Mike Leavitt to patients: “F*** you”

A number of us in the blogosphere have been outraged by Bush’s Department of Health and Human Services’ desire to put the arbitrary wants of doctors before the needs of patients. At first it was just a draft proposal, but now Mike Leavitt is pushing to implement the changes. Soon, it may be legally acceptable to deny you a needed health service because the health care provider thinks your decisions are immoral.

I’ve already written several times about why there can be no “conscientious objectors” in health care. This law would essentially allow doctors to ignore the standard of care set by their professional organizations. Let’s hear a bit from Leavitt himself:
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Theocracy in action—HHS proposes to limit birth control

I’m so angry I can barely type coherently. I have very strong feelings about abortion, but I believe it is possible to respectfully disagree about the ethical issues involved. I have an obstetrics colleague who does not perform abortions, but refers patients needing this service to others. That’s the ethical way for a doctor to oppose abortion—don’t do it, don’t prosteletize, refer out. My personal feeling is a woman has the right to control her body and all that dwells within, but I can see why others would disagree.

All that being said, if you chose a profession that will, by its very nature create an insoluble ethical conundrum, you need to get a new job. Pharmacists who refuse to dispense birth control when given a lawfully written prescription should be fired immediately and consider a change in careers.

The Religious Right is trying to protect these types of “acts of conscience.” Traditional passive resistance in the model of Thoreau and King emphasized the breaking of unjust laws and the acceptance of any punishment that goes with it. The religious right in this country is not content with this model—they would prefer to allow for acts of conscience without consequences. In this vein, the Church Amendment was passed. This amendment protects professionals who are trying to impose their values on others by mandating that health care providers who receive federal funds not require providers to provide services that to which they morally object. This has not been widely enforced apparently, because a draft is circulating at the Department of Health and Human Services that would step up enforcement, and broaden the services to which people could object, even protecting them if they refuse to refer to an alternate provider. This document terribly flawed for a number of reasons.
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Feministe on Gardasil

Complementing Pal’s essay on Gardasil yesterday is our buddy la Pobre Habladora guest blogging on Feministe.

Which, I think, brings us to a new angle on anti-vax denialism because as Pal mentions, the motivations behind harping on Gardasil are different than the usual nonsense. Gardasil, to everyone’s dismay, has become intertwined with sexual politics in this country. As the only vaccine that has been identified as preventing a sexually-transmitted disease (the HepB vaccine managed to avoid this, not to mention an association with IV-drug use) there has been a clear impetus among the anti-sex crowd to malign this treatment for girls.

Two things which I think are disgusting and idiotic about this practice. One, I’m willing to bet if it were for boys and not girls, we wouldn’t have this problem. Second, it suggests there is a subset of parents that feels that if their children somehow violate the rules of sex that disease and death should be the wages of their sin.

Is there nothing not disgusting about these attitudes? While the CNN article doesn’t get into this nonsense, let’s not forget the main obstacle to the acceptance of this highly-effective vaccine is not safety issues (it’s a very safe vaccine and the incidents cited in the article are likely coincidence) but rather the amoral bigotries of idiots who are desperate to control women’s sexuality – even to the detriment of women’s health.

A pregnancy boom at a Massachusetts high school

Surprisingly, it’s not due to the horribly misguided abstinence education nonsense. In fact, I can’t even begin to wrap my mind around this one.

As summer vacation begins, 17 girls at Gloucester High School are expecting babies–more than four times the number of pregnancies the 1,200-student school had last year. Some adults dismissed the statistic as a blip. Others blamed hit movies like Juno and Knocked Up for glamorizing young unwed mothers. But principal Joseph Sullivan knows at least part of the reason there’s been such a spike in teen pregnancies in this Massachusetts fishing town. School officials started looking into the matter as early as October after an unusual number of girls began filing into the school clinic to find out if they were pregnant. By May, several students had returned multiple times to get pregnancy tests, and on hearing the results, “some girls seemed more upset when they weren’t pregnant than when they were,” Sullivan says. All it took was a few simple questions before nearly half the expecting students, none older than 16, confessed to making a pact to get pregnant and raise their babies together. Then the story got worse. “We found out one of the fathers is a 24-year-old homeless guy,” the principal says, shaking his head.

Really? Assuming this isn’t some bizarre error of mis-reporting, this is clearly not a failure of contraception, but what I can only assume is a failure of our culture. Here’s why:

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Women physicians—a waste of a good education?

Think about your own experiences—you’re at a party or a restaurant, and someone you’re with says something obviously racist. You cringe, but given the setting, you can’t decide how to react; after a pause, you probably decide to say something. Now imagine you’re at meeting for work, and a senior partner says something racist. You want to say something, and you even know that under some circumstances there are laws behind you, but you don’t want to get branded a trouble maker and risk subtle (or not-so-subtle) discrimination.

Now imagine you are sitting in the doctors’ lounge, and a senior physician says that sending women to medical school is a bit of a waste. The people sitting around the table make decisions every day about who to accept and reject to medical schools and residency programs, who to hire, who to promote, but hey, it’s just a group of guys having a cup of coffee. How would you react?

In the early 1960’s, about 5% of medical American medical students were women. Now about half are. Women are first authors on more medical papers than ever, yet fill only about 11% of department chairs, and fill about 15% of full professorship positions.

What’s behind this?

There is literature studying the trends in academic and clinical medicine. I’ll point you to the reference below as a starting point, but I’d like to give you a front-line perspective.

Something I hear every week is that women are likely to take time off for kids, and to work part-time, and that this somehow renders them less valuable. I’m not sure how this reasoning works. After all, doctors treat people of all ages, genders, and ethnicities, and doctors of different backgrounds often have different experiences and skills to bring to the table.

But I can see how some of these ideas are perpetuated. Slots in medical schools, residencies, and fellowships are quite limited, and it costs much more to create a doctor than tuition could ever cover. Some take a false utilitarian view that because it costs so much to create a doctor, only those who can give back the most in time and money should be trained.

Residencies are limited in both the number of residents they can take, and in how many hours these residents can work. When one becomes pregnant, it can burden the entire program.

Well, this is the real world, and in the real world, half of us are women, and women are the ones who bear children. Also, the prime years for physician training are prime child-bearing years. Get used to it. If we think women have at least as much to offer as physicians as men, we better get used to the fact that they have “lady parts” and that this has real effects. Are we to limit the contributions women are allowed to make because a short period of their lives may or may not involve child-bearing?

In clinical medicine (as opposed to academic medicine), there seem to be many more opportunities to work part-time than in the past. The less you work, the less you get paid, but the pay is still pretty good. But academia is still about productivity, and gaps are not acceptable.

As a society and a profession, we have to decide to take the role of women seriously. If we demean women’s role in our profession, we may be more likely to demean our female patients and family members.

Things are getting better, but we still have a long way to go.

References

Reshma Jagsi, M.D., D.Phil., Elizabeth A. Guancial, M.D., Cynthia Cooper Worobey, M.D., Lori E. Henault, M.P.H., Yuchiao Chang, Ph.D., Rebecca Starr, M.B.A., M.S.W., Nancy J. Tarbell, M.D., and Elaine M. Hylek, M.D., M.P.H. The “Gender Gap” in Authorship of Academic Medical Literature — A 35-Year Perspective. NEJM 355(3); 281-287. July 20, 2006.

Vox Day’s New Low

I love a crank that you only have to quote to utterly humiliate. From the guy who brought the logic of the Third Reich to bear on the immigration issue we have this thoughtful analysis of the real threat to science:

As I have demonstrated in “The Irrational Atheist,” religion is not a threat to any aspect of science: It does not threaten the knowledge base, it does not threaten the method and it does not threaten the profession. It never has.

But this is not to say there is not a genuine threat to all three aspects of science today. Unsurprisingly, it comes from the same force that is the primary threat to the survival of Western civilization: female equalitarianism.


The idea of biology classes being taught by lesbian professors who believe that heterosexual procreation is a myth or calculus courses being taught by women who can’t do long division may sound impossible today, but tell that to any software developer, and he’ll be able to provide you with plenty of current examples of computer science engineers, some with advanced CS degrees, who have no idea how to even begin writing a computer program.

Women love education; it’s the actual application they don’t particularly like. Whereas the first thought of a woman who enjoys the idea of painting is to take an art appreciation class, a similarly interested man is more likely to just pick up a paintbrush and paint something – usually a naked woman.

It is written that “women ruin everything”; having destroyed the liberal arts, the classics and the pseudo-sciences, it is now abundantly clear that the more rigorous sciences are next on the equalitarians’ destructive agenda. And so, in the not-too-distant future, two plus two will finally be determined to equal five if a women feels that it should, or at least it will as long as she happens to feel that way.

Wow. This guy really hates women. I mean, really hates them. Does anyone think this is too far even for the WorldNutDaily? Basically a screed calling all women stupid?

Women make great scientists, and I’m tired of these creationist idiots lecturing us on what is needed in the field they don’t even believe in. Especially if it’s just sexist garbage that is so out of place in this century even the WorldNutDaily should be deeply ashamed.

I can’t wait to see the little bigot try to explain away this latest insight into his small-mindedness.

Thanks to Ed.

* Update *

I’ll point out right on the heels of Vox days seemingly insane rant against women this turd of a satirical piece by Mike S. Adams at Townhall:

when they aren’t attending masturbation workshops and orgasm awareness festivals on unc campuses, our feminist “scholars” are usually thinking of new words to ban in order to make womyn feel more comfortable in the workplace. recently, one of the sociologists at unc-wilmington actually banned the use of the term “mankind” because of its “sexist” overtones.

having recently been named as a defendant in a lawsuit alleging first amendment retaliation, dr. (name deleted to ensure maximum comfort) still seems undeterred. but i write today, not for the purpose of ridiculing this seemingly outlandish feminist censorship. in fact, i’ve decided to join in with some new class rules i’ll use from now on (but not NOW on).

1. all capital letters will be banned. for some feminists, capital letters are a reminder of an erect penis. so, from now on, all my class correspondence will have erectile dysfunction.

The conservative movement has a problem with hating women that is pervasive. I don’t believe Vox day is exceptional, just exceptionally stupid for saying what he thinks out loud. After all, are these two pieces really that different? I think the only difference is that Adams was smart enough to only castigate the bogey-(wo)man feminists while Vox said what they really think. Women have no place in positions of authority or power.