Saturday, July 10, 2010
DA's office coverup death in Cape Cod Hospital
Cape Cod Hospital death ruled homicide
What is the status of this case? As a long time resident of Cape Cod, I want to know.
Wednesday, June 30, 2010
Choosing healthy foods now called a mental disorder
In its never-ending attempt to fabricate "mental disorders" out of every human activity, the psychiatric industry is now pushing the most ridiculous disease they've invented yet: Healthy eating disorder.
This is no joke: If you focus on eating healthy foods, you're "mentally diseased" and probably need some sort of chemical treatment involving powerful psychotropic drugs. The Guardian newspaper reports, "Fixation with healthy eating can be sign of serious psychological disorder" and goes on to claim this "disease" is called orthorexia nervosa -- which is basically just Latin for "nervous about correct eating."
But they can't just called it "nervous healthy eating disorder" because that doesn't sound like they know what they're talking about. So they translate it into Latin where it sounds smart (even though it isn't). That's where most disease names come from: Doctors just describe the symptoms they see with a name like osteoporosis (which means "bones with holes in them").
Getting back to this fabricated "orthorexia" disease, the Guardian goes on to report, "Orthorexics commonly have rigid rules around eating. Refusing to touch sugar, salt, caffeine, alcohol, wheat, gluten, yeast, soya, corn and dairy foods is just the start of their diet restrictions. Any foods that have come into contact with pesticides, herbicides or contain artificial additives are also out."
Wait a second. So attempting to avoid chemicals, dairy, soy and sugar now makes you a mental health patient? Yep. According to these experts. If you actually take special care to avoid pesticides, herbicides and genetically modified ingredients like soy and sugar, there's something wrong with you.
But did you notice that eating junk food is assumed to be "normal?" If you eat processed junk foods laced with synthetic chemicals, that's okay with them. The mental patients are the ones who choose organic, natural foods, apparently.
What is "normal" when it comes to foods?
I told you this was coming. Years ago, I warned NaturalNews readers that an attempt might soon be under way to outlaw broccoli because of its anti-cancer phytonutrients. This mental health assault on health-conscious consumers is part of that agenda. It's an effort to marginalize healthy eaters by declaring them to be mentally unstable and therefore justify carting them off to mental institutions where they will be injected with psychiatric drugs and fed institutional food that's all processed, dead and full of toxic chemicals.
The Guardian even goes to the ridiculous extreme of saying, "The obsession about which foods are "good" and which are "bad" means orthorexics can end up malnourished."
Follow the non-logic on this, if you can: Eating "good" foods will cause malnutrition! Eating bad foods, I suppose, is assumed to provide all the nutrients you need. That's about as crazy a statement on nutrition as I've ever read. No wonder people are so diseased today: The mainstream media is telling them that eating health food is a mental disorder that will cause malnutrition!
Shut up and swallow your Soylent Green
It's just like I reported years ago: You're not supposed to question your food, folks. Sit down, shut up, dig in and chow down. Stop thinking about what you're eating and just do what you're told by the mainstream media and its processed food advertisers. Questioning the health properties of your junk food is a mental disorder, didn't you know? And if you "obsess" over foods (by doing such things as reading the ingredients labels, for example), then you're weird. Maybe even sick.
That's the message they're broadcasting now. Junk food eaters are "normal" and "sane" and "nourished." But health food eaters are diseased, abnormal and malnourished.
But why, you ask, would they attack healthy eaters? People like Dr. Gabriel Cousens can tell you why: Because increased mental and spiritual awareness is only possible while on a diet of living, natural foods.
Eating junk foods keeps you dumbed down and easy to control, you see. It literally messes with your mind, numbing your senses with MSG, aspartame and yeast extract. People who subsist on junk foods are docile and quickly lose the ability to think for themselves. They go along with whatever they're told by the TV or those in apparent positions of authority, never questioning their actions or what's really happening in the world around them.
In contrast to that, people who eat health-enhancing natural foods -- with all the medicinal nutrients still intact -- begin to awaken their minds and spirits. Over time, they begin to question the reality around them and they pursue more enlightened explorations of topics like community, nature, ethics, philosophy and the big picture of things that are happening in the world. They become "aware" and can start to see the very fabric of the Matrix, so to speak.
This, of course, is a huge danger to those who run our consumption-based society because consumption depends on ignorance combined with suggestibility. For people to keep blindly buying foods, medicines, health insurance and consumer goods, they need to have their higher brain functions switched off. Processed junk foods laced with toxic chemicals just happens to achieve that rather nicely. Why do you think dead, processed foods remain the default meals in public schools, hospitals and prisons? It's because dead foods turn off higher levels of awareness and keep people focused on whatever distractions you can feed their brains: Television, violence, fear, sports, sex and so on.
But living as a zombie is, in one way quite "normal" in society today because so many people are doing it. But that doesn't make it normal in my book: The real "normal" is an empowered, healthy, awakened person nourished with living foods and operating as a sovereign citizen in a free world. Eating living foods is like taking the red pill because over time it opens up a whole new perspective on the fabric of reality. It sets you free to think for yourself.
But eating processed junk foods is like taking the blue pill because it keeps you trapped in a fabricated reality where your life experiences are fabricated by consumer product companies who hijack your senses with designer chemicals (like MSG) that fool your brain into thinking you're eating real food.
If you want to be alive, aware and in control of your own life, eat more healthy living foods. But don't expect to be popular with mainstream mental health "experts" or dieticians -- they're all being programmed to consider you to be "crazy" because you don't follow their mainstream diets of dead foods laced with synthetic chemicals.
But you and I know the truth here: We are the normal ones. The junk food eaters are the real mental patients, and the only way to wake them up to the real world is to start feeding them living foods.
Some people are ready to take the red pill, and others aren't. All you can do is show them the door. They must open it themselves.
In the mean time, try to avoid the mental health agents who are trying to label you as having a mental disorder just because you pay attention to what you put in your body. There's nothing wrong with avoiding sugar, soy, MSG, aspartame, HFCS and other toxic chemicals in the food supply. In fact, your very life depends on it.
Monday, June 7, 2010
Death with dignity
Baltimore physician Dr. Larry Egbert is currently awaiting trial in both Arizona and Georgia, accused of assisted suicide.
The charges are unfounded. Dr. Egbert, a former Johns Hopkins professor, simply counseled patients with incurable diseases about their options as the end of their lives drew near. By talking to these folks, Dr. Egbert was fulfilling his responsibility as a medical professional.
To understand why, consider the plight of those suffering from Alzheimer's. The afflicted ? including 86,000 people in Maryland ? can expect a slow, painful descent into advanced dementia.
The moderate memory loss that marks the onset in patients will, over the years, deteriorate into inability to recognize close family members, dress themselves or remember significant experiences. Friends and family who are forced to witness their fall into oblivion suffer indescribably.
Given this bleak outlook, it's easy to see why some Alzheimer's patients choose to hasten their own death. It's also easy to see why Dr. Egbert was determined to help patients suffering from conditions like Alzheimer's and Lou Gehrig's disease make this difficult decision.
It is time for the world to recognize the right and the rationality for mentally competent adults in such circumstances to take their own lives.
As a practicing psychologist for 30 years, I have frequently worked to prevent mentally ill patients from ending their lives. But such a decision by a capable person stricken with unrelenting and intractable illness is a logical means of sparing the victim and others extraordinary misery and suffering.
Many find allowing people to take their lives morally reprehensible. In the abstract, the issue makes for interesting ethical discussions. When we become specific, though, the need for action becomes more visible: That's your mother screaming in that bed, dealing every day with some terrible disease like Lou Gehrig's. She can look forward to a body that can't move, speak or swallow food, a life of total dependency on others for every act of maintenance.
We respect and support the choice of anyone with a disease such as Lou Gehrig's to continue enduring these conditions, as Stephen Hawking, the 68-year-old astrophysicist, does, continuing to enrich science from his wheelchair. But heroism has many forms, and those who know their limits, who can face death in the eye and who choose not to stay alive via respirator and 24/7 care, are no less heroic.
Their form of courage should be honored without judgment.
Consider the 42,000 Americans diagnosed in 2009 with pancreatic cancer, a disease that is usually inoperable and accompanied by crippling abdominal and back pain until the end. All those patients will know is a future of intense agony followed by death. Some "life."
An aging nation means that these terrible diseases will become more common, and protecting the right to die with dignity, more urgent. For example, 5.3 million Americans are living today with Alzheimer's. By 2050, that number will be 16 million.
In a country where there isn't enough good health care for those who want to live, doesn't it seem insane to take those who desperately want to die and force them to stay alive against their wishes?
Who are those who have the heart to consign these people to a living hell? If the patient were their mother, would they? Do we not have a moral obligation to spare these patients and their families unspeakable torment?
We as a society do indeed have that power, and it is time we gathered in numbers and exercised it. That's where my organization, Final Exit Network, comes in. We provide information and counsel to patients who approach us seeking to deliver themselves from torture and make informed choices. The impetus comes from within them; we do not "encourage" anyone. We go to great lengths to ensure that the person is capable of choosing rationally.
What we do is wholly different from physician-assisted suicide, since we never supply any equipment or administer any lethal chemicals. We are careful to keep our efforts within the law. That, however, has not prevented some local governments, notably Georgia and Arizona, from persecuting many of my colleagues ? including our former medical director, Dr. Egbert.
Ending a life of unbearable pain and indignity is a basic human right. We at Final Exit Network provide compassion in the form of information and empathy, and we are proud of our work.
We hope that those antagonists who insist on making people suffer a few more days, weeks, or even years, will never themselves need to endure the horrors that they now force others to experience.
~~~~~~~~~~
Jerry Dincin is president of Final Exit Network and a retired psychologist with more than 30 years of clinical experience. Mr. Dincin may be reached at info@finalexitnetwork.org.
Thursday, May 20, 2010
Novartis Fined $250 Million in Sex Discrimination Suit
Published: May 19, 2010
The drug maker Novartis must pay $250 million in punitive damages for discriminating against thousands of female sales representatives over pay, promotion and pregnancy, a federal jury ruled on Wednesday.
The decision was announced federal court in Manhattan by a jury of five women and four men who ruled Monday that the company’s United States division, the Novartis Pharmaceuticals Corporation, engaged in a pattern of discrimination against women.
The $250 million in punitive damages is 2.6 percent of the company’s $9.5 billion 2009 revenue. The women had sought from $190 million to $285 million.
In the first part of its ruling, the jury awarded $3.3 million in compensatory damages to 12 of the women who testified.
Novartis, which for the last 10 years has been declared one of the 100 best companies by Working Mother magazine, showed a pattern of discrimination against women employees from 2002 through 2007, the jury found after a five-week trial and four days of deliberation.
The award to the 12 opens the door for 5,588 others who can also apply for compensatory damages. The damages will likely be determined on an individual basis by a court-appointed special master, said Katherine Kimpel, a lawyer for the plaintiffs.
Judge Colleen McMahon of United States District Court will determine a lump sum for back pay, lost benefits and adjusted wages that will be distributed to plaintiffs, lawyers said. They said they were seeking $37 million to cover back pay.
Novartis said after the verdict was returned on Monday that it would appeal.
Carol Evans, president of Working Mother Media, said in a statement Wednesday that the lawsuit had not barred Novartis from repeatedly winning its 100 best companies award because the magazine had a different role than the court system.
“We are disappointed that Novartis has engaged in discriminatory practices against women and mothers,” Ms. Evans added. “We applaud the court system for effectively finding redress for this discrimination.”
She said the magazine’s award was based on programs that Novartis had in place to support working mothers, like flextime, telecommuting and paid maternity leave.
“We hope that Novartis will not appeal the ruling against them and instead turn their efforts to making sure that the company has no further incidences of discrimination,” Ms. Evans said.
Thursday, April 8, 2010
Thinking Outside the Pillbox? Scary implications.
As many as half of all patients do not adhere faithfully to their prescription-medication requirements, and the result is more than $100 billion spent each year on avoidable hospitalizations. David Cutler and Wendy Everett discuss how to improve medication adherence.
Thinking Outside the Pillbox —Medication Adherence as a Priority for Health Care Reform
David M. Cutler, Ph.D., and Wendy Everett, Sc.D.
Poor adherence to treatment regimens has long been recognized as a substantial roadblock to achieving better outcomes for patients. Data show that as many as half of all patients do not adhere faithfully to their prescription-medication regimens — and the result is more than $100 billion spent each year on avoidable hospitalizations.1 Nonadherence to medication regimens also affects the quality and length of life; for example, it has been estimated that better adherence to antihypertensive treatment alone could prevent 89,000 premature deaths in the United States annually.2
What is less clear is why adherence to the 3.8 billion prescriptions written every year is so poor. Out-of-pocket costs for medication clearly affect adherence; people use more drugs when the prices of the drugs are lower. But even if drugs were free, nonadherence would persist: one recent study showed that even among patients who have health plans with no cost sharing for medications, rates of nonadherence were nearly 40%.3
Lack of coordination of care is another major factor. There is much more that could be done at the time a physician prescribes a medication to optimize and tailor regimens for individual patients. For patients with coexisting conditions who take multiple medications prescribed by multiple physicians, there is a vital need to reconcile the prescribed regimen with what a patient is actually taking and to understand why there is a difference between the two. But optimizing and reconciling medications require substantial investments of time by a skilled health care practitioner, as well as electronic data sharing among practitioners — neither of which is widely available in today’s model of health care delivery.
There are also numerous factors that affect adherence at the individual level, including lifestyle, psychological issues, health literacy, support systems, and side effects of medications. Indeed, patients’ personal attributes probably have the strongest influence on adherence. Engaging and supporting patients in improving their adherence are critical to improving health outcomes. In today’s system, however, there are neither the incentives nor the support systems to do so.
Taken together, these findings suggest that improved adherence will require changes in health care delivery, particularly in the area of primary care, along with continued investment in information-technology systems and new health plan designs that focus on achieving improved health outcomes. Fortunately, there are a number of real-world examples that teach important lessons about how to improve medication adherence. For instance, two well-known integrated health care delivery systems, Geisinger Health System and Group Health Cooperative, have made adherence a priority and have begun to tackle the problem through multidimensional approaches. The Community Care of North Carolina program has a similar objective (see Current Integrated Approaches to Promoting Adherence and Their Effects). And studies point to improved adherence and outcomes among patients with particular conditions, such as HIV infection, AIDS, and heart failure. The success stories are there, though they are still scattered.
All these programs leverage information technology and patient-level data. They focus on understanding the patients’ attributes and tailoring interventions to those attributes. In addition, they offer follow-up and patient support provided by health care professionals who are trained and empowered to work closely with patients to improve adherence.
We believe that there are four lessons to be learned from the successes in the field. First, measures for improving adherence must address financial barriers, especially the copayments that patients must make for medications. Given the growing evidence showing a strong link between reducing copayments for medications for chronic conditions and improving adherence, the movement by many large employers toward value-based insurance design (tailoring cost sharing to the value of the service provided) is an excellent first step. But more can be done. For example, patients could be given financial incentives or other rewards for appropriate adherence to medication regimens. Research shows that the more frequent the reward, the better; thus, smaller amounts provided regularly are likely to be more effective than bigger amounts provided sporadically.
Second, data and data infrastructure that support interventions to boost adherence need to be a high priority in the country’s new investment in health information technology (HIT) and electronic health records. The guidelines promulgated by the Obama administration for “meaningful use” of HIT are promising. But the country’s HIT strategy should not only recommend the incorporation of accurate medication data (e.g., medication histories and rates of filling and refilling of prescriptions) into electronic medical records but also encourage data sharing across care providers and care settings, including physicians’ offices, hospitals, pharmacies, home health care agencies, and others.
Third, payment reform will be essential. Shifting from a fee-for-service model to payment systems that reward care providers for better patient outcomes and encourage coordination of care is critical to providing the incentives and investments that are required for improving adherence. Recent shifts to paying for medical homes and care transitions are trends that should support improved adherence. But to ensure that adherence actually improves, goals for medication adherence should be explicitly written into the performance measures for medical homes, accountable care organizations, and care transition teams. In the short run, efforts aimed at increasing adherence to medication regimens will require funds to be allocated up front. Over time, there should be savings. Thus, the structure of reimbursement must create an inducement for investment (typically by providers) that is financed by the groups that will save (usually insurers).
Finally, there needs to be greater use of proven screening and assessment tools to identify and target the patients who are at the greatest risk for nonadherence. Treatment guidelines for chronic conditions, for instance, should recommend screening for depression, which can be an indicator of poor adherence. In addition, assessment tools can broadly predict a patient’s proclivity to adhere to treatment,4 which is valuable information for providers to use in encouraging adherence both at the point of prescribing and in follow-up contacts with patients.
Once the right patients are targeted, there is still a lot to learn about tailoring adherence interventions to individual patients. Although we know about many common features of adherence programs, it is more difficult to determine the best possible combination of such features for any given person. New investments in research, including efforts associated with the government’s expanded program of comparative-effectiveness research, could dramatically enhance the evidence base for effective adherence interventions.
The bottom line is this: We’ve known for some time that improved adherence can lead to improvements in health outcomes and reductions in health care spending. What we haven’t known is where to start. With the new federal health care reform law moving into implementation, the existing movements toward deployment of HIT, improved coordination of care, and payment reform together create a desire and an infrastructure for improving health outcomes through improved adherence. Now we just need to get moving.
Current Integrated Approaches to Promoting Adherence and Their Effects.
Community Care of North Carolina (CCNC), a loose affiliation of 14 physician networks serving Medicaid and uninsured patients, has launched the Pharmacy Home Project, a plan that pays participating physicians a monthly fee for coordination of care. Adherence is promoted through the use of case managers who are embedded throughout the networks and clinical pharmacists who serve multiple physician practices on a rotating basis and through the collection of data on patient medications from multiple sources including medical charts, claims records, and records of prescriptions filled to provide prescribers with complete and accurate data for use in reviewing medications. Under this program, CCNC has achieved a 5 to 7% increase in adherence rates.
Geisinger Health System, in Pennsylvania, has begun implementing multiple programs to address adherence. One approach is to collect patients’ medication preferences through an electronic survey completed before a physician sees the patient. As part of Geisinger’s medical home model, nurses actively follow up with patients to monitor medication use and address any questions or concerns the patient might have. The health system has also made changes to its own employee health benefits by reducing copayments and deductibles for medications for chronic conditions. Geisinger reports that it has achieved a 5 to 7% reduction in monthly costs.
At Group Health Cooperative, in Washington State and northern Idaho, the approach to adherence relies on nurse case managers who interview patients to assess whether they are managing their medical conditions and to increase patients’ adherence to their medication regimens. Case managers also educate patients about their conditions, create action plans with patients, and refer patients to programs that help them find more affordable medications. The Group Health Cooperative reports that the results have included annual savings — representing avoided health care costs — of more than $476 per participant.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
Source Information
From Harvard University (D.M.C.) and the New England Healthcare Institute (W.E.) — both in Cambridge, MA.
This article (10.1056/NEJMp1002305) was published on April 7, 2010, at NEJM.org.
References
- Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005;353:487-497. [Free Full Text]
- Cutler DM, Long G, Berndt ER, et al. The value of antihypertensive drugs: a perspective on medical innovation. Health Aff (Millwood) 2007;26:97-110. [Free Full Text]
- Doshi JA, Zhu J, Lee BY, Kimmel S, Volpp KG. Impact of a prescription copayment increase on lipid-lowering medication adherence in veterans. Circulation 2009;119:390-397. [Free Full Text]
- Mosen DM, Schmittdiel J, Hibbard J, Sobel D, Remmers C, Bellows J. Is patient activation associated eLIZABETH lA
Saturday, March 13, 2010
"Good Life. Good Death. Your Choice."
Assisted suicide group Final Exit Network plans billboards for N.J. and California
By The Associated Press
March 10, 2010, 1:47PM
Jerry Dincin is the new president of the Final Exit Network which offers counseling and assistance to people with medical conditions who want to end their life. He faces trial on a charge of helping a cancer patient kill himself.The leader of assisted suicide group Final Exit Network plans to put up billboards in New Jersey and California, as means of validating the group's work.
Jerry Dincin discussed the planned billboards as his group, Final Exit Network, prepares for a trial in Georgia after helping a 58-year-old man with cancer kill himself.
Dincin said Tuesday they have been preparing for the trial for more than a year, and is "glad it's moving along."
He became the group's leader after then-president Ted Goodwin and three other members were arrested in February 2009. The four members and the group itself were indicted Tuesday by a Forsyth County grand jury.
Dincin said the billboards planned for New Jersey and California will read:
"Good Life. Good Death. Your Choice."
Final Exit Network - Georgia Four will be indicted on April 1
You will have to wait a moment for a TV ad but it will come on immediately.
"To establish that a mentally competent person, suffering from irreversible illness or intractable pain, has the right to end his or her life, and the right to choose the timing, method, help, and companion, free of any restrictions no matter how well intentioned"
The Ultimate Human Right of the 21st Century
Visit our new web site at Final Exit Network
Monday, March 8, 2010
Conspicuous And Invidious Consumption
From The Motly Fool
The economist Thorstein Veblen is best known for the expression "conspicuous consumption" which describes the kind of lavish spending which is primarily performed for the purpose of displaying income and wealth. Veblen was arguably the first economist to look at luxury goods in any detail and he showed that a great deal of spending on luxury goods is for what he describes as "invidious consumption" where the purchaser intends to display the goods to create feelings of envy in those who see their purchases.
If you've sat through someone's wobbly videos and badly-shot photographs of their expensive holiday, it probably wasn't to give you any great insights into the local architecture and culture. Part of the reason for taking the holiday was for invidious consumption and the holidaymakers must tell others to make them envious! :-) Invidious consumption can be seen everywhere from people flashing their "bling" to telling your friends about your new pair of shoes ;-)
Someone who spends £500 on a bottle of wine does so, in part, to convince themselves that they are in an elite club. Just don't show them the research published in the April 2008 issue of the Journal of Wine Economics which showed that that the vast majority of wine consumers cannot tell the difference between cheap and expensive wines :-) Most people are better off with a £4.99 bottle from Tesco.
Conspicuous consumption and housing
In the U.S., a trend in 1950s towards large houses began, with the average size of a home about doubling over a period of 50 years. This trend has been compared to the rise of the SUV, also often a symbol of conspicuous consumption. **Such large homes can also facilitate other forms of consumption, in providing extra storage space for vehicles, clothes, and other objects. (!!)
** I find this both hilarious and sad at the same time. Just MHO.
Virtual Revolution: The Cost Of Free
Virtual Revolution: The Cost Of Free
How commerce has been transformed by the online market.
Tuesday, February 23, 2010
The Virtual Revolution: The Great Levelling?
In the first in this four-part series, Dr Aleks Krotoski charts the extraordinary rise of blogs, Wikipedia and YouTube, and traces an ongoing clash between the freedom the technology offers us, and our innate human desire to control and profit.
Thursday, February 11, 2010
Whistle-Blowing Nurse Is Acquitted in Texas
A West Texas jury took but an hour Thursday to acquit a nurse who had been charged with a felony after alerting the state medical board that a doctor at her hospital was practicing unsafe medicine.
The uncommon prosecution had ignited deep concern among health care workers and advocates for whistle-blowers about a potential chilling effect on the reporting of malpractice.
But after a four-day trial in Andrews, Tex., a state court jury quickly found that the nurse, Anne Mitchell, was not guilty of the third-degree felony charge of “misuse of official information.” Conviction could have carried a prison sentence of up to 10 years and a fine of up to $10,000.
The prosecution said Mrs. Mitchell, 52, who had been a nurse at Winkler County Memorial Hospital for 25 years, had used her position to obtain and disseminate confidential information — patient file numbers — in her letter to the medical board with the intent of harming Dr. Rolando G. Arafiles Jr. The prosecutor argued that state law required that reports of misconduct be made in good faith, and that Mrs. Mitchell had been waging a vendetta against Dr. Arafiles since his arrival at the hospital in April 2008.
Witnesses testified that they had heard Mrs. Mitchell refer to Dr. Arafiles, a proponent of alternative medicine and herbal remedies, as a “witch doctor.”
But other nurses vouched that Mrs. Mitchell’s concerns were legitimate, and that internal complaints were not dealt with adequately by the hospital’s administration.
The jury foreman said the panel of six men and six women voted unanimously on the first ballot, and questioned why Mrs. Mitchell had ever been arrested.
“We just didn’t see the wrongdoing of sending the file numbers in, since she’s a nurse,” said the foreman, Harley D. Tyler, a high school custodian.
Mrs. Mitchell, who did not testify in her defense, said after the verdict that she had been trying only to protect her patients.
“It’s a duty to every nurse to take care of patients,” she said, after wiping away tears of relief.
The prosecution has so polarized the small town of Kermit, where the hospital is located, that the judge moved the trial to a neighboring county. The case was investigated by Sheriff Robert L. Roberts Jr., a friend and admiring patient of Dr. Arafiles, and tried by the county attorney, Scott M. Tidwell, a political ally of the sheriff and, according to testimony, Dr. Arafiles’s personal lawyer.
Sheriff Roberts said he was disappointed in the verdict but did not regret the prosecution.
“The defense had to spin this as a reporting issue, that nurses were not going to be able to report bad medical care, and it’s never been that,” he said. “We encourage people to report bad medical care. But I encourage public servants to report it properly.”
Mrs. Mitchell and Vickilyn Galle, a co-worker who helped her write the anonymous letter to the medical board, were fired by the hospital last June, shortly before being indicted. The charges against Mrs. Galle, 54, were dismissed late last month at the prosecutor’s discretion.
After the verdict, the nurses’ lawyers pivoted quickly to the lawsuit they have filed in federal court against the county, the hospital and various officials, charging that the firings and indictments amounted to a violation of due process and their First Amendment rights.
“We are glad that this phase of this ordeal has ended and that Anne has been restored to her liberty,” said Mrs. Mitchell’s lawyer, John H. Cook IV, “but there was great damage done in this case, and this does not make them whole.”
Mr. Cook presented broad evidence that the nurses’ concerns about Dr. Arafiles, 47, were well founded, and that Mrs. Mitchell had violated no laws or regulations in alerting the governmental body that licenses and regulates physicians. He walked the jury through a series of questionable cases involving Dr. Arafiles, including one in which the doctor performed a skin graft in the hospital’s emergency room, despite not having surgical privileges, and another where he sutured a rubber tip to a patient’s crushed finger for protection.
Some watchdog groups worried that the prosecution would stifle reporting of improper medical care, regardless of the outcome. But Rebecca M. Patton, president of the American Nurses Association, called the verdict “a resounding win on behalf of patient safety.”
Ms. Patton said, “The message the jury sent is clear: the freedom for nurses to report a physician’s unsafe medical practices is non-negotiable.”
Monday, February 8, 2010
Nurse to Stand Trial for Reporting Doctor
By KEVIN SACK
KERMIT, Tex. — It occurred to Anne Mitchell as she was writing the letter that she might lose her job, which is why she chose not to sign it. But it was beyond her conception that she would be indicted and threatened with 10 years in prison for doing what she knew a nurse must: inform state regulators that a doctor at her rural hospital was practicing bad medicine.
When she was fingerprinted and photographed at the jail here last June, it felt as if she had entered a parallel universe, albeit one situated in this barren scrap of West Texas oil patch.
“It was surreal,” said Mrs. Mitchell, 52, the wife of an oil field mechanic and mother of a teenage son. “I said how can this be? You can’t go to prison for doing the right thing.”
But in what may be an unprecedented prosecution, Mrs. Mitchell is scheduled to stand trial in state court on Monday for “misuse of official information,” a third-degree felony in Texas.
The prosecutor said he would show that Mrs. Mitchell had a history of making “inflammatory” statements about Dr. Rolando G. Arafiles Jr. and intended to damage his reputation when she reported him last April to the Texas Medical Board, which licenses and disciplines doctors.
Mrs. Mitchell counters that as an administrative nurse, she had a professional obligation to protect patients from what she saw as a pattern of improper prescribing and surgical procedures — including a failed skin graft that Dr. Arafiles performed in the emergency room, without surgical privileges. He also sutured a rubber tip to a patient’s crushed finger for protection, an unconventional remedy that was later flagged as inappropriate by the Texas Department of State Health Services.
Charges against a second nurse, Vickilyn Galle, who helped Mrs. Mitchell write the letter, were dismissed at the prosecutor’s discretion last week.
The case has been infused with the small-town politics of this wind-whipped city of 5,200 in the heart of the Permian Basin, 10 miles from the New Mexico border. The seeming conflicts of interest are as abundant as the cattle grazing among the pump jacks and mesquite.
When the medical board notified Dr. Arafiles of the anonymous complaint, he protested to his friend, the Winkler County sheriff, that he was being harassed. The sheriff, an admiring patient who credits the doctor with saving him after a heart attack, obtained a search warrant to seize the two nurses’ work computers and found the letter.
Both sides acknowledge that the case has polarized the community, and the judge has moved the trial to a neighboring county.
The state and national nurses associations have called the prosecution an outrage and raised $40,000 for the defense. Legal experts argue that in a civil context, Mrs. Mitchell would seem to be protected by Texas whistle-blower laws.
“To me, this is completely over the top,” said Louis A. Clark, president of the Government Accountability Project, a group that promotes the defense of whistle-blowers. “It seems really, really unique.”
Until they were fired without explanation on June 1, Mrs. Mitchell and Mrs. Galle had worked a combined 47 years at Winkler County Memorial Hospital here, most recently as its compliance and quality improvement officers.
The nurses, who are highly regarded even by the administrator who dismissed them, said the case had stained their reputations and drained their savings. With felony charges pending, neither has been able to find work. They said they could feel heads turn when they walked into local lunch spots like El Joey’s Mexican restaurant.
“It has derailed our careers, and we’re probably not going to be able to get them back on track again,” said Mrs. Galle, 54, a grandmother who is depicted around town as the soft-spoken Thelma to Mrs. Mitchell’s straight-shooting Louise. “We’re just in disbelief that you could be arrested for doing something you had been told your whole career was an obligation.”
It was not long after the public hospital hired Dr. Arafiles in 2008 that the nurses said they began to worry. They sounded internal alarms but felt they were not being heeded by administrators.
Frustrated and fearing for patients, they directed the medical board to six cases “of concern” that were identified by file numbers but not by patient names. The letter also mentioned that Dr. Arafiles was sending e-mail messages to patients about an herbal supplement he sold on the side.
Mrs. Mitchell typed the letter and mailed it with a separate complaint signed by a third nurse, who wrote that she had resigned because of similar concerns about Dr. Arafiles. That nurse was not charged.
To convict Mrs. Mitchell, the prosecution must prove that she used her position to disseminate confidential information for a “nongovernmental purpose” with intent to harm Dr. Arafiles.
Mari E. Robinson, executive director of the Texas Medical Board, has warned in a blistering letter to prosecutors that the case will have “a significant chilling effect” on the reporting of malpractice.
The nurses’ lawyers, John H. Cook IV and Brian Carney, have filed a civil lawsuit in federal court charging the county, hospital, sheriff, doctor and prosecutor with vindictive prosecution and denial of the nurses’ First Amendment rights.
Nonetheless, the sheriff, Robert L. Roberts Jr., and the prosecutor, Scott M. Tidwell, express confidence in their case.
“The only side of the story that the town has heard is that these are sisters of mercy, missionaries of peace,” said Mr. Tidwell, who is trying the case because the district attorney is in poor health. “The town has not heard the whole story.”
Dr. Arafiles, 47, who attended medical school in his native Philippines and trained in Baltimore and Buffalo, said his lawyer had advised him not to talk. “I’ve been brutalized and abused,” he said. “I’m the victim in this case, and that is all I can say.”
Several Texas laws would seem to enshrine a nurse’s right, and perhaps duty, to report a physician when he or she believes that patients are at risk. Lawyers on both sides agree that the case will hinge on whether a jury believes that Mrs. Mitchell reported in good faith. In civil whistle-blower cases, the Supreme Court of Texas has held that good faith requires only a reasonable belief that the conduct being reported is illegal.
The hospital administrator, Stan Wiley, said in an interview that Dr. Arafiles had been reprimanded on several occasions for improprieties in writing prescriptions and performing surgery and had agreed to make changes. Mr. Wiley, who said it was difficult to recruit physicians to remote West Texas, said he knew when he hired Dr. Arafiles that he had a restriction on his license stemming from his supervision of a weight-loss clinic.
In a surprise inspection last September, state investigators found several violations by Dr. Arafiles and concluded that the hospital had discriminated against the nurses by firing them for “reporting in good faith.”
But Sheriff Roberts, who has held the post for 18 years, said the state would show that the complaint had been filed in vengeance. “If it’s made to destroy somebody’s reputation or forcing them to leave town,” he said, “then I don’t believe it is good faith.”
Sheriff Roberts called Dr. Arafiles “the most sincerely caring person I have ever met.”
Mr. Wiley said he believed that the nurses had acted in bad faith because they went to the state despite his internal efforts to discipline Dr. Arafiles. But, he said, “I don’t believe they did it on a personal vendetta.”
Mrs. Mitchell said all she saw at the hospital was delay.
“The medical staff needed to make a decision on him,” she said. “You don’t get a second chance to save somebody’s life.”
Sunday, January 24, 2010
The Lethal White Wall of Silence
Watch this video to the end. Then think about how many people have been and will continue to be injured and killed by medical cover-ups and hush money.
Sunday, January 17, 2010
Animal Expolitation & Experimentation - Part II of Animals & Us
In Part II of Animals & Us focuses on the scientific establishment's attachment to using animals, and considers the future. Might social justice for other species actually benefit humans?
This is a must hear program from the BBC.
Click here to listen to Part II
Please visit KINSHIP CIRCLE to read about why animal testing causes more harm than good to HUMANS.
Sunday, January 3, 2010
Animals & Us - A must listen
Click here to Listen to "Animals & Us"
A documentary from the BBC
I encourage everyone to listen hard to this special documentary from the BBC. Pay attention, folks. I usually refrain from preaching vegetarianism to people who eat animals, but it's time for the real cruelty involved in eating the flesh of slaughtered animals is put square in the faces of those who continue what amounts to cannibalism.
I'm tired of tempering my feelings on this issue. I stopped eating meat 25 years ago when I began seeing beyond the disguised pieces of carcase on my plate to the living animal who suffered a horrible life and death to end up there. Since then, I can honestly say I would starve before eating an animal again. But I don't have to starve, and anyone who stops eating animals won't either. In fact, I have never eaten as well since eliminating meat from my diet.
The sight of a meat counter in a grocery store turns my stomach, and I am grateful for that. It reminds me that I am still human enough to appreciate the suffering of all living creatures and haven't conveniently distanced myself from this fact. There is simply no excuse to continue eating animals.. not the way our society raises them. It is a disgusting, selfish, inhumane habit. I am also sick and tired of people saying they can feed a family for less by stuffing their faces with burgers at fast food joints. You can feed a family on a sack of rice and beans for an entire week for a few bucks. You don't need a certificate from Le Cordon Bleu to learn to cook rice and dal..
The only thing I would add to this piece is to recommend that people place a colored picture of animals in a factory farm, slaughter house, etc. next to your plate every time you chose to eat a murdered animal. Be aware of what you are putting into your mouth to sustain your body- the muscle tissue of an animal raised in filthy, horrific conditions, and killed the same way. Keep this in mind while you chew its cooked flesh. Would you eat your pet dog or cat?
There's plenty to eat without choosing meat.
Watch the trailer of HBO's "Death on A Factory Farm"