Health Care

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.

The execrable gender ideologue Admiral Rachel Levine is no longer in government. That’s great news in the long run for children with gender dysphoria, because the new administration wants to actually protect these disturbed minors. Accordingly, President Trump today signed an executive order protecting such children from being subjected to often irreparable body-altering “gender-affirming care.” From the order, “Protecting Children from Chemical and Surgical Mutilation:”

Across the country today, medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions. This dangerous trend will be a stain on our Nation’s history, and it must end.

Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding. Moreover, these vulnerable youths’ medical bills may rise throughout their lifetimes, as they are often trapped with lifelong medical complications, a losing war with their own bodies, and, tragically, sterilization.

Accordingly, it is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called “transition” of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.

Excellent.

The American medical establishment remains radically committed to the misnamed “gender-affirming care” model, refusing to even consider following the examples of the U.K., Sweden, Denmark, Finland, New Zealand, France, Norway, and others whose health ministries have hit the brakes hard on providing puberty blockers, hormones, and surgeries to gender dysphoric children.

Example: The current New England Journal of Medicine published a “Perspectives” screed attacking the Cass Review — widely respected for its thorough investigation of the lack of significant data supporting puberty blocking of gender dysphoric children. From “The Future of Gender Affirming Care“:

Our concern here is that the Review transgresses medical law, policy, and practice, which puts it at odds with all mainstream U.S. expert guidelines. The report deviates from pharmaceutical regulatory standards in the United Kingdom. And if it had been published in the United States, where it has been invoked frequently, it would have violated federal law because the authors failed to adhere to legal requirements protecting the integrity of the scientific process.

Fresh off publishing an unsubstantial attack on the Cass Review that recommended against puberty blockers for gender dysphoric youth, the New England Journal of Medicine offers an advocacy piece demanding that prisoners claiming to be transgender be given free “transition surgeries.” From “Gender-Affirming Surgical Care in Carceral Settings“: Several U.S. courts have held that access to gender-affirming care during incarceration is a trans person’s right. This conclusion is reflected in the Federal Bureau of Prisons (BOP) clinical guidance, which governs clinical care provision within federal carceral facilities, which house an estimated 1200 trans people. The BOP, whose guidance often sets the standard for health care delivery in state and local carceral facilities, recommends provision of gender-affirming care during incarceration, including Read More ›

What a debacle. More than 15,000 people died in Canada in one year because they couldn’t access care in the country’s collapsing socialized health-care system. From the Toronto Sun story: Close to 15,500 people died waiting for health care in Canada between April 1, 2023 until March 31, 2024, according to data compiled by SecondStreet.org via Freedom to Information Act requests across the country. However, SecondStreet.org says the exact number of 15,474 is incomplete as Quebec, Alberta, Newfoundland and Labrador don’t track the problem and Saskatchewan and Nova Scotia only provided data on patients who died while waiting for surgeries — not diagnostic scans. SecondStreet.org says if it extrapolates the unknown data, then an estimated 28,077 patients died last year Read More ›