just another example that some healthcare is nothing more… nothing less than a FOR PROFIT BUSINESS

EXCLUSIVE: ‘No basis in science or data… just ideology’: Critics slam Harvard children’s hospital for claiming babies know in the WOMB if they’re transgender

https://www.dailymail.co.uk/health/article-11280475/Harvard-hospital-claims-babies-know-WOMB-transgender.html

A Harvard-affiliated children’s hospital has sparked outrage after claiming some babies know they are transgender ‘from the womb’.

In a now-deleted video, the Boston Children’s Hospital suggested an even larger number of minors know ‘as soon as they can talk’.

Critics told DailyMail.com the claim was was not based on science and suggested  medics at the clinic are unwilling to question children who are often vulnerable.

The hospital, part of the Harvard University medical system, also faces claims it rushed under-18s into life-altering sex change surgery.

In the clip posted to the Boston hospital’s official YouTube page in August, psychologist Dr Kerry McGregor explains the type of patients she sees.

She says: ‘So most of the patients we have in the clinic actually know their gender, usually around the age of puberty.

‘But a good portion of children do know as early as – seemingly – from the womb.

‘And they will usually express their gender identity as very young children, some as soon as they can talk… kids know very, very early.’ 

It comes as several states begin to clamp down on puberty blockers being prescribed to children. Texas Gov. Greg Abbott has previously likened it to ‘child abuse’. 

The Boston clinic sees children as young as two and three usually up to the age of nine. New patients come to the clinic and meet with psychologists to discuss their issues with the sex they were born into

The Boston clinic sees children as young as two and three usually up to the age of nine. New patients come to the clinic and meet with psychologists to discuss their issues with the sex they were born into

Organic Chemistry Prof Fired for Being Tough on Students

This quote from this professor is such HOR$E $HIT… 

“This is the entitlement generation,” Starnes said. “I don’t want any surgeon cutting on my body who failed organic chemistry. I want the best of the best.”

I had a surgeon who was a good friend and his biggest concern – and he shared it often –  he was somewhat insecure on his ability to properly diagnose health issues that needed a surgical intervention…  He would say that he would rather someone else diagnosed “what needed to be cut out “…  he was very confident of his surgical skills.

Personally, I see very little relationship between being able to pass Organic Chemistry and being a competent surgeon.

Actually the Professor that I had for Inorganic chemistry was probably the biggest arrogant ba$tard of all my college professors.  At the time, I was a chemistry major and I was going to a local extension of Indiana University.  There was abt 100 students in two different chemistry classes – one day class abd one night class – both taught by the same professor…  The first day of class this professor told the class that 60%-70% would not be taking the second semester of Chemistry… BECAUSE that is typically how many of his students gets a “D” or “F” in the first semester class.  This was a first level college chemistry course, but his doctorate was in physical chemistry – which is course work you take after taking Inorganic and Organic level courses..  and much of his instruction was more about physical chemistry level work.  Explains why most of student taking this/his course….  most everyone – at best – had only had some high school chemistry.  I got a “B” this semester … so on I go with about 30 others in the class to second semester inorganic chemistry class – with the same professor.   When the final for the second semester came around… this ARROGANT JERK… said that the final was going to be over BOTH SEMESTERS.  The test was suppose to be a TWO HOUR TEST… and I was the first one done at 2:10 -2:20 and I got a 94 on the test and the JERK would not give me a “A”, I guess my grade point average for the semester was in the “B” range.  I guess that getting a “A” grade on a two semester final … was no proof to him that I knew the material.  It was useless to argue about the grade, because I was already accepted and going to Butler U in the fall to major in pharmacy and grade points do not transfer… just credit for taking and passing courses at another accredited university. This was the only teacher/professors in my 13 yrs of education to have a semester final test over both semesters of the course work.  Pursuit of a college degree can be such an interesting journey 🙁

 

An organic chemistry professor at New York University has been fired for being a tough grader.

Maitland Jones Jr., who has taught college students for decades, was booted from teaching after students petitioned his removal. The students complained that his class was too difficult.

The 84-year-old educator also told the Times that the real loss of focus by students began years ago, but the pandemic made matters worse.

He also reported that students weren’t showing up to his class, and those complaining weren’t putting in the work needed to succeed.

National radio host Todd Starnes slammed the snowflake students on the “Todd Starnes Show” Thursday.

“This is the entitlement generation,” Starnes said. “I don’t want any surgeon cutting on my body who failed organic chemistry. I want the best of the best.”

 

 

Open enrollment for Medicare starts Oct 15,2022

It looks like the monthly Medicare Part B will be lower for 2023…. They may be because last year, Medicare “jumped the gun” and instead of following the law in how the Part B premiums are suppose to be determined and because of a newly approved Alzheimer meds that was approved late in 2021.. that was going to have a yearly cost of some $40,000/yr.  Part B Premium are suppose to be calculated on the cost per Medicare beneficiary for 2 yrs back… 2023 rates were suppose to be based on the per capital expenditures  for 2021.  But Medicare based the 2022 rates on the ANTICIPATED costs of this new Alzheimer’s med being used… BUT… the clinical studies and pt outcomes were overly optimistic on this particular med and the pharma introducing this med cut its price by HALF.  So this new med was not used as much as anticipate and charges were per dose were cut in half. Looking at what we paid/month for Medicare part B for 2022… 2023 Medicare Part B premium should be about $10/month LESS.

Here is the hyperlink that should allow you to compare various Medicare program options for 2023.   https://www.medicare.gov/plan-compare/#/?year=2023&lang=en  REMEMBER that Medicare Part D and Medicare Advantage (Part C) are provided by FOR PROFIT INSURANCE COMPANIES… who are paid so many $$$/pt/month to provide services/products to a pt.

Zero-premium Medicare Advantage plans: What to know

Enrollment for 2023 opens next week

https://www.foxbusiness.com/personal-finance/zero-premium-medicare-advantage-plans-what-to-know

The annual open enrollment period for joining, switching or dropping Medicare Advantage health insurance plans provided by private companies starts next week, and zero-premium offerings are expected to be more popular than ever with Americans feeling the squeeze of inflation.

Starting Oct. 15 and running through Dec. 7, people ages 65 and older, or younger individuals with certain disabilities who qualify under the government’s guidelines, can apply for coverage that begins at the start of 2023.

A page from the 2019 U.S. Medicare Handbook in Washington. (AP Photo/Pablo Martinez Monsivais, File / AP Newsroom)

But not all plans are the same, and experts say shoppers are advised to do their research to be sure they are receiving optimal coverage even if no premium is charged — and there could be other costs involved.

“It’s not a one-size-fits-all program,” Melissa Brenner, an insurance broker in Charlotte, North Carolina, told the Associated Press. “You don’t want to look at a zero plan and just enroll in it.”

Medicare Advantage plans are similar to traditional government-run plans, except they typically require patients to visit health care providers or pharmacies within a network. Individuals with the private plans will also still need to pay the monthly cost of Medicare Part B to cover doctor’s visits.

Medicare Advantage plans often require policyholders to visit health care providers within a network. (Craig F. Walker/The Boston Globe via Getty Images / Getty Images)

Next year, that cost will come out to $164.90 a month and is usually deducted from Social Security checks.

Brenner recommends that shoppers review the networks, co-pay costs and annual out-of-pocket maximums when comparing plans rather than just looking at the price of premiums (or lack thereof).

No-premium plans can be great for people who are healthy and do not require a lot of medical services, but plans with less coverage can be a greater risk for those who are not and amount to more significant out-of-pocket costs.

Medicare Advantage plans often require policyholders to visit health care providers and pharmacies within a network. (Tom Williams/CQ-Roll Call, Inc via Getty Images / Getty Images)

Experts recommend that shoppers do their homework early when it comes to comparing plans and not wait until the end of the enrollment period in early December to sign up, because there is a rush at the end, and people who are late can be locked out.

To enroll in Medicare, call the Social Security Administration at 1-800-772-1213 or visit ssa.gov/.

New policies and procedures for Indiana’s PDMP INSPECT and maybe many other states’ PDMP

All of this is the new warning texts on Indiana’s PDMP INSPECT login page and Bamboo Health is who operates Narxcare and Bamboo Health is owned byhttps://www.experian.com/ I have read that they have moved all of their databases off shore to a country where our HIPAA laws don’t apply.  If INSPECT database is the template of other state PDMP’s,  I don’t see any way for a individual user to enter specific data on a individual. But I am sure that most pharmacy software system has a way to enter specific data on a pt… Of course, the pt is patronizing a chain pharmacy… I am sure that whatever a pharmacist puts into that particular chain’s pharmacy software system… will show up on the computer terminal in any of their Rx depts…  I have been told that at least at Walgreens,  a Pharmacist can “black ball” a pt at one store and that pt will be “black balled” at all the chains Rxs dept… with Walgreens and CVS… that will be 9,000 Rx depts of each chain.  Of course, if you are patronizing a independent pharmacy, where you will be dealing with the Pharmacist/owner…  the pt can only be black balled in that ONE STORE’S COMPUTER.  Here is a hyperlink to search for a independent pharmacy by zip code and mile radius  https://ncpa.org/pharmacy-locator

Bamboo Health End User Agreement

In order to protect access to patient data and ensure compliance with software Terms of Use, we require annual acceptance of the following agreement before continuing.

By checking the following boxes, I affirm that the following statements are accurate and truthful:

I have not, and will not:

I certify that I am authorized to access the PMP, the identifying information on my account I have entered is true and accurate, I am the owner of this account, and I comply with the above requirements of use.

Note that failure to comply with the above requirements is a violation of the software Terms of Use and may be punishable under State and Federal law.

Limited Usage of INSPECT report information This report is only intended to provide INSPECT users with an overview of a patients prescription activity over a specific period of time. The State of Indiana does not warrant this information to be fully complete or accurate. Sources of prescriptive data in report The records in the report cannot be altered or modified by members of the INSPECT staff without the express written consent of the dispensing pharmacy. Safeguarding patient confidentiality All healthcare provider users should run INSPECT reports only on those patients to whom they are providing treatment or identifying the need for treatment. It is a violation of HIPAA and a patients right to privacy to discuss the contents of this report with individuals who are not directly involved in providing treatment to the subject of the INSPECT report. Approved manner of sharing and storing report The Information contained in the INSPECT report is privileged medical treatment information that should not be shared or discussed with anyone not in some way involved in the provision of medical treatment to subject of the report. The report, or the contents of the report, should not be faxed, mailed, emailed or otherwise disseminated.

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In case IP-anonymization is activated on this website, your IP address will be truncated within the area of Member States of the European Union or other parties to the Agreement on the European Economic Area. Only in exceptional cases the whole IP address will be first transferred to a Google server in the USA and truncated there. The IP-anonymization is active on this website.

Google will use this information on behalf of the operator of this website for the purpose of evaluating your use of the website, compiling reports on website activity for website operators and providing them other services relating to website activity and internet usage.

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what to do when a Pharmacist refuses to fill your C-II Rx that has been sent electronically

I am having pts reach out to me with what I see is a fairly disturbing pattern…  One of the basic functions of the practice of medicine is the starting, changing or stopping a pt therapy.  It use to be that if a pharmacist refused to filled a Rx – C-II in particular, the pharmacist should hand the paper Rx back to the pt.

Now with all- or nearly all – Rxs being transmitted electronically, if a Pharmacist refuses to fill a C-II… the particular C-II literally becomes a INVALID RX.  Unless the DEA has changed their rules/regulations, any chain using a central server/database… any store in the chain can pull the E-Rx C-II on the central server and fill it…

At least ten years ago, Walgreen granted their Pharmacists the permission to “black ball” any pt… for any particular reason – or no reason at all  – and the pt is “black balled” in all 9,000 stores. There is rumors that CVS has adopted the same procedure/protocol.  Each of those chains has abt 9,000+ stores, so a single pt can be black balled in a single store in each chain and they are black balled in about 25% – 30% of all the retail/community pharmacies in the country.

Any electronically sent Rx – other than C-II – can be transferred to another pharmacy either verbally by the Pharmacist or simply print out the electronic Rx data and fax it to the store that it is to be transferred to.

I think that a pt that has a pharmacist to refuse/decline to fill a electronic C-II,  should ask the Pharmacist to print out the electronic Rx data – it can’t be a valid C-II – because in order for it to be a legal  C- II hard copy is for it to be SIGNED IN INK by the prescriber.

Shouldn’t the pt be entitled to a copy of the prescribed med/strength, quantity and directions with the pharmacist’s name and license number and be signed by the Pharmacist. Ask that any notes added by Pharmacy staff on the Rx be print out as well.

CLINICAL REASON(S) FOR DENYING TO FILL the C-II

In health care… it is typically quoted … “if it isn’t documented ….  IT DID NOT HAPPEN …”

If the Pharmacist refused/declines to provide a hard copy of the Rx data information.

I can’t think of any valid reason that a Pharmacist would use to not give a pt a copy of the Rx info.  What if the Pharmacist put notes of the Rx … “I’m not comfortable filling this”… “the pt appears to under the influence…”  or some other derogation comments about the pt.

It is not outside the possibility- it has happened before –  that the Rx dept staff are refusing to fill C-II… so that they can fill it after the pt has left … for diversion purposes.   Many of the opiates are “worth $1/mg ” on the street.

 

 

Walgreens sued for denying leave to pregnant worker who miscarried

Walgreens sued for denying leave to pregnant worker who miscarried

https://www.reuters.com/legal/government/walgreens-sued-denying-leave-pregnant-worker-who-miscarried-2022-09-29/

Sept 29 (Reuters) – Walgreen Co has been sued by the U.S. Equal Employment Opportunity Commission (EEOC) for allegedly refusing to allow a pregnant, diabetic retail worker in Louisiana to take emergency medical leave, forcing her to quit hours before she miscarried, the agency announced on Thursday.

The EEOC filed a lawsuit on Wednesday in Alexandria, Louisiana federal court claiming a manager in December 2020 told the worker she had asked for “too many accommodations” and could not leave to see her doctor unless she found a replacement.

The EEOC said the worker identified as Jane Doe had asked to leave after she noticed that she was spotting, then quit before having a miscarriage later that day.

A spokesperson for Walgreens declined to comment.

The EEOC accused Walgreens of violating the federal Pregnancy Discrimination Act (PDA) and Americans with Disabilities Act by refusing to grant Doe a reasonable accommodation related to her pregnancy and disability.

In a 2015 case involving UPS Inc, the U.S. Supreme Court said the PDA requires employers to grant pregnant workers the same accommodations that they give to employees who are injured or disabled.

The EEOC in Wednesday’s complaint said Walgreens ordinarily permits employees to leave work if they are having an emergency.

The commission is seeking backpay and compensatory and punitive damages on behalf of Doe.

In a statement, EEOC lawyers said the case highlights that emergency leave can be considered a reasonable accommodation.

“No one should have to choose between losing a pregnancy and losing a job,” said Andrew Kingsley, a senior trial attorney.

The case is EEOC v. Walgreen Co, U.S. District Court for the Western District of Louisiana, No. 1:22-cv-05357.

For the EEOC: Andrew Kingsley

For Walgreens: Not available

(NOTE: This article has been updated to reflect that Walgreens declined to comment on the lawsuit. A previous version of the article also incorrectly identified Walgreen Co as Walgreens Co.)

CDC 2022 Opioid Prescribing Guideline: Tapering

CDC 2022 Opioid Prescribing Guideline: Tapering

https://www.practicalpainmanagement.com/resources/clinical-practice-guidelines/cdc-2022-opioid-prescribing-guideline-tapering

In this analysis, we break down the various aspects of the proposed revisions to the CDC Guideline on Opioid Prescribing for Chronic Pain to help clinicians, patients, and caretakers alike understand their nuances and to provide expert review of their applicability, potential benefits, and potential concerns. Specifically, we examine an integral part of the 2016 original and 2022 revised guidelines: recommendations on opioid tapering.

Decision-Making

The Decision to Taper an Opioid Prescription

Opioid tapering has historically been, and continues to be, one of the most controversial aspects of the original 2016 CDC prescribing guideline, and, thus, has become a crucial topic to examine in the proposed 2022 guidelines (expected to be finalized and released by the end of this year).

The concept of tapering does not exclusively apply to opioids, as it describes the general process of lowering any amount of medication in a gradual way to avoid potential precipitation of withdrawal and to ensure that a patient’s condition does not worsen without said medication. However, with opioids in particular, inappropriate reasons to taper or the use of an inappropriate tapering process can be associated with detrimental cognitive, physical, and emotional issues, all of which should be avoided when possible.

Prior to making the decision to taper an opioid, it is essential to establish an appropriate reason to taper in the first place. There could be several clinical reasons for initiating a taper:

  • lack of efficacy
  • attempt at opioid rotation
  • development of adverse events
  • abhorrent use/misuse
2016 Recommendations

Opioid Tapering in the 2016 CDC Prescribing Guideline

MME Limits

Each of the reasons to taper noted above are specifically noted in the 2016 CDC Guideline on Prescribing Opioids for Chronic Pain,¹ however, to the dismay of several expert clinicians, researchers, organizations, and stakeholders,²⁻⁵ the recommendation seemed to emphasize achieving a dosing threshold of 90 morphine milligram equivalents (MME) or lower per day. In addition, the 2016 recommendation advised to “consider tapering opioids to a lower dosage or to taper and discontinue opioids” if the patient is at ≥ 90 MME/day.

While the authors of the CDC guideline did not outright recommend blind and blanket tapering for those on opioids at ≥ 90 MME/day, unfortunately, because of the framing of the recommendations, several states enacted legislation while third-party payers created policies revolving around cutoffs utilizing the 90 MME/day threshold.¹˒⁶ These regulations resulted in blind tapering, reductions, and, in some cases, abrupt discontinuation of opioids across many patient populations who had been maintained on stable opioid therapy.²⁻⁸

Tapering Process

Regarding the process of how to taper, the 2016 guidelines were more vague, although their recommendations were more in line with the literature and best practice of the time.⁹ The CDC guideline authors did note that clinicians should collaborate with the patient on a tapering plan and that, if the patient agreed to taper, and that taper should remain slow, gradual, and even require pauses to allow for “gradual accommodation.”¹

They also recommended patients be monitored closely for anxiety, among other symptoms that may result from a taper.¹

2022 Recommendations

Opioid Tapering in the Proposed 2022 CDC Guideline

Regarding the pending update to the CDC opioid prescribing guideline, there seems to be a greater emphasis by not only the authors but also by relevant stakeholders and the review panel, on gradual, patient-centered tapers.¹⁰

MME Limits

Despite what the authors indicate regarding MME/day cutoffs, there is a section in the draft update that discusses the plateauing of analgesia at opioid dosing of around 50 MME/day based on evidence with a level of “type 2” quality.¹⁰ While there is no mention of using 50 MME/day as a new dosing cutoff, the inclusion of 50 MME/day to describe evidence of efficacy is concerning, to say the least.

Tapering Process

There has been no significant change in recommendations for appropriate reasons to taper.¹⁰ Additionally, similar to the 2016 guideline, the 2022 draft update recommends a vague but gradual approach to opioid tapering, recommending specifically against blanket tapers or abrupt discontinuation.¹⁰ The authors of the updated document (who, of note, are the same authors of the 2016 guideline aside from one new contributor) also make a specific note, highlighted in the summary, that the guidelines are not “a law, regulation, and/or policy that dictates clinical practice or [serves as] a substitute for FDA-approved labeling.” This distinction is especially important to consider given that more than 170 policy changes made between 2016 and 2018 related to opioid-dosing cutoffs and MME/day thresholds, many of which were directly in response to the 2016 guidelines.⁶˒¹⁰

In fact, the 2022 draft update confirms the misapplication of the 2016 recommendations (specifically with regard to policies) concerning “opioid tapers and abrupt discontinuation without collaboration with patients; rigid application of opioid dosage thresholds.”¹⁰ The 2022 authors agree, as they did in a 2019 article published in the New England Journal of Medicine,⁷ that misapplying these recommendations in particular may have contributed to physical and psychological patient harm, undertreated pain, withdrawal symptoms, and suicidal ideation and behavior.¹⁰ They indeed recommend against the strict utilization of dosing thresholds based off of MME/day cutoffs.¹⁰

Table I: How the CDC Guideline Update May Alter Opioid Tapering.
2016 CDC Guideline on Prescribing
Opioids for Chronic Pain
2022 CDC Proposed Guidelines on
Prescribing Opioids for Chronic Pain
Reasons to Taper • lack of efficacy
• attempt at opioid rotation
• development of adverse events
• abhorrent use/misuse
no change
Tapering Process • collaborate with patient on tapering plan
• use a slow, gradual, process that allows for pauses
• monitor patient’s anxiety, among other symptoms that may result from taper
no significant change; greater emphasis on avoiding blind tapers/abrupt discontinuations

still needed: evidence-based consensus on tapering duration, reduction amount, and/or frequency of reduction

Noted MME/day* 90 MME 50 MME
*Cutoffs are not required, but language is vague
Discussion

Expert Opinion

Like other revisions to the new guidelines, it does appear that the CDC has attempted to clarify and highlight important concerns that arose after the vast implementation of their 2016 opioid prescribing guidelines around opioid tapering. We commend the CDC for confirming the appropriate reasons to taper, for emphasizing patient-centered decisions regarding tapering, and for emphasizing that tapers be enacted with a gradual and careful approach.

However, there has not been a consensus update by pain management specialists based on clinical trials or sound scientific data regarding specific tapering recommendations such as duration, reduction amount, or frequency of reduction, and, thus, there remains significant discomfort and disparity among clinicians regarding how to adequately taper a patient off of opioids.¹¹˒¹²

Further, as noted, the CDC’s discussion that “type 2” evidence does not support dosing of opioids greater than 50 MME/day because of lack of association with significant efficacy and increased risk of adverse events when used in chronic pain.¹⁰ While the CDC recommends against the use of rigid dosing cutoffs, the language around their concerns with doses greater than 50 MME/day reads similar to the language used in 2016 guideline on 90 MME/day. The latter was a major reason cited by providers for tapering stable patients off opioids.¹¹ To reduce these concerns, it would be prudent for the CDC to specifically recommend against the use of 50 MME/day as a potential dosing cutoff going forward.

Takeaways

Practical Takeaways

Overall, opioid tapering continues to be a difficult therapeutic aspect entwined within the use of opioids, not only because of the difficulties in identifying appropriate reasons/individuals to taper, but then to develop a tapering strategy with the patient. The CDC’s draft update to the opioid prescribing guideline attempts to provide some clarity on all of these aspects, however, remains vague in tapering strategies and allows for ambiguity around potential tapering in individuals on certain opioid doses.

No matter the final language, the authors believe it is pertinent that opioid tapering occurs in only appropriate situations, where patient physical and psychological harm is minimized, and where the tapering process remains individualized.

Back to our toolkit on the CDC opioid prescribing guidelines, including analyses on Initiating Opioid Therapy, Target Patient Populations and New: Subsequent Visits

Is this a new kind of “LEGAL CRAZY”

She Wanted An Abortion. Now The Embryo Is Suing Her Doctors

The ‘wrongful death’ suit could usher in a new threat for abortion providers and women nationwide

Four years ago in Arizona, a woman had an abortion. She was not ambivalent about the decision: She was upset to learn she was pregnant, scared of giving birth, and she did not want — she had never wanted — children. Even so, Arizona law requires a pregnant person absorb a litany of information before terminating: medical information (like the risks associated with the procedure), and legal information (like the fact that the father would be liable for child support if she carried the pregnancy to term). In Arizona, a person must sign a consent form officially acknowledging receipt of that information, then wait 24 hours before she can obtain an abortion. The woman signed her paperwork and returned the next day to pick up the pills. Six days later, she came back for a follow-up visit: The abortion was successful. 

Two years later, that woman’s ex-husband, Mario Villegas, created an estate for the aborted embryo, and filed a lawsuit on behalf of the embryo against the doctors and clinic who provided the abortion. Villegas accuses the clinic and doctors of failing to obtain his ex-wife’s informed consent, thus committing malpractice, causing the wrongful death of his potential child and violating his “fundamental right” to parent.

Last week, a lawyer representing the doctors and their Phoenix practice, Camelback Family Planning, made a last-ditch effort to avoid a trial in the case, asking the judge to issue a summary judgment finding that the woman had indeed given her informed consent. In depositions, the woman and her doctors “all said the same thing: that [she] knew what she was doing, she was fully advised, and they did the abortion according to Arizona law,” the doctors’ lawyer, Tom Slutes, says. “The purpose of the statute is to make sure that the mother is properly advised, and makes an informed decision, and this young lady did.”

Villegas’ lawyer, J. Stanley Martineau, doesn’t dispute that she signed paperwork consenting to the abortion. He argues her consent wasn’t informed because, among other technical faults, the clinic’s paperwork didn’t use the phrase “unborn child” when describing the embryo, as Arizona’s informed consent statute does. (He also faults the clinic for not offering a printed-out copy of the Arizona department of health services website, which the law says can be made available to pregnant person “if she chooses to review” it.) “If you interpret [the statute] literally, any slip-up in what kind of information you give is going to create a potential liability,” Martineau says. 

Superior Court Judge Bryan Chambers is considering the motion to resolve the case without a trial, and says he will come to a decision within sixty days. But Villegas and his lawyer can already claim a kind of victory: They successfully convinced the judge that Villegas should be allowed to argue that his ex-wife’s embryo, whom they call “Baby Villegas” in legal documents, is a person for the purposes of the wrongful death lawsuit. If the case goes to trial, and if a jury ultimately finds in favor of the plaintiffs, it will be the first time that an aborted embryo has triumphed in a wrongful death lawsuit, ushering in a new legal threat not just for doctors, but for anyone who can become pregnant.

“This case was brought against the abortion provider, but it is required that the pregnant person, the ex-partner, be a witness in this case,” says Dana Sussman, deputy executive director for the National Advocates for Pregnant Women. Sussman worries that future litigants could use a similar strategy — suing for wrongful death — but go even further, by targeting the woman herself. “I could see a universe in which an ex-partner, in an attempt to harass or terrorize or create fear in the pregnant person, would try to bring a wrongful death lawsuit against the pregnant person herself, in addition to the provider.”

Villegas’ lawyer calls the judge’s decision “significant” because, Martineau says, “in a way, it’s saying that an unborn fetus has rights.” And, for decades, anti-abortion activists have been trying to establish both laws and case law that say exactly that. 

The movement for fetal personhood grew out of Roe v. Wade itself, when, among other issues, the Supreme Court considered whether a fetus constituted a person with rights of its own under the Constitution. The justices ultimately concluded it didn’t, but Harry Blackmun, writing for the majority, asserted that “if this suggestion of personhood is established, [Roe’s] case, of course, collapses, for the fetus’ right to life would then be guaranteed.” Ever since, activists have been lobbying aggressively to pass “fetal personhood” laws that radically reimagine a woman’s legal rights the moment she becomes pregnant. 

Today, eleven states, including Arizona, have broad laws that have redefined the term “person” to include a fertilized egg, embryo, or fetus, paving the way for cases like the one Mario Villegas filed. Before the Dobbs decision, federal protections for abortion acted as a kind of guardrail against some of the most extreme interpretations of those laws. But “without Roe as a fundamental constitutional right,” NAPW’s  Sussman says, “we are now starting to grapple with what exactly these laws mean in practice.” 

For years, advocates have warned of the consequences fetal personhood laws could have for pregnant women, including the potential to rebrand any behavior that might pose a risk to a pregnancy as child endangerment. As anyone who has been pregnant knows, the list of activities that constitute a “risk” during pregnancy is virtually endless and can include pursuits as anodyne as consuming soft cheeses or sushi. (In many cases, admonitions around “risky” pregnancy behavior aren’t even grounded in science, but are instead based on the absence of scientific evidence, since the very idea of performing a study to quantify the risk would pose a risk of its own.) Under the legal theory that a fetus is a person with rights, even simply crossing the street can open a pregnant person up to legal liability: In one case, a court allowed a woman who was hit by a car while seven months pregnant to be sued by her future child for negligence because she failed to use “a designated crosswalk.” 

According to an analysis by National Advocates for Pregnant Women, personhood laws were already having far-reaching consequences before Dobbs, creating conditions in which pregnant women were either denied medical care or had it forced upon them against their wishes. But, without federal protections, the group warns these laws could end up outlawing or curtailing the practice of IVF in at least thirty states, or requiring the “adoption” of unused embryos; they could hamper research that involves embryonic stem cells, determine whether or not a person is entitled to use the carpool lane, and change how much they pay in taxes or child support.

There is also the potential, noted in NAPW’s report, for former partners to weaponize such laws to prevent their partners (or ex-partners) from obtaining an abortion. In the past, the group found, courts have been largely unsympathetic to the arguments men have made when trying to block their ex-partners from obtaining abortions. But, surveying the history of those failed cases, they note a marked shift in legal framing “from the man’s right to the fetus’s right, reflecting the rise of personhood ideology.”

Villegas’ lawyer argues that both the father and the embryo had rights that were violated by the woman’s abortion. (Arizona’s informed consent statute allows the “father of the unborn child” to sue if he was married to the person who sought the abortion at the time.) The complaint declares Villegas has experienced “pain, grief, sorrow, anguish, stress, and mental suffering” over the loss of his ability to parent a hypothetical child. Throughout the complaint, his ex-wife is similiarly portrayed as victim who “suffered” an abortion because the doctors “failed to obtain” her informed consent. 

In sworn testimony she was compelled to give in the case, however, Villegas’ ex-wife is crystal clear about her desire to have the abortion. She describes an unhappy and ill-conceived five-year marriage that ultimately ended with her seeking an order of protection against her ex-husband, who has a previous conviction of aggravated assault with a deadly weapon. The pregnancy came toward the end of their relationship and, she said, as a surprise, since Villegas had a vasectomy before they were married. (Villegas’ lawyer insists she was aware of her then-husband’s vasectomy reversal.) She puts it very plainly in the deposition: “I never wanted children and he knew that.” She describes fear of the “pain” of giving birth, and her disinterest in being responsible for a child: “I barely take care of myself as it is.” (The woman, who does not have a lawyer representing her in the proceedings, declined to be interviewed.) 

Her absolute clarity of mind around her decision underscores the ways in which elevating an embryo’s rights instantly strips a woman of her own. The woman had a vision of her future that is incompatible with her ex-husband’s vision of her embryo’s future. Now, he’s asking the court to disregard hers entirely.

If the case goes to trial, and a jury ultimately finds that the doctors violated the statute, the doctors could be fined, forced to pay Villegas’ attorneys fees and possibly damages. Their medical licenses could be suspended or revoked as well. The case will offer a blueprint that could be replicated to re-litigate abortions in the future. While potentially devastating, those consequences seem almost quaint this week, as Arizonans wait for a different judge to issue a decision that could allow an abortion ban dating back to 1864 back into effect. The ban would make abortion illegal in every instance, except to save the life of the mother, and punish providers who violate the law with two to five years in prison.  

ATTENTION: CALIFORNIA PTS !!!

WH Spokesperson: number of illegal fentanyl poisoning have leveled off.. Our “North Star”prgm is working

It is claimed that we already spend > 100 billion/yr in fighting the war on drugs and we have spent collectively about TWO TRILLION since the Controlled Substance Act was signed into law in the early 70’s. So adding an additional couple of billion to fighting the war on drugs… is going to dramatically change the course of substance abuse of most illegal substances ?  The director of the White House Office of National Drug Control Policy seems impressed that in the last 12 months opiate poisoning killed about the same number of people as in the previous period. I guess the families/relatives of the 70K-75K that died/poisoned from using illegal fentanyl were happy that the rate of poisoning didn’t increase 🙁

More $$ On the Way to Fight the Opioid Overdose Crisis, White House Says

https://www.medpagetoday.com/psychiatry/opioids/100901

Officials also plan to keep buprenorphine prescribing flexibilities for 1 year after the PHE ends

WASHINGTON — The Biden administration announced several new actions aimed at tackling the opioid overdose crisis, including more funding for states and territories and new guidance designed to increase access to naloxone (Narcan).

“Our nation is facing 108,000 overdose deaths in just 12 months,” said Rahul Gupta, MD, director of the White House Office of National Drug Control Policy (ONDCP), on a phone call with reporters Thursday evening. “That’s one life lost every 5 minutes around the clock … Our North Star is to save lives and connect more Americans to treatment and recovery support services. We have already seen our efforts take effect. After a more than 35% increase in overdose deaths during the first 18 months of the pandemic, more recent 12-month rolling total overdose death counts have remained largely unchanged.”

Actions announced by the administration on Friday include:

  • $1.5 billion in funding to states and territories to address addiction and the opioid crisis. The funding, which is being given through the Substance Abuse and Mental Health Services Administration, will be used to increase access to treatment for substance use disorder, remove barriers to public health interventions like naloxone, and expand access to recovery support services such as 24/7 opioid treatment programs, according to a White House fact sheet. States can also use the funds to increase their investments in overdose education and to hire peer support specialists for emergency departments.
  • $104 million in funds to expand substance use treatment and prevention in rural areas. This funding, which will come through the Health Resources and Services Administration, will go to public, profit, and nonprofit organizations as part of the multi-year Rural Communities Opioid Response Program. The money will be spent to open new medication-assisted treatment sites, help with workforce mentorship and training, and allow communities to invest in education and outreach to prevent and treat substance use disorder, the White House said.
  • New guidance to increase access to naloxone. The FDA issued guidance Friday to ease distribution of FDA-approved naloxone products. The guidance, which is effective immediately, makes naloxone exempt from certain laws related to drug purchase and distribution under the Drug Supply Chain Security Act. Making these exemptions “helps to address some of the obstacles that have existed in obtaining access to naloxone, and may help eligible community-based programs acquire FDA-approved drugs directly from manufacturers and distributors,” the White House noted.
  • More funding for law enforcement. In April, the ONDCP announced $275 million in funding for the High Intensity Drug Trafficking Areas Program to support law enforcement officials working against drug traffickers. The agency is now adding another $12 million to that funding, which also includes money for efforts to prevent gun crimes associated with drug trafficking.

Asked during a question-and-answer session about why the opioid crisis continued to escalate during the pandemic, Gupta said that “we know that the increase in drug overdose and poisoning deaths was beginning to rise even prior to the pandemic, and it has been very clear that the pandemic has clearly exacerbated the suffering to Americans, both in terms of isolation and of early shutdown of treatment facilities.” That’s why the administration has implemented “a number of things, including telehealth provisions, that allowed some significantly increased access to care, both for rural populations but also other marginalized and underserved communities, and populations such as [prison inmates],” he added.

MedPage Today asked officials whether any thought had been given to continuing the newly loosened restrictions on buprenorphine prescribing; as part of the COVID-19 public health emergency, the administration lifted the training requirement for a buprenorphine prescribing “X-waiver” in April 2021, although doctors still have a limit of 30 patients for whom they can prescribe the drug at any given time.

“We certainly have heard from communities” that the loosened restrictions “have been so helpful,” said Miriam Delphin-Rittmon, PhD, HHS Assistant Secretary for Mental Health and Substance Use. In addition, “for individuals who are on either methadone or accessing buprenorphine, it has been helpful to be able to receive those medications through telehealth, or to receive take-home doses. We are currently looking to continue those flexibilities for 1 year beyond the end of the public health emergency,” and also considering extending them even beyond that date, she said. “That is all in process and under discussion. But currently, for at least 1 year beyond the public health emergency, those flexibilities will be continued.”

Gupta added that as an X-waivered physician himself, he knows that “it is very difficult for providers and clinicians all over the country to be able to provide that access on par with the ability to write [prescriptions for] other Schedule II drugs … We want to make sure that these flexibilities that Dr. Delphin-Rittmon’s talking about — the telehealth provision and access to methadone to take home, as well as the mobile vans for methadone that significantly increased access to people, especially in rural communities — [continues because] it is critical, and we know treatment saves lives.”

However, he added, “we also need to make sure that the clinician community steps up and is providing those prescriptions, addressing the stigma that goes along [with addiction], including in healthcare, and providing people the help.”