Dr. Peter Pronovost is a distinguished physician known for his efforts to decrease the frequency of deadly hospital-borne infections. His remedy to the problem is surprisingly simple: a checklist of ICU protocols that directs physician sanitary practices (e.g. hand-washing). Hospitals that have put Pronovost’s checklist into practice have had immediate success, reducing hospital-infection rates somewhere between (estimates vary) well over a third to a whopping two-thirds within the first few months of its adoption. Yet as the story goes, many physicians have rejected this solution and Pronovost has struggled to persuade hospitals to adopt his reform.
The Centers for Disease Control and Prevention estimates that nearly 100,000 American deaths are caused or contributed to by hospital-borne infections. Blood clots following surgery or illness are the leading cause of avertable hospital deaths in the U.S., which by the most liberal estimates might contribute t o the death of almost 200,000 patients annually. Given such a hideous fact, why exactly does a doctor need to travel about and emphatically seek to persuade other medical institutions to adopt, in effect, a cost-free idea that could save so many lives?
How is that an industry which stridently decries the high cost of liability insurance or the absolute injustice of our tort system(which does need reform) need such petitioning to embrace such a simple technique to save thousands of lives? Moreover, in the United States it is not unheard of for a whole business to shut down due a single illness from some suspicious food—yet, we tolerate the killing-via-negligence on such a grand scale in our hospitals? Medical mistakes and institutional carelessness do not qualify as some must-be-accepted inevitability.
This reality has been almost entirely been neglected in the discourse on health care reform. Beyond the structure and financing troubles of our medical system, the institutional practice and governance of hospitals are in need of severe criticism. For example, in what alternate dimension does the peculiar scheduling of hospital work shifts in any way benefit the patient? A few weeks at the hospitals virtually guarantees a never-ending string of new personnel assigned to one patient’s care. If this can be avoided, should it not? It seems quite reasonable to presume that passing patients off from doctor to doctor, or nurse to nurse, might increase the chance of someone making a mistake? The effect of changing such a seemingly small problem could be huge. Or, take for example, the “sanitary” environment of hospitals in general, which contribute to the nearly 100,000 annual American deaths. Anyone who has ever worked in “corporate America” or in a large building in general might note that the trash is picked up once daily. Is it any different in a hospital? It takes some sort intellectual schizophrenia to insist on ICU sterility in a building if one has not the slightest care over how many times trash (never mind what is in it) is picked up in a day.
Any array of complaints about institutional malpractice must lead to the inevitable question: how is it that the most technologically advanced medical institutions in the industrialized world miss out on a just as modern, just as recent, revolution of quality control and customer-service that has pervaded every other consumer-based industry? The answer to this question is telling. Continue reading
Health care reform has been at the forefront of the American political discourse in the past few months. One of the most difficult tasks in this debate is to discern an authentically Catholic approach to reform efforts. The Catholic Church takes no official position as to how a health care system ought to be structured, but rather presents enduring moral principles that must be present in public policy.
Adhering to the richness of Catholic social teaching, the ultimate goal for Catholics must be to establish a system that is capable of universal access and coverage for all American citizens, one way or another. Any number of schemes might achieve universal health insurance and preferences will differ based on political philosophy, but the end result seems to be a Catholic moral obligation. In this sense, no Catholic ought to oppose universal health care, if it means achieving coverage for all Americans citizens either through market schemes, government assistance, “third sector” non-profit organizations, co-operatives efforts (co-ops), or some combination of these depending on the social need, the ethical principles at stake, and the resources each solution offers.
Catholic social teaching treats health care as a profound social interest and essential for the common good. Health care, because of this, ought not to be viewed as a mere commodity. The poor and vulnerable, by default, are immediately disadvantaged as health care costs increase. The United States, we are told, has the most technologically advanced and best quality medical care. But, one must inquire: at what cost? Other consumer “goods” are not essential safeguards to the indispensable good of human life in the same way as medical care.
Health care markets that are laissez-faire, an inherently utilitarian mechanism, do not necessarily yield nor are they ordered toward natural justice. Natural law theory is alien to such a mechanism— it is not intrinsic to it, neither is solidarity or preferential option for the poor, though these things are not necessarily excluded by it.
It is self-evident that different spheres of society appropriately employ different standards of distribution. College professors assign grades based on merits of achievement; athletic competition employs the same principle. Parents might distribute slices of cake at a birthday party to strict equality. In the same way, numerical equality governs votes in a democratic society. Food, clothing, shelter, electronic goods, clothing, automobiles, jewelry, etc, receive unequal distribution by market mechanisms—sometimes justly, sometimes not.
Need is one of those principles of distribution (and one of those things often argued about) recognized in some spheres, but not others. Need is terrible for distributing grades, but the proper principle for distributing emergency food supplies. Need, arguably, is a proper principle for the distribution of health care. Health is necessary for a community’s proper functioning. Justice, in terms of health care, will require a redeveloped way of distributing health care based on personal responsibility, collective interest, and legitimate need—the weakest and most vulnerable among us first and foremost.
Many important areas of life must resist “commodification,” at least in the same sense as dispensable goods. This could not be more evident than by the fact that people are becoming commodities to other people. Children are the prime example of this, from abortion to assisted reproduction. Fundamentally, justice demands that we re-examine our consumerism for it is the heart of the issue and I believe, the life-source of the “Culture of Death.” Continue reading
I was thinking of writing a lengthy piece over lunch, when I wrote up my task list and realized that “lunch” needed to be no more than twenty minutes long. So instead, I present a number of pieces that struck me as interesting lately, but which I don’t have a whole post worth of things to say about.
InsideCatholic just reprinted a lengthy piece by medievalist Sandra Miesel discussing the realities of witch burning in the Middle Ages through “Age of Reason”. It’s an article well worth the time to read, avoiding both the slanders of anti-Catholics and the overly rosy rebuttals used by some apologists.
Entrepreneur Paul Graham has an interesting essay on what an essay should be, why people ought to write them, and how high school English classes do a pretty poor job of teaching people this skill. Continue reading
The Anchoress is on fire here about the ham-fisted efforts of the Obama administration to stifle dissent. Eventually someone in Obama’s administration is going to have a “Yamamoto moment” and turn to him and say words to the effect of: I fear all we have done is to rouse a sleeping giant and fill him with a terrible resolve.
I do not believe I was morally wrong or politically naive to personally give President Obama the benefit of the doubt and, until he proved otherwise, accept his claims of wanting to ‘work with’ pro-lifers at face value. I believe prudent and ethical politics, as well as the requirements of Christian charity, placed such an obligation on me, though I understood why some Catholics strongly disagreed. Even just recently I wrote a blog suggesting that we should not engage in nasty rhetoric against the president – and for the most part, I still believe that.
But with Obama’s selection of Dr. John P. Holdren to “Director of the White House Office of Science and Technology Policy”, among a few other high positions – and with the recent revelations of what this man, along with his co-authors, advocated in a 1977 book called Ecoscience (of which I was entirely ignorant), I believe the benefit of the doubt has just been cut.
After disbanding the [President Bush’s] Council on Bioethics, what kind of advisory body will Obama put together? — Elenor K. Schoen considers the question for the Catholic World Report.:
The Washington Post reported Sunday here, hattip to Instapundit, that the White House is getting nervous about the political fallout from the unprecedented spend-and-borrow binge upon which Obama has placed the country.
“Results from a Gallup survey released last week show that although more than six in 10 Americans approve of Obama’s overall job performance, fewer than half say they approve of how he is handling the deficit and controlling federal spending. The poll also shows a decline from the previous month in the percentage of Americans who approve of Obama’s handling of the economy, although a majority still does.”
Miguel H. Diaz has been chosen by President Obama, peace be upon him, as the new ambassador to the Holy See. The secular media and Catholic Left has been hailing Mr. Diaz as a Rahner scholar and “pro-life” Democrat. Jesuit Father James Martin of America magazine, who recently claimed that Obama is not pro-abortion, has praised Mr. Diaz for being a Latino, in addition to being a “faithful” Catholic and for receiving a degree from the University of Notre Dame.
Abbot John Klassen of St. John’s Abbey had this to say about Mr. Diaz’s Latino and theological credentials [emphasis mine]:
“He is a strong proponent of the necessity of the Church to become deeply and broadly multi-cultural [I guess we need priestesses to be more multi-cultural], to recognize and appreciate the role that culture plays in a living faith [sounds too much like a living, breathing constitution]. Born in Havana, Cuba [Being born in Havana, Cuba is a good start in creating his Latino credentials.], he is a leading Hispanic theologian in United States.”
The protests around Obama’s honorary degree from Notre Dame University had many of the more politically progressive Catholic voices complaining that pro-life advocates had moved into a practice of loudly protesting absolutely everything that seemed vaguely positive for Obama without regard for whether it was an important issue. As someone who cares about the integrity of Catholic education, I think they were wrong in regards to Notre Dame’s decision to give Obama an honorary law degree — it was a big deal and it was appropriate to decry the choice.
However, I think that Jay Anderson and Feddie are right in making the case that the nomination of Sonia Sotomayor to the Supreme Court is not something that pro-life groups should be knocking themselves out to contest.
Given how early it is in his presidency and how high his political approval ratings are, Obama could have decided to spend political capital and put a top notch, liberal intellectual ideologue on the court who could work to shift the balance strongly to the left. Instead, he made the fairly bland, identify politics “first” pick which had been conventional wisdom in Democratic circles for some time, despite the doubts of those who wanted to see a more intellectual and ideological pick. As pro-lifers, we certainly don’t need to praise this pick. She is doubtless pro-choice and will work to support Roe and other Culture of Death decisions. But we also don’t need to pick this to raise a stink over. She will be confirmed regardless, given the composition of the senate, and if we can both conserve our political energy and provide Obama with some positive reinforcement that sticking to bland conventional wisdom candidates will be rewarded with a lack of partisan rancor, so much the better.
Again, I’m not saying that pro-lifers need to praise or support Sotomayor, but Obama could have stuck it to us a lot worse — and since kicking a fuss will achieve nothing other than encouraging the administration to play only to their base next time with a strictly ideological pick (and win the pro-life movement more of a reputation for constant shrillness) this would be a good time for us to hold our fire and concentrate on other things, like the next crop of pro-life candidates.
I would like to think that I rarely, if ever, use my privileges here to get on a “soapbox” or as a means to be politically partisan and issue an attack on any person or group. Similarly I hope the subject that I am undertaking reflects my commitment. I would like to admit in regard to the subject that I am terribly biased and I don’t think I am wrong about the matter. I am no source of infallibility, obviously; everyone is free to contradict me. I will passionately disagree, but will respect everyone’s right to intellectual freedom presupposing the same respect.
My self-identification as a Democrat is no secret. After President Obama was elected last November, I was hopeful, that despite his horrific position on life issues, a Democratic Administration and Congress would be able to go, in what I deem, a positive direction on many issues. One of these issues, I hoped, would be repealing “Don’t Ask, Don’t Tell.”
President Obama on the campaign trail reiterated how he supported “equality” for gay and lesbian Americans. While his definition of “equality” is incompatible with my Catholic faith, I find the matter of “Don’t Ask, Don’t Tell” one in which good Catholics may disagree on and it is one I thought the President and I agreed. Let me clarify: I do not march in GLBT parades or belong to any of their advocacy groups.
Just yesterday I learned that allegedly, 619 individuals were discharged last year from the military under the “Don’t Ask, Don’t Tell” policy. I won’t address those 619 discharges because I do not know any of the details to cast any sensible judgments.
However, it so happens that just yesterday a White House official indicated that there were no plans in the foreseeable future to repeal “Don’t Ask, Don’t Tell.” (cf. Barack Obama campaign promises).
So, why does this bother me so much?
Reflecting on Nancy Pelosi and the torture controversies, E.D. Kain makes the following prediction:
To me, Pelosi’s denial (and accusation against the CIA) lays bare a deeper truth about the Democrats. Without Obama they’d be nearly as big a mess as the Republicans. Most of them are complicit in the Bush torture program and the wars. The party is almost headless without Obama – led by the fickle and hardly inspiring Reid/Pelosi duo. After Obama, if conservatives learn anything over the next eight years – yes, I’m predicting it will be eight – unless the Democrats get some sort of order and discipline and more importantly, some grander vision, then I think the GOP should have no trouble at all coming in and cleaning up.
I have thought for a while that the Republicans will be out of power for a significant period of time, both because of the Bush administration’s failures, and because the current Republican attempts to rebuild (e.g. constant infighting, unconvincing narratives about the role of fiscal excesses in Bush’s unpopularity, rallying around Rush, and Michael Steele’s various embarrassments) seem woefully ill-suited to the current political environment. I still think E.D. overstates things considerably when he says that Republicans “should have no trouble at all coming in and cleaning up,” but the idea that Obama is a sui generis figure is worth entertaining. The gap in charisma between Obama and Nancy Pelosi or Henry Reid, for instance, is substantial, and Obama is significantly more popular than many of his policies. Will the Democrats still look as relatively desirable once Obama is no longer the spokesperson of the party? And will Obama’s popularity wane significantly as his Presidency progresses?
With the announced retirement of Supreme Court Justice David Souter President Obama wasted no time in addressing the issue of what he’s looking for to fill this vacancy. In so many words he clearly stated his desire for an activist judge with an eye towards reengineering America [emphasis and comments mine].
“It is also about how our laws affect the daily realities of people’s lives [meaning he wants a Justice who holds fast to the Living Constitution Theory,ie, an activist judge finding invisible law where none existed], whether they can make a living and care for their families, whether they feel safe in their homes and welcome in their own nation.”
The following excerpt clearly reveals President Obama’s contempt for legislative history in effect eliminating a potential nominee that adheres to the theory of original intent.
“I will seek someone who understands that justice is not about some abstract legal theory or footnote in a casebook.”
One thing is for sure, it will be an extremist liberal and pro-abortion nominee.
Obama has picked Dawn Johnsen to head the Office of Legal Counsel for the Department of Justice. Dawn Johnsen was the legal director of the National Abortion Rights Action League back in the eighties.