A split Supreme Court today declared that the Second Amendment protects an individual’s right to own guns for self-defense, striking down the District of Columbia’s ban on handgun ownership as unconstitutional.  Be prepared for an increase in gun violence in DC.

District of Columbia officials argued they had the responsibility to impose “reasonable” weapons restrictions to reduce violent crime. Intrestingly Justice Breyer argued in his dissent that the framers of the Constitution did not present self-defense as their main reason for the Second Amendment. “The self-defense interest in maintaining loaded handguns in the home to shoot intruders is not the primary interest, but at most a subsidiary interest,” he wrote. “The Second Amendment’s language, while speaking of a ‘militia,’ says nothing of ‘self-defense.’ “

Virginia Commonwealth University (VCU), signed a secret contract in 2006 to do research for Philip Morris Altria Group, the nation’s largest tobacco company. The VCU scientists were given money to study how to identify early warning signs of pulmonary disease, and how to reduce nitrogen and phosphorus drained into rivers from processing tobacco leaves. What is shocking is the extremely restrictive terms that the university must follow. Some were:

A. Professors are not allowed to publish the results of the studies with out tobacco company’s permission

B. Professors are not allowed to talk about the results without the tobacco companies permission

C. All patent and other intellectual property rights go to the tobacco company, not the university or its professors

D. The contract also includes a longer than usual time (180 days) for Philip Morris Altria Group to review and grant/deny  permission to VCU for any possible publications by the researchers. VCU’s own guidelines state that any industry reviews take no more than 90 days.

More shocking is that the VCU even admits that it knew that many of the provisions violated the university’s guidelines for industry-sponsored research. About 15 public health and medical schools no longer accept donations from the tobacco industry, and many major research universities continue to do so only if guaranteed independence to carry out the research and publish the results. Universities should not take money from tobacco companies because of the public health impact of smoking and the tobacco industry’s past misuse of scientific research.

There are two issues involved first, New York City law prohibits smoking anywhere in a hotel though it does exempt smoking in rooms that are “used exclusively for functions where the public is invited for the primary purpose of promoting and sampling tobacco products, and the service of food and drink is incidental to such purpose.” The event is being promoted, food and drink are not incidental, but an integral part of the event. This is an issue in that non-smoking Marriott hotel staff will be forced to be exposed to harmful second hand smoke. It is unclear if staff that refuse to work the event will lose their job.

The second issue is that Marriott’s own stated policy to be 100 percent smoke free, which includes all guest rooms, restaurants, lounges, meeting rooms, public space and employee work areas. Once a corporation makes a public promise, they’re bound by it unless they publicly announce that they’re changing it. For example, a recent case where McDonald’s paid an $8 million settlement for not publicizing a delay in implementing its publicly announced promise to remove trans fat from its food. Marriott simply cannot grasp the honorable title of 100% Non-smoking hotels and all of the press and other good things that come from that declaration…and then not honor that policy.

Kathleen Duffy, public relations at Marriott Hotels, says that while it is true that Marriott International announced last year that its hotels in North America would be smoke-free, Marriott has a contractual obligation to hold the event. Duffy adds that the hotel plans to do major commercial cleaning, filtering, and venting of the Marquis ballroom, where the Big Smoke will be held. She also says, “I can confirm that we have a contract [for the Big Smoke event] for this year and at least next year at the Marriott Marquis.”

This year the American Public Health Association will be holding it annual meeting in Washington DC. Some participants will be staying at the Marriott at Metro Center the week of November 5.  If the Marriott continues I would suggest that all APHA members Boycott all Marriott hotels during the 2008 October 25-29 annual meeting in San Diego.  

Eliminating the Tiahrt rider is not about weakening the perceived Second Amendment rights but rather it is about transparence with public health data that keeps the public safe by identifying unscrupulous gun vendors. Read more

Washinton Post Editorial, Wednesday, July 11, 2007; Page A14.

http://www.bradycampaign.org/action/tiahrt/

Recently, pharmaceutical companies have become the biggest sponsors of CME courses, even at the nation’s top medical schools, a development that critics say raises health-care costs, skews doctors’ treatment decisions and allows the industry to skirt laws against advertising “off-label” uses for its products. The trend toward pharmaceutical industry sponsorship  accelerated after the government backed off a plan to limit commercial sponsorships in 2002 at the urging of the industry.

Now, nearly two-thirds of the cost of continuing education courses sponsored by medical schools, popular for their prestige, are paid for by drug and medical device companies and other commercial interests, figures show. Overall, commercial sponsors pick up about half of the $2.25 billion annual cost of the courses doctors must attend to keep their licenses.

Scott Lassman of the Pharmaceutical Research and Manufacturers of America state the following for the practice of pharma funding:

• a way to educate physicians about the latest medical and scientific research.

• are viewed as running independently of the pharmaceutical company. The company may be providing the funding for it, but they are not directing the content.”

• Allows for physicians to learn about “off-label”  uses of drugs since “A lot of times, the regulatory process lags behind the science,” Thus “[he] think it’s a benefit for physicians, as long as it’s independent and as long as the scientific information is solid.”

J. Gregory Rosenthal, of Physicians for Clinical Responsibility For doctors and others states the following against the practice:

• “[Pharma] makes it very difficult [for a physician] to know what research to believe”

• “[a physician] can’t go onto a CME Web site without being confronted by sponsorship logos.”

• the drug industry does hold some sway over which topics are covered in the courses.

• “[CME] are promotional activities disguised as education.”

Read more: Conflict Alleged in Drug Firms’ Education Role, Elizabeth Williamson and Christopher Lee, Washington Post Wednesday, June 27, 2007; Page A03 .

Congress created and passed the Emergency Medical Treatment and Active Labor Act (“EMTALA”) as a response to “patient dumping”, EMTALA was written so that federally funded hospitals were required to give emergency aid in order to “stabilize” a patient suffering from an “emergency medical condition” or “active labor” before discharging or transferring that patient to another facility (Fosmire, 2003). An “emergency medical condition” is defined by Section (e)(1) of EMTALA as a condition with “acute symptoms” of a “sufficient severity” such that the absence of “immediate medical attention” could reasonably be expected to result in serious health risks and/or disability. The courts have interpreted the phrase “emergency medical condition” to mean a condition which puts the patient in imminent danger of death or serious disability. Unfortunally hospitals still do practice patient dumping.

In order to combat “patient dumping” hospital must fulfill six duties. They include providing a medical screening examination to all patients that present themselves ED premises regardless of ability to pay; providing stabilizing care; not transferring patients who are potentially unstable if the hospital has the capabilities to treat the patient (Patients may only be transferred under EMTALA for medical necessity such as burn patients who need a Burn Unit); providing medically appropriate transfers where the patient is transferred for medically necessity; maintaining an on-call system for physicians to provide coverage to be available to assist stabilizing patients; and accepting requests for in-coming transfer if the hospital has the specialized capabilities needed by the patient, and the transferring hospital is relatively less able to care for the patient (Fosmire, 2003).

Federal government penalties under EMTALA may be against hospitals and or individual physicians if they negligently dump a patient. They may face civil penalties up to $50,000/violation and or exclusion from participation in the Medicare and Medicaid reimbursement programs. In addition, EMTALA allows for civil actions for individual who experience personal harm. Interestingly, enforcement of EMTALA remains a patient complaint-driven process. In other words, the investigation of a hospital’s practices, are initiated only by a patient or public complaint. Thus, there is no federal “EMTALA Police” performing undercover hospital inspections. However, as patients become more consumer-oriented and informed about their patient rights, it is probable that dissenting hospitals and physicians will be identified and curtailed.

Tuberculosis is caused by germs that are spread from person to person through the air. It affects the lungs and can lead to symptoms such as chest pain and coughing up blood. It kills nearly 2 million people each year worldwide. Multidrug-resistant” TB can withstand the mainline antibiotics isoniazid and rifampin. The man at the center of the current case was infected with something even worse — “extensively drug-resistant” TB, also called XDR-TB, which resists many drugs used to treat the infection.

A few points to ponder after listening to Andrew Speaker interview. If Speaker truly believed that he was harmless then why was his father compelled to secretly tape record the conversation? I think there are two reasons for this (a) if the CDC quarantined him, the tape would have been used to sue the CDC and health officials for denying his civil liberties by detaining and confining him against his will, or (b) suing the CDC and health officials for not properly warning him if he had actually infected someone else. Either way, it does show that he or at least the father knew that he was in a high risk situation and that he was more concerned about his own wedding happiness and any potential legal fallout then with the actual fact that he might actually cause pain and suffering in another human being.

Point 2.  Somewhere around the time when Speaker was notified that he had XDR-TB he found out that he was put on the no-fly list and that he was asked to check himself into a hospital.  By his actions I can only assume his only thoughts were “How can I get the best treatment for myself regardless of who I come in contact with”. Once again this shows his utter disregard for his fellow man.

Point 3. In Atlanta on May 10^th Speaker admitted that “They said I was multi-drug resistant. I wanted to stay in Atlanta for treatment but they convinced me that with all the toxicity of the drugs and since there weren’t that many drugs left for me I should go to Denver, that it was my best chance of living through this.” Why wasn’t he in fear for his life at this time? Then in Europe on May 18^th, Speaker said officials wanted him to check into a treatment center in Rome indefinitely. But he feared that if he did, he might not make it to Denver. “It is a very real threat that I could have died” in
Italy, he said.

Speaker’s attorneys will likely paint him as a “victim” despite the fact that he himself created hundreds of potential victims when he exposed them to one of the deadliest strains of TB via his reckless globe-trotting. So why should he be a victim? And one more thing, who is going to pay for testing all these people?