Date: 1/11/2009
By MIKE STOBBE
AP Medical Writer
Children who want to be vegetarians need to “fill in the blanks” of their low-protein diets by eating alternatives to red meat, fish and poultry, experts say.
Good examples are soybeans, fortified soy milk and nuts. Those are important sources of the protein, iron, zinc, calcium and vitamin D that most kids get from meat.
Nutritional yeast — which has a cheesy flavor — has the much-needed vitamin B-12. And flaxseed is good for linolenic acid.
Vegetarian children who eat eggs and dairy products will most likely get all the nutrition they need. But those who become vegan — abstaining from dairy — need to be more diligent, said Dr. David Ludwig of Children’s Hospital Boston, a specialist in pediatric nutrition.
“It really requires much more attention to avoid nutrient deficiencies,” Ludwig said.
Children can start on a vegetarian diet from birth, said Sarah Krieger, a spokeswoman for the American Dietetic Association who is a registered dietitian at All Children’s Hospital in St. Petersburg, Fla.
Breast milk or an iron-fortified formula are necessary in the first six months, she said, adding that soy-based formula is an option.
Copyright 2009 The Associated Press.
Search abandoned for NJ baby’s body, lost in trash
Date: 1/8/2009
JERSEY CITY, N.J. (AP) — Police who searched dumps in three states for the remains of a baby thrown out in a Jersey City hospital’s trash gave up Thursday, saying they had little chance of success.
“We have come to the harsh reality that efforts to locate the remains of Bashere Davon Moyd Jr. would be a Herculean undertaking with little probability of a successful conclusion,” Jersey City police Chief Thomas Comey said in a statement posted on the department’s Web site.
Authorities had been looking for the baby’s body since Jan. 2, when it was discovered missing from the morgue at Christ Hospital. The remains apparently were thrown away with the hospital’s trash sometime between Dec. 21 and Jan. 2, police said.
They searched dumps in New Jersey and Pennsylvania before focusing on a landfill in Ashland, Ky., where the waste may have been transferred. On Wednesday, Comey said he feared the waste was sent elsewhere and may have been incinerated.
Hospital officials and police have declined to say exactly how the baby ended up in the trash.
“The investigation failed to uncover any evidence of criminal conduct, but rather indicated this unfortunate incident was the result of procedural deficiencies and human error,” Comey said.
The baby was delivered Dec. 21. Hospital officials say it was stillborn, but the mother, 26-year-old Kalynn Moore, said her son was born alive with a weak heartbeat and died about 20 minutes later as doctors tried to save him.
Whether the child was stillborn is an important legal distinction because New Jersey law does not recognize stillborn babies as human.
Moore’s lawyer, Michael Anise, has said that a lawsuit is likely. He maintains there is no reason for the body of a fetus to have been thrown into the trash.
Copyright 2009 The Associated Press.
JERSEY CITY, N.J. (AP) — Police who searched dumps in three states for the remains of a baby thrown out in a Jersey City hospital’s trash gave up Thursday, saying they had little chance of success.
“We have come to the harsh reality that efforts to locate the remains of Bashere Davon Moyd Jr. would be a Herculean undertaking with little probability of a successful conclusion,” Jersey City police Chief Thomas Comey said in a statement posted on the department’s Web site.
Authorities had been looking for the baby’s body since Jan. 2, when it was discovered missing from the morgue at Christ Hospital. The remains apparently were thrown away with the hospital’s trash sometime between Dec. 21 and Jan. 2, police said.
They searched dumps in New Jersey and Pennsylvania before focusing on a landfill in Ashland, Ky., where the waste may have been transferred. On Wednesday, Comey said he feared the waste was sent elsewhere and may have been incinerated.
Hospital officials and police have declined to say exactly how the baby ended up in the trash.
“The investigation failed to uncover any evidence of criminal conduct, but rather indicated this unfortunate incident was the result of procedural deficiencies and human error,” Comey said.
The baby was delivered Dec. 21. Hospital officials say it was stillborn, but the mother, 26-year-old Kalynn Moore, said her son was born alive with a weak heartbeat and died about 20 minutes later as doctors tried to save him.
Whether the child was stillborn is an important legal distinction because New Jersey law does not recognize stillborn babies as human.
Moore’s lawyer, Michael Anise, has said that a lawsuit is likely. He maintains there is no reason for the body of a fetus to have been thrown into the trash.
Copyright 2009 The Associated Press.
Shaping good health as teens outgrow pediatrician
Date: 1/5/2009
AP Medical Writer
WASHINGTON (AP) — Ever watched a teen skulk in the corner of a toddler-packed pediatrician’s waiting room, obviously wishing to be anywhere else?
Adolescents aren’t just big kids, and too many start falling through cracks in the health care system when they pass the stage of preschool shots and summer camp checkups — what a major new report calls missed opportunities to shape the next generation’s well-being.
The period between ages 10 and 19 is unique, bringing more rapid biological changes than perhaps any age other than infancy. Even though most of the nation’s 42 million adolescents seem to be thriving, it is a time of risk-taking and pushing boundaries in ways that can mean immediate consequences: Car crashes, experimenting with alcohol or drugs, teen pregnancy, sexually transmitted disease.
And it’s also an age when many of the habits that determine good health during adulthood are set, or not.
“They are quite literally our future. If we don’t take good care of them, there’s a strong likelihood when they’re running the ship they’re not going to have a good time running the ship,” said Dr. Frank Biro of Cincinnati Children’s Hospital’s long-running adolescent medicine program.
Yet the system of care for tweens and teens is fragmented and poorly designed. Few doctors specialize in adolescents’ complex needs, or provide comprehensive care that earns their trust, concludes a recent probe by the National Research Council and Institute of Medicine. Most at risk are the poor.
The result: The past decade has brought declines in teen pregnancy and smoking but little other overarching progress. Tweens and teens increasingly are overweight; physical activity’s dropping; chronic diseases like asthma and diabetes are on the rise; and injuries, chiefly from car crashes, remain this age’s leading cause of death.
While 20-somethings tend to see primary-care doctors the least, a gradual falloff begins in adolescence. Only a fraction of tweens and teens have been screened for risky behavior so doctors can intervene before a problem arises, the report found. Between 10 percent and 20 percent of adolescents annually experience a mental health disorder, such as depression or anxiety, with less access to that specialty care. Five million are uninsured, too often even left out of federal-state programs designed to provide health coverage to children.
Yet half of deaths among adults are due to health-related behaviors that often start during adolescence.
“A 10-year-old is probably the healthiest person in America,” notes Dr. Frederick Rivara of the University of Washington, a co-author of the new report. “Something happens between age 10 and age 25.”
Teens do tend to see a doctor, clinic or school-based care program somewhat regularly, if not because parents demand it, then for vaccinations or the 15-minute physical required by sports teams. But the report notes it can take at least 40 minutes to do a thorough adolescent checkup, including screening and counseling for risky behaviors — the kind that may prompt enough trust for the teen to return with a problem he or she doesn’t want Mom to know about.
But with fewer than 500 doctors certified as adolescent medicine specialists between 1996 and 2005 — some states have none — most families will need to hunt a pediatrician or family physician with the communication and social skills and, perhaps more importantly, the true interest to engage a teen.
“Adolescents have so much energy. They see the world so differently than you or I,” says Biro, Cincinnati’s adolescent medicine chief, who wasn’t part of the report and says society’s stereotype of sex and drugs isn’t the typical teen.
The relationship starts with the doctor making clear that the adolescent has a right to patient confidentiality that grows with age, although he or she must work with the parents, too.
As Biro describes the balancing act: “As long as you’re not hurting yourself, another person or getting hurt by another person, I will hold that information confidential. … If there’s a direct health risk that could involve their life, then I will share that.”
Then comes recognizing that the early teen years are when kids move from concrete thinking to more abstract thought — they begin to connect the dots, Biro explains. They may assume the doctor connected the dots the same way, meaning a girl who complains of stomach pain may not volunteer that she’s fears pregnancy.
“It’s not that they’re withholding information. They figure they’ve just told you everything you need to know because the rest of it you should be able to figure out,” Biro says. “I prove to them I am indeed about as smart as mud and I have to ask them more probing questions.”
___
EDITOR’s NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
___
On the Net:
Society for Adolescent Medicine: http://www.adolescenthealth.org
Adolescent medicine report: http://www.iom.edu
Copyright 2009 The Associated Press.
AP Medical Writer
WASHINGTON (AP) — Ever watched a teen skulk in the corner of a toddler-packed pediatrician’s waiting room, obviously wishing to be anywhere else?
Adolescents aren’t just big kids, and too many start falling through cracks in the health care system when they pass the stage of preschool shots and summer camp checkups — what a major new report calls missed opportunities to shape the next generation’s well-being.
The period between ages 10 and 19 is unique, bringing more rapid biological changes than perhaps any age other than infancy. Even though most of the nation’s 42 million adolescents seem to be thriving, it is a time of risk-taking and pushing boundaries in ways that can mean immediate consequences: Car crashes, experimenting with alcohol or drugs, teen pregnancy, sexually transmitted disease.
And it’s also an age when many of the habits that determine good health during adulthood are set, or not.
“They are quite literally our future. If we don’t take good care of them, there’s a strong likelihood when they’re running the ship they’re not going to have a good time running the ship,” said Dr. Frank Biro of Cincinnati Children’s Hospital’s long-running adolescent medicine program.
Yet the system of care for tweens and teens is fragmented and poorly designed. Few doctors specialize in adolescents’ complex needs, or provide comprehensive care that earns their trust, concludes a recent probe by the National Research Council and Institute of Medicine. Most at risk are the poor.
The result: The past decade has brought declines in teen pregnancy and smoking but little other overarching progress. Tweens and teens increasingly are overweight; physical activity’s dropping; chronic diseases like asthma and diabetes are on the rise; and injuries, chiefly from car crashes, remain this age’s leading cause of death.
While 20-somethings tend to see primary-care doctors the least, a gradual falloff begins in adolescence. Only a fraction of tweens and teens have been screened for risky behavior so doctors can intervene before a problem arises, the report found. Between 10 percent and 20 percent of adolescents annually experience a mental health disorder, such as depression or anxiety, with less access to that specialty care. Five million are uninsured, too often even left out of federal-state programs designed to provide health coverage to children.
Yet half of deaths among adults are due to health-related behaviors that often start during adolescence.
“A 10-year-old is probably the healthiest person in America,” notes Dr. Frederick Rivara of the University of Washington, a co-author of the new report. “Something happens between age 10 and age 25.”
Teens do tend to see a doctor, clinic or school-based care program somewhat regularly, if not because parents demand it, then for vaccinations or the 15-minute physical required by sports teams. But the report notes it can take at least 40 minutes to do a thorough adolescent checkup, including screening and counseling for risky behaviors — the kind that may prompt enough trust for the teen to return with a problem he or she doesn’t want Mom to know about.
But with fewer than 500 doctors certified as adolescent medicine specialists between 1996 and 2005 — some states have none — most families will need to hunt a pediatrician or family physician with the communication and social skills and, perhaps more importantly, the true interest to engage a teen.
“Adolescents have so much energy. They see the world so differently than you or I,” says Biro, Cincinnati’s adolescent medicine chief, who wasn’t part of the report and says society’s stereotype of sex and drugs isn’t the typical teen.
The relationship starts with the doctor making clear that the adolescent has a right to patient confidentiality that grows with age, although he or she must work with the parents, too.
As Biro describes the balancing act: “As long as you’re not hurting yourself, another person or getting hurt by another person, I will hold that information confidential. … If there’s a direct health risk that could involve their life, then I will share that.”
Then comes recognizing that the early teen years are when kids move from concrete thinking to more abstract thought — they begin to connect the dots, Biro explains. They may assume the doctor connected the dots the same way, meaning a girl who complains of stomach pain may not volunteer that she’s fears pregnancy.
“It’s not that they’re withholding information. They figure they’ve just told you everything you need to know because the rest of it you should be able to figure out,” Biro says. “I prove to them I am indeed about as smart as mud and I have to ask them more probing questions.”
___
EDITOR’s NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
___
On the Net:
Society for Adolescent Medicine: http://www.adolescenthealth.org
Adolescent medicine report: http://www.iom.edu
Copyright 2009 The Associated Press.
Man being prosecuted in NM under federal fetus law
Date: 12/30/2008
ALBUQUERQUE, N.M. (AP) — Federal prosecutors in New Mexico believe they may be the first to use a 2004 law to charge someone with killing a fetus while causing the death or injury of the mother.
Charges against Frederick Beach, accused of beating his pregnant girlfriend to death, include one under the Unborn Victims of Violence Act. U.S. Attorney Greg Fouratt said his office’s research found “no other case in the country in which that section (of law) has been charged,” the Albuquerque Journal reported Tuesday.
Attorneys for Beach, 37, said they expect to pursue any available legal challenges.
“We may be breaking ground on a new area of law,” said defense attorney Amy Sirignano. “We’re not sure where that will lead us.”
Beach pleaded not guilty last week to killing a fetus and to first-degree murder and child abuse charges.
He is accused of beating to death Verlinda Kinsel, 29, in September and killing the fetus she had said was his. Authorities say the victim’s 9-year-old son witnessed the assault.
If convicted, Beach faces life in prison.
The case is being prosecuted in federal court because Kinsel was killed on the Navajo reservation.
The Unborn Victims of Violence Act stemmed from the abduction and murder of a pregnant woman, Laci Peterson, in California in 2003. The law makes it a crime to kill a fetus in utero at any stage of development while committing another federal crime; it does not require the perpetrator to know the woman was pregnant.
___
Information from: Albuquerque Journal, http://www.abqjournal.com
Copyright 2008 The Associated Press.
ALBUQUERQUE, N.M. (AP) — Federal prosecutors in New Mexico believe they may be the first to use a 2004 law to charge someone with killing a fetus while causing the death or injury of the mother.
Charges against Frederick Beach, accused of beating his pregnant girlfriend to death, include one under the Unborn Victims of Violence Act. U.S. Attorney Greg Fouratt said his office’s research found “no other case in the country in which that section (of law) has been charged,” the Albuquerque Journal reported Tuesday.
Attorneys for Beach, 37, said they expect to pursue any available legal challenges.
“We may be breaking ground on a new area of law,” said defense attorney Amy Sirignano. “We’re not sure where that will lead us.”
Beach pleaded not guilty last week to killing a fetus and to first-degree murder and child abuse charges.
He is accused of beating to death Verlinda Kinsel, 29, in September and killing the fetus she had said was his. Authorities say the victim’s 9-year-old son witnessed the assault.
If convicted, Beach faces life in prison.
The case is being prosecuted in federal court because Kinsel was killed on the Navajo reservation.
The Unborn Victims of Violence Act stemmed from the abduction and murder of a pregnant woman, Laci Peterson, in California in 2003. The law makes it a crime to kill a fetus in utero at any stage of development while committing another federal crime; it does not require the perpetrator to know the woman was pregnant.
___
Information from: Albuquerque Journal, http://www.abqjournal.com
Copyright 2008 The Associated Press.
Nursing home industry worries about new ratings
Date: 12/18/2008 6:42 AM
By KEVIN FREKING
Associated Press Writer
WASHINGTON (AP) — Rating systems help people decide which restaurants to go to or hotels to stay at. So why not something similar from the federal government for the nation’s 16,000 nursing homes?
Such a simple rating for so complex a task as caring for the elderly is leading to much anxiety in the nursing home industry. Home operators worry about the ramifications for their business if they get one or two stars — when five is the best.
The Centers for Medicare and Medicaid Services was to let everyone know Thursday just how many stars each home is getting. Already the industry is questioning the validity of the rankings. To operators, the five-star system is a great idea whose time has not yet come.
The system “is poorly planned, prematurely implemented and hamhandedly rolled out,” said Larry Minnix, president and chief executive officer of the American Association of Homes and Services for the Aging, an industry trade group.
Federal officials say the rankings will put nursing homes “on the path to improvement” because they know family members will think twice before putting someone in a one-star home.
The ratings are based on state inspections, staffing levels and quality measures, such as the percentage of residents with pressure sores. The nursing homes will receive stars for each of those categories as well as for their overall quality.
Consumer groups like the concept, but they agreed there are some potential problems with the data. For example, the staffing data is self-reported just before state surveys and is widely recognized as unreliable.
“From a consumer viewpoint, it’s not stringent enough,” said Alice H. Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform. “It’s basically taking information already available on Medicare’s Nursing Home Compare Web site and pulling it into an easier system for consumers to use, and that is a good thing.”
Hedt said consumers should consider the star ratings, but not solely rely on them when comparing facilities. Her organization also issued a press release warning that nursing homes may appear in the ratings to give better care than they actually do.
“Our initial reaction is that consumers should probably avoid any facility with a one- or two-star rating and even a three-star rating unless people they trust convince them that the rating is inaccurate or unfair,” she said.
But, in Indiana, eight nonprofit nursing homes have reported they got one star for staffing even though they have some of the highest staffing levels in the states, said Jim Leich, president and chief executive officer of the Indiana Association of Homes for the Aging. He believes the one-star rating is the result of a records glitch particular to any nursing home that is part of a campus that includes housing for residents with less intensive care needs.
“It’s really going to be an injustice for some of our best facilities,” he said.
The Jennings Center for Older Adults in Garfield Heights, Ohio, got four stars for its nursing home, said Martha Kutik, the center’s president and CEO. Still, she’s worried that the rating system relies on surveys that measure cracks in the ceiling but don’t measure patient and family satisfaction.
“Any system that’s going to measure quality for consumers should keep satisfaction high on the list,” Kutik said.
___
On the Net:
Medicare’s Nursing Home Compare Web site: http://Medicare.gov/NHcompare
Copyright 2008 The Associated Press.
By KEVIN FREKING
Associated Press Writer
WASHINGTON (AP) — Rating systems help people decide which restaurants to go to or hotels to stay at. So why not something similar from the federal government for the nation’s 16,000 nursing homes?
Such a simple rating for so complex a task as caring for the elderly is leading to much anxiety in the nursing home industry. Home operators worry about the ramifications for their business if they get one or two stars — when five is the best.
The Centers for Medicare and Medicaid Services was to let everyone know Thursday just how many stars each home is getting. Already the industry is questioning the validity of the rankings. To operators, the five-star system is a great idea whose time has not yet come.
The system “is poorly planned, prematurely implemented and hamhandedly rolled out,” said Larry Minnix, president and chief executive officer of the American Association of Homes and Services for the Aging, an industry trade group.
Federal officials say the rankings will put nursing homes “on the path to improvement” because they know family members will think twice before putting someone in a one-star home.
The ratings are based on state inspections, staffing levels and quality measures, such as the percentage of residents with pressure sores. The nursing homes will receive stars for each of those categories as well as for their overall quality.
Consumer groups like the concept, but they agreed there are some potential problems with the data. For example, the staffing data is self-reported just before state surveys and is widely recognized as unreliable.
“From a consumer viewpoint, it’s not stringent enough,” said Alice H. Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform. “It’s basically taking information already available on Medicare’s Nursing Home Compare Web site and pulling it into an easier system for consumers to use, and that is a good thing.”
Hedt said consumers should consider the star ratings, but not solely rely on them when comparing facilities. Her organization also issued a press release warning that nursing homes may appear in the ratings to give better care than they actually do.
“Our initial reaction is that consumers should probably avoid any facility with a one- or two-star rating and even a three-star rating unless people they trust convince them that the rating is inaccurate or unfair,” she said.
But, in Indiana, eight nonprofit nursing homes have reported they got one star for staffing even though they have some of the highest staffing levels in the states, said Jim Leich, president and chief executive officer of the Indiana Association of Homes for the Aging. He believes the one-star rating is the result of a records glitch particular to any nursing home that is part of a campus that includes housing for residents with less intensive care needs.
“It’s really going to be an injustice for some of our best facilities,” he said.
The Jennings Center for Older Adults in Garfield Heights, Ohio, got four stars for its nursing home, said Martha Kutik, the center’s president and CEO. Still, she’s worried that the rating system relies on surveys that measure cracks in the ceiling but don’t measure patient and family satisfaction.
“Any system that’s going to measure quality for consumers should keep satisfaction high on the list,” Kutik said.
___
On the Net:
Medicare’s Nursing Home Compare Web site: http://Medicare.gov/NHcompare
Copyright 2008 The Associated Press.
Medicare Rewarding Doctors for Paperless Prescriptions
The question we all must ask as we contemplate the below story on paperless prescriptions: do we trust doctors’ computers more than we trust electronic voting machines? One of the most treacherous areas for medical mistakes are prescription foul-ups. Will this eliminate or create more problems? Do we trust our health to our health to the efficiency experts who thunk this one up? Why do I get the sense that it may take the trial lawyers to bring sanity back to this process?
Attorney Gordon Johnson
http://subtlebraininjury.com
http://thelegaltimes.net
http://tbilaw.com
http://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
©Attorney Gordon S. Johnson, Jr. 2008
Date: 12/15/2008 9:41 PM
BC-MED–HealthBeat-Paperless Prescriptions,2nd Ld-Writethru/855
Pushing more doctors to ditch the prescription pad
WASHINGTON (AP) — The push for paperless prescriptions is about to get a boost: Starting in January, doctors who e-prescribe can get bonus pay from Medicare.
For patients, the benefits are obvious — from shorter drugstore waits to increased safety, as pharmacists no longer squint to decipher doctors’ messy handwriting.
But persuading U.S. doctors to ditch their prescription pads for electronic prescribing so far has been a long, uphill battle. Only about 10 percent of doctors are taking the plunge like Dr. Ted Epperly in Boise, Idaho, who’s adopting the technology now.
Still, the movement is gaining steam as Medicare warns that its bonus payments are for a short time only: Holdouts still sticking to paper in 2012 will find their Medicare payments cut.
And continuing the push for medical information technology is a key part of President-elect Barack Obama’s health-reform plans, in hopes that moving to computerized records — not just prescriptions, but all those troublesome paper charts that contribute to medical errors and wasted care — ultimately could save millions of dollars a year.
“We’d never go back,” says Epperly, also president of the American Academy of Family Physicians. Patients “recognize that, ‘Hey, Dr. Epperly’s in the information age, and my safety is better and the quality of care is better.'”
What’s a paperless prescription? When the doctor writes it by computer and sends it directly to the drugstore by computer, no little piece of paper to get lost or stolen anywhere along that trail.
Some doctors do write prescriptions via computer but then hand the patient a printout, or it arrives at the drugstore as a fax. Those don’t count as true electronic prescribing.
In December 2007, 35,000 doctors were writing at least some paperless prescriptions, according to SureScripts-RxHub, which operates drugstores’ e-prescription network.
The 2008 count isn’t finished yet, but SureScripts estimates that number has doubled to more than 70,000. Moreover, the volume of prescriptions filled electronically grew about 15 percent a month since August, faster than the 5 percent to 8 percent monthly increase seen earlier in the year — presumably as doctors geared up for the Medicare incentive.
The biggest reason for the paperless push is to improve safety. More than 1.5 million Americans are injured every year by medication mistakes. Deciphering doctors’ chicken-scratch — was that 100 milligrams or 100 micrograms? — does play a role. But perhaps more important, electronic prescribing systems can flash an alert if the dose seems wrong or patient records show use of another drug that can dangerously interact.
By avoiding unnecessary medication injuries, Health and Human Services Secretary Michael Leavitt has estimated that widespread e-prescribing could save as much as $156 million over five years.
It can save patients cash, too. Most insurance plans divide their formularies into tiers with escalating co-pays, and e-prescribing can let doctors debating which drug to recommend take patient cost into account. A study published last week found that Massachusetts doctors increased use of the cheapest drugs by 6.6 percent during their first year of e-prescribing.
Patients appreciate that price discussion, says Dr. Joe Heyman, chairman of the American Medical Association’s trustees and a longtime e-prescriber. An obstetrician/gynecologist, he regularly discusses big contraceptive price differences.
While some patients may need Brand X instead of Generic Y, “in general any of the birth-control pills will do the job,” Heyman says. “If when you e-prescribe, it tells you this is a Tier 3 drug and will cost the patient $50 instead of $10, somehow that can be more persuasive” than the ad the woman saw for a pricier version.
So why haven’t more doctors joined?
There’s definitely some upfront pain, as the office staff enters patient information into electronic prescription programs that can cost $3,000 per doctor. The Medicare incentive — an extra 2 percent in reimbursement rates in 2009 and 2010, and smaller bonuses the next three years — could offset the investment by earning the doctor an extra $1,000 to $1,500 a year, Epperly estimates.
A bigger barrier: Narcotic painkillers and other controlled substances that account for 20 percent of all prescriptions are banned from electronic prescribing. The Drug Enforcement Administration is working on rules to allow that switch.
Then there’s the drugstore link. While almost all pharmacy chains are part of a national e-prescription network, smaller ones may not be — only 27 percent of independent pharmacies were in 2007 — and doctors also must use software recognized by the network. In Boise, Epperly says more drugstores still receive his e-prescriptions as a fax than as fully paperless, his biggest frustration.
“Change itself was a bit of a barrier,” he says.
___
On the Net:
Searchable list of e-prescribers: http://www.learnaboutEprescriptions.com
Copyright 2008 The Associated Press.
Attorney Gordon Johnson
http://subtlebraininjury.com
http://thelegaltimes.net
http://tbilaw.com
http://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
©Attorney Gordon S. Johnson, Jr. 2008
Date: 12/15/2008 9:41 PM
BC-MED–HealthBeat-Paperless Prescriptions,2nd Ld-Writethru/855
Pushing more doctors to ditch the prescription pad
WASHINGTON (AP) — The push for paperless prescriptions is about to get a boost: Starting in January, doctors who e-prescribe can get bonus pay from Medicare.
For patients, the benefits are obvious — from shorter drugstore waits to increased safety, as pharmacists no longer squint to decipher doctors’ messy handwriting.
But persuading U.S. doctors to ditch their prescription pads for electronic prescribing so far has been a long, uphill battle. Only about 10 percent of doctors are taking the plunge like Dr. Ted Epperly in Boise, Idaho, who’s adopting the technology now.
Still, the movement is gaining steam as Medicare warns that its bonus payments are for a short time only: Holdouts still sticking to paper in 2012 will find their Medicare payments cut.
And continuing the push for medical information technology is a key part of President-elect Barack Obama’s health-reform plans, in hopes that moving to computerized records — not just prescriptions, but all those troublesome paper charts that contribute to medical errors and wasted care — ultimately could save millions of dollars a year.
“We’d never go back,” says Epperly, also president of the American Academy of Family Physicians. Patients “recognize that, ‘Hey, Dr. Epperly’s in the information age, and my safety is better and the quality of care is better.'”
What’s a paperless prescription? When the doctor writes it by computer and sends it directly to the drugstore by computer, no little piece of paper to get lost or stolen anywhere along that trail.
Some doctors do write prescriptions via computer but then hand the patient a printout, or it arrives at the drugstore as a fax. Those don’t count as true electronic prescribing.
In December 2007, 35,000 doctors were writing at least some paperless prescriptions, according to SureScripts-RxHub, which operates drugstores’ e-prescription network.
The 2008 count isn’t finished yet, but SureScripts estimates that number has doubled to more than 70,000. Moreover, the volume of prescriptions filled electronically grew about 15 percent a month since August, faster than the 5 percent to 8 percent monthly increase seen earlier in the year — presumably as doctors geared up for the Medicare incentive.
The biggest reason for the paperless push is to improve safety. More than 1.5 million Americans are injured every year by medication mistakes. Deciphering doctors’ chicken-scratch — was that 100 milligrams or 100 micrograms? — does play a role. But perhaps more important, electronic prescribing systems can flash an alert if the dose seems wrong or patient records show use of another drug that can dangerously interact.
By avoiding unnecessary medication injuries, Health and Human Services Secretary Michael Leavitt has estimated that widespread e-prescribing could save as much as $156 million over five years.
It can save patients cash, too. Most insurance plans divide their formularies into tiers with escalating co-pays, and e-prescribing can let doctors debating which drug to recommend take patient cost into account. A study published last week found that Massachusetts doctors increased use of the cheapest drugs by 6.6 percent during their first year of e-prescribing.
Patients appreciate that price discussion, says Dr. Joe Heyman, chairman of the American Medical Association’s trustees and a longtime e-prescriber. An obstetrician/gynecologist, he regularly discusses big contraceptive price differences.
While some patients may need Brand X instead of Generic Y, “in general any of the birth-control pills will do the job,” Heyman says. “If when you e-prescribe, it tells you this is a Tier 3 drug and will cost the patient $50 instead of $10, somehow that can be more persuasive” than the ad the woman saw for a pricier version.
So why haven’t more doctors joined?
There’s definitely some upfront pain, as the office staff enters patient information into electronic prescription programs that can cost $3,000 per doctor. The Medicare incentive — an extra 2 percent in reimbursement rates in 2009 and 2010, and smaller bonuses the next three years — could offset the investment by earning the doctor an extra $1,000 to $1,500 a year, Epperly estimates.
A bigger barrier: Narcotic painkillers and other controlled substances that account for 20 percent of all prescriptions are banned from electronic prescribing. The Drug Enforcement Administration is working on rules to allow that switch.
Then there’s the drugstore link. While almost all pharmacy chains are part of a national e-prescription network, smaller ones may not be — only 27 percent of independent pharmacies were in 2007 — and doctors also must use software recognized by the network. In Boise, Epperly says more drugstores still receive his e-prescriptions as a fax than as fully paperless, his biggest frustration.
“Change itself was a bit of a barrier,” he says.
___
On the Net:
Searchable list of e-prescribers: http://www.learnaboutEprescriptions.com
Copyright 2008 The Associated Press.
China says 300,000 babies sickened by tainted milk
Date: 12/2/2008
By GILLIAN WONG
Associated Press Writer
BEIJING (AP) _ China has dramatically raised the toll from its tainted milk powder scandal, saying six babies likely died and 300,000 were sickened, figures that back up months of complaints from parents and show the government is beginning to acknowledge the scale of the crisis.
The scandal has been met with public dismay and anger, particularly among parents who feel the government breached their trust after their children were sickened or died from drinking infant formula authorities had certified as safe.
The Health Ministry’s revised death toll is twice the previous figure, while the new count of 294,000 babies who suffered urinary problems from drinking contaminated infant formula is a six-fold increase from the last tally in September.
“Most of the sickened children received outpatient treatment for only small amounts of sand-like kidney stones found in their urinary systems, while some patients had to be hospitalized for the illness,” the ministry said in a statement late Monday.
The latest statistics show that China’s communist leaders are slowly acknowledging the scale of China’s worst food safety scare in years. During such crises, the government often deliberately releases information piecemeal in part to keep from feeding public anger.
Thousands of parents have been clamoring for compensation for their sickened and dead children. The release of the figures raises the question of whether the Health Ministry is getting closer to finalizing a compensation scheme.
“The new figures are more realistic and objective than previous figures. We knew the previous ones could not have been accurate,” said Chang Boyang, a Beijing lawyer who has provided legal assistance to families of children who became ill.
Four of the six deaths were recorded in the provinces of Jiangxi, Zhejiang, Guizhou and Shaanxi, and the other two were in Gansu province in the northwest, the ministry said.
The ministry said it investigated 11 possible deaths related to melamine-tainted milk and ruled five of them out. Melamine poisoning could not be ruled out in the remaining six cases, it said but gave no further details or explanation. It also did not make clear whether three earlier reported deaths were included in the new total.
The ministry said it checked into babies who died before Sept. 10, and that between then and last Thursday, no new deaths were reported.
The ministry declined phone interviews Tuesday and did not respond to faxed questions from The Associated Press.
There are other families who say their children died from drinking milk powder made by Shijiazhuang Sanlu Group Co., the dairy at the center of the crisis, but their cases were apparently still not classified as caused by tainted formula.
Without the official verdict, families fear they will be refused compensation promised by the government through the Health Ministry, which has also said it would provide free medical treatment for children sickened by tainted milk. Some parents expressed pessimism about receiving compensation promised by the government.
“I’ve talked with a lawyer and at first we wanted lots of compensation, but later we agreed to settle for a much smaller amount, although I wasn’t happy. But now even that seems impossible as nobody has ever talked to us about it,” said apple farmer Tian Xiaowei of Shaanxi province, whose year-old boy died in August.
“The economy in this country is bad now, I don’t think the Communist Party will take care of our problem,” Tian said.
The health bureau of Ru’nan county where he is from first ruled his son died from tainted milk powder, but a higher authority said there was no proof his death was linked to infant formula, Tian said.
The attorney Chang said there was still no word of compensation, and the group of volunteer lawyers he belongs to was considering starting a fund to help the victims’ families, with contributions from all sectors and the public.
“I assume that the government is worried about the situation of the dairies and is afraid the companies may fall if they have to pay for the compensation amid the current financial crisis,” Chang said. “The government may be worrying about the interests of the companies first.”
The scandal was first reported in September, but the government has said that Sanlu, the dairy, knew as early as last year that its products were tainted with melamine and that company and local officials first tried to cover it up.
Like a number of major dairies, Sanlu was said to have excellent quality controls that allowed it to enjoy a government-granted inspection-exempt status.
The scandal highlighted the widespread practice of adding melamine — often used in manufacturing plastics — to watered-down milk to fool protein tests. Melamine is rich in nitrogen, which registers as protein on many routine tests. Though melamine is not believed harmful in tiny amounts, higher concentrations produce kidney stones, which can block the ducts that carry urine from the body, and in serious cases can cause kidney failure.
The crisis prompted authorities to announce a complete overhaul of the country’s dairy industry to improve safety. The scare badly hit dairy exports, which fell 92 percent in October from the previous year as snags in the supply chain forced a loss in orders, and importers became wary of Chinese food products, the official China Daily newspaper reported.
___
Associated Press researchers Chi-Chi Zhang, Xi Yue and Yu Bing contributed to this report.
Copyright 2008 The Associated Press.
By GILLIAN WONG
Associated Press Writer
BEIJING (AP) _ China has dramatically raised the toll from its tainted milk powder scandal, saying six babies likely died and 300,000 were sickened, figures that back up months of complaints from parents and show the government is beginning to acknowledge the scale of the crisis.
The scandal has been met with public dismay and anger, particularly among parents who feel the government breached their trust after their children were sickened or died from drinking infant formula authorities had certified as safe.
The Health Ministry’s revised death toll is twice the previous figure, while the new count of 294,000 babies who suffered urinary problems from drinking contaminated infant formula is a six-fold increase from the last tally in September.
“Most of the sickened children received outpatient treatment for only small amounts of sand-like kidney stones found in their urinary systems, while some patients had to be hospitalized for the illness,” the ministry said in a statement late Monday.
The latest statistics show that China’s communist leaders are slowly acknowledging the scale of China’s worst food safety scare in years. During such crises, the government often deliberately releases information piecemeal in part to keep from feeding public anger.
Thousands of parents have been clamoring for compensation for their sickened and dead children. The release of the figures raises the question of whether the Health Ministry is getting closer to finalizing a compensation scheme.
“The new figures are more realistic and objective than previous figures. We knew the previous ones could not have been accurate,” said Chang Boyang, a Beijing lawyer who has provided legal assistance to families of children who became ill.
Four of the six deaths were recorded in the provinces of Jiangxi, Zhejiang, Guizhou and Shaanxi, and the other two were in Gansu province in the northwest, the ministry said.
The ministry said it investigated 11 possible deaths related to melamine-tainted milk and ruled five of them out. Melamine poisoning could not be ruled out in the remaining six cases, it said but gave no further details or explanation. It also did not make clear whether three earlier reported deaths were included in the new total.
The ministry said it checked into babies who died before Sept. 10, and that between then and last Thursday, no new deaths were reported.
The ministry declined phone interviews Tuesday and did not respond to faxed questions from The Associated Press.
There are other families who say their children died from drinking milk powder made by Shijiazhuang Sanlu Group Co., the dairy at the center of the crisis, but their cases were apparently still not classified as caused by tainted formula.
Without the official verdict, families fear they will be refused compensation promised by the government through the Health Ministry, which has also said it would provide free medical treatment for children sickened by tainted milk. Some parents expressed pessimism about receiving compensation promised by the government.
“I’ve talked with a lawyer and at first we wanted lots of compensation, but later we agreed to settle for a much smaller amount, although I wasn’t happy. But now even that seems impossible as nobody has ever talked to us about it,” said apple farmer Tian Xiaowei of Shaanxi province, whose year-old boy died in August.
“The economy in this country is bad now, I don’t think the Communist Party will take care of our problem,” Tian said.
The health bureau of Ru’nan county where he is from first ruled his son died from tainted milk powder, but a higher authority said there was no proof his death was linked to infant formula, Tian said.
The attorney Chang said there was still no word of compensation, and the group of volunteer lawyers he belongs to was considering starting a fund to help the victims’ families, with contributions from all sectors and the public.
“I assume that the government is worried about the situation of the dairies and is afraid the companies may fall if they have to pay for the compensation amid the current financial crisis,” Chang said. “The government may be worrying about the interests of the companies first.”
The scandal was first reported in September, but the government has said that Sanlu, the dairy, knew as early as last year that its products were tainted with melamine and that company and local officials first tried to cover it up.
Like a number of major dairies, Sanlu was said to have excellent quality controls that allowed it to enjoy a government-granted inspection-exempt status.
The scandal highlighted the widespread practice of adding melamine — often used in manufacturing plastics — to watered-down milk to fool protein tests. Melamine is rich in nitrogen, which registers as protein on many routine tests. Though melamine is not believed harmful in tiny amounts, higher concentrations produce kidney stones, which can block the ducts that carry urine from the body, and in serious cases can cause kidney failure.
The crisis prompted authorities to announce a complete overhaul of the country’s dairy industry to improve safety. The scare badly hit dairy exports, which fell 92 percent in October from the previous year as snags in the supply chain forced a loss in orders, and importers became wary of Chinese food products, the official China Daily newspaper reported.
___
Associated Press researchers Chi-Chi Zhang, Xi Yue and Yu Bing contributed to this report.
Copyright 2008 The Associated Press.
Study: Many kids in Katrina trailer park anemic
Date: 11/25/2008
By JANET McCONNAUGHEY
Associated Press Writer
NEW ORLEANS (AP) _ Dozens of infants and toddlers who lived in Louisiana’s biggest trailer park for those displaced by Hurricane Katrina were anemic because of poor diets, at a rate more than four times the national average.
About 41 percent of 77 children under the age of 4 suffered from the condition this year, according to a study released Monday by the Children’s Health Fund. Most, and possibly all, lived in the Renaissance Village trailer park in Baker.
Iron deficiency anemia can cause fatigue and learning problems. Severe deficiency in young children can delay growth and development and even cause heart murmurs.
The national rate for children that young is below 10 percent. Louisiana has one of the nation’s highest anemia rates, with about 24 percent of all children below the age of 5 affected, according to the 2007 Pediatric Nutrition Surveillance survey.
Dr. Irwin Redlener, president of the Children’s Health Fund and director of Columbia University’s National Center for Disaster Preparedness, said the Renaissance Village rate was double the rate for homeless children the same age in New York City shelters.
The study used records for all 261 babies and children who lived in New Orleans until Katrina and were treated last year at CHF’s mobile clinics at the trailer park and Baton Rouge schools, said Roy Grant, the organization’s director of applied research and policy analysis.
While most of the affected children were storm evacuees, it was possible that a few were natives of Baton Rouge.
But studying the problem further and providing follow-up care for the children is difficult because the state closed the parks in May.
“Now it’s more difficult, because they’re no longer in the trailer area. They’re dispersed around the state. So it’s a little harder to get follow-up,” said Dr. Jimmy Guidry, Louisiana’s health officer.
___
On the Net:
http://www.cdc.gov/nccdphp/dnpa/nutrition/nutrition_for_everyone iro n_defici ency/index.htm
Copyright 2008 The Associated Press.
By JANET McCONNAUGHEY
Associated Press Writer
NEW ORLEANS (AP) _ Dozens of infants and toddlers who lived in Louisiana’s biggest trailer park for those displaced by Hurricane Katrina were anemic because of poor diets, at a rate more than four times the national average.
About 41 percent of 77 children under the age of 4 suffered from the condition this year, according to a study released Monday by the Children’s Health Fund. Most, and possibly all, lived in the Renaissance Village trailer park in Baker.
Iron deficiency anemia can cause fatigue and learning problems. Severe deficiency in young children can delay growth and development and even cause heart murmurs.
The national rate for children that young is below 10 percent. Louisiana has one of the nation’s highest anemia rates, with about 24 percent of all children below the age of 5 affected, according to the 2007 Pediatric Nutrition Surveillance survey.
Dr. Irwin Redlener, president of the Children’s Health Fund and director of Columbia University’s National Center for Disaster Preparedness, said the Renaissance Village rate was double the rate for homeless children the same age in New York City shelters.
The study used records for all 261 babies and children who lived in New Orleans until Katrina and were treated last year at CHF’s mobile clinics at the trailer park and Baton Rouge schools, said Roy Grant, the organization’s director of applied research and policy analysis.
While most of the affected children were storm evacuees, it was possible that a few were natives of Baton Rouge.
But studying the problem further and providing follow-up care for the children is difficult because the state closed the parks in May.
“Now it’s more difficult, because they’re no longer in the trailer area. They’re dispersed around the state. So it’s a little harder to get follow-up,” said Dr. Jimmy Guidry, Louisiana’s health officer.
___
On the Net:
http://www.cdc.gov/nccdphp/dnpa/nutrition/nutrition_for_everyone iro n_defici ency/index.htm
Copyright 2008 The Associated Press.
Child deaths test faith-healing exemption
Date: 11/21/2008
By WILLIAM McCALL
Associated Press Writer
OREGON CITY, Ore. (AP) _ When Dr. Seth Asser saw row after row of flat headstones marking children’s graves in a small cemetery not far from the end of the historic Oregon Trail, he knew many of these early deaths should not have happened.
The children’s parents relied on faith healing, instead of doctors.
The pediatrician published a landmark study concluding many of the deaths could have been prevented if the children had received medical care.
“What struck me was the fact that it was obvious from the expressions on the headstones that the children were loved,” Asser said. “So it was especially troublesome they were not afforded the care that most parents would give their children.”
His study 10 years ago brought attention to the issue, and yet today three criminal cases — two in Oregon and one in Wisconsin — have revived concerns about exemptions that most states grant to parents who rely on faith healing instead of doctors to treat sick children.
Faith healing has deep roots in American history, and yet it may seem surprising that in the 21st century, children still die because parents choose not to seek medical help from physicians.
State laws across the nation exempt members of religious groups from prosecution if they choose faith healing over science. Asser and a colleague, Rita Swan, have been trying to get states to repeal such laws, arguing that safety should always come first, no matter what the parents believe.
“We can’t legislate good parenting, but at least we shouldn’t have laws allowing bad parenting,” said Swan, who now heads the advocacy group Children’s Healthcare.
But Swan and Asser have been lonely voices, partly because tragedies are rare and partly because legislators are loath to challenge parental rights, especially when they are intertwined with the constitutional right to freedom of religion.
“There hasn’t been a groundswell of organized advocacy to get the laws changed,” said Shawn Francis Peters, a University of Wisconsin professor and author of a book on faith healing. “I do think there’s broad public sentiment to do it, but that doesn’t get things through the meat grinder of legislation.”
According to the U.S. Department of Health and Human Services, at least 30 states have specific exemption laws on the books.
What does federal law say? According to HHS, nothing in the amendments to the original 1974 Child Abuse Prevention and Treatment Act, can “be construed as establishing a federal requirement that a parent or legal guardian provide any medical service or treatment that is against the religious beliefs of the parent or legal guardian.”
Five states have repealed exemption laws, Swan said: Hawaii, Maryland, Massachusetts, Nebraska and North Carolina.
Some states have revised their laws, including Oregon in 1999. After a stormy debate in the Oregon Legislature, then-Gov. John Kitzhaber — a doctor — signed a compromise bill into law that eliminated the Oregon spiritual healing exemption in some manslaughter and criminal mistreatment cases.
Many of the exemption laws were enacted in the 1970s, promoted by two top advisers to former President Nixon — Bob Haldeman and John Erlichman — and an influential senator, Charles Percy of Illinois, who practiced Christian Science.
The religion, founded by Mary Baker Eddy just after the Civil War, embraces a form of faith healing its adherents say is unique and different from the way it is practiced by some fundamentalists.
The Church of Christ, Scientist, emphasizes that it does not prevent any members from seeking medical care, and it is quick to distance itself from other religious groups that demand prayer be the only method for healing.
“One of the mistakes people make is lumping all these groups together,” said Stephen Lyons, a Boston attorney who has defended Christian Scientists.
Church leaders also deny their lobbying efforts with state lawmakers across the country have kept the laws on the books, even though Peters and a fellow author on faith healing, Boston College historian Alan Rogers, say the effort is intense and largely successful.
“It’s remarkable,” Rogers said. “Without exception, it has been the push of the Christian Science church.”
Two pending criminal cases expected to test Oregon’s revised law are against parents belonging to the Followers of Christ Church, the same religious sect that owns the cemetery visited by Asser in 2001.
Jeffrey Dean Beagley, 50, and his 46-year-old wife, Marci Rae Beagley, have pleaded not guilty to charges of criminally negligent homicide for failing to provide adequate medical care, in violation of their duties as parents.
Their 16-year-old son, Neil, died in June from complications of a urinary-tract blockage that triggered heart failure. Doctors said a simple procedure could have saved his life.
In the other Oregon case, Carl Brent Worthington and his wife, Raylene, have pleaded not guilty to charges of manslaughter and criminal mistreatment in the death of their 15-month-old daughter, Ava, who died at home from bacterial pneumonia and a blood infection, conditions the state medical examiner said were treatable.
The Beagleys and the Worthingtons have refused to talk to reporters, and their attorneys have declined to comment, along with prosecutors.
In a third case, in Wisconsin, Leilani and Dale Neumann face reckless homicide charges in the death of their 11-year-old daughter due to complications from diabetes.
Leilani Neumann has said the family believes in the Bible and that healing comes from God, but she said they do not belong to an organized religion or faith and have nothing against doctors.
The Followers of Christ figured prominently in a state legislative battle over the Oregon exemption that began in 1998 with the discovery of the children’s graves, and the death of an 11-year-old member of the sect from complications caused by diabetes.
The political battle ended with revision of the law, but not its repeal.
“I was there” — for repeal, said Oregon Senate President Peter Courtney. And, he notes, so were churches, child health care advocates, law enforcement and plenty of parents.
What stopped the Legislature from an outright repeal of the law was an effort to protect religious freedom and parental rights and at the same time protect children.
“We tried and tried and tried to figure out a way to speak to, to be sensitive to, and balance all those influences,” Courtney said. “Did we do it? I don’t know.”
“These are extremely sensitive cases nationally,” said Josh Marquis, an Oregon district attorney who has been part of the debate over how to balance those conflicting rights. “It’s where faith meets the law.”
In a 1998 study published in the medical journal Pediatrics, Asser and Swan, herself a former Christian Scientist, documented 172 faith-related child deaths in the United States between 1975 and 1995. They found that 140 of the children died from conditions for which survival rates with medical care exceeded 90 percent.
Asser notes that no government agencies systematically collect data, and reliance on faith healing is not a category listed on a death certificate.
Before federal medical privacy laws were tightened, he was able to talk to medical examiners about cases, but that has become more difficult.
Asser has tracked a handful of cases that have gotten media attention in the past decade, including deaths in Philadelphia, Massachusetts and California. But he still learns about many of the deaths only through concerned friends or family members who contact him or Swan.
And death is not the only troubling outcome when children avoid doctors because of their parents’ relig ious beliefs.
Beth Young, a professor at the University of Central Florida, says her hip dysplasia, which could have been easily corrected when she was an infant, went unnoticed and untreated by her Christian Scientist parents. Young finally went to a doctor in her 20s to find out why it was such a struggle to walk and climb stairs.
She learned her hip joints were deteriorating — but that it was too late for a surgical fix.
“It’s not going to get any better,” Young said in an interview. “I think about that every day. If my parents knew how simple the treatment was, I don’t think they would have ignored it. So I do feel cheated.”
She added: “I can remember times when I would pray and pray and pray, and I would think that maybe I’m healed now, and then I would go check, and I’d go walk in front of a mirror or something, and then I would discover, no I’m not.”
Lyons, the Boston lawyer, has drawn national attention for defending parents in faith healing cases.
He successfuly represented David and Ginger Twitchell, Christian Science parents in Boston who were acquitted of manslaughter charges in the 1986 death of their 2-year-old son from a congenital defect that caused the bowel to twist and become obstructed.
The landmark case caused enough concern to persuade Massachusetts lawmakers to abolish the religious exemption, said Jetta Bernier, executive director of Massachusetts Citizens for Children.
But even when such exemptions are abolished or revised, prosecutions can be difficult so long as parents show they are sincere in their religious beliefs, legal experts say.
“The status quo is very difficult to upset,” said Jesse Choper, the Earl Warren Professor of Public Law at the University of California, Berkeley.
Copyright 2008 The Associated Press.
By WILLIAM McCALL
Associated Press Writer
OREGON CITY, Ore. (AP) _ When Dr. Seth Asser saw row after row of flat headstones marking children’s graves in a small cemetery not far from the end of the historic Oregon Trail, he knew many of these early deaths should not have happened.
The children’s parents relied on faith healing, instead of doctors.
The pediatrician published a landmark study concluding many of the deaths could have been prevented if the children had received medical care.
“What struck me was the fact that it was obvious from the expressions on the headstones that the children were loved,” Asser said. “So it was especially troublesome they were not afforded the care that most parents would give their children.”
His study 10 years ago brought attention to the issue, and yet today three criminal cases — two in Oregon and one in Wisconsin — have revived concerns about exemptions that most states grant to parents who rely on faith healing instead of doctors to treat sick children.
Faith healing has deep roots in American history, and yet it may seem surprising that in the 21st century, children still die because parents choose not to seek medical help from physicians.
State laws across the nation exempt members of religious groups from prosecution if they choose faith healing over science. Asser and a colleague, Rita Swan, have been trying to get states to repeal such laws, arguing that safety should always come first, no matter what the parents believe.
“We can’t legislate good parenting, but at least we shouldn’t have laws allowing bad parenting,” said Swan, who now heads the advocacy group Children’s Healthcare.
But Swan and Asser have been lonely voices, partly because tragedies are rare and partly because legislators are loath to challenge parental rights, especially when they are intertwined with the constitutional right to freedom of religion.
“There hasn’t been a groundswell of organized advocacy to get the laws changed,” said Shawn Francis Peters, a University of Wisconsin professor and author of a book on faith healing. “I do think there’s broad public sentiment to do it, but that doesn’t get things through the meat grinder of legislation.”
According to the U.S. Department of Health and Human Services, at least 30 states have specific exemption laws on the books.
What does federal law say? According to HHS, nothing in the amendments to the original 1974 Child Abuse Prevention and Treatment Act, can “be construed as establishing a federal requirement that a parent or legal guardian provide any medical service or treatment that is against the religious beliefs of the parent or legal guardian.”
Five states have repealed exemption laws, Swan said: Hawaii, Maryland, Massachusetts, Nebraska and North Carolina.
Some states have revised their laws, including Oregon in 1999. After a stormy debate in the Oregon Legislature, then-Gov. John Kitzhaber — a doctor — signed a compromise bill into law that eliminated the Oregon spiritual healing exemption in some manslaughter and criminal mistreatment cases.
Many of the exemption laws were enacted in the 1970s, promoted by two top advisers to former President Nixon — Bob Haldeman and John Erlichman — and an influential senator, Charles Percy of Illinois, who practiced Christian Science.
The religion, founded by Mary Baker Eddy just after the Civil War, embraces a form of faith healing its adherents say is unique and different from the way it is practiced by some fundamentalists.
The Church of Christ, Scientist, emphasizes that it does not prevent any members from seeking medical care, and it is quick to distance itself from other religious groups that demand prayer be the only method for healing.
“One of the mistakes people make is lumping all these groups together,” said Stephen Lyons, a Boston attorney who has defended Christian Scientists.
Church leaders also deny their lobbying efforts with state lawmakers across the country have kept the laws on the books, even though Peters and a fellow author on faith healing, Boston College historian Alan Rogers, say the effort is intense and largely successful.
“It’s remarkable,” Rogers said. “Without exception, it has been the push of the Christian Science church.”
Two pending criminal cases expected to test Oregon’s revised law are against parents belonging to the Followers of Christ Church, the same religious sect that owns the cemetery visited by Asser in 2001.
Jeffrey Dean Beagley, 50, and his 46-year-old wife, Marci Rae Beagley, have pleaded not guilty to charges of criminally negligent homicide for failing to provide adequate medical care, in violation of their duties as parents.
Their 16-year-old son, Neil, died in June from complications of a urinary-tract blockage that triggered heart failure. Doctors said a simple procedure could have saved his life.
In the other Oregon case, Carl Brent Worthington and his wife, Raylene, have pleaded not guilty to charges of manslaughter and criminal mistreatment in the death of their 15-month-old daughter, Ava, who died at home from bacterial pneumonia and a blood infection, conditions the state medical examiner said were treatable.
The Beagleys and the Worthingtons have refused to talk to reporters, and their attorneys have declined to comment, along with prosecutors.
In a third case, in Wisconsin, Leilani and Dale Neumann face reckless homicide charges in the death of their 11-year-old daughter due to complications from diabetes.
Leilani Neumann has said the family believes in the Bible and that healing comes from God, but she said they do not belong to an organized religion or faith and have nothing against doctors.
The Followers of Christ figured prominently in a state legislative battle over the Oregon exemption that began in 1998 with the discovery of the children’s graves, and the death of an 11-year-old member of the sect from complications caused by diabetes.
The political battle ended with revision of the law, but not its repeal.
“I was there” — for repeal, said Oregon Senate President Peter Courtney. And, he notes, so were churches, child health care advocates, law enforcement and plenty of parents.
What stopped the Legislature from an outright repeal of the law was an effort to protect religious freedom and parental rights and at the same time protect children.
“We tried and tried and tried to figure out a way to speak to, to be sensitive to, and balance all those influences,” Courtney said. “Did we do it? I don’t know.”
“These are extremely sensitive cases nationally,” said Josh Marquis, an Oregon district attorney who has been part of the debate over how to balance those conflicting rights. “It’s where faith meets the law.”
In a 1998 study published in the medical journal Pediatrics, Asser and Swan, herself a former Christian Scientist, documented 172 faith-related child deaths in the United States between 1975 and 1995. They found that 140 of the children died from conditions for which survival rates with medical care exceeded 90 percent.
Asser notes that no government agencies systematically collect data, and reliance on faith healing is not a category listed on a death certificate.
Before federal medical privacy laws were tightened, he was able to talk to medical examiners about cases, but that has become more difficult.
Asser has tracked a handful of cases that have gotten media attention in the past decade, including deaths in Philadelphia, Massachusetts and California. But he still learns about many of the deaths only through concerned friends or family members who contact him or Swan.
And death is not the only troubling outcome when children avoid doctors because of their parents’ relig ious beliefs.
Beth Young, a professor at the University of Central Florida, says her hip dysplasia, which could have been easily corrected when she was an infant, went unnoticed and untreated by her Christian Scientist parents. Young finally went to a doctor in her 20s to find out why it was such a struggle to walk and climb stairs.
She learned her hip joints were deteriorating — but that it was too late for a surgical fix.
“It’s not going to get any better,” Young said in an interview. “I think about that every day. If my parents knew how simple the treatment was, I don’t think they would have ignored it. So I do feel cheated.”
She added: “I can remember times when I would pray and pray and pray, and I would think that maybe I’m healed now, and then I would go check, and I’d go walk in front of a mirror or something, and then I would discover, no I’m not.”
Lyons, the Boston lawyer, has drawn national attention for defending parents in faith healing cases.
He successfuly represented David and Ginger Twitchell, Christian Science parents in Boston who were acquitted of manslaughter charges in the 1986 death of their 2-year-old son from a congenital defect that caused the bowel to twist and become obstructed.
The landmark case caused enough concern to persuade Massachusetts lawmakers to abolish the religious exemption, said Jetta Bernier, executive director of Massachusetts Citizens for Children.
But even when such exemptions are abolished or revised, prosecutions can be difficult so long as parents show they are sincere in their religious beliefs, legal experts say.
“The status quo is very difficult to upset,” said Jesse Choper, the Earl Warren Professor of Public Law at the University of California, Berkeley.
Copyright 2008 The Associated Press.
No infant euthanasia reported in Netherlands
Date: 11/14/2008
AMSTERDAM, Netherlands (AP) _ No cases of infant euthanasia were reported in the Netherlands in the first year after laws on mercy killings were expanded to cover newborns, Dutch officials said Friday.
The Netherlands legalized euthanasia for adults in 2001 in cases where the patients are suffering unbearable pain due to illness with no hope of recovery, and ask to die. Several doctors must agree before a lethal cocktail of sedatives and painkillers is administered.
In 2006, that policy was expanded to include newborns with extreme birth defects, who can be killed at the request of their parents.
The commission set up to vet whether guidelines are followed in such cases said doctors did not report any incidences in 2007, the commission’s first year of operation.
Studies in the 1990s found that 15-20 such babies were probably euthanized illegally each year in the Netherlands, a country of 16 million people. Doctors were hardly ever prosecuted because authorities were reluctant to press charges in a country where euthanasia has been widely accepted as ethical.
The panel of medical and ethical experts wrote in a report sent to Parliament that one explanation for the absence of reported infant euthanasia cases may be that fetuses with dire defects are being detected via ultrasound examinations and aborted before the 24th week of pregnancy.
The commission said members plan to visit all neonatal intensive care units in the country this year to encourage more reporting of euthanasia.
Copyright 2008 The Associated Press.
AMSTERDAM, Netherlands (AP) _ No cases of infant euthanasia were reported in the Netherlands in the first year after laws on mercy killings were expanded to cover newborns, Dutch officials said Friday.
The Netherlands legalized euthanasia for adults in 2001 in cases where the patients are suffering unbearable pain due to illness with no hope of recovery, and ask to die. Several doctors must agree before a lethal cocktail of sedatives and painkillers is administered.
In 2006, that policy was expanded to include newborns with extreme birth defects, who can be killed at the request of their parents.
The commission set up to vet whether guidelines are followed in such cases said doctors did not report any incidences in 2007, the commission’s first year of operation.
Studies in the 1990s found that 15-20 such babies were probably euthanized illegally each year in the Netherlands, a country of 16 million people. Doctors were hardly ever prosecuted because authorities were reluctant to press charges in a country where euthanasia has been widely accepted as ethical.
The panel of medical and ethical experts wrote in a report sent to Parliament that one explanation for the absence of reported infant euthanasia cases may be that fetuses with dire defects are being detected via ultrasound examinations and aborted before the 24th week of pregnancy.
The commission said members plan to visit all neonatal intensive care units in the country this year to encourage more reporting of euthanasia.
Copyright 2008 The Associated Press.
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