Daily Archives: May 5, 2008

The elderly and infirm will be allowed to die off in next pandemic

Doctors to decide who lives and who dies in coming pandemic

Who should MDs let die in a pandemic? Report offers answers

AP | May 5, 2008

By LINDSEY TANNER

CHICAGO (AP) — Doctors know some patients needing lifesaving care won’t get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn’t be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals “so that everybody will be thinking in the same way” when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

The idea is to try to make sure that scarce resources — including ventilators, medicine and doctors and nurses — are used in a uniform, objective way, task force members said.

Their recommendations appear in a report appearing Monday in the May edition of Chest, the medical journal of the American College of Chest Physicians.

“If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing,” the report states.

To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won’t get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:

_People older than 85.

_Those with severe trauma, which could include critical injuries from car crashes and shootings.

_Severely burned patients older than 60.

_Those with severe mental impairment, which could include advanced Alzheimer’s disease.

_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

Dr. Kevin Yeskey, director of the preparedness and emergency operations office at the Department of Health and Human Services, was on the task force. He said the report would be among many the agency reviews as part of preparedness efforts.

Public health law expert Lawrence Gostin of Georgetown University called the report an important initiative but also “a political minefield and a legal minefield.”

The recommendations would probably violate federal laws against age discrimination and disability discrimination, said Gostin, who was not on the task force.

If followed to a tee, such rules could exclude care for the poorest, most disadvantaged citizens who suffer disproportionately from chronic disease and disability, he said. While health care rationing will be necessary in a mass disaster, “there are some real ethical concerns here.”

James Bentley, a senior vice president at American Hospital Association, said the report will give guidance to hospitals in shaping their own preparedness plans even if they don’t follow all the suggestions.

He said the proposals resemble a battlefield approach in which limited health care resources are reserved for those most likely to survive.
Bentley said it’s not the first time this type of approach has been recommended for a catastrophic pandemic, but that “this is the most detailed one I have seen from a professional group.”

While the notion of rationing health care is unpleasant, the report could help the public understand that it will be necessary, Bentley said.
Devereaux said compiling the list “was emotionally difficult for everyone.”
That’s partly because members believe it’s just a matter of time before such a health care disaster hits, she said.

“You never know,” Devereaux said. “SARS took a lot of folks by surprise. We didn’t even know it existed.”

CIA Chief Sees Unrest Rising With Population

Washington Post | May 1, 2008

By Joby Warrick

Swelling populations and a global tide of immigration will present new security challenges for the United States by straining resources and stoking extremism and civil unrest in distant corners of the globe, CIA Director Michael V. Hayden said in a speech yesterday.

The population surge could undermine the stability of some of the world’s most fragile states, especially in Africa, while in the West, governments will be forced to grapple with ever larger immigrant communities and deepening divisions over ethnicity and race, Hayden said.

Hayden, speaking at Kansas State University, described the projected 33 percent growth in global population over the next 40 years as one of three significant trends that will alter the security landscape in the current century. By 2050, the number of humans on Earth is expected to rise from 6.7 billion to more than 9 billion, he said.

“Most of that growth will occur in countries least able to sustain it, a situation that will likely fuel instability and extremism, both in those countries and beyond,” Hayden said.

With the population of countries such as Niger and Liberia projected to triple in size in 40 years, regional governments will be forced to rapidly find food, shelter and jobs for millions, or deal with restive populations that “could be easily attracted to violence, civil unrest, or extremism,” he said.

European countries, many of which already have large immigrant communities, will see particular growth in their Muslim populations while the number of non-Muslims will shrink as birthrates fall. “Social integration of immigrants will pose a significant challenge to many host nations — again boosting the potential for unrest and extremism,” Hayden said.

The CIA director also predicted a widening gulf between Europe and North America on how to deal with security threats, including terrorism. While U.S. and European officials agree on the urgency of the terrorism threat, there is a fundamental difference — a “transatlantic divide” — over the solution, he said.

While the United States sees the fight against terrorism as a global war, European nations perceive the terrorist threat as a law enforcement problem, he said.

“They tend not to view terrorism as we do, as an overwhelming international challenge. Or if they do, we often differ on what would be effective and appropriate to counter it,” Hayden said. He added that he could not predict “when or if” the two sides could forge a common approach to security.

A third security trend highlighted by Hayden was the emergence of China as a global economic and military powerhouse, pursuing its narrow strategic and political interests. But Hayden said China’s increasing prominence need not be perceived as a direct challenge to the United States.

“If Beijing begins to accept greater responsibility for the health of the international system, as all global powers should, we will remain on a constructive, even if competitive, path,” he said. “If not, the rise of China begins to look more adversarial.”

Related

Revolution, flashmobs, and brain chips. A grim vision of the future

Reports show systemic abuse at Texas’ psychiatric hospitals

The state’s juvenile prisons, group homes for the disabled, and state schools for people with mental disabilities all came under fire last year for reports of widespread physical and sexual abuse.

Dallas Morning News | May 4, 2008

By EMILY RAMSHAW

AUSTIN – Patients with severe mental illness are committed to Texas’ state psychiatric hospitals to be protected from themselves. Instead, some are suffering vicious abuse from the very caregivers hired to look after them.

Last year, one state mental hospital employee tackled an adolescent patient who was sobbing for his mother, dragging him across the floor by his wrists and hair.

The year before, another brought a female patient into a hospital bathroom and sexually abused her.

And dozens more have participated in brutal beatings at the psychiatric hospitals since 2005, employee disciplinary reports show – using chokeholds, headlocks and threats of violence to restrain the patients under their watch.

In all, 72 employees across Texas’ 10 state mental hospitals have been fired in the last three years for allegations of physical abuse, according to a Dallas Morning News analysis of state personnel records. Hundreds more have been terminated for other violations, the records show, from sleeping on the job to over-medicating mentally ill patients.

State officials say there will always be some reports of abuse and neglect in an institutional setting. And they say they take any allegations of mistreatment seriously. But the records show that as in other state-run facilities, abuse and neglect are systemic.

The state’s juvenile prisons, group homes for the disabled, and state schools for people with mental disabilities all came under fire last year for reports of widespread physical and sexual abuse. The state psychiatric hospitals, like other systems for vulnerable Texans, are chronically starved for cash, advocates of more state funding say, and services at the local level can’t keep up.

“You get what you pay for,” said Rep. Garnet Coleman, D-Houston, who has bipolar disorder. “When you financially dumb something down, you make services cheap, something’s got to give. Unfortunately, it usually ends up being a mentally ill or disabled Texan.”

Officials with the Department of State Health Services, the agency that runs the psychiatric hospitals, say abuse and neglect are “absolutely not” pervasive – and verified cases are actually dropping.

In the last two years, they confirmed 15 “Class I” cases – the most serious abuse. On average, investigators substantiate 5 percent of the more than 2,000 allegations they examine annually. And 90 percent of patient deaths since 2005 were attributed to natural causes, agency spokesman Doug McBride said. Five were suicides, and none were the result of abuse.

“Keep in mind there are about 7,400 employees, 18,000 patient admissions and probably hundreds of thousands of staff-patient interactions in a year,” Mr. McBride said.

State officials acknowledge that the psychiatric hospitals are stressful environments; there are times, Mr. McBride said, when employees “do not handle a situation appropriately.” But they say the rules for reporting abuse and neglect are stringent – and confirmed cases of physical and sexual abuse are reported to police.

And they balk at the suggestion that conditions bear a resemblance to the state schools for people with mental disabilities, where the U.S. Justice Department has intervened twice in recent years.

The state psychiatric hospitals, which have about 2,500 patients daily, had 137 confirmed abuse cases in 2007. The state schools for people with disabilities, which have twice as many residents, have an average of 300 confirmed abuse cases per year.

But some advocates fear the mentally ill patients may face greater risks. Patients of the psychiatric hospitals are largely indigent, transient and not connected to their families, so they have few allies as they bounce through the mental health system.

“It’s a population that’s easy to abuse because they’re not on the radar in any way,” said Richard Hansen, a Texas mental health advocate who was chemically restrained, shackled and beaten to the point of broken ribs years ago while suffering from bipolar disorder in a New York mental hospital.

But there are few alternatives, advocates say, because smaller community-based services are as strapped as the state system.

Full Story

Mennonite Farmer Hauled Off for Selling Fresh Milk

The Criminalization of Raw Milk

Counterpunch | Apr 27, 2008

A Mennonite Farmer is Hauled Away

By LINN COHEN-COLE

On April 25, 2008, in Cumberland County, Pennsylvania, Mark Nolt, a Wenger Mennonite (Horse and Buggy Mennonite) dairyman, threatened for months with arrest for selling raw milk without a permit was removed from his property by state troopers.

Jonas Stoltzfus, a friend, fellow farmer, and Church of the Brethen, was asked by Mr. Nolt to speak for him, and said of the raid yesterday – “Six state troopers and a man with the Pennsylvania Department of Agriculture trespassed onto his property, and stole $20-25,000 of his product and equipment.”

Mr. Stoltzfus explained that Mr. Nolt did not have a permit because “he chose to turn his permit back in because it did not cover all the products he was selling. He felt he was being dishonest selling stuff that was not covered by the permit. He is a man of great integrity.”

“According to reports from neighbors and the Farm-to-Consumer Legal Defense Fund, several officials of the Pennsylvania Department of Agriculture participated in the raid, and while Mark was being transported by police car to the courthouse, PDA officials confiscated $20,000 to $25,000 worth of dairy products and production equipment. Neighbors reported the farm had been closed and that a large group of officials had gathered, with videos prohibited.”

“Mr. Nolt was told that people had gotten sick from eating his food, but no one ever came forward and no proof was ever offered.”

“This is a Gestapo raid,” Jonas Stotlzfus said, “complete with state troopers, raiding a hard-working farmer selling milk to friends and customers. And his customers ARE his friends.” Mr. Nolt

Mr. Stoltzfus said of Mr. Nolt, “he is not going to stop [selling raw milk] til he is ready to stop. He is the equivalent of that little black lady in Alabama who wouldn’t go to the back of the bus. He is doing the same thing, he won’t go to the back of bus.” Mr. Stoltzfus said “she got arrested for that and so did Mr. Nolt. He ignored [the threat] and kept on selling. He is a courageous man.” Mr. Stoltzfuz said “Mark believes it is his right to sell, according to the constitution, just like it was Rosa Park’s right to sit wherever she wanted on the bus. Same deal. There is nothing in the constitution to prevent Mr. Nolt from buying and selling, especially to his friends,” Mr. Stoltzfus said.

Stoltzfus commented that Mr Sheridan of the Pennsylvania Department of Agriculture (Stoltzfus does not have the spelling and believes he is with the licensing division) used to work for Dean Foods and Hershey Foods, big corporate operations, and that Sheridan was “jealous that farmers make a better product” and called the raid by Mr. Sheridan “a vendetta.”

This case is similar to that involving Meadowsweet Dairy LLC in New York, in that both Pennsylvania and New York allow raw milk sales, but adamantly oppose the sale of other raw dairy products.

Mr. Nolt was doing things the way his community has for generations, selling milk straight from his cows to those he knows.

Mr. Nolt contends that the regulations have not been approved by the legislature and shouldn’t apply to him because he is selling directly to consumers, via private contracts that are outside the purview of the state, making a privilege out of a right he believes he has – the right to private contracts.”

The permitting issue, ostensibly for food safety, is contradicted by a look both at raw milk itself and at its competition, corporate milk – pasteurized and often from cows injected with rBGH.

Fox News commentators agree: DC Madam’s “Suicide” Very Suspicious

Was the DC Madam murdered to protect high officials in the US Government? Four out of four commentors on Fox News seem to agree.

Fox News: Alex Jones on DC Madam Palfrey’s Murder

Machine Gun-Toting Officers To Patrol NYC Subway

herculesteam

A member of the New York City Police Department Hercules Team patrols New York’s Times Square.

CBS | Apr 24, 2008

M4 Carbine Rifles, MP5 Submachine Guns & Bomb Sniffing Dogs Part Of New “Torch Team” Anti-Terror Efforts

By Magee Hickey

NEW YORK (CBS) ― The NYPD is pulling out all the stops to beef up safety of the subways. On Thursday it launched a new anti-terror effort called “Operation Torch,” but the cost of the program is raising some eyebrows.

The NYPD’s new firepower consists of cops with Mp5 submachine guns, rifles, body armor and bomb-sniffing dogs.

Starting Thursday, five or six teams a day will patrol the major transit hubs in the city in the new program, all thanks to a 50 percent increase in a Homeland Security grant.

“Times Square, Grand Central, Penn Station … the locations you would expect, but not only those locations. The assignments will vary and will be following no discernible pattern,” NYPD Commissioner Ray Kelly said.

Many straphangers were thrilled to see the city going all the way to protect its citizens.

“It’s a very good idea,” Patricia Knight Williams said. “It’s like a deterrent. It’s going to make me feel safer, much safer, yes it will. It’s a good idea.”

The city’s massive subway system, With 5 million riders a day, has long been considered a potential terror target ever since Sept. 11, 2001.

Similarly equipped NYPD units known as “Hercules” teams have been patrolling the ground on Wall Street, the Empire State Building and other city landmarks.

Everyone seems to like the idea of an added police presence, particularly to fight terrorism on subway platforms, but then when you mention the price tag — $151 million – then people aren’t so sure.

“I think it’s a waste of money,” Michael Rivers said. “If someone wants to put a bomb in the subway how do you stop it?”

“It’s a hard time for a lot of people. That’s a lot of money to spend,” Ellen Payne added.

“Everybody has their opinion,” Kelly said. “We think this is a reasonable expenditure of funds. We’re doing everything that we think is appropriate to prevent another attack.”

Of the $151 million in the federal grant, $30 million will be used for this underground anti-terrorist program for the next two years.

In case you’re thinking you’ve seen this kind of police patrol on the subways, you’re right. Units like the Hercules teams have been sent underground during times of heightened security.

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London Police officers to be ‘microchipped’

Multinationals make billions in profit out of growing global food crisis

Independent | May 4, 2008

By Geoffrey Lean

Giant agribusinesses are enjoying soaring earnings and profits out of the world food crisis which is driving millions of people towards starvation, The Independent on Sunday can reveal. And speculation is helping to drive the prices of basic foodstuffs out of the reach of the hungry.

The prices of wheat, corn and rice have soared over the past year driving the world’s poor – who already spend about 80 per cent of their income on food – into hunger and destitution.

The World Bank says that 100 million more people are facing severe hunger. Yet some of the world’s richest food companies are making record profits. Monsanto last month reported that its net income for the three months up to the end of February this year had more than doubled over the same period in 2007, from $543m (£275m) to $1.12bn. Its profits increased from $1.44bn to $2.22bn.

Cargill’s net earnings soared by 86 per cent from $553m to $1.030bn over the same three months. And Archer Daniels Midland, one of the world’s largest agricultural processors of soy, corn and wheat, increased its net earnings by 42 per cent in the first three months of this year from $363m to $517m. The operating profit of its grains merchandising and handling operations jumped 16-fold from $21m to $341m.

Similarly, the Mosaic Company, one of the world’s largest fertiliser companies, saw its income for the three months ending 29 February rise more than 12-fold, from $42.2m to $520.8m, on the back of a shortage of fertiliser. The prices of some kinds of fertiliser have more than tripled over the past year as demand has outstripped supply. As a result, plans to increase harvests in developing countries have been hit hard.

The Food and Agriculture Organisation reports that 37 developing countries are in urgent need of food. And food riots are breaking out across the globe from Bangladesh to Burkina Faso, from China to Cameroon, and from Uzbekistan to the United Arab Emirates.

Benedict Southworth, director of the World Development Movement, called the escalating earnings and profits “immoral” late last week. He said that the benefits of the food price increases were being kept by the big companies, and were not finding their way down to farmers in the developing world.

The soaring prices of food and fertilisers mainly come from increased demand. This has partly been caused by the boom in biofuels, which require vast amounts of grain, but even more by increasing appetites for meat, especially in India and China; producing 1lb of beef in a feedlot, for example, takes 7lbs of grain.

World food stocks at record lows, export bans and a drought in Australia have contributed to the crisis, but experts are also fingering food speculation. Professor Bob Watson – chief scientist at the Department for Environment, Food and Rural Affairs, who led the giant International Assessment of Agricultural Science and Technology for Development – last week identified it as a factor.

Index-fund investment in grain and meat has increased almost fivefold to over $47bn in the past year, concludes AgResource Co, a Chicago-based research firm. And the official US Commodity Futures Trading Commission held special hearings in Washington two weeks ago to examine how much speculators were helping to push up food prices.

Cargill says that its results “reflect the cumulative effect of having invested more than $18bn in fixed and working capital over the past seven years to expand our physical facilities, service capabilities, and knowledge around the world”.

The revelations are bound to increase outrage over multinational companies following last week’s disclosure that Shell and BP between them recorded profits of £14bn in the first three months of the year – or £3m an hour – on the back of rising oil prices. Shell promptly attracted even greater condemnation by announcing that it was pulling out of plans to build the world’s biggest wind farm off the Kent coast.

World leaders are to meet next month at a special summit on the food crisis, and it will be high on the agenda of the G8 summit of the world’s richest countries in Hokkaido, Japan, in July.