Long referred to as “Bush’s poodle” Tony Blair has broken ranks with his master, at least when it comes to abortion. I’m sure that George doesn’t like to see his pet getting so uppity, especially over such a crucial issue of morality, but Tony seems to be getting a little backbone.

Tony Blair does not believe abortion should be an election issue, arguing it is a matter for individual conscience.

“However much I dislike the idea of abortion, you should not criminalise a woman who, in very difficult circumstances, makes that choice.

Complete story in the BBC.

Is this a step towards Tony Blair rediscovering the fact that the UK is in Europe and not the 51st state? For certainly, these views are certainly much more in line with those of Western Europe, rather than the current viewpoint of the seated American president.

This is a really sad case, and quite the opposite of Terri Schiavo. Sun Hudson was five months ago, and suffers from thanatophoric dysplasia, a genetic condition characterized by extremely short limbs, a narrow chest, small ribs and underdeveloped lungs. Infants usually are stillborn or die shortly after birth from respiratory failure. He has been on a ventilator since birth.

His mother, who sounds like she’s definitely marching to a different tune, says that the child was “fathered” by the sun, hence the name “Sun.” I suppose that this is just another version of the Jesus story, except that this baby ended up at Texas Children’s Hospital in Houston, rather than a manger.

At any rate, the doctors and ethics committee came to the decision that there was nothing more that could be done for the child (and this facility has a superb reputation), and decided to remove him from artificial life support. The baby was basically, slowly suffocating to death.

His mother, seemingly in intense denial and continuing to march to her own drum, said that the baby just needed to grow, and then he could be weaned off the ventilator. Texas law allows hospitals to end life support in cases such as this but requires that families be given 10 days to find another facility to care for the patient. No other hospital would take the baby, however.

Texas Children’s officials have said a team of doctors and bioethics specialists determined it would be “unethical to continue with care that is futile and prolongs Sun’s suffering.” This case went back and forth to court, sort of a mini-Terri Schiavo ordeal. But in this instance, there was clear cut evidence that the infant had a birth defect that was incompatible with life, he couldn’t survive without artificial life support, and just to prolong his suffering made absolutely no sense–except to his mother. And since the woman believes that this child was an immaculate conception, the product of a union between the sun and human, well, not much to go on from there. I would hardly consider her mentally capable to be making decisions for her own medical care, let alone someone else’s.

“His chest cavity and lungs will never grow. He is slowly suffocating,” doctors said in court papers. “It would be unethical to continue with care that is futile and prolongs Sun’s suffering.”

She has interrupted court hearings with rambling outbursts and talked about how she communicates with Sun telepathically. She testified that she spent three days in a psychiatric hospital after his birth because doctors were alarmed that she was calling her child the human embodiment of the sun.

I don’t understand why she wasn’t removed as his legal guardian, and someone appointed in her place. That probably would have resolved this case a lot sooner.

Making Legal History

This is the first time in the nation’s history that a U.S. judge has allowed life support to be removed from a living infant. Today a judge lifted an injunction which had prevented the doctors from halting life support, while the mother presented her case. Sun Hudson died soon afterwards.

In both of these cases, an incompetent guardian tried to make life and death decisions for a person who is unable to speak for themselves. In this instance, a mentally unbalanced mother was fighting to keep a baby alive on artificial life support, because the sun was giving her directions and guidance. In the Terri Schiavo case, we have a husband who refuses to divorce his wife, lives with another woman and has two children, has denied Terri basic care (doesn’t allow her to go outside, restricts visitors, has denied her antibiotics, doesn’t allow a dentist to see her, doesn’t allow her up in a wheelchair, never gave her any sort of rehab, etc), and has spent the better part of the last decade trying to kill her. Why are these people left in charge, who are obviously not fit to be making decisions for the person in question?

Dr. Frist likes to position himself as a physician/politician whose only interest is in the wellbeing of his constituents. But Dr. Frist has multiple ties to the industry, so his intentions have to be taken with a tablespoon of salt. At any rate, this press release is from the Association of Trial Lawyers of America (ATLA), and while they definitely have their own agenda and special interests, I have to agree with their position on malpractice. Or should I say, the Bush rendition of solving the “malpractice crisis.”

Frist appears to have thrown in his lot with the Bush camp, ie, that saving the finances of insurance companies and the industry at large is far better than making sure that injured patients are compensated. Anyway, ATLA has come up with three questions that should be presented to Frist at his press conference today, in the hope of forcing him to address the core issues (wishful thinking, I know).

3 Questions for Senator Frist about Medical Malpractice

Senator Frist and several of his colleagues have scheduled a 3:30 p.m. (ET) press conference today to talk about medical malpractice. Here are some questions that deserve answers:

1. Name one case. It seems that if a jury decides to award more than $250,000 in a medical malpractice case, then that would have to be a serious case, not a frivolous one. Can you give me an example or two of a case where the jury awarded more than $250,000 in non-economic damages that you would consider frivolous?

2. Answer your constituent. No one wants to see doctors gouged by malpractice insurance rate hikes, but I’d like you to answer the question posed by Monty Huggins of Knoxville, Tennessee, a self-described “life-long, active Republican” who lost his healthy 39-year-old wife to Vioxx-induced heart attack. He testified at the House Energy and Commerce Committee Hearing on Malpractice on Feb. 10:

“The proposed medical malpractice bill supported by the President will protect the makers of drugs like Vioxx. Why do you want to protect companies that may have knowingly killed people? Especially at a time when we know that our own government is doing a lousy job of protecting us from dangerous drugs.”

3. Do the facts matter? How do the results of a new study of Texas malpractice claims released Mar. 10 showing no evidence of a malpractice crisis or a connection between malpractice costs and doctors’ insurance premiums affect what you are calling for Congress to do? As the authors, four legal scholars at the University of Texas, Columbia, and the University of Illinois – two of whom are also doctors – wrote in a New York Times op/ed:

“As far as medical malpractice cases are concerned, for 15 years the Texas tort system has been remarkably stable. Texas’s situation is not unique. One study of Florida’s experience from 1990 to 2003 also found declines in paid claims per 100 practicing physicians as well as per 100,000 population. Over the same period in Missouri, the total number of malpractice claims fell by about 40 percent and the number of paid claims dropped almost by half.

“Malpractice premiums have risen sharply in Texas and many other states. But, at least in Texas, the sharp spikes in insurance prices reflect forces operating outside the tort system. The medical malpractice system has many problems, but a crisis in claims, payouts and jury verdicts is not among them. Thus, the federal ‘solution’ that Mr. Bush proposes is both overbroad and directed at the wrong problem.”

As they wrote in the study itself, “Our point, which has been largely neglected in the furious battle over malpractice liability, is that attempts to avoid crises in malpractice insurance prices should focus on insurance, not litigation.”

When you read this kind of stuff, then you truly know why nursing is in such a mess. Now, I promised yesterday that I would discuss the faculty shortage in greater detail. Well here is my promised evaluation. Read it and roll your eyes, especially if you are someone who’d like to be a nurse one day.

Flash bulletin. Stop what you’re doing and read this right now. The American Association of Colleges of Nursing (AACN) has come up with a groundbreaking report.

New Data Confirms That Shortage of Nursing School Faculty Hinders Efforts to Address Nursing Shortage!

Lions and tigers and bears, oh my! It’s 2005 and they are just figuring this out? I could have saved them a lot of time and money and told them that very thing 10 or 15 years ago. Haven’t they been paying any attention? Did they really need to issue this exciting and breathtaking report which tells us what we’ve been seeing for years–that most nurses are not interested in teaching? And that no one has attempted to make it a more desirable career path?

As one nurse commented on a bulletin board:

I’m finishing up a master’s degree program right now, and in my region, a PhD is required to teach nursing at the BSN level. I am now in debt for almost $30,000, I am in my late 40s, and I would have to take a very significant pay cut to become a faculty member. Plus, no one can tell me if I would ever get tenure. So even though I would like to teach, I can’t afford the cut in pay.

Another nurse wrote that when she completed her PhD about ten years ago, the only ones who could get interviews for faculty positions were nurse practitioners. Now that sounds smart, don’t you think? This nurse also goes on to say that while she would be willing to teach, the schools are not interested in someone like her. In her experience, they want younger teachers who are willing to kiss the ass of senior faculty members, and who are willing to work for minimum salaries.

A third nurse echoed the comment of poor treatment being a major factor. I would be willing to take the pay cut for a good faculty job, but still won’t do it because of the working conditions. People who have not spent their entire lives in the ivory tower of academia are generally treated very badly by the administrations and by senior faculty.

The reality though, for most, is the pay. Money money money. Teaching is about the lowest paid job in nursing, considering the educational requirements. Some of the salaries start as low as $35,000 a year! For someone with a master’s or PhD? Even in the “rock bottom” states, a nurse who has a community college education will make at least that much at her first job out of school. And a nurse with a higher degree, who works as a nurse practitioner, a consultant, an administrator, a medical writer, or whatever, has the potential to earn over $100,000 a year. So who in their right mind would take a faculty position.

Amazingly enough, most schools seem content to scream and cry, and have done little to nothing as far as increasing the pay and the incentive to teach. The University of Vermont, for instance, has started a program to offer scholarships to nurses pursuing advanced education and who want to teach. But how much are the scholarships? That wasn’t mentioned in the article that I linked to, so I can’t say, but to make any impact at all, it has to be more than a token amount. If an education cost, say, $25,000 to get a MSN at a state supported school, awarding a scholarship of $5,000 isn’t going to do it.

So why haven’t schools just raised the salaries of their instructors? I know, they’re bleating that they can’t afford it, but where there’s a will there’s a way. Make instructor salaries comparable with other nursing jobs, and you’ll get your teachers. Sure beats bitching and moaning and feeling sorry for yourself.

And here’s another hint; waive all tuition and all costs for nurses who want to pursue an advanced degree. Even give them free campus housing and meal coupons. In exchange, they can teach at your school for a designated time period. Wow, what a brainstorm. Offer free tuition to their kids and spouse as well. You see, teachers aren’t just going to show up by magic. You’ve got to give a little too.

Do I think that will happen? Will nursing programs swallow their pride and decide to be innovative, or will they just sit and watch one old professor after another retire, until there aren’t any left?