Yesterday, Nancy and I spent most of the day at an event on the Auraria College Campus in downtown Denver. The event was the showing of huge Pro-Life signs and posters by the college organization, Justice For All. The pictures revealed very graphic portrayals of actual abortion results and asked pointed questions of the observers about their attitudes toward abortion.
Nancy and I and about 30 volunteers circulated through the crowd asking the people what they thought about the demonstration and dialoguing with them about their attitudes toward abortion. Of course, we found that the majority of the students there were “Pro-Choice,” but their Pro-Choice position was only relative in many cases, i.e., a lot of them were opposed to late term abortions but in favor of early abortions.
The striking thing about those “interviews” on the street was that many of the people we talked to had not adequately thought out their position. One young man told me that he had no objection to the killing of unborn babies. Nor did he object to the idea of killing babies who were already born, nor anyone else, for that matter. He even told me that he would not even object if someone were to kill him! (Now, THAT, is dedication to a belief, if you ask me!!)
Of course, some in the crowd had actually done some deep thinking about the issue, and they sometimes concluded that abortion is an acceptable procedure. Nancy and I and the other counselors would reason with them, trying to show them that it is really important to defend unborn human life; but their beliefs were almost always deeply ingrained in their minds. We concluded by asking them to look closely at the pictures and ask themselves the question: “Do you think that, looking at those pictures, abortion can be a right decision?”
The day was exhilarating to both Nancy and me. The opportunity to speak the words of Christ and His truth into a harsh culture and to practice reasoning with hard hearts was an inspiration to us.
We were very impressed with the organization, Justice For All. If any of my readers would like to get more information about this organization, I would invite them to look at the organization’s web site. www.JFAweb.org.
Tuesday, April 12, 2011
Thursday, April 7, 2011
How to Influence the Government via E-mail
We, Americans have the privilege of freedom of speech. We are entitled to express our opinions to our government representatives. They have the right to pay attention to what we say or to ignore our opinions. Sometimes, they actually listen to what we are saying. Especially, they will listen when large numbers of constituents write to them on the same subject. Following are some directions on how to contact our government and our representatives:
Go to USA.gov. You will see a list of contacts you might like to make on the left side of the page starting with the President and Vice President of the United States. Below, you will see listed U.S. Senators, U.S. Representatives, State Governors, State Representatives, and then agencies you might like to contact. Follow the links, and you will be able to contact the person to whom you might want to speak.Here are a few tips on what to say:
1) Write each e-mail concerning only one issue.
2) Put the main point in the subject line. Very likely that is all that your addressee will read. For instance, your subject line should read something like this—Vote Yes on S. 528, the STAND UP Act.
3) Whenever you can, always refer to legislative bills by number as well as name.
4) Familiarize yourself with Thomas.loc.gov, the web page for the U.S. Congress and Senate, you should read at least the summary of a bill you are petitioning about. Often, advocates for a bill may unfairly represent that bill on the web or in an e-mail. Always try to look at the bill, yourself—it only takes a minute to do that.
5) In examining state legislation, go to USA.gov and choose State Legislators; choose the state; then, choose bills. I have found that in most states, when looking for a concise and accurate summary of a bill, it is best to look at “fiscal impact” in the bill menu.
6) Limit your message to one or two short paragraphs. The longer your message, the less likely it will be read.
7) Be sure to mention how this issue will affect you.
8) Write to legislators whom you know disagree with your point of view—they need to hear from you, too; and they are the ones you really want to influence, anyway.
9) Be sure to include the President or the Governor in your addressee list. Do not write only to Senators or Representatives.
10) Write to the same representatives repeatedly on the same issue. This is especially important when writing to United States legislators or the President. Those representatives will seldom read your e-mail; but they have aides who read and tabulate issues for their bosses. The legislator will only see the tabulation of the issues.
11) Be courteous always.
Go to USA.gov. You will see a list of contacts you might like to make on the left side of the page starting with the President and Vice President of the United States. Below, you will see listed U.S. Senators, U.S. Representatives, State Governors, State Representatives, and then agencies you might like to contact. Follow the links, and you will be able to contact the person to whom you might want to speak.Here are a few tips on what to say:
1) Write each e-mail concerning only one issue.
2) Put the main point in the subject line. Very likely that is all that your addressee will read. For instance, your subject line should read something like this—Vote Yes on S. 528, the STAND UP Act.
3) Whenever you can, always refer to legislative bills by number as well as name.
4) Familiarize yourself with Thomas.loc.gov, the web page for the U.S. Congress and Senate, you should read at least the summary of a bill you are petitioning about. Often, advocates for a bill may unfairly represent that bill on the web or in an e-mail. Always try to look at the bill, yourself—it only takes a minute to do that.
5) In examining state legislation, go to USA.gov and choose State Legislators; choose the state; then, choose bills. I have found that in most states, when looking for a concise and accurate summary of a bill, it is best to look at “fiscal impact” in the bill menu.
6) Limit your message to one or two short paragraphs. The longer your message, the less likely it will be read.
7) Be sure to mention how this issue will affect you.
8) Write to legislators whom you know disagree with your point of view—they need to hear from you, too; and they are the ones you really want to influence, anyway.
9) Be sure to include the President or the Governor in your addressee list. Do not write only to Senators or Representatives.
10) Write to the same representatives repeatedly on the same issue. This is especially important when writing to United States legislators or the President. Those representatives will seldom read your e-mail; but they have aides who read and tabulate issues for their bosses. The legislator will only see the tabulation of the issues.
11) Be courteous always.
Tuesday, April 5, 2011
Is Common Sense Returning to Government?
Well, well, it seems that the longer the Obama Administration remains in power, the more it returns to the policies of George W. Bush. How strange!
Ever since President Obama took office, our problems with the economy have gotten worse. Major spending increases have failed to deliver promised jobs. The safety net for the poor is coming apart at the seams. Government health and retirement programs are growing at unsustainable rates. The new health-care law is a fiscal train wreck. And a complex, inefficient tax code is holding back American families and businesses. (However, that last problem can hardly be laid at the foot of President Obama, alone.)
The president’s recent budget proposal would accelerate America’s descent into a debt crisis. It doubles debt held by the public by the end of his first term and triples it by 2021. It imposes a $1.5 trillion in new taxes, with spending that never falls below 23% of the economy. His budget permanently enlarges the size of government. It offers no reforms to save government health and retirement programs.
Now, we are seeing more and more of President Bush’s policies being resurrected to remedy the problems we have at this time. Even the closing of Guantanamo seems to have been cancelled.
In my opinion, the most problematic part of the current governmental formula is its discouragement of private business. As I noted in my last blog post, Blacks in America are recognizing these problems with the welfare state; and they are migrating to parts of the United States where business and employment possibilities are better.
I think the new GOP Path to Prosperity being proposed by the House Budget Committee is very probably the best policy for our country at this time. I think we should try it. The current policy is just not working.
This blog post was partly inspired by articles in the Wall Street Journal of 5 April 2011, pages A15 and A13.
Ever since President Obama took office, our problems with the economy have gotten worse. Major spending increases have failed to deliver promised jobs. The safety net for the poor is coming apart at the seams. Government health and retirement programs are growing at unsustainable rates. The new health-care law is a fiscal train wreck. And a complex, inefficient tax code is holding back American families and businesses. (However, that last problem can hardly be laid at the foot of President Obama, alone.)
The president’s recent budget proposal would accelerate America’s descent into a debt crisis. It doubles debt held by the public by the end of his first term and triples it by 2021. It imposes a $1.5 trillion in new taxes, with spending that never falls below 23% of the economy. His budget permanently enlarges the size of government. It offers no reforms to save government health and retirement programs.
Now, we are seeing more and more of President Bush’s policies being resurrected to remedy the problems we have at this time. Even the closing of Guantanamo seems to have been cancelled.
In my opinion, the most problematic part of the current governmental formula is its discouragement of private business. As I noted in my last blog post, Blacks in America are recognizing these problems with the welfare state; and they are migrating to parts of the United States where business and employment possibilities are better.
I think the new GOP Path to Prosperity being proposed by the House Budget Committee is very probably the best policy for our country at this time. I think we should try it. The current policy is just not working.
This blog post was partly inspired by articles in the Wall Street Journal of 5 April 2011, pages A15 and A13.
Saturday, April 2, 2011
Demographic Changes in the United States
This blog post was written by William Sowell and published on Townhall.com 3/29/11.
The latest published data from the 2010 census show how people are moving from place to place within the United States. In general, people are voting with their feet against places where the liberal, welfare-state policies favored by the intelligentsia are most deeply entrenched.
When you break it down by race and ethnicity, it is all too painfully clear what is happening. Both whites and blacks are leaving California, the poster state for the liberal, welfare-state and nanny-state philosophy.
Whites are also fleeing the big northeastern liberal, welfare states like Massachusetts, New York, New Jersey and Pennsylvania, as well as the same kinds of states in the midwest, such as Michigan, Ohio and Illinois.
Although California has long been a prime destination of Asian immigrants and the homes of their descendants, the 2010 census shows a striking increase in the Asian American population of Nevada, more so than any other state. Nevada is adjacent to California but has no income tax nor the hostile climate for business that California maintains.
The movement of the black population-- especially educated young blacks-- is the most striking of all. In the past, the massive movements of millions of blacks out of the South in the early 20th century was one of the epic migrations of a people-- comparable in size with the millions of the Irish who fled the famine in Ireland in the 1840s or the millions of Jews who fled persecution in Eastern Europe in the late 19th and early 20th centuries.
In more recent decades, blacks have been moving back to the South, however. While the overall black population of the northeastern and midwestern states has not declined in the past ten years, except in Michigan and Illinois, the net increase of the black population nationwide has increasingly been in the South. About half of the national growth of the black population took place in the South in the 1970s, two-thirds in the 1990s and three-quarters in the past 10 years.
While the mass migrations of blacks out of the South in the early 20th century was to places where there were already established black communities, such as New York, Chicago and Philadelphia, much of the current movement of blacks is away from existing concentrations of black populations.
Blacks are moving to suburbs, and even to cities like Minneapolis. Overall, the racial residential segregation patterns are declining in the great majority of the largest major metropolitan areas.
Among blacks who moved, the proportions who were in their prime -- from 20 to 40 years of age-- were greater than in the black population at large, and college degrees were more common among them than in the black population at large. In short, with blacks, as with other racial or ethnic groups, those with better prospects are leaving the states that are repelling their most productive citizens in general with liberal policies.
Detroit is perhaps the most striking example of a once thriving city ruined by years of liberal social policies. Before the ghetto riot of 1967, Detroit's black population had the highest rate of home-ownership of any black urban population in the country, and their unemployment rate was just 3.4 percent.
It was not despair that fueled the riot. It was the riot which marked the beginning of the decline of Detroit to its current state of despair. Detroit's population today is only half of what it once was, and its most productive people have been the ones who fled.
Treating businesses and affluent people as prey, rather than assets, often pays off politically in the short run-- and elections are held in the short run. Killing the goose that lays the golden egg is a viable political strategy.
As whites were the first to start leaving Detroit, its then mayor Coleman Young saw this only as an exodus of people who were likely to vote against him, enhancing his re-election prospects.
But what was good for Mayor Young was disastrous for Detroit. There is a lesson here somewhere, but it is very doubtful if either the intelligentsia or the politicians will learn it.
The latest published data from the 2010 census show how people are moving from place to place within the United States. In general, people are voting with their feet against places where the liberal, welfare-state policies favored by the intelligentsia are most deeply entrenched.
When you break it down by race and ethnicity, it is all too painfully clear what is happening. Both whites and blacks are leaving California, the poster state for the liberal, welfare-state and nanny-state philosophy.
Whites are also fleeing the big northeastern liberal, welfare states like Massachusetts, New York, New Jersey and Pennsylvania, as well as the same kinds of states in the midwest, such as Michigan, Ohio and Illinois.
Although California has long been a prime destination of Asian immigrants and the homes of their descendants, the 2010 census shows a striking increase in the Asian American population of Nevada, more so than any other state. Nevada is adjacent to California but has no income tax nor the hostile climate for business that California maintains.
The movement of the black population-- especially educated young blacks-- is the most striking of all. In the past, the massive movements of millions of blacks out of the South in the early 20th century was one of the epic migrations of a people-- comparable in size with the millions of the Irish who fled the famine in Ireland in the 1840s or the millions of Jews who fled persecution in Eastern Europe in the late 19th and early 20th centuries.
In more recent decades, blacks have been moving back to the South, however. While the overall black population of the northeastern and midwestern states has not declined in the past ten years, except in Michigan and Illinois, the net increase of the black population nationwide has increasingly been in the South. About half of the national growth of the black population took place in the South in the 1970s, two-thirds in the 1990s and three-quarters in the past 10 years.
While the mass migrations of blacks out of the South in the early 20th century was to places where there were already established black communities, such as New York, Chicago and Philadelphia, much of the current movement of blacks is away from existing concentrations of black populations.
Blacks are moving to suburbs, and even to cities like Minneapolis. Overall, the racial residential segregation patterns are declining in the great majority of the largest major metropolitan areas.
Among blacks who moved, the proportions who were in their prime -- from 20 to 40 years of age-- were greater than in the black population at large, and college degrees were more common among them than in the black population at large. In short, with blacks, as with other racial or ethnic groups, those with better prospects are leaving the states that are repelling their most productive citizens in general with liberal policies.
Detroit is perhaps the most striking example of a once thriving city ruined by years of liberal social policies. Before the ghetto riot of 1967, Detroit's black population had the highest rate of home-ownership of any black urban population in the country, and their unemployment rate was just 3.4 percent.
It was not despair that fueled the riot. It was the riot which marked the beginning of the decline of Detroit to its current state of despair. Detroit's population today is only half of what it once was, and its most productive people have been the ones who fled.
Treating businesses and affluent people as prey, rather than assets, often pays off politically in the short run-- and elections are held in the short run. Killing the goose that lays the golden egg is a viable political strategy.
As whites were the first to start leaving Detroit, its then mayor Coleman Young saw this only as an exodus of people who were likely to vote against him, enhancing his re-election prospects.
But what was good for Mayor Young was disastrous for Detroit. There is a lesson here somewhere, but it is very doubtful if either the intelligentsia or the politicians will learn it.
Wednesday, March 30, 2011
The Price of Taxing the Rich
The more I look at the economic situation of the United States, the more sympathy I have for economists and politician/bureaucrats—their task seems almost impossible.
The genius of the American economic experiment has been that our society has ever sought to increase the gross domestic product and to distribute the benefits evenly.
Most states are funded mainly by income taxes. Now, we are facing a situation where the incomes of some few families are going up rapidly, and this should be producing lots of tax money for the states. However, state/federal budgets are in deficit. Why has this happened?
Californians have studied this phenomenon most closely, where the distress over the economy is most acute. In California, before the recession, half of the state’s income came from the top 1% of its earners, i.e., those households with incomes above $490,000/year.
It has been found that the highest income groups experience the greatest income volatility when anything happens to the economy or to the progressive tax structure, which we have in almost all states and in the Federal income tax system, i.e., the higher the income, the higher the tax bracket.
Many people, mostly Democrats, have thought that to save failing state and national economies, it is necessary to tax the wealthy as heavily as possible in order to fund lots more government programs and to distribute wealth more evenly. This sounds very logical; but this approach has its difficulties.
The situation that now exists is one in which the top earners are paying very high taxes; and those taxes are driving the people with the least money in the high tax bracket out of the high bracket because their income has volatilized downward. The others in that high tax bracket, however, have figured out how to make lots of money due to the exit of their lower income competitors. This effect is producing an even greater spread in the income of Americans, with the very rich becoming even richer. Of course, the very rich are paying lots of income tax; and they are keeping the government tax income up. But…the problem is that as the income of the people who are losing net value and income declines, they are not investing in the economy. For that reason, the economy is lagging—despite the fact that the very rich are making a lot of money.
The logical imperative for government and economists, today, is to keep the base of upper income people very broad and the tax rate low. That goal is hard to reach; but raising taxes at a time like this is only exacerbating the problem. It is driving many rich people out of the investment mode and making the very rich even richer, though fewer in number.
This blog post was inspired by articles in the Wall Street Journal, 26 March 2011, pages C1 and C2.
The genius of the American economic experiment has been that our society has ever sought to increase the gross domestic product and to distribute the benefits evenly.
Most states are funded mainly by income taxes. Now, we are facing a situation where the incomes of some few families are going up rapidly, and this should be producing lots of tax money for the states. However, state/federal budgets are in deficit. Why has this happened?
Californians have studied this phenomenon most closely, where the distress over the economy is most acute. In California, before the recession, half of the state’s income came from the top 1% of its earners, i.e., those households with incomes above $490,000/year.
It has been found that the highest income groups experience the greatest income volatility when anything happens to the economy or to the progressive tax structure, which we have in almost all states and in the Federal income tax system, i.e., the higher the income, the higher the tax bracket.
Many people, mostly Democrats, have thought that to save failing state and national economies, it is necessary to tax the wealthy as heavily as possible in order to fund lots more government programs and to distribute wealth more evenly. This sounds very logical; but this approach has its difficulties.
The situation that now exists is one in which the top earners are paying very high taxes; and those taxes are driving the people with the least money in the high tax bracket out of the high bracket because their income has volatilized downward. The others in that high tax bracket, however, have figured out how to make lots of money due to the exit of their lower income competitors. This effect is producing an even greater spread in the income of Americans, with the very rich becoming even richer. Of course, the very rich are paying lots of income tax; and they are keeping the government tax income up. But…the problem is that as the income of the people who are losing net value and income declines, they are not investing in the economy. For that reason, the economy is lagging—despite the fact that the very rich are making a lot of money.
The logical imperative for government and economists, today, is to keep the base of upper income people very broad and the tax rate low. That goal is hard to reach; but raising taxes at a time like this is only exacerbating the problem. It is driving many rich people out of the investment mode and making the very rich even richer, though fewer in number.
This blog post was inspired by articles in the Wall Street Journal, 26 March 2011, pages C1 and C2.
Saturday, March 26, 2011
Foolish Decisions at the End of Life
As a geriatric physician and an old man, myself (I am 75 years old.), I feel constrained to share with my readership some observations I have made over the years concerning end-of-life decisions. I have repeatedly seen terrible decisions made by former patients, their families, and, now, with my friends and peers. As we grow older, we have a tendency to deny that our physical lives are nearly over; and we often find ourselves making unwise decisions that do not prolong life. Sometimes, these bad decisions only prolong death. Very often bad decisions strain the financial and social lives of our survivors to the point that they may even wish we were already deceased. Most of these bad effects can be avoided by looking at our lives realistically, having assurance that Christ has come to take us home with Him, and trusting Him to do it for us. Following are some specific bad decisions about which we should think before we make them, ourselves.
1)I will have my cancer treated with all the radiation and chemotherapy available. Patients need to understand that their doctors are pledged to defend life to the very last ditch. Many of them look at death in their patients as a personal defeat. Some, unfortunately look at advanced cancer as an opportunity to make money from hurting people. (Fortunately, this is probably an unusual situation.) Many doctors are willing to allow patients and their families push them into ill-advised treatment methods, which they know are fruitless and even harmful. This latter group of doctors rationalizes their treatment activities by saying that they are only carrying out the sincere wishes of their patients. And patients, after all, should have sovereignty over their own treatment options. (There is some truth in this attitude.) Far too many doctors are victims of overactive curiosity about new drugs and new treatment options. They want to try every new drug that comes on the market. Unfortunately, many new drugs prove themselves no better than the older, standard drugs with which there are known complications and success rates. Many cancers, however, are only slightly affected by chemotherapy and radiation; and those treatment modalities are often not advisable. Patients should develop the practice of asking the doctors specific questions about survival and side effects of the treatments they are contemplating. Following is a list of questions that patients should ask their physicians:
a)What are the one year and the five year survival rates for my cancer if I accept this treatment? What are the survival rates without this treatment?
b)What are the complications and side effects of this treatment?
c)How long has this treatment been in use?
d)How many times have you, personally, used this treatment?
e)What is the microscopic grade and the anatomical stage of my tumor; and how does that affect my outlook for life expectancy and general life quality?
f)Where can I read about the success and the complications of this treatment?
g)Is this treatment accepted as standard treatment? If not, why not?
h)Do other doctors have recommendations to make about this treatment? Where can I find those recommendations?
i)Does the U.S. Food and Drug Administration recommend this treatment? What about the recommendations of the American Board of Oncology? (Bear in mind that oncologists have a reputation for very aggressive and sometimes ill-advised treatment.) What are the recommendations of the specialty board that is concerned with the organ system giving rise to the cancer that I have? (For instance, the American Board of Urology for cancer of the prostate)
j)What are the alternative forms of treatment available?
Remember that a consultation with a geriatric specialist who has no vested interest in radiation or chemotherapy might yield an unbiased and impartial opinion about these kinds of treatment.
If your doctor feels threatened by the above questions or if he/she reacts defensively or adversely toward them, perhaps you should consider changing doctors. The answer to these questions is a privilege you have as a patient. This is all your business; do not be hesitant to ask these questions.
2)I want every possible treatment modality available used to the uttermost to keep me alive as long as possible. Sometimes patients with incurable diseases and the family members of those patients do not realize that the complications and side effects of some treatment methods do not warrant their use. Two examples of this follow:
a)Chronic hemodialysis (use of the artificial kidney) is often abused as an end-of-life measure because patients believe that it makes life longer and more comfortable. This treatment can certainly make life longer; but the price in symptoms and side effects of the treatment is often not worth it. Patients on this kind of treatment usually live with constant thirst, muscle cramps, nausea, and itching all over the body. They have to submit to 2-3 hour sessions on the artificial kidney twice weekly. The artificial kidney should be used in cases where the patient’s kidneys are expected to recover in the near future and the patient is expected to be able to get off the kidney machine soon. Chronic use in old age for permanent kidney failure is not a good decision. Conditions which should certainly prevent the decision to use chronic hemodialysis are congestive heart failure, advanced dementia, and any other incurable disease that will soon lead to death (such as cancer). It is my opinion that chronic hemodialysis should not be used in patients over the age of 75 years or in anyone else with a life expectancy of less than 3 years.
b)Coronary artery bypass grafting is often used to excess in the elderly to keep the heart working just a little longer. I have seen this procedure used in patients over the age of 90 in the vain hope that it will prolong life significantly. What a dream, if only it were true! Opening the chest to repair arteries to the heart is no small procedure; and in aged patients, it is fruitless. The placement of coronary artery stents, on the other hand, is often effective and useful in the aged. That procedure is quite invasive, but it does not entail much in the way of side effects—it is often effective in producing desirable results. Patients often go home within a day or two.
c)One caveat to remember about desperate, life-sustaining, procedures is that cardiopulmonary resuscitation (CPR) in nursing homes has an almost zero survival rate after 3 months. This fact has been ascertained in repeated studies around the nation. All nursing homes ask patients if they want to be resuscitated in the case of cardiac arrest; and, unfortunately, in many cases, patients will indicate that they want that procedure done. That decision is a mistake when it is made in a nursing home—the procedure is worthless, costly, and often inflicts a lot of pain.
3)I will never turn off life-support machinery being used in the care of my loved one. That would be the same as murder. There is a great difference between pulling the plug on a respirator and actively causing the death of a patient by deadly injection—which is, indeed, murder. We are called on to defend life to the last ditch—unless it involves using extraordinary means. What are “extraordinary means?” Extraordinary means are any treatments that involve advanced medical measures, which are not expected to produce life-giving results in the future. Extraordinary means certainly include the use of respirators in brain-dead patients—respirators can keep these patients “alive” with pulse and blood pressure for years. But—-is that life? I do not believe so. Even the use of feeding tubes inserted through the abdomen or nose may be considered extraordinary means, in my opinion. If those tubes are used to keep a permanently unconscious patient alive indefinitely, I think they should be removed.
We come down to the difficult question of what does it mean to be “alive.” Of course, medical people often use the presence or absence of pulse, blood pressure, and brain waves on an electroencephalogram as criteria to determine whether a patient is alive or dead. Personally, I think that the ability or disability to give and receive love should be strongly considered in the determination of whether a person is alive or dead.
4)I will go to Mexico to obtain the very best and most advanced treatment available. (This decision is almost too ludicrous to even discuss.) There are, along the Mexican border, several unscrupulous and unethical doctors who advertise that they can cure almost anything with treatments that have been outlawed or found ineffective in the United States. They charge high fees for treatments that do no good, at best, and that have dangerous side effects at worst.
I remember one doctor, in particular—-a doctor in Piedras Negras, a small town across the Rio Grande from Eagle Pass, Texas. We, doctors in the southwestern U.S., called him “the bad guy from black rock.” He claimed he could cure arthritis. I noticed that his patients, returning to my practice, appeared from their side effects, to be taking huge doses of cortisone. They came back to me for treatment of their high blood pressure and broken bones apparently caused by osteoporosis—-well known complications of improper cortisone treatment. I called him on the phone one day and asked if he were treating patients with cortisone—-he denied it, saying that he was using only Valium and aspirin. I obtained some of his pills from a patient and had them analyzed at a laboratory in Denver. They were found to consist of the extract of a Mexican yam plant that is the crude material from which cortisone is produced. He was overloading arthritis patients with cortisone—-a well-known toxic form of treatment.
Some of these Mexican border doctors are treating cancer with useless dietary restrictions; another I have heard of is supposedly using stem cells on an out-patient basis to treat chronic lung disease. I know of no chronic lung disease that responds to stem cell treatment, although papers were published as late as 2007 indicating that experimentation with stem cells shows some promise in mice with certain lung diseases. (To be effective, stem cell treatment is one of the most highly technical treatments available. A course of treatment requires weeks to accomplish. To be using it frivolously in an out-patient setting is obviously fraudulent. Furthermore, I seriously doubt that any genuine stem cells are being used in the first place!) Going to Mexico to have advancing disease treated by one of these border doctors is like going to West Africa to have diabetes treated by a witch doctor.
5)I will never go into a nursing home or assisted living home—-those places do no good; and I know patients just go there to die. Of course, people die in nursing homes. They die anyway—-some time and some place; but nursing homes do not hasten their death. Nursing homes make life more comfortable when advanced care is necessary. My mother resisted nursing home placement energetically in her advanced old age. She was having a difficult time caring for her basic needs at home. When she finally entered the nursing home, however, her comment was, “Why did I not do this earlier? It is such a relief to me to be cared for like this!”
6)I will not accept hospice care. It does no good; and they won’t treat my disease, anyway. They will only let me die. Hospice care, on the other hand gives considerable relief to intractable symptoms in advancing, incurable diseases at the end of life. Hospice care avoids unnecessary side effects of useless treatment and relieves pain and suffering in a major way. Hospice care should be enlisted early in the course of advancing, incurable disease. Although it is designed to alleviate symptoms, hospice care does not preclude treatment of the disease present if the treatment can prolong life and relieve symptoms. Hospice care aims to keep patients in their homes where they can be made comfortable by frequent home visits by skillful nurses and home health helpers.
7)I don’t need to make out a will. I’m not that bad off, anyway. Wills are not only necessary for people who are “bad off;” they should be written long before a person even becomes ill. To avoid writing a will makes life miserable for survivors who have worked hard to help a dying patient in his last days. Patients who resist making a will are only denying what is inevitable, i.e., that we all die some day. One of the kindest and most helpful things that we can all do for our survivors is to make out a thoughtful will.
Readers of this blog may think that I am personally in favor of health care rationing. If you think that way, you are right. I believe that health care dollars can be used much more effectively to produce health for the American people without spending thousands of dollars extending the life of 90 year olds for an extra few months.
I would invite you all, especially if you are in the elderly age group to read the following book: Nearing Home: Comforts and Councils for the Aged by William Edward Schenck available from Amazon.com for $27.93 in paperback. This book is not a scientific tome; it is a book for Christian believers; and I think that it presents a philosophy on the subject of death that should be comforting and practical to help us all make better end-of-life decisions.
1)I will have my cancer treated with all the radiation and chemotherapy available. Patients need to understand that their doctors are pledged to defend life to the very last ditch. Many of them look at death in their patients as a personal defeat. Some, unfortunately look at advanced cancer as an opportunity to make money from hurting people. (Fortunately, this is probably an unusual situation.) Many doctors are willing to allow patients and their families push them into ill-advised treatment methods, which they know are fruitless and even harmful. This latter group of doctors rationalizes their treatment activities by saying that they are only carrying out the sincere wishes of their patients. And patients, after all, should have sovereignty over their own treatment options. (There is some truth in this attitude.) Far too many doctors are victims of overactive curiosity about new drugs and new treatment options. They want to try every new drug that comes on the market. Unfortunately, many new drugs prove themselves no better than the older, standard drugs with which there are known complications and success rates. Many cancers, however, are only slightly affected by chemotherapy and radiation; and those treatment modalities are often not advisable. Patients should develop the practice of asking the doctors specific questions about survival and side effects of the treatments they are contemplating. Following is a list of questions that patients should ask their physicians:
a)What are the one year and the five year survival rates for my cancer if I accept this treatment? What are the survival rates without this treatment?
b)What are the complications and side effects of this treatment?
c)How long has this treatment been in use?
d)How many times have you, personally, used this treatment?
e)What is the microscopic grade and the anatomical stage of my tumor; and how does that affect my outlook for life expectancy and general life quality?
f)Where can I read about the success and the complications of this treatment?
g)Is this treatment accepted as standard treatment? If not, why not?
h)Do other doctors have recommendations to make about this treatment? Where can I find those recommendations?
i)Does the U.S. Food and Drug Administration recommend this treatment? What about the recommendations of the American Board of Oncology? (Bear in mind that oncologists have a reputation for very aggressive and sometimes ill-advised treatment.) What are the recommendations of the specialty board that is concerned with the organ system giving rise to the cancer that I have? (For instance, the American Board of Urology for cancer of the prostate)
j)What are the alternative forms of treatment available?
Remember that a consultation with a geriatric specialist who has no vested interest in radiation or chemotherapy might yield an unbiased and impartial opinion about these kinds of treatment.
If your doctor feels threatened by the above questions or if he/she reacts defensively or adversely toward them, perhaps you should consider changing doctors. The answer to these questions is a privilege you have as a patient. This is all your business; do not be hesitant to ask these questions.
2)I want every possible treatment modality available used to the uttermost to keep me alive as long as possible. Sometimes patients with incurable diseases and the family members of those patients do not realize that the complications and side effects of some treatment methods do not warrant their use. Two examples of this follow:
a)Chronic hemodialysis (use of the artificial kidney) is often abused as an end-of-life measure because patients believe that it makes life longer and more comfortable. This treatment can certainly make life longer; but the price in symptoms and side effects of the treatment is often not worth it. Patients on this kind of treatment usually live with constant thirst, muscle cramps, nausea, and itching all over the body. They have to submit to 2-3 hour sessions on the artificial kidney twice weekly. The artificial kidney should be used in cases where the patient’s kidneys are expected to recover in the near future and the patient is expected to be able to get off the kidney machine soon. Chronic use in old age for permanent kidney failure is not a good decision. Conditions which should certainly prevent the decision to use chronic hemodialysis are congestive heart failure, advanced dementia, and any other incurable disease that will soon lead to death (such as cancer). It is my opinion that chronic hemodialysis should not be used in patients over the age of 75 years or in anyone else with a life expectancy of less than 3 years.
b)Coronary artery bypass grafting is often used to excess in the elderly to keep the heart working just a little longer. I have seen this procedure used in patients over the age of 90 in the vain hope that it will prolong life significantly. What a dream, if only it were true! Opening the chest to repair arteries to the heart is no small procedure; and in aged patients, it is fruitless. The placement of coronary artery stents, on the other hand, is often effective and useful in the aged. That procedure is quite invasive, but it does not entail much in the way of side effects—it is often effective in producing desirable results. Patients often go home within a day or two.
c)One caveat to remember about desperate, life-sustaining, procedures is that cardiopulmonary resuscitation (CPR) in nursing homes has an almost zero survival rate after 3 months. This fact has been ascertained in repeated studies around the nation. All nursing homes ask patients if they want to be resuscitated in the case of cardiac arrest; and, unfortunately, in many cases, patients will indicate that they want that procedure done. That decision is a mistake when it is made in a nursing home—the procedure is worthless, costly, and often inflicts a lot of pain.
3)I will never turn off life-support machinery being used in the care of my loved one. That would be the same as murder. There is a great difference between pulling the plug on a respirator and actively causing the death of a patient by deadly injection—which is, indeed, murder. We are called on to defend life to the last ditch—unless it involves using extraordinary means. What are “extraordinary means?” Extraordinary means are any treatments that involve advanced medical measures, which are not expected to produce life-giving results in the future. Extraordinary means certainly include the use of respirators in brain-dead patients—respirators can keep these patients “alive” with pulse and blood pressure for years. But—-is that life? I do not believe so. Even the use of feeding tubes inserted through the abdomen or nose may be considered extraordinary means, in my opinion. If those tubes are used to keep a permanently unconscious patient alive indefinitely, I think they should be removed.
We come down to the difficult question of what does it mean to be “alive.” Of course, medical people often use the presence or absence of pulse, blood pressure, and brain waves on an electroencephalogram as criteria to determine whether a patient is alive or dead. Personally, I think that the ability or disability to give and receive love should be strongly considered in the determination of whether a person is alive or dead.
4)I will go to Mexico to obtain the very best and most advanced treatment available. (This decision is almost too ludicrous to even discuss.) There are, along the Mexican border, several unscrupulous and unethical doctors who advertise that they can cure almost anything with treatments that have been outlawed or found ineffective in the United States. They charge high fees for treatments that do no good, at best, and that have dangerous side effects at worst.
I remember one doctor, in particular—-a doctor in Piedras Negras, a small town across the Rio Grande from Eagle Pass, Texas. We, doctors in the southwestern U.S., called him “the bad guy from black rock.” He claimed he could cure arthritis. I noticed that his patients, returning to my practice, appeared from their side effects, to be taking huge doses of cortisone. They came back to me for treatment of their high blood pressure and broken bones apparently caused by osteoporosis—-well known complications of improper cortisone treatment. I called him on the phone one day and asked if he were treating patients with cortisone—-he denied it, saying that he was using only Valium and aspirin. I obtained some of his pills from a patient and had them analyzed at a laboratory in Denver. They were found to consist of the extract of a Mexican yam plant that is the crude material from which cortisone is produced. He was overloading arthritis patients with cortisone—-a well-known toxic form of treatment.
Some of these Mexican border doctors are treating cancer with useless dietary restrictions; another I have heard of is supposedly using stem cells on an out-patient basis to treat chronic lung disease. I know of no chronic lung disease that responds to stem cell treatment, although papers were published as late as 2007 indicating that experimentation with stem cells shows some promise in mice with certain lung diseases. (To be effective, stem cell treatment is one of the most highly technical treatments available. A course of treatment requires weeks to accomplish. To be using it frivolously in an out-patient setting is obviously fraudulent. Furthermore, I seriously doubt that any genuine stem cells are being used in the first place!) Going to Mexico to have advancing disease treated by one of these border doctors is like going to West Africa to have diabetes treated by a witch doctor.
5)I will never go into a nursing home or assisted living home—-those places do no good; and I know patients just go there to die. Of course, people die in nursing homes. They die anyway—-some time and some place; but nursing homes do not hasten their death. Nursing homes make life more comfortable when advanced care is necessary. My mother resisted nursing home placement energetically in her advanced old age. She was having a difficult time caring for her basic needs at home. When she finally entered the nursing home, however, her comment was, “Why did I not do this earlier? It is such a relief to me to be cared for like this!”
6)I will not accept hospice care. It does no good; and they won’t treat my disease, anyway. They will only let me die. Hospice care, on the other hand gives considerable relief to intractable symptoms in advancing, incurable diseases at the end of life. Hospice care avoids unnecessary side effects of useless treatment and relieves pain and suffering in a major way. Hospice care should be enlisted early in the course of advancing, incurable disease. Although it is designed to alleviate symptoms, hospice care does not preclude treatment of the disease present if the treatment can prolong life and relieve symptoms. Hospice care aims to keep patients in their homes where they can be made comfortable by frequent home visits by skillful nurses and home health helpers.
7)I don’t need to make out a will. I’m not that bad off, anyway. Wills are not only necessary for people who are “bad off;” they should be written long before a person even becomes ill. To avoid writing a will makes life miserable for survivors who have worked hard to help a dying patient in his last days. Patients who resist making a will are only denying what is inevitable, i.e., that we all die some day. One of the kindest and most helpful things that we can all do for our survivors is to make out a thoughtful will.
Readers of this blog may think that I am personally in favor of health care rationing. If you think that way, you are right. I believe that health care dollars can be used much more effectively to produce health for the American people without spending thousands of dollars extending the life of 90 year olds for an extra few months.
I would invite you all, especially if you are in the elderly age group to read the following book: Nearing Home: Comforts and Councils for the Aged by William Edward Schenck available from Amazon.com for $27.93 in paperback. This book is not a scientific tome; it is a book for Christian believers; and I think that it presents a philosophy on the subject of death that should be comforting and practical to help us all make better end-of-life decisions.
Monday, March 21, 2011
Can’t Find A Christian Job?
I have recently run across some blog posts and blog comments that, although the writer wants very much to be strongly oriented on Christ and wants to do some Christ-honoring work, he/she cannot find anything to do in the world of Christian work or ministry. This blog post is designed to alleviate that problem.
There is a world of constructive, Christ-oriented, work in our country; and with the resources available, there is no excuse for anyone to have difficulty finding multiple sources for many kinds of Christian work.
I would suggest that anyone looking for Christian ministry look first at Google and search “Christian ministries (then enter the name of your city); that will produce more ideas than you can ever digest. Another very good source is USAChurch (your city). Christian matching services are available to help you find the best match for your skills and available Christian positions. Those services can be found at Intercristo and Finishers.com. If you are looking for work in a pregnancy center, look on Google for Care Net and Heartbeat International. If you are looking for Christian missionary work, look at the web sites for SIM International and TEAM (The Evangelical Alliance Mission).
Happy browsing, and may God bless you in your search for things to do for Him!
There is a world of constructive, Christ-oriented, work in our country; and with the resources available, there is no excuse for anyone to have difficulty finding multiple sources for many kinds of Christian work.
I would suggest that anyone looking for Christian ministry look first at Google and search “Christian ministries (then enter the name of your city); that will produce more ideas than you can ever digest. Another very good source is USAChurch (your city). Christian matching services are available to help you find the best match for your skills and available Christian positions. Those services can be found at Intercristo and Finishers.com. If you are looking for work in a pregnancy center, look on Google for Care Net and Heartbeat International. If you are looking for Christian missionary work, look at the web sites for SIM International and TEAM (The Evangelical Alliance Mission).
Happy browsing, and may God bless you in your search for things to do for Him!
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