Tag Archives: VA

Discarding Medical Ethics

There really is no way to ignore the White supremacist and patriarchal roots of MAGA and the Trump administration. The behavior of ICE in conflating Brown skin with “illegal” status is one aspect; the bigoted nature of so many Trump’s insane Executive Orders is another. A recent federal court decision–handed down by a judge appointed by Ronald Reagan–expressed astonishment at the obvious discriminatory motive behind the administration’s NIH cuts. Etc.

Now, the administration is encouraging the VA to be “selective” in providing medical care to veterans. According to a recent report from The Guardian,

Doctors at Department of Veterans Affairs (VA) hospitals nationwide could refuse to treat unmarried veterans and Democrats under new hospital guidelines imposed following an executive order by Donald Trump.

The new rules, obtained by the Guardian, also apply to psychologists, dentists and a host of other occupations. They have already gone into effect in at least some VA medical centers.

Medical staff are still required to treat veterans regardless of race, color, religion and sex, and all veterans remain entitled to treatment. But individual workers are now free to decline to care for patients based on personal characteristics not explicitly prohibited by federal law.

Language requiring healthcare professionals to care for veterans regardless of their politics and marital status has been explicitly eliminated.

I sent this article to my cousin, a long-time cardiologist whose medical knowledge I sometime share on this site; he responded that this “goes against all the rules that guide the medical profession, not to mention against the guiding principles of this entire nation! It’s simply additional confirmation of Trump’s insanity, not that we needed it! “

According to the report, this permission of discrimination isn’t limited to patient care. “Doctors and other medical staff can also be barred from working at VA hospitals based on their marital status, political party affiliation or union activity.” The changes even apply to chiropractors, nurse practitioners, optometrists, podiatrists, licensed clinical social workers and speech therapists.

The administration claims that these changes were intended to support the president’s executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”. That executive order purported to eliminate existing government protections from transgender people, and since it was issued, the VA has stopped  providing most gender-affirming care.

The administration has also forbidden a long list of words, including “gender affirming” and “transgender”, from clinical settings.

The article quoted a former VA administrator who said the changes would allow doctors to refuse to treat veterans based on the reason they were seeking care, including allegations of rape and sexual assault. Refusal could also be based upon current or past political party affiliation or political activity, and on personal behaviors like alcohol or marijuana use.

Most Americans fail to recognize just how extensive the VA is. The Department of Veterans Affairs operates the nation’s largest integrated hospital system; it has more than 170 hospitals and more than 1,000 clinics, employs 26,000 doctors and serves 9 million patients annually. It is hardly an exaggeration to say that rule changes of this sort are likely to have profound consequences.

In an emailed response to questions, the VA press secretary, Peter Kasperowicz, did not dispute that the new rules allowed doctors to refuse to treat veteran patients based on their beliefs or that physicians could be dismissed based on their marital status or political affiliation.

Dr. Arthur Caplan, a prominent medical ethics expert, called the new rules “extremely disturbing and unethical.”

The changes are part of a larger attack on the independence of medicine and science by the Trump administration, Caplan said, which has included restrictions and cuts at the National Institutes of Health and the Centers for Disease Control and Prevention, where the secretary of the Department of Health and Human Services, Robert F Kennedy Jr, last week fired every member of a key panel that advises the government on vaccines. The Guardian has earlier reported on a VA edict forbidding agency researchers from publishing in scientific journals without clearance from the agency’s political appointees.

Just one more drop in the ocean of ignorance and “othering” that characterizes MAGA and Trumpism. From the “very fine” people Trump insisted were among the bigoted rioters at Charlottesville, to his description of (majority Black) “shithole countries,” to his efforts to bar entry into America from Muslim countries, to his constant manifestations of racism, misogyny, and anti-Semitism, Trump has represented and ingratiated himself with the White “Christian” supremacists who form the base of his support.

America’s divisions aren’t political. They’re moral and ethical. And MAGA is on the wrong side of that divide.

 
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The Hits Keep Coming…

A few weeks ago, I asked one of my sons if he’d read my blog that morning; he said he hadn’t, because most of my posts depressed him. I completely understand that reaction; I have begun “skimming” the headlines rather than reading the “doom and gloom” reporting and punditry that constitutes the overwhelming majority of items delivered to me each morning.

I’m convinced that–if one can take a sufficiently “removed” perspective–there is evidence  that Americans are moving toward a more inclusive, democratic future. But the day-to-day reporting doesn’t reflect broad social movements–for one thing, bad news and dire predictions are today’s iteration of the media’s longtime devotion to “if it bleeds, it leads.” Negative and shocking stories capture eyeballs, and it isn’t only Facebook that focuses on “engaging” readers.

It’s hard to keep a balanced view–let alone a positive one–when we hear more every day about the extent to which (mostly Republican) officeholders have descended into behaviors that range from financial self-dealing to unashamed bigotry. Two recent examples are illustrative.

Propublica has reported

Former President Donald Trump empowered associates from his private club to pursue a plan for the Department of Veterans Affairs to monetize patient data, according to documents newly released by congressional investigators.

As ProPublica first reported in 2018, a trio based at Trump’s Mar-a-Lago resort weighed in on policy and personnel decisions for the federal government’s second-largest agency, despite lacking any experience in the U.S. government or military.

While previous reporting showed the trio had a hand in budgeting and contracting, their interest in turning patient data into a revenue stream was not previously known. The VA provides medical care to more than 9 million veterans at more than 1,000 facilities across the country.

Patient data–which veterans have every right to expect will be subject to doctor/patient privacy rules– could be sold to major companies for hundreds of millions of dollars. The trio–described by Propublica as “the Mar-a-Lago crowd”–obviously knew their plans were improper. One of the emails obtained by the publication demonstrated that the group took efforts to conceal its activities. It read “We are still unsure what can be put in emails and what to discuss verbally,”

New evidence that the former administration was essentially a gang of grifters won’t surprise anyone who isn’t a brainwashed MAGA partisan. Despicable as such behaviors are, theft and self-dealing are longtime human transgressions, and understandable albeit reprehensible. Less comprehensible is the GOP’s eagerness to flaunt their bigotries.

As the Religion News Service has reported,

The Republican members of the Senate’s Small Business Committee have failed to attend confirmation hearings for Dilawar Syed, the Biden administration’s pick to be the deputy administrator of the Small Business Administration.

Syed’s first confirmation hearing was scheduled for April 12, but on that day and three subsequent dates — the latest on Sept. 21— the Republicans have effectively boycotted the nominee, who, if confirmed, would be the highest-ranking Muslim in the administration.

 A number of religious groups, including African American Ministers In Action, Sojourners, the Reconstructionist Rabbinical Association and the National Council of Churches, have  accused the GOP of “anti-Muslim animus” for its opposition to Syed, whose nomination is also supported by the U.S. Chamber of Commerce.

A report from Huffpost notes the changing excuses for opposition to Syed, who is clearly well-qualified for the position.

He is a businessman ― currently president and CEO of Lumiata, a health care analytics company ― who has also stepped into public service roles in both California and at the federal level, leading engagement with small businesses after the passage of the 2009 stimulus package for President Barack Obama’s administration. He is also co-founder of AAPI Victory Fund, a super PAC dedicated to mobilizing Asian American voters.

When Jewish organizations demonstrated the falsity of accusations of anti-Israel activity, Republicans shifted their argument…to Planned Parenthood.

Instead, they all pointed to a joint statement saying they will oppose filling the deputy SBA job until the Biden administration commits to taking back loans given to some Planned Parenthood affiliates under the Paycheck Protection Program. The loans, handed out during President Donald Trump’s administration, were meant to help small businesses keep employees on their payroll during the pandemic…

“It has been a successive series of things. And if one didn’t stick, they found another one. And if that didn’t stick, they found another one,” said Shekar Narasimhan, a friend of Syed’s and co-founder of AAPI Victory Fund.

It is glaringly obvious that the Republican Senators’ real objection is that Syed is Muslim.

It isn’t just the ever-growing looney-tune caucus composed of the likes of Marjorie Taylor Greene and Louie Gohmert. The once Grand Old Party is currently composed  almost entirely of conspiracy theorists, grifters and bigots.

it can’t crash and burn soon enough.

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