While You Were Busy Watching Dancing With The Stars A Little Bit More of Your Right To Privacy Died
So this 9th Circuit Court decision looked a little more outrageous when I first saw it, but it still remains a fine excuse to bring up the political topic most important to me. Civil liberties.
I’m sure it will come as a surprise to many but Border and Customs Agents can essentially seize any electronic device you are transporting into the U.S. and hold it for as long as it takes them to ’search’ it. And such is what they’ve been doing more of late.
Laptops may be scrutinized and subject to a “forensic analysis” under the so-called border search exemption, which allows searches of people entering the United States and their possessions “without probable cause, reasonable suspicion or a warrant”…
The 9th Circuit Court recently reaffirmed the legality of data on electronic devices being scrutinized under the border search exemption to the 4th Amendment. What I really disagree with is the breadth of the border search exemption, but ruling it extends to data on electronic devices is nothing new. As Wired and Yahoo! blogs point out such searches of computers has been upheld since at least 2004. But the claim that searches of US citizens at the border “are reasonable simply by virtue of the fact that they occur at the border,” (as the Supreme Court has put it) and current U.S. Customs law are far too broad of a mandate for current U.S. Customs.
Some discretion is being used in determining who gets searched and who does not. Allowing Border Agents such authority has some benefits, they are the ones on the front line, but it also has major pitfalls in terms of our privacy.
Let me frame the the security versus freedom issue. These are on a scale. We could always be safer at the expense of further rights. We could all renounce our right to privacy further and have cameras in our homes and renounce our right to property further and have the taxes to pay for people to monitor those cameras. True, the yield for each further bit of privacy we forfeit is probably less but the maxim holds.
That might seem like an obvious definition of the debate but I’m currently annoyed by arguments such as those claiming that if you’re not a criminal you have nothing to fear or asserting that the U.S. has to protect its borders. Such are ridiculous in that they contribute nothing in trying to define how to tilt the scale of freedom versus safety.
In any case, the border exemption is far too broad at present. I hate it.
As for the extension of such to electronic data, there is a reasonableness to the legal argument considering how the border exemption has been defined. However, the pragmatic result seems fishy at best.
We should try to maximize the return on our forfeit of liberties (such as the right to privacy). The return for checking IDs, checking citizenship, checking large vehicles for illegal immigrants or devices of terrorism is considerably higher than that for checking a number of laptops based on the suspicions of some GED carrying Border Agent.
I would’ve hoped, however much their legal arguments were in line with prior court holdings, that the 9th Circuit Court (here and here and here) would’ve had some gall and would’ve help reverse the general decline in our civil liberties.
Brittney Spears underwent a very publicly reported invasion of her privacy during two stays at UCLA affiliated hospitals. As happens with celebrities many hospital employees took a look at her records without a need to.
The trouble is that physicians who did so apparently got off lighter than other employees.
[A]t least 53 UCLA staffers — including 14 physicians — looked at Spears’ medical records on the two occasions, even though they were not treating her, according to statistics from the state and UCLA officials. Eighteen non-doctors resigned, retired or were dismissed after their prying was discovered, according to data provided to The Times by UCLA. No physicians quit or were fired.
“Historically, doctors have been treated in a way that may be more lenient than non-physicians, and we will address that,” said Dr. David Feinberg, chief executive of the UCLA Hospital System.
“We will do everything possible in the future not to be accused of that.”
Watcher’s World goes over some of the reasons that physicians typically get off lighter. One of the reasons is that physicians, in the private world, are not typically employees of a hospital. They simply have priviliges to practice at that hospital and in return for such, that is where their patients get admitted when they need to be in the hospital. In this case however I would imagine that the majority of physicians with priviliges at the hospital are UCLA faculty and salaried employees. Firing them might have been a real possibility.
In anycase, the moral of the story is simple: don’t look at patient’s medical records unless you need to. No duh.
Ana Puente was an infant with a liver disorder when her aunt brought her illegally to the U.S. to seek medical care. She underwent two liver transplants at UCLA Medical Center as a child in 1989 and a third in 1998, each paid for by the state.
But when Puente turned 21 last June, she aged out of her state-funded health insurance and was unable to continue treatment at UCLA.
Now this young lady is getting a fourth transplant.
Here are the two arguments made, summed up in a sentence each. For restricting illegal immigrant access to organs,
“All transplants are about rationing,” said Roy Beck, executive director of NumbersUSA
For transplanting illegal immigrants,
“People are people, and when you make an incision in an organ donor, you don’t find little American flags planted on their organs,” [Dr. Michael] Shapiro said.
I’m torn by the issue. There really are two separate issues here and I think, despite some ethicists opinions to the contrary, that I can separate the two. From a bioethical standpoint, I think as long as we’re going to allocate organs through a central sharing process (and notice that I’m a long time supporter of targeted donation and actually a donor’s right to sell their organs) that such should be done on need and independent of citizenship or alien status. But I really don’t think, as in most instances, that tax dollars have any place supporting illegal immigrants.
Sovereignty is important. While their odds are no doubt much worse in their home countries that is where these illegal immigrants should be seeking their organ donations. Or they should be seeking legal immigration into this country.
As I type, front page on CNN is a profile piece on a plastic surgeon and several of his patients who are upset he continued to operate while in an alcohol treatment program.
[Dr.] West is an alcoholic, according to a Medical Board of California decision, and a member of the state’s Physician Diversion Program.
The program keeps the doctors’ identities private, so it allowed him to continue to treat patients, even operate on them, while he was secretly getting treatment for his addiction.
[…]
A study by the Federation of State Physician Health Programs found about one percent of all physicians practicing in the United States are in confidential treatment. That’s about 8,000 doctors whose patients may have no idea they are addicts.
A physician doesn’t have to disclose his drug or alcohol troubles and gets to keep practicing on unaware patients. A little shocking at first light. Let me tell you why it isn’t and why I think these confidential treatment programs are extremely important.
These are not programs for physicians who have been caught practicing under the influence, who have made mistakes because they’ve been inebriated. The way I understand it, these are physicians who sought help of their own volition. Physicians without documented professional troubles secondary to substance abuse.
That is an incredibly important point. It is highlighted in this quote from the CMA president,
[T]he California Medical Association, a physicians advocacy group, is fighting to keep the program running, and to keep the names of doctors enrolled confidential.
The association’s president, Joe Dunn, told CNN, “We believe very strongly this is the absolute best way to ensure patient safety. We need to get physicians out of the shadows.”
Dunn believes if the program is shut down in July, doctors will continue to feed their addiction privately and not get help. He argues, “Without a diversion program, no one knows. Patients don’t know. Health professionals who could help don’t know.”
It absolutely positively is the difference between having more physicians out there who are actively abusing substances with patients none the wiser and having physicians out there who are getting treatment for abusing substances with patients none the wiser. I don’t think, when framed appropriately like such, that that is really any choice at all.
Internet griefers descended on an epilepsy support message board last weekend and used JavaScript code and flashing computer animation to trigger migraine headaches and seizures in some users.
The nonprofit Epilepsy Foundation, which runs the forum, briefly closed the site Sunday to purge the offending messages and to boost security.
RyAnne Fultz, a 33-year-old woman who suffers from pattern-sensitive epilepsy, says she clicked on a forum post with a legitimate-sounding title on Sunday. Her browser window resized to fill her screen, which was then taken over by a pattern of squares rapidly flashing in different colors.
Fultz says she “locked up.”
“I don’t fall over and convulse, but it hurts,” says Fultz, an IT worker in Coeur d’Alene, Ohio. “I was on the phone when it happened, and I couldn’t move and couldn’t speak.”
After about 10 seconds, Fultz’s 11-year-old son came over and drew her gaze away from the computer, then killed the browser process, she says.
This is, based on the actual physical nature of the attack, one of the worst hacks ever if the report is accurate. A terrible tale and these guys should go to jail under some kind’ve assault statute if there’s any justice and serve non-consecutive time for illegally accessing the forum as well.
[T]he Supreme Court ruled on Wednesday that the manufacturer of a federally approved medical device cannot be sued under state law if the device causes an injury.
In 1996, a balloon catheter burst and severely injured Charles R. Riegel while he was undergoing an angioplasty. Mr. Riegel and his wife, Donna, sued the company in federal court, contending that the catheter had been designed, labeled and manufactured in a way that violated New York state law, and that those defects had caused severe and permanent injuries to Mr. Riegel.
But a federal district court and the United States Court of Appeals for the Second Circuit, in Manhattan, dismissed the Riegels’s suit on the ground that the catheter had been given pre-market approval by the Food and Drug Administration, thus protecting the manufacturer from liability under state law.
The Supreme Court upheld the lower federal courts on Wednesday, with Justice Antonin Scalia writing for the majority that Medtronic and other manufacturers were protected under the Medical Device Amendments of 1976, which in its section on pre-emption bars states from imposing on medical devices “any requirement which is different from, or in addition to, any requirement applicable under this chapter.”
Basically, federal law says that state laws cannot put further requirements on medical devices than what the FDA does. Such is for better or worse I suppose.
Senator Edward M. Kennedy of Massachusetts, the chairman of the Senate Health, Education, Labor and Pensions Committee, agreed, saying: “Congress never intended that F.D.A. approval would give blanket immunity to manufacturers from liability for injuries caused by faulty devices. Congress obviously needs to correct the court’s decision. Otherwise, F.D.A. approval will become a green light for shoddy practices by manufacturers.”
Hamed’s 4-year-old son, Mohamed, was dying of cancer and needed an artery transplant that cost $5,000. The only savings Hamed had was what he fished from his pockets at the end of the day.
There was another way, one whispered about for those with nothing. A man could wager part of himself, slip into a hospital gown, and wake up with an incision above the gut.
Hamed sold a section of his liver for a bit more than the price of his son’s operation. The boy died in surgery.
With his scar healing and his son buried, Hamed, whose knowledge of anatomy would perhaps fill a single page, decided that driving a bus was not the fate of the man he wanted to be. He brokered his first liver deal four months ago. He earned $900. Four more sales have followed.
There are virtually no laws governing organ donations in Egypt. Or so the article makes it sound like.
Mohamed Queita, a member of the Egyptian parliament and the ruling National Democratic Party, has been working for 12 years to pass a law to regulate organ transplants and stop an expanding black market that draws patients from across the Middle East and as far away as Europe.
“It’s the worst kind of business in Egypt. It’s worse than slavery,” says Queita, who has no comprehensive statistics but notes that one Cairo clinic had a waiting list of 1,500 people willing to sell their organs. “I don’t want the poor turned into spare parts for the rich. . . . People are coming from all over to buy organs in Egypt. They’re mainly gulf Arabs. If you’re a rich man from the gulf, you go to a private Egyptian hospital that has contacts with organ brokers. Serious cases of poverty in this country are causing an increase in the theft and sale of organs.”
The emphasis is my own. This kind’ve paternalism is just wrong. There are terrible, horrific stories out there but no matter the motives or the life situation that forces someone into selling an organ, it seems something like such is a personal decision without any negative consequences for anyone else. The government has no place regulating such decisions.
It’s real simple - just let people do what they want with their bodies.
It isn’t like western societies’ bans on selling/buying organs are achieving their goals anyway. Protecting the poor? Maintaining some ‘equality’ in the distribution of limited organs? Nonesense.
You can’t make direct payments, but those with resources are still open to bettering their odds of getting an organ by doing everything just short of paying the previous owner of the organ.
An NPR piece looks at physician blogs and quotes some who ask if stories about patients, even composite stories, are too close to giving away patients’ privacy.
Blogging can be a great marketing tool for raising a physician’s profile and attracting new patients, says health care marketing expert Fard Johnmar.
“Patients who see physicians who blog realize that these physicians understand implicitly that patients are hungry for information. By providing this information sometimes they will become much more trusted by patients because they believe that they are going to be much more responsive,” Johnmar says.
But not all physician blogs are geared toward marketing. In fact, just the opposite seems to be the case in some extremely candid blogs, like “White Coat Rants,” “Cancer Doc” and “M.D.O.D.,” which bills itself as “Random Thoughts from a Few Cantankerous American Physicians.” These are more like diaries in which doctors vent about reimbursement rates, difficult cases and what a “bummer” it is to have so many patients die.
Dr. Debra Peel, a psychiatrist and founder of the group Patient Privacy Rights, thinks physician blogs often step too close to the limits of patient privacy.
“The problem with physicians blogging about patients is the danger that that person will be able to identify themselves, or that others that know them will be able to identify them,” she says.
Physicians have been sharing case reports and stories about patients since the profession grew into itself. I don’t know why just because such are more visible with the emergence of blogs, that anyone imagines doctors can’t maintain the same ideals in this new medium as they do in more vouched methods of publication.
I Don’t Think I’ve Ever Seen An Episode of Three’s Company
Back in 2003 John Ritter had chest pain while he was on the set of 8 Simple Rules…
Turns out he was suffering a dissection of his ascending aortic aneurysm. Although he made it to the hospital the dissecting aneurysm cost him his life. It was a tragedy. And of course, in many people’s imagination someone needed to pay for that tragedy. Which is why Ritter’s widow sued everyone in the phone book. And last year actually settled with a good number of them. Here are Kevin’s thoughts when the suit was filed.
However, today comes news that two other doctors and their insurance, who didn’t settle and took the suit to trial, have emerged victorious. One of them was a radiologist who performed a whole body scan on John Ritter a year before his AA claimed his life and the other was a cardiologist who was called into the hospital late that night, hours after Ritter had been admitted, once he took a turn for the worse.
Jurors said the majority believed the cardiologist summoned to the hospital after Ritter was diagnosed with a heart attack had no time to order a chest X-ray that might have found the tear.
[…]
Defense testimony characterized the aortic dissection as lethal and contended that even with surgery the outcome would have been the same.
As in all MSM reported malpractice cases we don’t know all the specifics. Aortic dissections are notoriously hard to diagnose and ascending ones (near where the aorta takes off from the heart) easily mimic heart attacks, which is what apparently his physician at the hospital thought he was suffering. One thing that I can’t imagine is that it took the hospital physicians and staff so long to get a chest x-ray on Ritter which certainly might’ve shown a widened mediastinum.
Testimony showed that an X-ray was ordered as soon as Ritter arrived at the emergency room but for unknown reasons it was never done.
Even with that though, all aortic dissections carry something like a 33% mortality rate (although most of that is attributable to the time to diagnose this very acute problem).
Without passing judgment on the verdict itself, I am a little worried by some apparent attitudes on the defense side.
“I disagree with the jury’s decision but I believe in the system and I respect it,” said the widow, Amy Yasbeck. “It inspires me even more to find, with these brilliant medical minds, a path to diagnose aortic diseases.”
If she admits the difficulty in diagnosing this condition why did she vehemently press on in her malpractice suits for more than a year? To force more aggressive defensive medicine in California ERs, in the hopes someone else’s dissecting aneurysm is caught earlier? I don’t know, it’s likely I’m reading her media reported comments out of context but that line that I italicized is certainly fishy.
A transplant surgeon is charged with hastening a patient’s death, after coming to a hospital he did not have priviliges at to retrieve organs from a patient, and making some overzealous medication orders at the end of life. This entire case could defintely have some negative consequences.
[A] transplant team including Dr. Roozrokh arrived at the hospital. .
According to a police interview with Jennifer Endsley, a nurse, Dr. Roozrokh stayed in the room during the removal of the respirator and gave orders for medication, something that would violate donation protocol. Ms. Endsley, who stayed to watch because she had never seen the procedure, also told the police that Dr. Roozrokh also asked an emergency room nurse to find and administer more “candy” — meaning drugs — after Mr. Navarro did not die after the removal of his respirator.
Dr. Roozrokh shouldn’t have even been in the room with the patient and he certainly shouldn’t have been making orders for the patient’s care at a hospital with which he was unaffiliated. In his Kaiser Permanente online biography, Dr. Roozrokh says,
I THRIVE by endeavoring to practice good karma.
That will certainly be tested here.
I will say there is at least something fishy about the civil complaints (if not the criminal charges) he is facing. Obviously it is difficult to put yourself in the place of a parent who has lost a child, but the civil suit by the mother seems borderline…at best. Indeed, it doesn’t even appear she was around when they took her son off life support. And her excuse for such, if accurately reported by the media (always a possibility that it wasn’t), borders on ludicrous.
Ms. Navarro, a disabled machinist from Oxnard, Calif., said she did not have enough money to stay another night near her son.
Now, despite the fact that the coroner has already ruled the patient’s death was of natural causes, the mother has filed suit against everyone involved (and already settled with the hospital). We don’t know the whole story or the whole of the mother’s position and obviously I cannot ever truly empathize, truly understand her pain but you can’t help but question some elements of her lawsuit.
In the end, despite Dr. Roozrokh’s actions the organs ended up being unusable. Just an unfortunate story all the way around. Hopefully this will not scare desperately needed organ donors away.
Prosecutors say the nurses’ resignations — without notice — on April 7, 2006, jeopardized the lives of children at Avalon Gardens in Smithtown, where some of the patients are on ventilators and required constant monitoring.
None of the patients suffered ill effects, but an indictment alleges the nurses knew their sudden resignations would make it difficult to find replacements. Their trial is scheduled to begin Jan. 28.
Defense attorneys say they are perplexed why the case is proceeding to trial because two separate state-agency investigations cleared the 10 nurses. [Prosecutor] Spota said the legal standards for a prosecution differ from those of the state agencies.
While, not knowing the specifics of the incident, in general I would say something like this should be far from a criminal matter…in a just society.
Blue Cross of California had been sending out letters asking physicians to disclose any medical history that patients hadn’t disclose when applying for health insurance with Blue Cross. They were searching for expensive pre-existing conditions, so they could cancel (or modify) those patient’s policies.
The state’s largest for-profit health insurer is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose “material medical history,” the Los Angeles Times reported on its Web site.
“Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately.”
And although the program was far from new apparently, once it broke out into the media it naturally drew an outcry. Now BC has agreed to stop the practice but there is one thing to note,
After getting slammed yesterday by everybody from Arnold Schwarzenegger to Hillary Clinton, Blue Cross of California said it would stop sending letters to doctors asking them to help find patients who had failed to report pre-existing medical conditions to the insurance company.
The company said it had been sending out the letters — which include a copy of the patient’s insurance application — for years, and hadn’t received any complaints.
Obama, who is vying to become the first black president in US history, “would certainly not last long, a black man in the position of president. They would murder him,” Lessing, 88, told the Dagens Nyheter daily.
But I’ve laughed about Europeans’ view of race relations in America in recent years, and I think comments like this are a further example of the myopia plenty of Europeans have concerning world wide race relations.
As Europe deals with an incredible influx of immigrants from former colonial territories they’re seeing racial strife (or here) at least as significant as anything in the United States.
‘Hate crime’ is a loose term with vastly differing definitions in legislation by country, but it is incredible to note the per capita hate crime rates in the United Kingdom versus the United States. Europe is the new racial hot box (not that the United States doesn’t require continued work towards improving our own situation).
Doris Lessing probably needs to take account of the world she lives in nowadays and not that of her earlier years. Controlling for the increased number of firearms per capita in this country and America’s propensity for violence (i.e. American leaders in general are probably more likely to face assassination than most leaders of western Europe) the first African-American President is no more likely to be assassinated than the first black Prime Minister in the UK.
As the anesthetic wore off, Naseem Mohammed said, he felt an acute pain in the lower left side of his abdomen. Fighting drowsiness, he fumbled beneath the unfamiliar folds of a green medical gown and traced his fingers over a bandage attached with surgical tape. An armed guard by the door told him that his kidney had been removed.
Mr. Mohammed was the last of about 500 Indians whose kidneys were removed by a team of doctors running an illegal transplant operation, supplying kidneys to rich Indians and foreigners, police officials said.
Many of the donors were day laborers, like Mr. Mohammed, picked up from the streets with the offer of work, driven to a well-equipped private clinic, and duped or forced at gunpoint to undergo operations.
Initially, the ‘head’ surgeon beind the ring seemed to have escaped.
[Amit Kumar] was arrested in 1994 on suspicion of running a kidney transplant racket in Mumbai, but jumped bail, changed his name and set up work again from several clinics hidden in residential apartments in Gurgaon, a prosperous city outside Delhi.
The police raided one of his clinics in 2000, but somehow he was allowed to continue working. Officials neglected to investigate further even after at least one television investigation exposed his work.
Apparently tipped off to the raid, Dr. Kumar escaped arrest. Only one of the four main doctors implicated has been detained.
The officials suspect that several private hospitals in Delhi and its suburbs were quietly complicit in Dr. Kumar’s work and treated patients recovering from kidney transplants.
Dr. Amit Kumar, smiling and with an apparent air of confidence, was paraded before reporters at the end of a news conference in which he declared his innocence.
“I have not duped anyone. I have not done anything wrong,” Kumar said before authorities whisked him away. “You know that.”
He appears to contend that the donors did so voluntarily and were compensated. Still, that would be illegal under Indian law where, like the United States, it is illegal to sell organs.
I actually think transparent and well consented (if that’s even a phrase) compensated live organ donation should be legal. At the least this horrific ‘kidney ring’ in India appears to fall well short of that and it sounds like, by media accounts, actually involved the shocking theft of kidneys.
I’ve talked about black market organ transplantation before on this blog. This just serves as further documentation of that. If everyone would sign up as an organ donor, the “necessity” of rings like this would decrease significantly.
I did my undergrad work in USC's School of Cinema-Television Cinematic Arts. I have a Bachelors of Fine Arts in Writing for Screen & Television. I loved it, but a future of waiting tables and taking meetings with B-List producers was not for me.
This blog is ostensibly to discuss healthcare policy and maybe educate a few of my fellow medical students. But it will stray into current events, politics, and other science topics when they draw my interest
Other odd notes about me:
I've skied half the resorts on this list (Squaw Valley/Lake Tahoe, Snowbird/Park City, Whistler, Taos, Vail)
I "played" lacrosse in high school and through a club level team in college
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