rights. A rule  implemented by former President Obama after the 2012 Sandy Hook shooting (“WE HAVE TO DO SOMETHING!!!”) would have required the Social Security Administration to report the records of some mentally ill beneficiaries to the FBI’s National Instant Criminal Background Check System. Those who have been deemed mentally incapable of managing their financial affairs — roughly 75,000 people — would have then been prevented from owning guns.

The American Civil Liberties Union and advocates for the disabled opposed the restriction, which was so broadly drawn that an Asperger’s sufferer could have his Second amendment rights taken away. And what, exactly, is the link between not being able to handle one’s financial affairs and violence? Hell, I can barely handle my financial affairs.

By a 57-43 margin, the Republican-led Senate voted last week  to repeal the measure, and it now heads to the White House for President Trump’s signature.

Iowa Sen. Chuck Grassley, a leading Republican critic of the rule, said that it was filled with “vague characteristics that do not fit into the federal mentally defective standard” that could legally prohibit someone from buying or owning a gun. “If a specific individual is likely to be violent due to the nature of their mental illness, then the government should have to prove it,” Grassley said

Sen. Chris Murphy, a Democrat from Connecticut where the Sandy Hook massacre occurred, and thus obligated to grandstand regardless of the fact that he’s on shaky 2nd Amendment, 5th  Amendment and also Equal Protection  ground, declaimed on the Senate floor,

“The [Congressional Review Act] we have before us today will make it harder for the federal government to do what we have told them to do for decades, which is to put dangerous people and people who are seriously mentally ill on the list of people who are prohibited from buying a gun….If you can’t manage your own financial affairs, how can we expect that you’re going to be a responsible steward of a dangerous, lethal firearm?”

Well, I guess nobody in Congress should own a gun either, right, Senator? Continue reading →

The 8th Annual Ethics Alarms Awards: The Worst of Ethics 2016: The Last Of The Worst

/ Jack Marshall / 23 Comments

how-lead-gets-injpg-1e9d798a1edee129

Ethics Alarms wraps up the Worst in 2016 Ethics with the usual education and journalism breaches, Ethics Dunce of the Year, and more delights for the sadistic…

Unethical Government Fiasco Of The Year

The Flint, Michigan water crisis.  A failure of competence, diligence, responsibility and honesty, compounded by bureaucrats, elected officials, the city of Detroit, Michigan Governor Rick Snyder and the EPA made people sick and cost billions.

Good job, everybody!

Scam of the Year

Sen.Ted Cruz’s fake “official” mailer before the Iowa Caucus. Cruz’s campaign  sent out mailers labeled in all capital letters, “ELECTION ALERT,” “VOTER VIOLATION,” “PUBLIC RECORD,” and “FURTHER ACTION NEEDED.” On the other side, the mailer said, in red letters at the top, “VOTING VIOLATION.” The text read:

You are receiving this election notice because of low expected voter turnout in your area. Your individual voting history as well as your neighbors’ are public record. Their scores are published below, and many of them will see your score as well. CAUCUS ON MONDAY TO IMPROVE YOUR SCORE and please encourage your neighbors to caucus as well. A follow-up notice may be issued following Monday’s caucuses.

This is why Trump’s nickname for Cruz, “Lyin’ Ted,” was crude but accurate.

Ethics Dunces Of The Year

All the social media users and others who ended Facebook friendships, genuine friendships and relationship over the 2016 election. Haven’t they ever seen “It’s A Wonderful Life”? Morons. Shame on all of them.

Weenies of the Year

The college students who demanded that exams be cancelled, therapists be available, safe spaces be found, puppies be summoned and cry-ins be organized because the awful candidate they supported in the Presidential election lost, as candidates often do.

How embarrassing.

Unethical University Of The Year 

Liberty University.  This is the most competitive of categories, with all the schools that railroaded male students based on questionable sexual assault claims while quailing in fear of the Dept. of Education’s “Dear Colleague Letter,” and all the schools that signaled that the results of a simple election justified PTSD treatment for their shattered charges, as well as making it clear to any students who dared to tilt Republican that they were persona non grata. Nonetheless, Liberty University takes the prize with its unique combination of greed, hypocrisy, and warped values. From the Ethics Alarms post:

Last week, with great fanfare, Liberty hired Ian McCaw as its new athletic director. “My vision for Liberty is to position it as a pre-eminent Christian athletic program in America,” McCaw said during a news conference.

This is his first paying assignment since May, when he left his job as the athletic director at Baylor, also a Christian university. His departure was made essential after a thorough investigation that found that those overseeing Baylor’s  football team as well as the management of  the athletic department—that is, McCaw— had been informed of multiple gang rapes and sexual assault by team members and had ignored it, as any good football-loving Christian would….especially when a star was involved.

Continue reading →

A Banner Day For Unfairness, Pettiness, Dishonesty, And Hypocrisy, Raising The Ethics Query: How Low Can Democrats And The News Media Go?

/ Jack Marshall / 21 Comments
Actually, mudslinging would be an improvement...

Actually, mudslinging would be an improvement…

…as well as the related queries..

1. How low do they think they can go without alienating every American with a conscience and a brain?

2. Does any leader with integrity, courage and influence exist in either journalism or the political left to call out this escalating madness?

Yesterday was a stinking garbage scow of unfiltered anti-Trump hate and public deception.

The Prayer Breakfast Freak-Out: I wondered if the Washington Post, which has made very clear its own attitude regarding prayer (and religion generally), would have the gall to criticize the President for not being sufficiently pious during yesterday’s Prayer Breakfast. Just two weeks ago, the Post mocked the Secretary of Agriculture nominee for once “praying for rain.” (The mocking headline has been scrubbed now) Sure enough, the Post did have such gall; so did MSNBC and other media outlets that regularly display contempt for the genuinely religious, a significant majority of whom are conservative and Republican.

The critics of the President’s comments care nothing about prayer, basically like me, but unlike Ethics Alarms they are willing to plow new ground in hypocrisy by using this superfluous event to launch more gratuitous outrage. The Prayer Breakfast has the same origins as the addition of God to the Pledge of Allegiance. It was an anti-Godless Communism grandstanding stunt by Fifties era Republicans at the height of their Red-Baiting mode.  Now the same anti-religion liberals who routinely condescend to the faithful, and lobby for taking all references to “God” out of official documents, the same anti-religious  zealots who have condemned Betsy DeVos for her support of Catholic schools, are deeply, deeply offended that the President joked about “The Apprentice” at a Prayer Breakfast.

The Frederick Douglas freakout: The President spoke of Douglas in the present tense in his random remarks about Black History Month on February first, prompting multiple cheap shots and despicable contrived insults. The Post wrote yesterday, Continue reading →

Dentistry Ethics, Arkansas-Style: “Nice Little Dental Practice You Have Here, Dr….Too Bad If Anything Were To Happen To It!

/ Jack Marshall / 20 Comments

Smiling female dentist procedure of teeth cleaning

In 2013, Dr. Ben Burris, a successful Arkansas orthodontist, began offering low-cost teeth cleanings at his 11 offices around the state. This, he says, was a public service on his part, as he knows that preventive care is critical for teeth and that citizens who can’t afford dental insurance, which is expensive, often neglect cleanings. His cleanings cost $99 for adults and $69 for kids, far less than what other dentists charged in the state.

Burris quickly heard from  the Arkansas State Board of Dental Examiners and was told that he was breaking the law.  The Board threatened him with loss of  his license if he didn’t cease his bargain  cleanings. Why?

Well, Arkansas, like some other states, prohibits licensed dental specialists like orthodontists from doing work outside of their specialty even though they are certified to practice general dentistry.  With over a hundred employees out of work, Ben suspended the program.

What’s going on here? Boy, I did a seminar on dental ethics a few years ago: I wish I had another one where I could discuss this. The regulation is nothing more than the profession lobbying the legislature and limiting services to drive up prices. What other possible explanation is there? Cleaning teeth is not the rocket science of dentistry, and any qualified dentist should be completely competent to supervise the task, especially since much of teeth cleaning is handled by hygienists. A licensed dental hygienist is legally qualified to work in a general dentist’s office or that of a specialist without restrictions.  But the orthodontist was venturing outside of the little specialist’s box the state had built for him. Continue reading →

Self-Driving Car Ethics: Who Do They Decide To Kill? You?

/ Jack Marshall / 25 Comments

av-choice

CBS’s “Bull,” a drama about a jury consultant (played by “NCIS” alum Michael Weatherly) is an ethics mess…but then, so is the former jury consultant Weatherly’s  character is loosely  based on: “Dr.” Phil McGraw. The show does find some interesting ethics issues, however. A couple of weeks ago the story involved the programming in an experimental self-driving car. The issue: is it ethical for such a car to be programmed to kill its passenger if it has to make a life or death choice?

The ethical conflict involved is the so-called “trolley problem,” which is, as the name suggests, over a hundred years old. British philosopher Philippa Foot developed it into series of hypotheticals in 1967. In 1985, American philosopher Judith Jarvis Thomson scrutinized and expanded on Foot’s ideas in The Yale Law Journal. Here is one of Thompson’s scenarios:

“Suppose you are the driver of a trolley. The trolley rounds a bend, and there come into view ahead five track workmen, who have been repairing the track. The track goes through a bit of a valley at that point, and the sides are steep, so you must stop the trolley if you are to avoid running the five men down. You step on the brakes, but alas they don’t work. Now you suddenly see a spur of track leading off to the right. You can turn the trolley onto it, and thus save the five men on the straight track ahead. Unfortunately,…there is one track workman on that spur of track. He can no more get off the track in time than the five can, so you will kill him if you turn the trolley onto him.”

The problem: Now what, and why?

A. Throw the switch in order to maximize well-being (five people surviving is greater than one).
B. Throw the switch because you are a virtuous person, and saving five lives is the type of charitable and compassionate act a virtuous person performs.
C. Do not throw the switch because that would be a form of killing, and killing is inherently wrong.
D. Do not throw the switch because you are a Christian, and the Ten Commandments teach that killing is against the will of God.
E. Do not throw the switch because you feel aiding in a person’s death would be culturally inappropriate and illegal. Continue reading →

Why Health and Human Services Nominee Price’s Smoking Gun Ethics Breaches Won’t Disqualify Him

/ Jack Marshall / 11 Comments

smoking-gun

There was good news on the Trump Administration Ethics Train Wreck, still just pulling out of the station. Despite the ethically-challenged reaction fro the Trump transition team when it was revealed that Monica Crowley had plagiarized in her latest book, somebody, somewhere, persuaded the conservative radio talk-show host to resign her new White House post. Good. But as many—most?—predicted, the muck is just beginning to bubble to the surface.

CNN reports that Rep. Tom Price,Trump’s nominee for Secretary of Health and Human Services who will have much of the responsibility for dismantling Obamacare  without triggering a health system crash, appears to have engaged in a flagrant instance of using his position for financial gain.  Last year, Price purchased shares in Zimmer Biomet, a medical device manufacturer [Full disclosure: I have one of their artificial hip joints, setting off metal detectors at airports all over the world] right before he introduced  legislation that would have directly benefited the company.

Price bought between $1,001 to $15,000 worth of shares in the company last March, and then, less than a week after the transaction,  introduced the HIP Act (Clever!) to delay until 2018 a regulation that industry analysts believed  would significantly hurt Zimmer Biomet, one of two companies most affected by a regulation that limits payments for joint implant procedures. Not only did Price have a financial stake in the regulation he tried to stall,but after Price introduced  his bill, Zimmer Biomet’s political action committee donated to the Georgia congressman’s reelection campaign.

Merely a coincidence, I’m sure.

Price is scheduled to appear before the Senate Health Committee this week, and the Senate Finance Committee later. He should withdraw, or failing that, Trump should pull the nomination. Price’s purchase of the Zimmer Biomet shares isn’t the first time he’s used inside information (the inside information being “I’m going to propose a bill”) to buy shares in a company. The Wall Street Journal reported last month that he traded roughly $300,000 in shares over the past four years in health companies while pursuing legislation that could affect their bottom lines.

Yeccch. Continue reading →

Presenting The First New Rationalization Of 2017: #32A Imaginary Consent, or “He/She Would Have Wanted It This Way”

/ Jack Marshall / 39 Comments

roxieThe addition of  New Rationalization #32A Imaginary Consent, or “He/She Would Have Wanted It This Way” to the Ethics Alarms Rationalizations List became obligatory after it got a work-out over the holidays. Disney turning long dead character actor Peter Cushing into a zombie performer for the new “Star Wars” film was defended with the claim, which was almost surely also used by his heirs who were paid handsomely for the use of Cushing’s CGI avatar.

And that’s always the way this rationalization arrives. Someone wants to profit through some dubious scheme or transaction, and uses the argument that a revered and quite dead family member, personage of importance or icon “would have approved,” or “would have wanted it.” Like its progenitor 32. The Unethical Role Model: “He/She would have done the same thing,” which employs misdeeds of presumably admirable figures of the past as precedent for misdeed in the future, this is an appeal to irrelevant authority. Worse, Imaginary Consent presumes what cannot possibly be determined without prior express statements from the deceased.

This is one reason why DNR (“Do not resuscitate”) orders are essential. Using a fictional consent to absolve a decision-maker from actual responsibility is both a dodge and cowardly, as well as dishonest. I remember the horrible day that my sister and I were called upon to decide whether to terminate my mother, who was unconscious, on life support and beyond recovery. We made the decision quickly, and what my mother “would have wanted” was never a factor. (She had delegated the decision on her own DNR to my sister.) What my mother wanted, we both agreed, was to live forever. She would have been willing to have her comatose body waiting for a miracle or a cure until the hospital crumbled around her….in fact, that’s why she delegated the decision without instructions. Sure, it would have been easier to fool ourselves with #32A. But it would have been a lie.

The other true story this rationalization makes be think of is the time the elderly parents of a friend decided to euthanize their wonderful, bounding, big and joyful dog Roxie, some kind of a felicitous hybrid between a boxer and a freight train. They were moving into a resort where dogs were not allowed.  I was aghast, but they insisted, “We just know Roxie wouldn’t be happy living with anyone else.”

I argued(they did not appreciate it), “You know what? I bet if she could talk, Roxie would say, ‘You know, I really like you guys, really, and I’ll miss you a lot, but on balance I think I’d rather keep living, thanks. I’ll miss you, but I’m pretty sure I’ll get over it. Have a great time in Florida.'”

They killed her anyway.

#32A is a way to pass off responsibility for an ethically  dubious decision on someone who is beyond participation in that decision, and sometimes even the victim of it. It is cowardly, unaccountable, and based on an assertion that may not be true.

___________________

Special Thanks to Reader/Commenter Zoltar Speaks!, who suggested the new entry.

Obamacare’s Epitaph: “Live By The Rationalization, Die By The Rationalization”

/ Jack Marshall / 46 Comments

obamacare-gravestoneRemember in 2010, when the Democrats ensured that the Affordable Care Act would clear its final hurdle to passage this way?

Democrats will finish their health reform efforts within the next two months by using a majority-vote maneuver in the Senate, Majority Leader Harry Reid (D-Nev.) said. Reid said that congressional Democrats would likely opt for a procedural tactic in the Senate allowing the upper chamber to make final changes to its healthcare bill with only a simple majority of senators, instead of the 60 it takes to normally end a filibuster.The move would allow Democrats to essentially go it alone on health reform, especially after losing their fillibuster-proof majority in the Senate after Sen. Scott Brown’s (R) special election victory in Massachusetts.

Republicans have protested the maneuver as a hyperpartisan tactic to ram through a health bill, and have said that plans to use the reconciliation process make moot a bipartisan summit at the White House this week, where both GOP and Democratic leaders are supposed to present their ideas on healthcare.

At the time, Republicans, as is their wont, over-stated their objections to the maneuver, calling it unconstitutional and a breach of rules. No, it wasn’t quite that, nor was it as unusual as the GOP claimed. It was within Senate rules, but still the first time it was ever used to amend a bill that had already passed the Senate via cloture, and under such contentious circumstances.  Reconciliation was legal, all right, but since the Affordable Care Act was so revolutionary and controversial, its passage needed to be seen as democratic, and it wasn’t. Democrats ignored the Golden Rule, and extended the acceptable use of reconciliation by using a number of rationalizations, as well as “the ends justify the means.”

Let’s see: “Everybody Does It” wouldn’t work, because the problem with using reconciliation was that everybody didn’t do it, at least not very often.  So Democrats opted for 13. The Saint’s Excuse: “It’s for a good cause”…23. Woody’s Excuse: “The heart wants what the heart wants”…#24. Juror 3’s Stand (“It’s My Right!”)…25. The Coercion Myth: “I have no choice!”…28. The Revolutionary’s Excuse: “These are not ordinary times.”…31. The Troublesome Luxury: “Ethics is a luxury we can’t afford right now” …40. The Desperation Dodge or “I’ll do anything!”…59. The Ironic Rationalization, or “It’s The Right Thing To Do”…and perhaps a few other rationalizations on the list. Continue reading →

Fake News Ethics: A Quick Audit

/ Jack Marshall / 9 Comments

fake-news

There is…

(1) fake news,

(2) misleading or incompetent reporting,

(3) news that some people call fake because they don’t like its likely effects or implications, and

(4) news that people want others to think is fake so they can peddle their own fake news.

Did genuine, unequivocal fake news affect the 2016 election—that is, the first kind, the kind peddled by hoax sites like The News Nerd, and the Macedonian junk like the story about the Pope endorsing Trump?  There’s no evidence that would suggest or support that. Many voters are naive, gullible, ignorant fools, but still: how many actually changed their votes based on complete fiction? It’s impossible to tell, but stating that this was the case is itself a form of fake news.

Democrats and partisan pundits had been using the “fake news” device to mute the voices of journalists who didn’t follow in lockstep to the mainstream media pro-Democratic march. The IRS scandal, which is real and damning, has been largely ignored by the mainstream news media and called a “nothingburger” in Obama Administration talking points.The assertion that it is a myth that the IRS is using its power to suppress conservative dissent is …..fake news.

Because Fox is the only major news outlet (I do not count the slimy Breitbart websites) that was consistently critical of the Obama administration when it deserved it (and sometimes when it did not), Democrats not-quite-successfully-enough set out to marginalize Fox, calling it “faux news” and pushing the Obama narrative that it wasn’t even a legitimate news source. Obama, in an interview with Rolling Stone (speaking of sources of fake news!), blamed Clinton’s loss in part on “Fox News in every bar and restaurant in big chunks of the country.”

Isn’t that amazing? What gall. It isn’t the fact that the debt (that Obama promised to reduce) is now just short of 20 TRILLION dollars, with Obama adding a record $7.917 trillion to it, it’s that the one news source that actively exposed that fact was available to middle class voters that led to Hillary’s loss.  It wasn’t that the Affordable Care Act didn’t let Americans keep their health care plans as Obama repeatedly swore it would, it was that Fox News kept reminding its viewers of that (as the rest of the news media soft-peddled it) , while also publicizing that thanks to the Affordable Care Act, one’s health care insurance was less affordable unless the government was paying for it. It wasn’t that Hillary Clinton had lied about her e-mail tricks for over a year, the problem was that Fox was responsibly reporting that she was lying, unlike CNN, NBC, and the rest.

You know. Fake news.

As part of an organized effort up and down Democratic groups, ranks, allies and media operatives to de-legitimatize Donald Trump’s victory, the definition of “fake news” has been conveniently expanded. The Washington Post published a jaw-droppingly sloppy, partisan piece last week alleging that

The flood of “fake news” this election season got support from a sophisticated Russian propaganda campaign that created and spread misleading articles online with the goal of punishing Democrat Hillary Clinton, helping Republican Donald Trump and undermining faith in American democracy, say independent researchers who tracked the operation.”

Continue reading →