William M. Briggs

Statistician to the Stars!

Stream: Bioethicists Want To Purge Christian Doctors

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Bioethicists Want To Purge Christian Doctors.

Two academic bioethicists want to bar Christians and those who hold other traditional religious beliefs from practicing medicine, and even from attending medical school. The pair fear, as the National Post summarizes, doctors might “impose their values on patients.”

Of course, it is impossible — not unlikely: impossible — for doctors not to impose their values on patients. Even using a tongue depressor on a patient presupposes certain moral values. (Presumably the doctor is doing this to aid in his goal of healing the patient, a moral value.) Since morality infuses all actions, the only real question is this: what moral values should doctors hold?

Julian Savulescu and Udo Schuklenk (I will refer to them as “the SS” hereafter), in their paper “Doctors Have No Right to Refuse Medical Assistance in Dying, Abortion or Contraception” in the journal Bioethics, argue that conscientious objectors not be allowed to train for or to practice medicine. “The problem with conscientious objection,” they write, “is that it has been freely accommodated, if not encouraged, for far too long.”

In their definition, conscientious objectors are those medical professionals who refuse to kill or to disperse contraception for traditional religious reasons. Throughout their paper the SS assume, but never argue, it is a moral good that doctors kill patients when patients demand to be killed, or that doctors kill the lives inside would-be mothers when requested.

“Enlightened, progressive secular countries like Sweden, have labour laws in line with our arguments. Sweden provides no legal right of employees to conscientious objection.” To the SS, the more enlightened and progressive a country is, in effect, the farther it is from Christianity.

The SS say anti-conscientious objection laws have “not had a detrimental effect on applications to these countries’ medical schools.” This must be false. If these laws have been applied, then they have prevented faithful Christians and other religious from (openly) entering these schools. If this turning-away hasn’t happened to many, it proves only how quickly Christianity has faded in these countries.

“We don’t know of any evidence that those with religious beliefs make better medical doctors,” say the SS. This is proof the SS aren’t up on medical history. If it weren’t for Christianity, the tradition of hospitals, nursing, and even doctoring would be far different, notably far less prevalent. They say, “We are deeply sceptical that holding religious beliefs makes one better at the practice of medicine.” But the opposite of these religious beliefs lead to killing patients and the lives inside women, as opposed to healing and preventing death. In their scheme, medicine is no longer what is best for the patient or mankind, but what is most expedient.

You know what to do. So do it.

23 Comments

  1. “Two academic bioethicists want …”
    Well, there’s your problem.

  2. “If society thinks …” ‘Society’, of course, doesn’t think. “The most strident voices in society say …” doesn’t carry the same weight.

  3. It is an absurd argument that because a thing is legal that therefore people have a “right” to it.

    If these acts are legal, this is the employers’ right [to choose not to hire].

    If it wasn’t legal would the employers still have the right or would they have lost the privilege of executing it? How is one argument different than the other?

  4. Ye Olde Statistician

    November 30, 2016 at 8:56 am

    Would the doctors also be compelled to operate on One-Hand Jason?
    http://tofspot.blogspot.com/2015/08/bruce-jenner-rene-descartes-and-stolen.html

  5. ‘Savita Halappanavar died after rushing to a hospital in Ireland when she was miscarrying at 17 weeks. At first she just complained of back pain but over the course of three days, Savita got sicker. Her pain was intense; she developed a serious blood infection; and she and her husband begged the doctors to complete the miscarriage by providing an abortion. But the hospital said they couldn’t “help her” because Ireland is a Catholic country.’

    ‘one doctor described a patient in the middle of her pregnancy who was miscarrying. She was bleeding so much that the whites of her eyes filled with blood, and she developed a serious infection and a 106 degree fever. The only way to treat her was to terminate the pregnancy. The Catholic hospital wouldn’t allow the abortion, however, until the fetus had no heartbeat. The doctor said that the woman was “dying before our eyes.” The doctor provided unauthorized treatment to save her life, and then promptly quit his job.’

    Catholic hospitals in the U.S. routinely violate the law by acting as described in the above paragraph; ghoulish Catholic “doctors” stand by, arms folded, and watch while their patients bleed to death.

    Sweden is on the right track.

    More details about how this dangerous cult causes death and suffering:
    ‘https://www.aclu.org/blog/speak-freely/one-nations-largest-catholic-hospital-systems-says-it-can-deny-women-emergency

  6. Conscientious Objection (CO) in the practice of medicine is a right granted to almost all of the EU , and then some (and also Norway and Switzerland). CO is not a legal right in EU member states Sweden, Finland, Bulgaria and the Czech Republic (or, Iceland). Ref: http://www.ncbi.nlm.nih.gov/pubmed/23848269

    In Canada, the two oddballs that want to impose what amounts to blacklisting of doctors who conscientiously object (CO) to various procedures appear to be advocating a policy that violates Canada’s Charters of Rights and Freedoms. Canada’s College of Physicians and Surgeons last year defended its policy — which DOES accommodate CO…except in emergency situations — in what it believes is an appropriate balance between physician rights and their ethical obligations to the public (in a govt-provided health care system): http://www.cpso.on.ca/Whatsnew/News-Releases/2015/Statement-from-the-CPSO-Professional-Obligations-a

    Thus, it seems the attention paid to the two (the “SS” as portrayed here) is just so much attention on a couple of kooks from the lunatic fringe examined from an ineffectual pseudo-philosophical viewpoint when the real, practical, perspective is one of legal permissibly: If the legal system can even accommodate their proposal if they tried (doesn’t appear to be a real possibility), or, if circumstances are such that such legal accommodation could be contrived (doesn’t appear to be the case).

    That, and a somewhat histrionic indirect/implied smearing of most so-called “enlightened” European countries, by focusing on Sweden, as if its allowance for discrimination against physicians that conscientiously object (CO) is somehow representative. It isn’t. In fact, most European countries place very very high value on one’s right to conscientiously object (CO) — a higher value on that then forcing such people to act against their values — to the extent the United Nations (UN) has been engaged to confront Sweden on its practice in this regard. See: http://eclj.org/conscientious-objection/systematic-violation-of-the-right-to-conscientious-objection-to-abortion-in-sweden-the-eclj-alerts-the-un-special-rapporteur-on-freedom-of-religion-or-belief-

    Whatever is underlying the value of preserving one’s right to conscientiously object, in the vast majority of “enlightened” countries, is worthy of identifying and then nurturing. That is what will keep in check such initiatives as the two “SS” are proposing.

    The legal analytical perspective is particularly appropriate in countries like Canada, where the State provides all health care (except in Quebec, where private insurance is permitted; maybe Ontario, where some legal challenges were raised). In Canada (and other countries), health care is a right. Doctors who work for the State in providing this health care are agents of the State — and as agents they are committed to fulfilling the State’s obligations … their individual right to CO is thus on shaky legal ground given that the citizen-patient has a right to all the health care services provided & promised by the State, which the physician-as-agent-of-the-State is committed to provide. At what point is a physician’s right to CO offset by the citizen-patient’s right to the health care promised/provided by the State? Ultimately this is a legal issue, with the relative limits of competing rights determined by each country’s legal precedents, etc.

  7. YOS

    Now you’ve done it talk about “the truth in hell” an excellent read….

    Would the doctors also be compelled to operate on One-Hand Jason?
    http://tofspot.blogspot.com/2015/08/bruce-jenner-rene-descartes-and-stolen.html

  8. I notice Lee’s comment avoids saying an abortion would have avoided poor Ms. Halappanavar’s death from scepticaemia. Thus clever lefty pro-aborts can take advantage of her shocking calamity without even lying. The false implication just hangs there tacit.

  9. Ye Olde Statistician

    November 30, 2016 at 5:16 pm

    I can relate to this case, since I too suffered from septic shock that was initially misdiagnosed. http://tofspot.blogspot.com/2012/03/tof-on-borderlands-of-death.html

    Savita Halappanavar died from septic shock resulting from an E.coli bacterial infection which had entered her bloodstream via the urinary tract. Severe sepsis of this type has a mortality rate of 60 percent. (In my own case, it was a blockage caused by a kidney stone. And my doctor said afterward, holding forefinger to thumb, that I was “this close” to being on “the wrong side of the grass.”) But it had nothing to do with her pregnancy. If your car doesn’t start, emptying the trunk will not normally help start it.

    Savita Halappanavar first presented at University College Hospital Galway on the afternoon of Sunday, October 21, with backache but she was sent home following an examination. (She had a history of back problems.) She returned later that evening having experienced blood loss and was admitted. A blood sample was taken.

    Again, my experience was similar. The weekend ER doc sent me home with a couple of pills and said to check again in the morning. Hit with alternating chills and fevers and sweating green, I went into the doctor on Monday and he sent me immediately back to the ER, where the resident discovered that no tests had been done on the lower abdomen. That’s when they discovered the white cell count and the infections.

    Early recognition of symptoms and initiation of treatment are vital. The diagnosis of sepsis must be confirmed by blood cultures and early administration of broad spectrum antibiotics, together with regular monitoring, is the key to survival.

    Savita’s blood tests also showed elevated white blood cell counts indicating infection, but though the results were processed almost immediately, they were not accessed until some 24 hours later by an unidentified member of staff, and later by Dr Katherine Astbury, five hours after she had been diagnosed with sepsis and after her condition had already rapidly deteriorated. After this, her case and mine diverge, since I received excellent care in the ICU over the next week or so.

    On the basis of clinical signs only, the doctor believed that that Savita was “distressed, but not unwell.” Delay, not dogma, was the problem

    Following her admission to the hospital, Savita’s membranes had spontaneously ruptured very late on the Sunday evening. Her cervix was thought to be fully dilated, so the staff believed delivery to be imminent. Since the ruptured membranes put Savita at a 30-40 percent increased risk of infection, she was given a course of oral antibiotics on Monday. (A bacterial infection needs to be aggressively targeted by broad spectrum antibiotics administered intravenously.)

    The burden of proof for infection in this situation is low. However the inquest discovered that vital four-hourly observations were missed, as were regular blood tests to identify trends in white blood cell count, and observations of her vital signs. Hence, the inquest’s verdict of “medical misadventure.”

    The proper broad spectrum antibiotics were not administered until 1pm on Wednesday. (Prior to this, Savita had been given erythromycin, a variant that was resistant to the E.Coli infection which was rapidly spreading throughout her body.)

    A lactate serum test which could have definitively confirmed the presence of sepsis was finally taken at 6am on the Wednesday morning but was stored in an inappropriate bottle before being sent to the lab, which then could not process it. Even if the sample had been stored correctly, the lab would have been unable to analyze the test — which should have been performed at a point-of-care unit on the ward.

    After 1pm on Wednesday, October 24, Savita was taken into the operating room, where she spontaneously delivered her deceased child, and then admitted to an ICU (“high dependency unit”). There, she received the highest possible standard of care. But the significant failures had occurred prior to this.

    Conservative management is the preferred clinical approach in cases of spontaneous miscarriage. In the absence of obvious signs of infection — masked by her painkillers — it’s not surprising that the medical staff decided intervention was unnecessary. With ruptured membranes and a dilated cervix, it was perfectly reasonable to assume that nature would soon take its course. The baby would still have been killed by the infection, but there would have been no long term ill-effects for the mother.

    Furthermore Savita’s unborn child was not the source of her bacterial infection so removing it would have done nothing to remove the cause.

    Upon learning that a miscarriage was inevitable, she requested the abortion so she could leave the hospital as quickly as possible. Her parents had been visiting her and were about to leave the country. She wanted to be able to say goodbye to them at the airport.

    But regarding an abortion, the presence of an infection is “a contraindication to surgical intervention because the clamps and forceps required in a procedure risk further infection.” And using drugs to contract the uterus and expedite delivery would have neither guaranteed swifter resolution nor ruled out the need for surgery.

  10. Speaking as a Doctor, I would suggest that if they got rid of all the religious ones, there would not be that many left.

  11. LOL! My GP is a little too much with the proselytizing but it doesn’t bother me.

    It’s funny, though, the other day I was visiting my surgeon (I have some health issues) and he’s this Irish immigrant-cum-US-citizen who still has all the Irish Catholic affectations (he told be he operates like a “‘tief in the night.” LOL!) I’m American, half Irish Catholic myself. So, we’re talking about these surgeries I need, and I’m going on about how bad I feel about always banging myself up, and getting all these damned hernias, and having these health issues and such, and he stops me and says, “You stop beating yourself up!,” and he gets up saying, “Here, I wrote a paper on this some time ago, I ‘tink you need to read…,” and he walks off for a couple minutes. So, he comes back with a printed copy of the paper entitled, “Don’t Beat Yourself Up Over That Hernia,” a little brilliantly explained diagnosis and prognosis of a common congenital problem complete with an Irish Catholic telling you not to feel guilty about it!

    Doctors, like everyone else, religious or whatever, and perhaps even more than others, should just relax and be themselves. It’s better for all involved. Besides, I’ll take a Catholic doctor any day.

    JMJ

  12. I assume you heard that now if you are an alcoholic in the Netherlands, you can just off yourself so as not to be a bother to others.

    http://www.independent.co.uk/news/world/europe/man-holland-netherlands-dutch-euthanised-alcohol-addiction-alcoholic-netherlands-a7446256.html

  13. If doctors are required to perform any medical procedure the patient requests then a doctor who objects to capital punishment might be forced to use organs from executed criminals.

  14. To Lee: If I wanted to read anecdotal evidence, I could read something by nativists.

  15. Looks like you’re in the right place.

  16. There’s no excuse for missing sepsis.
    There’s no excuse for missing a renal stone
    There’s no excuse for missing sepsis in a pregnant woman.
    Cardinal signs and red flags on questioning and examination would be enough on their own.
    Blood tests only confirm suspicions of infection particularly of that acute and severe nature.
    IV antibiotics should have been administered on spec.

    I can quite believe that some staff stood arms folded if the patient was being a patient and begging for ‘an abortion’ and the Dr instead of doing his job which is to care for the patient and use his head let alone his training, he chose to stand on principle and look down his nose at the woman. She might have been disgusting to him but he’s not there to make that call.
    Simply looking at her would have been enough to tell that something was acutely wrong. Redness of the eyes is not a sign of blood loss.
    Greying of the under eyelids and eventually whitening is what happens when someone bleeds out.

    The touch of her skin would have been clammy, her level of alertness or even confusion would have implied something infection related or metabolic.
    Her temperature would have been obviously high and she would have been shivering or shaking. There would be associated pain that would not fit the pattern at all of labour pains.
    There’s no excuse.

    YOS you were let down there. So much disinterest and ignorance in back pain leads some to miss stones but there’s no excuse. The pain is different, the symptoms and signs are different, the behaviour is different. I expect you knew it was visceral and non mechanical?
    I expect you also told them this in your own way. I also expect and am willing to bet you’re not a fuss pot and are a stoic quiet patient.

    Urine looks and smells different. urinalysis will reveal blood and white cells.
    Flow of urine is disrupted or altered. Pain sites are classic for kidney stones either iliohypogastric (high) or ingoinal, in the groin. Kidneys often refer pain along the front of the thigh because they sit on top of the lumbar plexus of nerves which supply set places in the anterior upper portion of the leg.

    There’s no reason if someone’s being thorough and listening for this to be missed.

    Many have stones and they sit happily in place not causing a problem. It’s only when they move or the body tries to eject them that renal colic starts.
    Internal bleeding due to the sharp and irregular shape or size of the stone and then associated infection is the inevitable outcome if the stone isn’t passed or shattered with ultra sound but all the signs would be there.
    For every hour you were left there was a seven percent chance drop in your chance of survival! Who cares about the statistics?
    The one with the chances offered to them, that’s who.

  17. Ye Olde Statistician

    December 1, 2016 at 2:53 pm

    Joy:
    The point is that her sepsis and later death was not due to the pregnancy, so terminating the pregnancy would not have dealt with the infection. What would have helped was proper diagnosis and speedy application of treatment for septicemia. They absolutely should have diagnosed the sepsis more quickly. That’s why the inquest returned “medical misadventure” as a verdict. But folks keep trying to make this into a refusal-to-abort-caused-a-woman’s-death thing.

    Everything else about imagining the doctor — a “she,” not a “he” — standing about with arms crossed and disgusted looks is pure fantasy. Probably from an attempt to shoehorn the events into the mold of a preconceived template; something the media are very prone to do.

  18. Here is a doctor with the relevant specialty explaining why delivery was indicated in this case, and why denial of an abortion was malpractice:

    https://drjengunter.wordpress.com/2012/11/14/did-irish-catholic-law-or-malpractice-kill-savita-halappanavar/

    The official post-mortem report and opinions of other experts make it abundantly clear that the substitution of Catholic dogma for generally accepted standards of medical care put the patient in mortal danger and nearly ensured her death. There were other serious lapses in care as well, and it’s impossible to know with certainty whether she might have been saved, without these lapses, while also being denied the delivery of her doomed fetus.

    “The point is that her sepsis and later death was not due to the pregnancy, so terminating the pregnancy would not have dealt with the infection.”

    This is logically confused. Regardless of what the infection was “due to”, once it developed the standard of care in this case called for a delivery.

  19. YOS,
    Yes, thank you I got the point. The sepsis is the emergency not then the pregnancy. This would be normal and routine priority. There’s no choice here to make. Once the treatment for infection is started and signs improve if they are going to which will happen fairly quickly then fitness for whatever procedure then can be assessed. Without the IV’s and vital support there’s no baby or mother.

    That he was a she makes perfect sense since in my view men make better obstetricians and gynaecologists. Women are a list of things which I won’t go into now.

    As far as the treatment is concerned I do think it is entirely likely that given the delay in providing IV antibiotics and treatment of vital signs was likely due to hand folding, chin rubbing and general dithering. That someone said it was because she was demanding or requesting an abortion would have absolutely thrown a spanner in the works for the practitioner who is not up to the job. There’s no other way to say it.

    To say that the baby being born in whatever state would not have treated the infection is to say something very silly and is aimed for a non medical audience. Another way of pretending they did nothing wrong. However, doing something right which would have been treating the infection was the right thing to do. Patients can be very difficult even when they’re relatively well. Relatives can be worse. I assume the Dr couldn’t handle the situation. Otherwise how did she miss the obvious?

    As for no guarantee of survival, of course there’s no guarantee. There never is.

    Removing baby is not a cure for infection. Whoever brought the religion into it did a bad job even if it were true because hospitals and staff have all sorts of reasons for messing up. They ought to have stuck to the clinical matter at hand if they wanted to make a sensible case.
    (not that I know there was a case, of course, I’ve just read the comments, not interested beyond the clinical matter.)

  20. The SS say anti-conscientious objection laws have “not had a detrimental effect on applications to these countries’ medical schools.” This must be false. If these laws have been applied, then they have prevented faithful Christians and other religious from (openly) entering these schools. If this turning-away hasn’t happened to many, it proves only how quickly Christianity has faded in these countries.

    Ah, I see, if any Christians apply, they must not be true, faithful Christians.

    You first negates SS’s claim, and then offer a possible explanation. Negating SS’s claim proves or disapproves nothing. So must it be false? If yes, why?

    “We don’t know of any evidence that those with religious beliefs make better medical doctors,” say the SS. This is proof the SS aren’t up on medical history. If it weren’t for Christianity, the tradition of hospitals, nursing, and even doctoring would be far different, notably far less prevalent.

    How did you manage to string those three seemingly unrelated sentences together? Granted the Christianity planted hospitals in certain countries, still, where is the evidence that those with religious beliefs make better medical doctors? Ah, I see, religious beliefs are one of the built-in qualifications for being “better medical doctor”. Well, why not? If you have Mexican heritage, you must not be a fair judge.

    Proof. What is “proof” to you, Mr. Briggs? A demonstration for a special case does not give you a proof of a nonsensical statement such as “two lines are perfectly correlated.” (Two lines are either parallel, or perpendicular or intersecting at a certain angel. What the heck does it mean to say that “two lines are perfectly correlated?” Yes, I have asked several mathematicians for a possible answer. )

  21. Ye Olde Statistician

    December 1, 2016 at 11:05 pm

    To say that the baby being born in whatever state would not have treated the infection is to say something very silly

    It’s actually to say that it does not address the root cause of her fatal condition.

    Had the tests been done in a timely manner; had the results been examined immediately as they were available; had the broad spectrum anti-biotics been administered, and administered by IV as indicated, all would have been well. Remember, the patient had asked for the abortion because she wanted to get out of the hospital to see her parents off on their flight home, not because anyone thought the pregnancy was in any way life-threatening. Because the needed testing had not yet been reviewed, no one knew she was in a critical state. I was very nearly in that state myself, due to an oversight very much the same.

  22. YOS
    The woman is said to have wanted to leave to catch a plane and needed an abortion. If this is actually true and lets assume that it is:
    My first thought would have been,
    This woman’s not entirely right…..if you get my drift….a little check up from the neck up might be in order…..perhaps she’s one sandwich short of a full picnic? Perhaps she’s metabolically unwell. This has happened to me countless times in practice particularly in outpatients where it is more likely. It would have been no different if the woman were pregnant or not. That is absolutely basic.

    If someone is being extra aggressive and acting crazy it can be there is something happening either with a direct injury to the brain or a systemic illness. A man once picked up the metal reflex hammer from the desk, twiddled the end which contains a pin for pinprick tests and brandished it saying quietly and with a smile he could poke my eyes out with it if he wanted right now. The man was ill. He had just received surgery close to the brain on his ear and the wound was still packed and dressed. He was there for a spinal assessment and was stroppy from the beginning, irritated by being questioned, understandably. I couldn’t have been more accommodating the sweeter I was the worse he got. So I just tried to look unimpressed and gently took the hammer. Went to the front and whispered to the receptionist that they should call security because ‘he’s about to blow.’ He needed an occipital X-Ray to clear him for MRI so I was able to send him away assorted by security to X-Ray where he blew and started smashing the place up and punching. I made the appropriate call to the ENT explained where he was and the rest was out of my hands or responsibility.

    He was then followed up by appropriate staff with respect to checking no surgical complications had occurred. Had I argued with the man or made a fuss I would have been attacked. Something weird like that was happening in this case. Women who are pregnant don’t start asking for an abortion because they’ve got backache and need to catch a plane, Sorry. Women who seek abortions do so by the regular means. (Perhaps, however she really was one sandwich short of a picnic maybe Some people are. There’s more to know about the case no doubt.)

    The first thought should not be, ever,
    “Oh what a horrid woman, she wants an abortion”
    “How could she act like this?”
    She is being a patient! That’s what they do, some of them. The sicker people are the more irrational they behave, not always, once they’ve collapsed everything changes. The clues are there. Staff are there to look out. Nowadays staff have got too used to saying,
    “I don’t have to put up with your abuse, the hospital has a policy”! I always thought this was the wrong way to manage the increase in aggression towards staff. Security can be called when it is determined that the patient is safe to be marched off the premises. Staff have become more dismissive and less forgiving. Just like the rest of society. One Friday at the Homerton security was called three times and one physio had a patient threatening to wait for her outside and follow her home. Mine was just staging a sit in in the cubicle and refusing to move as I wouldn’t see him half an hour late! Ron, The American physio boss was funny trying to get him to move. “Do you even know who I am!” Didn’t work. Actual manhandling was required.

    There’s a set way to consider patients for a reason. Snap judgements or actually judgements at all must be kept out of your mind until the person is no longer in your company. This is a sad case but this is one of the reasons a sense of humour is so vital.

    So given the assumption on my part that there was some delay in her receiving the appropriate treatment I blame the hospital.
    Whether the woman was horrid or not, whether the delay was due to complacency, lack of responsibility of individual staff members, slow response informed by all the fuss, who knows.
    The entire argument is a false one without all the details, in particular the time involved from first presenting to the first intervention.
    If there was any delay, the hospital is responsible.
    ~~~~~~~~~~~~~~~~~~~~~~
    Some of this is the result of moving training into universities to award degree status to staff who don’t actually need it. Training and quality of care have been affected by the same elements which have lowered standards in universities in general.

    Since the topic of the post is regarding suitability for medicine. It might be interesting to know that when I trained, students could be asked to leave after eighteen weeks. Exams practical and theory were not the only criteria. If you were considered unsuitable you could be thrown out without apeal or a chance to know why. This certainly kept everybody on their toes at least at the beginning. If lecturers thought there was a problem with someone and they oughtn’t be let lose on the public this was picked up. Nowadays universities aren’t allowed to fail a student let alone give them their marching orders.
    A friend of mine teaches physiotherapy at a London university and reported that some of the students turned up on day one looking like hoodies and texting with their phones at the back of the theatre. She was horrified at the thought that these people would be in such a position of authority and power over people’s lives which is what it is to be in any clinical role.

    If too many failed the university and then the staff were in trouble. I’d like nothing more than to set about myself in such a faculty. Not enough ever to be a lecturer though, too shy. Patients are suffering very bad care and it’s not just because some people are religious and some aren’t.

    End of life, palliative, respite, care of the elderly, like always with cinderella services are effected the most. It was the Christian countries, the army in fact, that developed the model for hospitals and the ranking system. You can see where it originated considering the shoulder tabs and all. There was a lot to be said for the military, matronly approach. The quest to preserve life has to be at the basis of providing healthcare. I will never accept such ideas as euthanasia overt or by default. I’m hopeful that the public eventually will find it’s way back to a more old fashioned approach. People need to matter again and not just the pretty ones.. The way care is given now is heading into a cul-de-sac and leads to a stunting of medical progress rather than the reverse.

    Starting by taking training schools back away from universities is a good idea. It takes money to set up schools and colleges. Start very small and build it from there.

  23. Orbital, not occipital. Checking for metal fragments.

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