November 5, 2012

Take a break


In this last day before  the election, take a break from all the breathless commentary and doom-mongers and take a look at this Charismatic Animal Portraits by Tim Flach


Posted by Jill Fallon at 1:45 PM | Permalink

Vote NO on Question 2 in Massachusetts

On the Massachusetts ballot this year is Question 2 which would allow physician-assisted suicide.  The sponsor behind the bill is the former Hemlock Society which has renamed itself Death with Dignity.  Corrupting not only language,  the initiative, if it became law, would corrupt the medical profession and pharmacists making them accomplices in suicide.    There is no reason why pain by dying patients can not be treated with medications.

It's an extremely poorly written law with no safeguards against abuse, not even a requirement that the death certificate shows suicide as the cause of death.  Families do not have to be notified nor are patients requesting such assistance required to have a psychiatric evaluation to ensure they are of sound mind.  We should be devoting our efforts to improving palliative care and promoting hospice so that those at the end of life can have a good death, a death with real dignity.  Dying alone after ingesting 100 seconal is not a death with dignity. 

Along with those listed below, I urge a vote NO on Question 2.

The Massachusetts  Medical Society

The proposed safeguards against abuse are insufficient.  Enforcement provisions, investigation authority, oversight, or data verification are not included in the act. A witness to the patient’s signed request could also be an heir.
Assisted suicide is not necessary to improve the quality of life at the end of life. Current law gives every patient the right to refuse lifesaving treatment, and to have adequate pain relief, including hospice and palliative sedation. 
Predicting the end of life within six months is difficult; sometimes the prediction is not accurate. From time to time, patients expected to be within months of their death have gone on to live many more months — or years. In one study, 17 percent of patients outlived their prognosis.
Doctors should not participate in assisted suicide. The chief policy making body of the Massachusetts Medical Society has voted to oppose physician assisted suicide.
“Allowing physicians to participate in assisted suicide would cause more harm than good. Physician assisted suicide is fundamentally incompatible with the physician’s role as healer. “Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. …  Patients must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.”

Boston Globe

Authorizing assisted suicide is “not, in itself, an answer to the far deeper question of how to help patients make end of life decisions.”

Boston Herald

Dr. Barbara Rockett, President of American Medical Association’s Foundation

Centuries ago the physician Hippocrates wrote the Hippocratic Oath, which many of us took when we became physicians and guides us in the ethical practice of medicine. It states that when treating patients, physicians will “First do no harm.” It goes on to state that “I will give no deadly medicine to anyone if asked nor suggest any such counsel.” Physician-assisted suicide is in direct conflict with this statement which, when followed, has protected the patient, physician, society and the family, and at the same time has committed doctors to compassion and human dignity.

Lahey Clinic Medical Ethics Lecture Series: The Arguments Against Question 2 and Physician-Assisted Suicide

Massachusetts Academy of Family Physicians.

Joseph Gravel, president of the MassAFP, said in a statement. “This certainly includes end-of-life care. It is clear that we need to continue to work to provide those suffering from serious illnesses, depression, and other conditions that can lead to hopelessness highly effective palliative and hospice treatments that are now available.

Committee Against Physician-Assisted Suicide

American Medical Association

Allowing physicians to participate in assisted suicide would cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.

Suicide is Always a Tragedy

Cardinal Sean O'Malley to Catholics:  It would bring spiritual death, a cheapening of human life, and a corrupting of the medical profession. It means making the pharmacists, doctors, nurses, family members, friends and society itself, accomplices in a suicide. Our task is to help prevent suicide and provide the very best palliative and hospice care for our terminally ill loved ones.

Cardinal O'Malley to non-Catholics:  Suicide is never a dignified way to die.  Suicide always impacts others beyond the individual.  Doctors strongly oppose.  Disability advocates strongly oppose.  Terminal diagnoses are often wrong.  Question 2 is strongly flawed (ingestion of 100 pills of Seconal without a doctor present;  no witnesses need be present; no oversight of drug after dispensed; no enforcement provisions, investigative authority, oversight or data verification).  No requirement for psychiatric evaluation.  Complex issues like this should be decided in a legislative context not by ballot initiative.

Vicky Kennedy, widow of Ted Kennedy in CapeCodOnline

The language of the proposed law is not about bringing family together to make end of life decisions; it's intended to exclude family members from the actual decision-making process to guard against patients' being pressured to end their lives prematurely. It's not about doctors administering drugs such as morphine to ease patients' suffering; it's about the oral ingestion of up to 100 capsules without requirement or expectation that a doctor be present. It's not about giving choice and self-determination to patients with degenerative diseases like ALS or Alzheimer's; those patients are unlikely to qualify under the statute. It's not, in my judgment, about death with dignity at all.
My late husband Sen. Edward Kennedy called quality, affordable health care for all the cause of his life. Question 2 turns his vision of health care for all on its head by asking us to endorse patient suicide — not patient care — as our public policy for dealing with pain and the financial burdens of care at the end of life. We're better than that. We should expand palliative care, pain management, nursing care and hospice, not trade the dignity and life of a human being for the bottom line.
When my husband was first diagnosed with cancer, he was told that he had only two to four months to live, that he'd never go back to the U.S. Senate, that he should get his affairs in order, kiss his wife, love his family and get ready to die.

But that prognosis was wrong. Teddy lived 15 more productive months. During that time, he cast a key vote in the Senate that protected payments to doctors under Medicare; made a speech at the Democratic Convention; saw the candidate he supported elected president of the United States and even attended his inauguration; received an honorary degree; chaired confirmation hearings in the Senate; worked on the reform of health care; threw out the first pitch on opening day for the Red Sox; introduced the president when he signed the bipartisan Edward M. Kennedy Serve America Act; sailed his boat; and finished his memoir "True Compass," while also getting his affairs in order, kissing his wife, loving his family and preparing for the end of life.

Physician-Assisted Suicide Is Not Progressive  Ira Byock in the Atlantic

Right to die" is just a slogan. No civil right to commit suicide exists in any social compact.
it's fair to say that most social conservatives ardently oppose assisted suicide, while a clear majority on the political left support legalization. That's the case in Massachusetts where Question 2 is on November's ballot, and according to recent polling is very likely to pass.

I am an outlier, in that I am a registered Democrat and progressive, as well as a physician who has cared for people with life-threatening conditions for more than three decades. I support universal health care, voting rights, disability rights, women's rights, Planned Parenthood, gay marriage, alternative energy, and gun control. I yearn to see an end to the war on drugs and the war in Afghanistan. And, I am convinced that legalization of physician-assisted suicide is something my fellow progressives should fear and loathe.
In today's "Newspeak" the Hemlock Society morphed into Compassion and Choices, which promotes "death with dignity" and objects to the word "suicide," preferring "aid-in-dying" and "self-deliverance." These terms sound more wholesome, but the undisguised act is a morally primitive, socially regressive, response to basic human needs.
America is failing people who are facing the end of life and those who love and care for them. Giving licensed physicians the authority to write lethal prescriptions is not a progressive thing to do.

When Your Doctor Is Your Executioner

It was a short step from there to deciding that illness and suffering needed a quick and “merciful” end. Rather than use the pain medications we have and care for those who are elderly or infirm, we quickly moved to the argument that killing them was the “moral” and “humane” thing to do. First we called it “mercy killing.” When that gentle phrase became tainted, the advertising folks supplied a new one. Today we call it “death with dignity.”  Somewhere along the line, we lost the understanding of just how dangerous a doctor who no longer feels a responsibility to be a healer can be.

Suicide by Choice?  Not so fast

NEXT week, voters in Massachusetts will decide whether to adopt an assisted-suicide law. As a good pro-choice liberal, I ought to support the effort. But as a lifelong disabled person, I cannot.
My problem, ultimately, is this: I’ve lived so close to death for so long that I know how thin and porous the border between coercion and free choice is, how easy it is for someone to inadvertently influence you to feel devalued and hopeless — to pressure you ever so slightly but decidedly into being “reasonable,” to unburdening others, to “letting go.”
Posted by Jill Fallon at 1:37 PM | Permalink

Pulling together in Sandy's aftermath and Get up and Go

 Composite Sandy Comingtogether

The Kindness of Strangers:  Pulling together in Sandy's aftermath

A heart-warming collection of photographs and tweets has captured the myriad acts of kindness from the past week, as the hardships of Hurricane Sandy brought devastated communities across the tri-state area together.

From the Mayor of Newark inviting constituents into his home to charge their phones and watch DVDs to an East Village doctor offering free treatments and kids selling cookies to raise money for the relief effort, the stories encapsulate how, in their time of need, people were helping each other.
There have been so many altruistic acts during the storm and its aftermath that a Facebook page called 'Hurricane Sandy Acts of Kindness' has been set up, giving those who received help the opportunity to thank their saviors and share their stories.
One image shows Staten Island resident Emily Ellington on Friday as she handed out one of 40 pizzas to locals devastated by the storm.

Scores of restaurants including The Dutch in Manhattan and Lonestar Taco served up free food to the many residents who were left for five days without power, food or fresh water, tweeting the news to their followers.
Many of those who still had electricity offered up their power plugs so passers by could charge their phones and contact loved ones.

Newark Mayor Cory Booker used Twitter to invite Hurricane Sandy victims to his house to charge their electronics, watch movies, and even get a free lunch, warming the hearts of his constituents.

East Village doctor Dave Ores offered his services to anyone in need of help, posting on his tumblr, 'I'm open today if I can help anyone. Until 6pm Spread the word. Thanks. 189 east 2nd street btw A and B.'

And then there's just plain Get up and Go

Today, my husband witnessed a wondrous act of resourcefulness. A man with a horse trailer hitched to his truck was filling up individual 5 gallon jugs of gas in order to transport them back to New Jersey.

He went out into the wide world of American plenty that lies just beyond disaster. He didn't wait like a hopeless fool in a line of idling cars for gasoline that is rationed by the spoonful. His neighbors hired him because he had a big, gas eating truck, and gave him money and jugs and sent him to Lancaster County to go shopping. He brought back not only gasoline, but food, water, clothing, blankets, batteries, and other things they might need. Those people are heroes, because they used their God-given talents and brains and didn't go crying to the cameras, asking for the government to come and help.

Volunteers Flock to Disaster Areas, Overwhelming City Relief Centers

Surfers with shovels fanned out in the Rockaways in Queens, helping residents clear their homes of mud and sand. An army of cyclists strapped packages of toilet paper to their backs and rode into Belle Harbor, Queens. Children broke open piggy banks, bought batteries and brought them to the parking lot of the Aqueduct Racetrack and Resorts World Casino, where a police inspector and his family set up a donation center for blankets, bottled water and other goods.

Many New Yorkers graced with power and heat in their homes on Sunday found it difficult to sit still as images of homeless and desolate city residents filled their television screens. They streamed into the hardest-hit sections of the city, at times nearly colliding with other would-be volunteers and overwhelming city relief centers.

“It feels like we all had the same impulse: This is my city and I want to do something to help it,” said Esther Pan Sloane, of Roosevelt Island, who drove a carload of supplies from Jackson Heights to a post office on Rockaway Beach where food and clothing were being handed out.
Posted by Jill Fallon at 11:34 AM | Permalink

Health round-up: Boosting brain power, LMTZ for Alzheimer's, Diagnosing cancer in 20 minutes, Redheads and melanoma

Taking up sport in middle age boosts brain power

‘You can give someone a cholesterol-lowering pill, you can give someone blood sugar-lowering medicine, but they have no impact on cognitive function.  But exercise can do all of that – and more.’

Exercise Prevents Dementia in Some Seniors

Older people who are living independently but have signs of cerebral damage may lower their risk of having progressive cognitive impairment or dementia if they remain physically active, researchers found.

Everyday drugs 'can help fight dementia as developing new medicines is too costly and slow

Experts believe antibiotics, acne pills and other routine treatments already in bathroom cabinets could double as dementia drugs.  They said it is time to re-examine medicines already in circulation as cheaper, quicker alternatives to new treatments.
Professor Clive Ballard said: ‘Defeating dementia is one of the biggest challenges facing both  medicine and society as a whole. Developing new drugs is incredibly important but it comes with a huge price tag and, for those affected by dementia, an unimaginable wait.  Everyday drugs will have passed multiple tiers of expensive safety tests and so could be prescribed for dementia in five to ten years."

Some of the drugs they are looking at.
• Diabetes medications eventide and liraglutide, which have been shown to stimulate the brain.
• Minocycline, an antibiotic for acne, and acitretin
• Acitretin, a drug used to treat psoriasis which researchers found modifies the way proteins linked to dementia form.
• High blood pressure medications including Nilvadipine, from the calcium channel blockers family.

Pill that halts Alzheimers could be here in four years

A pill said to halt the devastating onset of Alzheimer’s disease could be on the market within four years, scientists said yesterday.  Believed to be more than twice as good as anything already available, it could greatly slow or even halt the progression of the cruel illness.  Given early enough, it could stop Alzheimer’s from ever developing, an international dementia conference was told yesterday.

A version of the twice-a-day pill – developed by British scientists – has already been tested on patients, with ‘unprecedented’ results.  Its inventor, Professor Claude Wischik, of Aberdeen University, said: ‘It flatlines the disease. If you get in early, you can pull people back from the brink.’
The new drug, known only as LMTX, works in a different way to current treatments and to many of the Alzheimer’s tablets and jabs in development, which target the brain’s chemistry or the build-up of a brain-clogging protein called beta-amyloid.  LMTX, in contrast, dissolves the ‘tangles’ of protein that are a hallmark of the disease and spread through the brain like an infection, stopping them working from within.

An earlier version of LMTX, called Remember, has already been tested on patients with promising results.  Given to men and women with mild to moderate dementia, the Remember capsules slowed the progression of the disease by 90 per cent for two years.

The groundbreaking device that diagnoses cancer in just 20 minutes - AND tells doctors which drug will treat it

A groundbreaking device that can diagnose cancer in just 20 minutes is being developed by British scientists.  The world's first tumor profiler, as it is known, will allow doctors, nurses and pharmacists to quickly identify all known types of cancer while the patient waits.
Scientists say the Q-Cancer device will have a dramatic impact on the rapid and accurate diagnosis of cancer….The device makes use of advanced nanotechnology, analyzing submicroscopic amounts of tissue to work out the type of cancer, its genetic make-up and how far it has developed.
'As far as we are aware, QuantuMDx’s current underlying technologies, which can break up a sample and extract the DNA in under five minutes represents a world first for complex molecular diagnostics.

Redheads at a higher risk of melanoma even without the sun

It is well-known that redheads and others with fair skin have a higher risk of developing skin cancer, because they have less natural protection against the damaging effect of the sun.  Now researchers have found another cancer risk factor apart from being sensitive to UV radiation. Redheads have a pigment in their skin that can actively contribute to the development of melanoma.
The study, published in the journal Nature, explains that several types of the pigment melanin are found in the skin. A dark brown or black form called eumelanin is usually found in people with dark hair or skin while a blond-to-red pigment called pheomelanin is predominant in people with red hair, freckles and fair skin.
Posted by Jill Fallon at 10:56 AM | Permalink