Being Held Accountable

Here is an interesting article about a man who was wrongly convicted of killing his girlfriend in 1981. DNA evidence has finally cleared him and he was released from a Texas prison in April 2008. This article addresses an interesting point made by Dallas District Attorney Craig Watkins who believes that the prosecutors of wrongfully convicted cases should be held accountable, and face criminal charges, for their wrongfully convicted cases.

I think this is a very interesting perspective, especially in the context of American culture, which is: It has to be some one's fault, and that someone has to pay!

Upon first contemplation, I am in favor of this thought process for prosecutors, but I realize the end result may be similar to that of medicine.

A specific malpractice prosecuting attorney's commercial comes to my mind. Jim Sockalave advertises on television during daytime programing, and his selling point is: "when doctor's make mistakes, I make them pay." That is exactly what DA Watkins is proposing for prosecutors -- to make them pay -- and why not! The man in this article had 27 years of his free life taken from him. The article explains how hard it is for him to do things that most of us take for granted, such as opening a bank account, or getting a job (who is going to hire an employee that only has a prison issued ID?). So, it seems that this man should be given compensation for his lost years, and why shouldn't it be the prosecutors?

Of course, in real life, I do not think it is quite that easy. You could just as well hold the jury responsible, or the judge, or the police who investigated the crime. Perhaps you could even hold all of them jointly accountable.

The problem with this in the long run it may be similar to what has happened in the medical field. As physicians are sued more and more their malpractice insurance goes up, they make less money, and they move onto more lucrative and "safe" practices. The litigious nature of American culture related to medicine has lead to a severe shortage of physicians and health care staff. The same would happen to the judicial system; additionally citizens would try to avoid jury duty even more than they do now.

I'm not sure of the proper solution to any of these problems, but it seems that holding the legal system more accountable for their actions is a good idea. Society just needs to be sure that the pendulum does not swing too far in the other direction as it has in the health care system. The judgement should ultimately be based on whether or not a professional was properly trained, and if so did they make an appropriate decision based on the information that they had in front of them. I think that in most cases this should clear the professional (regardless of profession) of any legal charges.

football injury

This could be a huge breakthrough for spinal cord injuries. I don't know any of the details of this pro-football players spinal cord injury, and this may all be just a lot of media hype, but it also has the potential to be a new standard of care for spinal cord injuries. There is a lot of evidence to show that medically induced hypothermia has beneficial effects after a heart attack, or after a brain injury, and hypothermia therapy is being used in continually broadening areas.....could the same be true for spinal cord injury? I am very curious to find out!

Los Estados Unidos (The United States)

I have recently taken a beginner's Spanish class to improve my very limited Spanish speaking ability, and I plan to take the intermediate class next. I enjoy having some ability to communicate with the numerous Spanish speaking patients in the outpatient specialty practice where I work. One example is a kind gentleman who presented to my office today for his doctor's appointment, however the letter that he received (in Spanish) had an error of office location (it listed the 7th floor, instead of the 4th floor). I used my limited Spanish to re-direct him to the 4th floor where his specialty practice is located. This gentleman was extremely appreciative, and he was also apologetic that his English was "no good." Of course I do not think he had any reason to apologize, but I mention this interaction to show that he was not bitter that I do not speak fluent Spanish, he was simply appreciative of my efforts!

In addition, on a recent trip to Mexico City, with my fluent Spanish speaking cousin, the locals were eager to practise any English skill they had with us. Why are English speaking US citizens so reluctant to even hear the Spanish language? I have even heard US citizens complaining that they have to select Spanish or English when using an ATM. I mean.....come on......how long does that selection take? 0.2 milliseconds at most! I'm not suggesting we make Spanish the national language of a country that does not have a national language, I am simply suggesting that we need to increase tolerance of the Spanish language.

Here is an interesting article about the recent Democratic debate in which the networks limited the 2 Spanish speaking candidates from speaking Spanish during the debate. Instead they had all of the candidates speak English and then translators did the Spanish conversion. From a political standpoint I see the reasoning of this, especially given the 2 front runners do not speak Spanish, but this could have been a step towards Spanish tolerance.

helmets save heads

Read this article and find out how important helmets are. Just think, 20 years ago it was abnormal to wear a bike helmet, and this guy's head would have been.....well..... street pizza. I think that in 20 years smart people will be wearing car helmets! Does anyone want to start the car helmet campaign with me?

Cheddar Cheese

Here is an interesting web site where you can view the real life aging of cheddar cheese. The web site was put up by a craft cheese making group in South West England. They have an individual block of cheese which is web-camed 24/7. The cheese is to age for 1 year and then they will auction off the famous block of cheese to raise money for charity. On the web site is also a link to a You-Tube video which shows a quick glance at the first 3 months of the cheese's aging process. If you look closely at 22 seconds into the video on You-Tube you can see that a greeting card was placed next to the cheese. Apparently the block of cheese has it's own fan club, and receives emails, letters and cards.

It's a weird idea, but a fantastic advertising idea! They also have ordering options available on the web site.

Ethical Questions

Here is an article about the interesting ethical question of sterilization. The article tells the story of a 9 year old brain injured girl whose parents have gone to great lengths to alter her maturation, and growth development.

The parents, who live in the state of Washington, have given her hormones to stunt her growth, and most recently have had her uterus surgically removed so that she will not menstruate. The result of this is obviously sterilization, but the parents argue that it is for her best interest because she has a fear of blood. She will never have the mental faculties to knowingly conceive and care for a child so they argue it is not sterilization for the sake of sterilization, but for her best interest because she will also not have the faculties to understand why there is blood coming from her on a monthly basis.

The obvious ethical argument is sterilization of someone who did not make the decision for themselves. The article does point out that a court order can be obtained to sterilize someone who does not have the mental faculties to make their own decision. In this case the decision was made solely by the parents and medical staff, they neglected to get a court order.

I have a few ethical issues with this case. Clearly the girl will never be able to consent to conception, or care for a child, but does it really make sense to surgically alter her body? The family argues that it is for her own good, but I'm sure they are at least slightly influenced in their decisions by the knowledge of what it will be like to care for an adult body that does not have a mature brain to match. The family would need to perform all activities of daily living for her, including bathing, feeding, and transporting. Her stunted growth leaves her at a child's height and weight, which is much easier to care for. As a nurse who has cared for the mentally retarded and bed-bound I can attest to the difficulties associated, but I'm not sure we should physically alter their body to accommodate the caretaker.

If we are able to physically manipulate this child called "Ashley" what is next? Will we begin to physically manipulate the bodies of adults who have lost their mental faculties? I can attest it would be easier for a care taker to care (long term) for a paraplegic without legs, or for an obese mentally retarded patient at a lighter weight, and I will spare you the gross details of caring for a mentally retarded female who is menstruating. This does not mean we should allow families and caretakers to decide that the paraplegics legs be amputated, or the obese have bariatric surgery, or the menstruating have hysterectomies if they are not able to consent to the procedures themselves.

This also raises the medical ethical question to above all Do No Harm. What if something had gone wrong during this girls hysterectomy (removal of her uterus)? Would the procedure still be justified if a complication had lead to her death? I think the answer is clearly NO!

Mel's Bracelets

Recently I purchased several bracelets from this web site. I kept one for myself, and gave the rest to family and friends to spread Mel's story. I first learned of the bracelets when I complimented a co-worker for the bracelet that she was wearing. I learned that the woman who inspired the bracelets died of cancer about a year ago, and was a patient the Massachusetts General Hospital, where I work. Most of the proceeds from the purchase of the bracelets go to the Massachusetts General Hospital Cancer fund.

Even if you don't like the bracelets, Mel's story is an inspiring story.