Health Care

As many Western countries reverse their former embrace of so-called “gender-affirming care” as it applies to children, the American medical establishment has obstinately pretended that puberty blockers and transition surgeries are medically uncontroversial. The latest example: An advocacy article published in the February 12, 2025 New England Journal of Medicine — yet again — decrying laws passed to protect children from transition interventions. From “Advancing Transgender Health amid Rising Policy Threats” (citations omitted): Gender-affirming care is a cornerstone of multidisciplinary health support for transgender and nonbinary people; it is widely recognized as essential, evidence based, and often lifesaving. The standards of care issued by the World Professional Association for Transgender Health emphasize the critical role of interventions such as pubertal Read More ›

No matter election outcomes, presidential executive orders, and the ebbing support for the “woke” agenda among the general public, the medical establishment — epitomized by the New England Journal of Medicine — continues to push DEI ideology in medical school admissions policies. A recent advocacy article in the NEJM pledges fervid fealty to DEI, primarily focusing on gender ideology. From, “Facing Political Attacks on Medical Education — The Future of Diversity, Equity, and Inclusion in Medicine” (citations omitted): In recent years, the United States has seen an onslaught of legislation aimed at dismantling diversity, equity, and inclusion (DEI) initiatives in higher education, including medical education. Although these legislative actions are often construed as focusing only on race, they also explicitly or implicitly target members of Read More ›

With Texas experiencing a measles outbreak, some might expect RFK to play down vaccines or damn them with faint praise. Nope. He wrote an op-ed piece for Fox News praising the MMR vaccines — in a manner consistent with his belief that the decision to inoculate should be a matter of choice. From “Measles Outbreak Is Call to Action for All of Us:” Parents play a pivotal role in safeguarding their children’s health. All parents should consult with their healthcare providers to understand their options to get the MMR vaccine. The decision to vaccinate is a personal one. Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to Read More ›

Science, medical, and bioethics journals are setting themselves up as the new political resistance to Trump policies, most particularly around global warming controversies. For example, The Lancet published a piece blaming the Los Angeles fires on climate change, which is hardly a medical issue properly understood. A bit later — as I wrote about here — a major bioethics journal published an advocacy article asserting that it is up to bioethicists to prevent global warming. Not to be undone, JAMA has just published a column decrying Trump’s withdrawal from the Paris Climate Accord and claiming that preventing climate change is now up to doctors. From, “Defying Environmental Deregulation:” These policy changes may appear catastrophic for effective climate action, but they Read More ›

This is a delicate matter, but I think it must be confronted. The Journal of the American Medical Association has published an article that urges “neurodiversity” be given “holistic” consideration when accepting students into medical school in keeping with diversity goals. From “Embracing Neurodiversity in Medicine — Building a More Inclusive Physician Workforce:” The benefits of diversity have long been recognized with respect to persons with minoritized racial and ethnic backgrounds, women, persons who are LGBTQ+, and others, and there has been a wide range of efforts to increase the representation of these individuals among physicians. Currently, however, these same programs and institutions do not similarly prioritize neurodiversity, the range of developmental neurocognitive differences that underlie individual variation in thinking, learning, and behavior. Read More ›

I previously wrote about pending Oregon and Vermont legislation to do away with the requirement that only doctors be allowed to legally assist suicides. Now, it’s Washington’s turn, with a proposal to allow “qualified medical providers” to prescribe poison, defined as a licensed physician, physician’s assistant, or advanced practice registered nurse. I previously opined about why I think this is a very bad idea, so I won’t belabor the points further. The Washington bill also speeds up the waiting period between the first and second request for poison pills for some suicidal patients: Notwithstanding subsection (1) of this section, if, at the time of the qualified patient’s initial oral request in subsection (1) of this section, the attending qualified medical Read More ›

Yesterday, I posted about a Vermont bill that would allow nondoctors to prescribe death. I found out today that Oregon has similar legislation pending that would allow “providers” to lethally prescribe. SB 1003 specifies that “provider” can mean a licensed physician, a licensed physician assistant, or a licensed nurse practitioner. I wouldn’t trust a PA or NP to diagnose me with six months to live. Would you? That is not a putdown. These valuable medical professionals’ primary roles are to provide generalized care, monitor and manage chronic conditions, and provide wellness services. But they are not physicians. They receive less education and specialized training as compared with physician-certified specialists like cardiologists, oncologists, nephrologists, or neurologists. I suspect that the reason for expanding categories of eligible lethal Read More ›

Vermont has repeatedly expanded its assisted suicide law since it first passed. Nonresidents are allowed to receive lethal prescriptions, and assisted suicide can be prescribed via Zoom or Skype. Now, a bill has been filed that would allow nondoctor “clinicians” to prescribe death. From H.B. 75: This bill proposes to authorize naturopathic physicians, nurse practitioners, and physician assistants to participate in the processes established in Vermont’s patient choice at end-of-life laws. It would also allow naturopathic physicians to sign and issue do-not-resuscitate (DNR) orders and clinician orders for life-sustaining treatment. In other words, a suicidal patient would be able to access poison pills without ever seeing a doctor or having an in-person consultation or examination. What next? Pharmacists? Don’t laugh. Read More ›

Moves are afoot in bioethics to require caregivers to withhold food and water by mouth from a patient made incompetent by dementia if that patient, while compos mentis, has signed such a request — and even if the patient willingly eats, enjoys meals, or asks for food. It is sometimes called “voluntary stop eating and drinking [VSED] by advance directive,” in the parlance.

I have frequently criticized VSED by directive as inhumane to the patient, cruel to caregivers (as it forces them to starve people to death), and designed to open the door to lethally jabbing those with advanced dementia as the less onerous alternative to their being made to starve to death.

Now, as supposedly some form of compromise, there is a proposal on the table to barely feed — i.e., malnourish — dementia patients who have previously signed such a directive. From, “Mr. Smith Has No Mealtimes,” published in the Journal of Pain and Symptom Management (citations omitted):

Minimal Comfort Feeding (MCF)…is the provision of only enough oral nutrition and hydration to ensure comfort. With MCF, eating and drinking is not scheduled; rather, caretakers offer food and liquids only in response to signs of hunger and thirst. Patients are neither wakened for regular mealtimes nor encouraged to eat or drink. Instead, they are offered frequent, fastidious mouth care, continued social contact, therapeutic touch, sensory distraction, and medications to relieve distress associated with apparent thirst or hunger before being provided with minimal amounts of liquid or food.