Category Archives: Patient Rights

Capitalism Is Killing Patients… And Their Physicians

Photo Greanville Post

Physician burnout, depression, and suicide increasingly invade discussions within the medical field. Depression and suicide are more common among male and female physicians, with suicide rates 1.41 and 2.27 times greater than that of the general male and female populations, respectively. Though, the insults to the mental health of physicians begins much earlier in their career.

While the numbers may vary from study to study, some 28 percent of medical residents experience a major depressive episode during their training compared to 6 to 8 percent of the general population. These numbers are important, not only because suffering physicians are suffering humans in their own right, but also because this epidemic leads to poor patient care.

As a recent study out of the Stanford School of Medicine suggests, burnout and depression in physicians can lead to medical error and death. Many have tried to explain the causes of the epidemic, referencing everything from unmanageable workloads and work inefficiency, to lack of meaning in work and lack of work-life balance. Films are now being produced to shine light on the issue. In her TED talk “Why Doctors Kill Themselves,” Pamela Wible points to a medical school culture of hazing and bullying that continues into residency, along with a professional culture that hinders physicians from obtaining mental health treatment.

These factors certainly contribute to the epidemic, but when discussing physician suicide, we ignore the elephant in the room: capitalism. We are unable to recognize how the exploitation and alienation of physicians is integrally connected to this dominant economic system, but nothing could be more poignant, given in the state of the world today.

Ironically, the same destructive system that is driving physicians to extremes is also the main driver of the deterioration of health of the patients and populations, requiring patients to see physicians in the first place. The sooner we realize and confront our own exploitation, the sooner we can join in the fight to address the real driver of disease that is plaguing physicians and patients.

The System Outlined

Busy physicians may not have time to study how the world’s prevailing economic system functions, but doing so could benefit both our profession and the patients with whom we work. To briefly discuss, inside this system the working class that does not own the means of production is forced to sell its labor to an employer to survive.

A few corporations control most of the market for each of the commodities they produce. In these corporations, a very small sector of a board of directors and majority shareholders makes essentially all of the decisions on what to produce, where to produce and how to distribute profits. This puts the working class in a vulnerable position.  With the ultimate goal of profit maximization, decisions are often made by the corporate class which are not in the best interest of workers and negatively affect the health of entire communities.

Outsourcing work, closing factories, creating poor working conditions to cut costs, polluting waterways and the environment–decision after decision may initially increase profits, but in the long term harms health. This harm to health can be more obvious, as when air and water are polluted, or more subtle, for example, when families are put under chronic stress–which eventually leads to various forms of illness– from poor workplace conditions or income insecurity secondary to factory closure and outsourcing.

In this system, certain “costs”–the health of families, and entire communities being destroyed–are “externalized.” This means the business itself does not pay for these costs of poor societal health, which are created secondary to decisions made by business executives to increase profits. Such decisions are made by a small number of wealthy, powerful individuals pursuing their interests for greater wealth and power accumulation at expense of all else.

As economists such as Thomas Piketty have shown by combing through economic records from as far back as the 18th century, capitalism inherently generates inequality, concentrating wealth into the hands of the few at expense of everyone else. Study after study shows us that socioeconomic inequality itself is detrimental to patient health and actually increases morbidity and mortality.

Despite the negative effects, the working class today is more productive than ever, while wages remain flat (or are sometimes even lower) and work hours continue to increase. Workers struggle to put food on the table and meet basic needs, while the ownership class continues to become richer. Workers are exploited and reduced to tools for industry, many times forced to do mundane tasks or assignments over and over. They are alienated, or separated from the control and the product of their labor, each day they go to work. Inside this system workers are ultimately reduced to mechanistic cogs producing profit for large corporations.

This combination of being overworked and lacking true meaning and fulfillment in the work being done, drives more and more throughout both the white and blue collar sectors into despair. As Johan Hari, shows in his recent work Lost Connections: Uncovering the Real Causes of Depression and Unexpected Solutions, workers become separated from loved ones and from things that bring them joy as they work multiple jobs for longer hours as they struggle to make ends meet.

This constant stress leads to anxiety, depression, and various other forms of disease. Meanwhile, all medicine has to offer for them are at best poor attempts–many times with questionable supporting data demonstrating efficacy– to numb the pain that much larger systemic structures continue to create.

Unfortunately, the corporate elite know no limits in this system. They continue to exploit the masses and drive more and more into poverty and desperation while concentrating wealth in ever fewer hands. In America today, the three wealthiest individuals own the same wealth as the entire bottom half of the population, more than 160 million individuals. In order to maintain this system, the elite must ensure that the members of the working class fight amongst themselves rather than direct their rage toward those who are benefiting off of the oppression of the masses.

The capitalist system, born from racism and white supremacy as highlighted in studies such as Edward Baptist’s The Half That Has Never Been Told: Slavery and the Making of American Capitalism, continues to separate members of the working class based on social constructs such as race. At the same time, through a multitude of mechanisms, the system creates a self-loathing, insecure public, driven to constant consumption, leading to the pollution of the earth and poisoning of community after community.

These various forms of structural violence are the true drivers of disease and suffering, of which the health care system sees the results, but has little to no ability to truly address. The health of the majority of the population deteriorates and the elites benefit. Capitalism’s need to endlessly expand and its effect on the earth, has literally lead some scientists to call for the designation of a new geologic era called the anthropocene to describe the effect humans have had on the earth.

Scientists now warn we have moved into the sixth great mass extinction of species seen in our world’s history. A new report by the World Wildlife Fund (WWF) suggests, “Humanity has wiped out 60% of mammals, birds, fish and reptiles since 1970, leading the world’s foremost experts to warn that the annihilation of wildlife is now an emergency that threatens civilisation.” Meanwhile, a new U.N. Intergovernmental Panel on Climate Change (IPCC) report warns us that humanity has only a dozen years to address global warming to avoid increasing droughts, floods, etc., which will inevitably lead to more poverty and illness.

Capitalism does not just threaten the health and well being of every human, but life on this earth as we know it. Capitalism operates as a terminal cancer, knowing no limits to its endless growth and consumption, destroying systems necessary to survival and threatening the continued existence of its host.

Medicine Has Not Escaped

What is outlined above are the underlying causes of the majority of disease and suffering. The prevailing economic system in the world today commodifies every aspect of life including health care. As a result, the health of the public, especially the US public, is subjected to a barrage of market mechanisms.

US medical professionals, while often paid more than the typical member of the working class, are still forced to operate inside of this system that places profits above patient health. We see how this system harms our patients, limiting availability of the care they need, but we tend to miss that we also are damaged by this same system.

As Howard Waitzkin and the “Working Group on Health Beyond Capitalism” state in the book, Health Care Under the Knife: Moving Beyond Capitalism for Our Health,” until the 1980s, doctors, for the most part, owned and/or controlled their means of production and conditions of practice.” This allowed them to have control over things such as their work hours and how much time to spend with patients. As the Working Group references, “loss of control over the conditions of work has caused much unhappiness and burnout in the profession”.

As other members of the proletariat, or working class, have experienced for years, doctors now no longer have control over their labor. Now corporations or other large institutions control such decisions. Physicians have become “proletarianized” and while not members of the traditional working class, they have become tools in the corporate wheel of profit production. This has left us with a health system parasitized by the capitalism that cares more about profit production than it does the care of human beings.

The medical industrial complex, made of a multitude of different institutions–hospital corporations, large insurance companies, or pharmaceutical and device corporations and, more specifically the corporate elite who control these corporations–ultimately governs a majority of the large scale, structural decisions that affect patient care. The elite in these institutions, just like other capitalist organizations, make decisions that affect the lives of the majority with little to no input from those who are affected by these decisions.

They govern the prices of drugs–often leading to the obscene drug prices–and how long a physician should be spending with his or her patients in the clinic. These organizations have the primary goal of maximizing profit (regardless of whether they bear the title of “for profit” or “non-profit”) above all else. Consequently, patient health really becomes secondary in this system.

The metastasis of capitalism’s perverse incentives to even the sector that claims to care for the health of human beings, has given us the ineffective, damaging system we have today. Since profit production is of prime importance, physicians–and really health care providers in general–must be trained to be efficient tools for profit, seeing more patients more quickly, knowing how to bill appropriately, etc.

These incentives limit a physician’s ability to do what he or she actually went into medicine (or should have) for: to help people. Physicians want to help their patients, but are simply not able to truly address patient suffering because addressing the causes, as highlighted above, are outside the scope of a profit based medical system.

To understand how exactly this system creates human tools for health care profit while in the process leaving them physically and mentally broken, we must delve into the medical education and training structure and analyze how medical providers are conditioned to accept their own exploitation.

Training in the Art of Being Exploited

Step 1: Medical School

Medical trainees in the US enter medical school at least generally claiming they have some interest in caring for other human beings. Unfortunately, little do they know they are entering a system designed to prime them for their own exploitation from the second their training begins—one could argue even well before that point–and subsequently throughout their residency training.

During medical school, students are forced to study innumerable hours while being told they have to “lay a good foundation” of knowledge for their future practice. The first 2 years in most medical schools are classroom based, where insurmountable amounts of information are thrown at students as they are told “this is just the way medicine is, get used to it.”

Unfortunately though, much of the information students spend their time studying–or more often mindlessly memorizing–will never be used when caring for patients. This information is absorbed, regurgitated on an exam, and then often forgotten. One thing students do begin to learn–if they hadn’t already through their undergraduate education or their grade school education prior–is to listen to authority figures’ demands if they would like to succeed.

Students have little influence on what they are being taught. Instead, they must accept what they are being told or they may not pass their next exam. Students who entered medicine eager and idealistic, hoping to help others, begin to slowly withdraw from their individual passions and interests simply because tests, rotation evaluations determined by the opinions of supervising providers students must impress, and board exams are deemed more important. They are taught that listening to authority figures at the expense of their own interests and passions, comes first and then they can try to pursue their interests if they have time. This obviously can affect the mood and morale of a training physician.

During their third year, medical students are forced to spend numerous hours in the hospital. They are also required to take “shelf exams” at the end of each rotation, which can often have a large impact on their overall rotation grade. Because slight differences in grades can affect residency opportunities, students spend free-time studying for these exams instead of participating in activities to maintain their own mental and physical well being. While the exam scores offer little insight into the type of a physician the student will become, they serve to add extra pressure on students and ensure that they spend little time actually thinking for themselves while they are out of the hospital.

During fourth year many students are expected to complete sub-internships in the fields they are are interested in going into for residency training. These sub-internships normally require students to work near their 80 hour work limit, congruous to work limits of residents (more on that shortly). Medical students often carry their own patient panels, write notes that can be co-signed, and can even pend medication orders to be approved. The main difference between them and an actual paid intern is that they do not get paid. Instead they must work to “impress” their superiors in hopes of obtaining a positive evaluation. Once again, students are taught that listening to and striving to impress authority is their ultimate goal.

After four years of indoctrination, in addition to a medical degree, most medical students are given one final parting gift on their way into residency: hundreds of thousands of dollars of debt. This debt serves as a convenient way of pushing newly minted doctors into financial constriction when entering their residency.

No matter how they view their new employer or the field they have chosen, they know that they now have hundreds of thousands of dollars that they must find some way to pay back. This makes them much less likely to question or challenge authority in their new positions because doing so could impede completion of their training, sabotaging their career and only chance to escape debt. Along, with the inherent emotional stress of caring for sick patients, these financial difficulties can lead to depression, anxiety and a host of mental health issues in the newly minted physician.

Step 2: Residency

Once medical school graduates enter residency, they have already been primed for their inevitable exploitation, understanding that they need to take direction from authority, curtail their passions to make them more palatable to superiors, and most importantly, suppress any depression or anxiety they feel secondary to an ineffective, exploitative system. They now have few options–or are at least told so–other than to continue through residency. They know that to find themselves at this stage, they have made significant financial and emotional sacrifices, often losing connection with the people and things they love in order to fulfill education requirements.

Unfortunately, the exploitation of these newly minted doctors is just beginning.  During training, residents are forced to work often 80 hours per week doing a large portion of the patient care in hospitals (not to mention the additional hours of preparation outside of hospital or clinic, which are not counted toward this 80 hour limit). Residents are salaried, so they provide a cheap, efficient source of labor for hospitals and clinics. Residents become physically and emotionally exhausted trying to care for maxed out patient loads effectively in understaffed hospitals. Work hours become normalized over time and residents simply expect to be working an unhealthy amount of time in the hospital or at least convince themselves that it is normal to maintain their own sanity. It is no wonder this situation plunges many, who are already at risk, into burnout and depression.

Throughout residency, residents do, admittedly, grow exponentially in their ability to care for patients and become independently functioning physicians. Though, there is another type of growth that occurs during these years, which is seldom discussed.

Residents are groomed to be efficient, effective profit producers once they enter the workforce. For example, over their time in residency, a large degree of emphasis is placed on residents meeting particular “quality measures” for the clinic or hospital settings. Training after training is spent ensuring residents understand how to properly bill and submit insurance claims. Residents learn how to see patients extremely quickly and complete entire patient visits within 15 minutes. As anyone who has even interacted with a health care provider can attest, this is not enough time to actually make any significant interpersonal connection with a patient.

Either during this visit or after, residents must also learn to input information into whichever electronic medical record their training center uses. As Matt Anderson notes in Health Care Under the Knife commenting on EMRs, “most were designed to capture billing and quality information, not facilitate clinical care.” Residents end up spending more time looking at a computer than they do connecting with a patient. In the inpatient setting, a hospitalized patient might only see their doctor for a few minutes each day. This is partially because the rest of the day is spent documenting a coordinating care inside of a completely nonsensical system to ensure hospitals will be able to cash in on patient hospital stays.

This puts individuals, who went into medicine to care for and make connections with patients, torn between still trying to achieve this goal and meeting designated “quality measures.” If they are not able to see patients fast enough in the clinic or inpatient hospital setting they may not be seen as “marketable” to employers. This is clearly an environment that can breed physical, mental, and emotional suffering in the exploited trainee.

Even while studies have shown these grueling hours put both patients and residents at risk, when it comes to actually addressing the problems highlighted above, the onus is consistently put on the provider to maintain “self care.” From the beginning of residency, different “mental health departments” speak with residents about the importance of maintaining self care and “balance,” while at the same time maintaining an exploitative system that overworks its employees and drives suffering. Residents are a cheap form of labor for hospitals or clinics, and actually addressing this problem at a systemic level would be too threatening to the profitable status quo.

How the system’s leaders speak about these work conditions is very telling. For example, in 2016 Dr. Janice Orlowski, the Chief Health Care Officer with the Association of American Medical Colleges (AAMC), stated:

The individual is going to go into a profession where their profession calls on them to work extended hours and to be available at unusual hours […] We need to train individuals who can learn to pace themselves, who can recognize when they have sleep deprivation or when they are stressed.

This is an interesting statement, coming from someone who should know the demands put on residents drastically limits their capacity to “pace themselves.” It is clear that there is much more concern for protecting a public image of medicine and hospital programs than there is for addressing the crisis of physician depression and suicide.

Step 3: Practicing Physicians

Finally, if not already burned out, the physician has escaped residency and now believes that he or she will be able to practice “however one wants.” Unfortunately, any overburdened physician–either fresh out of residency or seasoned–who has worked inside a busy hospital or clinic, can attest to feeling tired, overworked, and often unfulfilled, in part due to their lack of patient connection as they are rushed from patient to patient and progress note to progress note.

Again, citing Matt Anderson in the Health Care Under the Knife’s section “Becoming Employees: The Deprofessionalization and Emerging Social Class Position of Health Professionals,” concepts typically lauded again and again in the health sector–”value, efficiency, quality, and market discipline–are part of an ideology to justify corporate control over the work of physicians and other works providing health services.” He references Marx’s concept of alienation–the separation of worker’s control over his or her labor– and describes how more and more health care providers are separated from what they once truly loved about their work, and now must fill the primary role of profit producer and secondary role of health care provider. If this separation did not occur during residency, there is a good chance it will when outside of training working for an employer.

While practicing, providers are still attempting to treat patients who present with illnesses created by the much larger system of capitalist exploitation referenced above, but their training prior to starting independent practice in no way, shape, or form has actually prepared them to join the communities they serve in combating these larger oppressive systems. On the contrary, what they were taught was to keep their head down, survive, and make it through exploitative residency programs. They are in regular practice and know how to put in a billing code and attempt the near impossible task of making a true connection with someone in a 15 minute clinic visit, but have not remotely learned how to begin to resist a parasitic capitalist system damaging both their colleagues and their patients.

At the same time, even if a physician did want to step outside of traditional boundaries to help challenge the true socioeconomic and structural causes of disease highlighted above, the provider still has a massive amount of student loans constricting their decisions. They may also have started a family or accumulated other financial constraints during residency. This leaves them with few options and many find it easier to get back in the clinic, put their heads down, and tell themselves they are really helping to address patient health. When in reality, they have been indoctrinated into a system based on profit maximization and blunting of patient suffering at best.

This endless process of day after day in clinic, seeing little to no progress at a systemic level, can become frustrating and make one’s work seem futile. Imagine spending over 10 years in training–from college, through medical school, through residency–to find yourself in this position. It is no surprise that more and more physicians are burning out, and feeling so desperate, that harming oneself becomes a viable option to escape.

Recognizing One’s Exploitation and Fighting Back

Capitalism’s parasitic economic structure has infiltrated all aspects of our society, and medicine has not been spared. This results in physicians being trained and conditioned to be obedient profit producers above all else. It leads them to be alienated from their loved ones and from their true passions. Inside our healthcare system, physicians are separated from the things that truly brought them joy and fulfillment. Yet we still continue to question why physicians are killing themselves?

Some maintain hope that there will be action around these issues from residency administrations, hospital working groups, or any number of hierarchical bodies that govern medical education, graduate medical education, or our healthcare system in general. The reality is that these issues will never be solved by any large committees or “task forces” we currently have in place, which continually put the onus onto medical students, residents, and practicing physicians to develop more “resilience” inside of a system that is built to do the exact opposite.

Those who have made it to the top positions of organizations such as the Accreditation Council for Graduate Medical Education (ACGME) or the Association of American Medical Colleges (AAMC) are there because they will continue to support the status quo. As political dissident and linguist Noam Chomsky discusses in reference to elite control of institutions, “an unstated but crucial premise is that the ‘responsible men’ achieve that exalted status by their service to authentic power, a fact of life that they will discover soon enough if they try to pursue an independent path.” These institutions will never consider the best interests of physicians or the patients they serve. Their leaders have been groomed to support the status quo. It is up to us to realize our exploitation and begin to fight against it.

Realizing this fact is easier said than done, as most physicians, due to the filtering mechanisms throughout our educational system, which typically lead to those from the upper classes securing seats in medical school, come from the exploitive classes themselves. Physicians are also paid more than a majority of other employees within our healthcare system such as nurses, technicians etc. They are conditioned to believe that they are somehow different or more important than the rest of the working staff when in reality all members are important in caring for the patient and all members are overworked and exploited by the same system.

Giving one member of an exploited group–in this case the physician–more benefits than others, helps to keep the fighting going between all groups as opposed to collaboration and organizing. We will be able to begin addressing the crisis of physician suicide once we, as physicians, accept that just as this capitalist system exploits our patients and coworkers, it is also exploiting us. And then we organize against it.

Whether it is consciously recognized or not, physicians specifically are also often boosted up with a false sense of elitism from the second they step into the field. This creates a blind spot for them being able to recognize their own suffering and exploitation and organize against it. They are given special white coats, which–besides becoming completely filthy after 80 hour work weeks–distinguish them from other hospital staff and distinguish themselves by the title of “doctor.”

While other staff members, such as nurses, actually have the collectivist mindset to organize against the damage the health care industrial complex causes to the patients they care for and even strike when necessary, physicians–especially those in the US–have been conditioned to believe they are too important to the system to do the same, even while that system is actively damaging them. Their administrators and peers say, “If we aren’t caring for patients, our patients will die.”

Those with a vested interest in maintaining the business as usual hold patients as hostages inside this system, guilting providers into accepting the status quo (inadequate care, inadequate access to care, medical errors, and crushing debt) with this rhetoric. It is despite the fact that physicians around the world have been able to organize and strike effectively while also continuing to provide absolutely necessary care.

Referencing Mark Ames’s 2005 book, Going Postal: Rage, Murder, and Rebellion: From Reagan’s Workplaces to Clinton’s Columbine and Beyond is useful for understanding this current phenomenon. In the book, Ames evaluates the mental anguish caused by Reagan era policies and analyzes how our capitalist system degrades and humiliates workers until they are pushed to harm themselves and others. In the following passage he speaks of how people can often deny their own exploitation until it is too late. He notes:

The middle class persistently denies its own unique pathos, irrationally clinging to an irrational way of measuring it, perhaps because if they did validate their own pain and injustice, it would be too unsettling–it would throw the entire world order into doubt. It is more comforting to believe they aren’t really suffering, to allocate all official pathos to the misery of other socioeconomic groups, and its more comforting to accuse those who disagree of being psychologically weak whiners. Despite its several hundred million strong demographic, the white bourgeoisie’s pain doesn’t officially count–it is too ashamed of itself to sympathize with its own suffering.

Until physicians are willing to accept the fact they they are being exploited by the same system that harms their patients, there will be no progress made in addressing physician depression and suicide. At that same time, until health care providers generally accept that it is our current capitalist system which puts profit production above the well being of every living thing on this planet–including themselves–we will not be able to effectively address true social and structural causes of disease and suffering.

Capitalism exploits, damages, and destroys us all. History shows us, large scale systemic change has never come from the beneficence of those in power and, frankly, it never will. As historian Howard Zinn writes speaking about public activism, the rights of the citizenry only come when “citizens organize, protest, demonstrate, strike, boycott, rebel, and violate the law in order to uphold justice.”

As physicians, if we truly care about the well being of our coworkers and of our patients, we must begin to organize, unionize, and rebel inside our practices, residency programs, etc, resisting business as usual, and finding ways to threaten the profits of capitalists if we want to see systemic change. We must begin to organize with communities and populations resisting oppression from a parasitic capitalist system as physicians in the past have done with groups such as the Black Panthers and Young Lords.

Once physicians can begin to view the dynamics of our capitalist system more clearly–and view the dynamics of our healthcare system as just one microcosm of how capitalism harms us all–it will become clear what needs to be done. We must put down our fancy white coats and begin to organize with our fellow healthcare staff–and, more importantly, with our patients–against a system that exploits and damages us all. Only then will we be able to begin developing a new system that actually cares about both people and the planet.

• First published in Popular Resistance

Glencore and Other Mining Corporations Make Record Profits and get Away with Murder Literally

Glencore, according to statistica.com is the world’s largest mining company by revenues. As a way of introduction, here is what statistica.com has to say about Glencore.

Glencore-Xstrata is a public limited company founded in 1974 by Marc Rich whose headquarters are based in Baar, Switzerland and also has registered office based in Saint Helier, New Jersey. Glencore-Xstrata is also a mining company whose headquarters are based in the United Kingdom. On May 2nd, 2013, the current company was established through a merger between Glencore and Xstrata. Glencore-Xstrata is the third largest family owned business in the world and was ranked number 10 on the list of Fortune Global 500 in 2015. Glencore Xstrata is the leading mining company in the world with estimated revenue earned in 2017 of $205 billion, on a rebound from 2015 (US$ 147billion) and compared to the best year so far, 2012 (US$237billion). Net earnings have skyrocketed in 2017 to US$ 5.8 billion, more than 4 times higher than in 2016 (US$ 1.4 billion).

The four next mining corporations in world ranking include BHP Billiton, Australia; British-Australian Rio Tinto; China state-owned Shenhua Energy, and Vale, Brazil. Their mining practices may not differ a lot from those of Glencore’s. However, what distinguishes Glencore is its particularly aggressive business style. Aggressive from all points of views – tax avoidance, corruption, total neglect for employees as well as communities they work in, non-responsiveness to critique.

Though it looks like Glencore’s aggressive business model is paying off. Glencore’s tax rate negotiated in Switzerland is next to zero. The Canton of Zug, where the city of Baar, seat of Glencore’s headquarters (HQ) is located, is the number one tax haven in Switzerland.  Glencore pays 0.2% taxes on its net earnings.

Glencore is exploiting developing countries to the maximum, not respecting any social and environmental laws or even humanitarian standards, brushing them aside and pushing ahead – poisoning and killing people on their way with toxic effluents from their mining practices, no regard, no attention to their fate, to their families, irrespective of whether they have been working for a Glencore mine, when they are sick they are out, no compensation; or whether they are just living in the contaminated environment, in communities on their own plots, exposed on a daily basis to water-ways and soil polluted with cancer-causing deadly heavy metals. The average life expectancy in South American mines is between 32 and 40 years for mine workers. Glencore leaves hardly any tax money or royalties in the country they exploit, on average about one cent per dollar of net earnings, as their tax residence is Switzerland.

This article looks specifically at an event which I witnessed and was able to interview victims about, at Glencore’s copper mine in Espinar, near Cusco, Peru, some 4,200 m above sea-level. Gold is a side product. Where there is copper, there is almost without fail also gold to be found and vice-versa. The mining and refining of both metals is highly toxic, leaving poisonous heavy metals, such as mercury, cyanite, cadmium, arsenic, chromium, lead and many more disease-causing toxins in water, soil, and air, poisoning fauna, flora and humans.

On April 3, 2018, a dozen or so indigenous unarmed, women – the poorest of the poor –protested with their bare hands in defense of their only water way left, a small stream. Glencore wanted to deviate it – totally illegally – for Glencore’s use. The women were attacked by police in full riot gear, beaten with batons. It is openly known that Glencore, like other mining corporations, literally buys the national or local police services for this type of abject brutality.

The police were helped by Glencore’s own security forces. All this was recorded on video and in photos. Arriving the following day on location with a group of locals, we interviewed several of the victims. See also my earlier article on the subject

As the above essay went to press, I wrote directly to Glencore’s CEO, Ivan Glasenberg, suggesting a personal meeting to discuss the event and the general circumstances that led to it. Mr. Glasenberg replied promptly through his director for Sustainable Development (sic), who proposed to meet – which we did, in a neutral place, a hotel lobby in Bern. The Glencore delegation consisted of the Sustainable Development director and her lawyer.  I was alone.

What transpired during a roughly two-hour non-confrontational, rather peaceful dialogue, I recorded in an Aide-Memoire, asking for their approval, comments or suggestions for change. The answer a few days later was a full rejection, saying none of the contents of the AM reflected our conversation. This is, of course, a flagrant lie. Under the circumstances, I decided to make the gist of our two-hour conversation public, as reflected in the Aide-Mémoire.

The conversation covered three key topics

  1. Beating of unarmed indigenous women in Alta Huata, Espinar, Cusco Province, Peru, by Police and Glencore’s Security Forces on 3 April 2018;
  2. Glencore’s contamination of water, soil, air, flora, fauna and humans by toxic chemicals used in the mining process; and
  3. Blood and urine samples – people who are sick from intoxication with mine effluents, working for the mine and/or living in the close vicinity of the mine, sought testing their blood and urine for heavy metals. They were never given the results from the tests from medical doctors, clinics and laboratories. Why?

Addressing point by point, starting with the Beating of unarmed women – the dozen or two bare-handed indigenous women were protesting in defense of their water against Glencore workers, wanting to deviate, actually steal the little stream for Glencore’s own use. They were brutally beaten by national police in government issued riot gear – imagine, in riot gear! – with the help of Glencore’s own security forces. This happened around noon on 3 April, when the women were alone, even more defenseless, while village men were working at the mine or in their small agricultural plots.

According to several accounts from the local population as well as from people in the town of Espinar, Glencore intended to reroute the small stream providing the only water source for the six or so villages higher up on the mountain. This is further corroborated by the large pile of big-sized pipes, deposited on the land next to the small stream. A nearby gigantic earth moving machine and fresh tracks traversing the small water way were also clear signs that water deviation works were planned.

In the early morning hours of 4 April, we went to Glencore’s copper mine at Alta Huata, about 4,200m above sea level, to meet with the mistreated women and to interview them. Still affected by indignation and pain, some of them under tears, showed us their badly bruised body parts. Evidence of the police assault and aggression by Glencore’s security forces is available as independent testimony in the form of short videos and photographs. An elderly woman (65) was beaten so severely, she was resting and moaning in a rickety stone shack which apparently was destroyed by Glencore’s bulldozers the week before and hastily rebuilt by the local population. The woman had pain all over her body, could not move, and got no medical attention, no pain medication – nothing – she was a ‘high risk’ case. Later, we learned, she was miraculously recovering with the care of the villagers.

The villagers told us they wanted to file a complaint with the local police which did not receive them. It is clear, if Glencore hired the police to do their dirty work, they, the police, will not receive the villagers’ complaint. It’s a revolving-door corruption at every level that is being practiced. I wonder whether Glencore’s boss, Mr. Glasenberg, is aware of it. If not, then at least this article which will be sent to him should remind him that he is complicit in serious crimes of his company by letting them happen.

During our meeting, the Glencore ‘sustainable development’ people said the workers were only doing repair work when the women appeared interfering with their job. Another flagrant lie. But how could they know? They are repeating what they are told by their people on the ground. And whenever they go to visit the area, we understand, they never set foot in the affected villages, to talk to the people or to the mayor, but only talk the inside-talk to Glencore insiders, another revolving door approach to resolving problems by being blind to them and keeping perpetuating the lies. The sustainable development people of Glencore also denied that Glencore had anything to do with the beating, that Glencore could not control the police. They dismissed the assertion, against all evidence on video, that Glencore’s security forces were also involved and, of course, that they actually called and hired the police in the first place.

Later we talked to villagers who lived in the mine-surrounding areas. With anguish, sadness and even resignation, they told us that contamination of water, soil, air, flora, fauna – and humans was evident. It appeared in the water ways and was reported in soil samples. Plants adjacent to water courses, rivers and effluents from the mine, were all contaminated by heavy metals, poisoning animals, as well as humans. Farm animals became sick and often died.

Many inhabitants of the mine-surrounding communities, so we were told, including by the former mayor, were sick with cancer and other terminal diseases which were caused by contact with, or ingestion of, contaminated water or food. To purify water efficiently from heavy metals – cyanide, mercury, lead, arsenic, cadmium and more – a complex and expensive process is required. It’s called reverse osmosis. In most cases, mining companies do not use this process. In the case of Glencore and Espinar, reverse osmosis is not in use, leaving the effluent waters highly and dangerously polluted.

We talked to several people, some working for the mine, others just living in the immediate vicinity of the mine – say, in a radius of 1 to 5 km. All said, they felt sick; their bodies hurt, they had respiratory problems and many suspected having different types of cancers, mainly lung cancer. The disease rate increased the closer they lived to the mine.

One of the peasants said that young people in his neighborhood were dying “like flies” from cancer. He added that the average life expectancy of people living near the mine was drastically reduced. He also said, that most people by now are just resigned to their fate and were tired of protesting and being frustrated, because Glencore would not respond and do nothing for them. They felt helpless.

To top it off, Glencore’s Sustainable Development people said that Glencore received certification from the municipality that the effluents from their mine were clean and not contaminated by the mine, and that it was common knowledge that the water was not potable, ridiculously ascertaining that contamination occurred naturally in these mountainous streams. This abject manipulation of the truth would be laughable if it weren’t so serious. But the people have no recourses to hire lawyers, and even if they would have the money to do so, no lawyer, no judge, no court would take on a case against Glencore. They are afraid to confront the mobsters from where the money flows – corruption at infinitum! Glencore’s sustainable development representatives rejected all responsibilities for the contamination and said they had no knowledge about the disease rates reported by the local population. They were never informed.

Well, if they didn’t know, they must know now. And Mr. Glasenberg would do well sending an HONEST delegation to Espinar to verify with neutral experts on location the veracity of this account and of the account of the victims. Question is, of course, will there be uncorrupt neutral experts daring to tell Glencore the truth?  And even if that were the case, what would Glasenberg do about it? Glasenberg is the key person. It’s a family business, one of the world’s largest, so if he wants to change the way Glencore does business, he can do it.

Who manages Glencore’s mines on the ground?  Mainly locals, we were told. In Espinar, Peru, it’s a Peruvian. This has two purposes. First, a Peruvian is familiar with the local ‘habits’ of how the ‘turntable’ turns, how to buy favors and how to threaten potential adversaries; and, second, if something goes wrong – like in the present case of brutally beating of inoffensive women, deadly contamination and people dying from cancers caused by intoxication from mine effluents – they, at Swiss HQs can say, we didn’t know; nobody told us. The we didn’t know effect seems to be effective, so effective, in fact, that the entire conversation of two hours was annihilated by the sustainable Glencore people. Even though the conversation took place as recorded, the sustainable people deny its contents.

We also talked with people who lived in the vicinity of the mine, who are feeling ill for years and worsening, mostly the lungs, but also their respiratory and nervous system, yet mine management not only ignores them, but also prevents them, directly or indirectly, from getting their blood and urine samples tested, paid for by the victims themselves. We were told that many of the people living in the communities near the mine, including the people who spoke with us, consulted doctors, clinics, hospitals, laboratories on their own, to get their blood and urine tested for heavy metals. They never received the test results back from these medical establishments.

The truth is beyond suspicion. These medical facilities, are either bought by Glencore, or they fear Glencore to a point that they prefer not to hand out negative health results, of which they know from where they emanate.  The people also said that they get absolutely no medical support from Glencore. They pay their medical expenses from their own pockets and yet, they are refused to see the test results.

Diseases stemming from heavy metals have often long gestation periods; i.e., cyanide and mercury do not necessarily lead to immediate symptoms, rather the impact may be slow, because heavy metals accumulate in the body and are not evacuated as other toxins may be. They affect over time the nervous system, respiratory tracts, the heart and often cause cancer and lead to early death. It is well known that mine workers in general in developing countries have a drastically reduced life expectancy; i.e., in some parts of Peru and Bolivia an average of around 35 years.

The director of the Sustainable Development Department appeared to be shocked. She was unaware, she said, and in an outburst of good will, she offered that any of the people who were sick and concerned may call her directly. Of course, none of this was even acknowledged once they received the Aide-Mémoire.

The moral of this story is multi-fold. There is Glencore, the largest mining corporation in the world, largely a family business, with Ivan Glasenberg, main shareholder, at the helm. He could personally intervene, stop the abuse and high crime, bringing about ‘as clean mining’ as there is, respecting environmental and social ethical rules, regardless of whether the country, where they operate, in this case Peru, is corrupt and can be bought. Glasenberg, the CEO, could become a shining example for ethics in mining which would bode well for the company as well as for the host country, Peru, and not least for their country of residence, Switzerland. The cost of implementing ethical environmental and social standards would hardly make a dent in Glencore’s net earnings, but the gains in positive reputation and improved image are priceless.

On the other hand, you have Switzerland that offers this UK-Swiss mining corporation their tax haven as residency. Yet, the Swiss Government does absolutely zilch, nothing, nada to impose and enforce certain standards of ethics to Glencore and other corporate sinners enjoying the Swiss tax paradise. Talking with people from a so-called Ethics Department (sic) in the Swiss Ministry of Foreign Affairs, the hush answer was, if we are too strict with them, they will leave Switzerland – and as an after-thought, besides, they [these corporations] have their own standards of due diligence and we trust that they adhere to them. If they don’t, then it’s up to their host country; i.e., in this case Peru, to enforce their laws.

Here you have it. The Swiss Government, the paradise for banking and finance and corporate ‘well-being’, the epicenter of neoliberal economics, where privatization reigns, is knowingly and intimately complicit in the crimes committed by these corporations. No wonder the lawmakers, the Swiss parliamentarians, are entitled to sit in as many corporate boards of directors they please – against all rules of ethics and ‘conflict-of-interest’ guidelines of OECD, of which Switzerland is a member. This built-in lobby of parliamentarians is making the laws in their favor, operating on a ‘legal basis’, not unlike a white-collar mafia.

Thriving on Dark Web: The My Health Record and Data Insecurity

Data is rarely inert.  It moves, finds itself diverting, adjusting and adapting to users and distributors. Ultimately, as unspectacular and banal as it might be, data sells, pushing the price in various markets whoever wishes to access it.  Medical data, given its abundance, can do very nicely in such domains as the Dark Web.  With governments attempting to find the optimum level of storing, monitoring and identifying the medical health of citizens, the issue of security has become pressingly urgent.

Britain’s National Health Service is a case in point.  Last year, that venerable, perennially criticised body of health provision, received the full attention of the WananCry virus. Much of this was occasioned by carelessness: a good number of organisations were running on out-of-date Windows XP software.  The principle of insecurity was, however, affirmed.

Last month, the Singaporean government faced the grim reality that 1.5 million health records had been accessed by hackers including, audaciously, the records of Prime Minister Lee Hsien Loong. This well landed blow riled all the more for that state’s heralded insistence on the merits of its own cybersecurity.  In the words of the government statement, “Investigations by the Cyber Security Agency of Singapore (CSA) and the Integrated Health Information System (IHiS) confirmed that this was a deliberate, targeted and well-planned cyberattack.”

Lee, in an obvious effort to reassure, perhaps more himself than anybody else, claimed that his data had nothing of value.  (If a thief takes your goods, make sure they are worthless.)  “My medication data is not something I would ordinarily tell people about, but there is nothing alarming in it.”

Obtaining medical data enables a stealthy plotting for the attacker, hoarding information clandestinely then deploying it with maximum effect.  “Patients who have had their medical information stolen,” goes Aatif Sulleyman for The Independent, “might not realise it’s even happened until the attackers have already set their plans in motion.”

Patient profiles can be built, with credentials mustered for reasons of impersonation to obtain health services.  Medical equipment and drugs can be duly purchased, and claims with insurers lodged.  That prospect is somewhat bleaker than one whose credit card details have been pinched; the bank, at the very least, might be able to put a halt on transactions with immediate effect.

Such excitement turns in anticipation and worried focus to the My Health Record proposition of the Australian government, which, it must be said, belies the usual blissful ignorance about what such an invitation tends to be.  Here, information utopia is paraded and extolled: to have such material in one spot, rather than diffused and intangible; to have the picture of one’s medical being in one location for those providing health care services.

Australia’s political representatives and bureaucrats have assumed a certain cockiness far exceeding health providers in other jurisdictions, making the My Health Record scheme a pinnacle of insecurity in medical care.  A pervasive sense exists that privacy concerns will simply vanish in a bout of extended apathy.  The scheme is astounding for the scope it enables prying of medical data that would otherwise be deemed private.

Deficiencies were spotted early on.  Far from being clinically-reliable as a record, it is dated and far from comprehensive.  Any such record would be, at worse, a distraction in an emergency.  Nor is there a track on who has seen it, except institutions en bloc.

If Australians do not opt out of the centralised medical scheme by October 15, a record by default will be created, stored and used.  This will mean that those in the healthcare provision business, be it pharmacists, nurses or podiatrists, not to mention a whole string of unknown providers, will have automatic access to the medical record without patient consent.  The notions of express and fully informed consent have been given a dramatic, contemptuous heave ho, with a focus on the patient’s volition to avoid the scheme altogether. The Australian government’s refusal to engage the public in any meaningful way, be it through a sustained advertising or information campaign, has been patchy, and, in some instances, entirely absent.

Such an approach flies in the face of such recommendations as those made by the UK Information Governance Review from 2013 acknowledging “an appropriate balance between the protection of the patient user’s information, and the use and sharing of such information to improve care”.  This balance was struck on principles derived in the 1997 Review of the Uses of Patient-Identifiable Information, chaired by Dame Fiona Caldicott. While admitting that information governance might at stages have to give way to sharing confidential patient information for the sake of that patient’s welfare, the principles of data security remain fundamental.

A skirt through the My Health Record system yields the extent of its shabbiness, and the level of its aspiration.  The My Health Record privacy policy is hardly glowing, acknowledging the problems with having such a database in the first place. “In any online platform, including the My Health Record system, there are inherent risks when transmitting and storing personal information.” Then comes the mandatory, if hollow, reassurance: “Despite this, we are committed to protecting your personal information, and ensuring its privacy, accuracy and security.”  A rich opportunity for the prying and the pilfering await.

When Health Care is a Privilege and Physician Shadowing is a Right

As it is presently constructed, the American health care system is predicated on the pernicious idea that good health care is a privilege. Meanwhile, medical students, residents, and other interlopers regard observing patients’ doctor’s visits to be their right, regardless of whether or not the patient’s consent has been obtained. This dichotomy embodies the egregious inequality inherent in the two-tier system, and is indicative of a complete inversion of the way any humane health care system must be ideologically oriented.

The subject of physician shadowing is inextricably linked with unfettered capitalism and the neoliberal project, where the privileged few have a vast array of options in regards to where and with whom they can seek care, while the under-insured masses can spend countless hours – sometimes in vain – searching for the appropriate specialist that takes their insurance. If an under-insured patient is able to find a specialist that takes their insurance, they often fall prey to the scourge of nonconsensual physician shadowing, as they can be coerced into becoming a medical model and teaching tool without their consent.

Physician shadowing must never be done without the patient’s consent, as this constitutes an egregious violation of medical ethics, patient privacy, and the patient’s moral right to meet with a physician in private should they choose to do so. Moreover, once a patient feels that their trust in the system has been violated, it will be extremely difficult, if not impossible, to ever fully restore it.

While a great deal of lip service is paid to “privacy,” “consent,” and “the doctor–patient relationship” in American teaching hospitals, all of these things are summarily jettisoned once medical students and residents get inculcated with the idea that it is acceptable to shadow a physician regardless of whether or not the patient’s consent has been obtained. In actuality, physician shadowing is a privilege that can be granted by one person, and one person only: the patient.

Under the neoliberal project, many physicians have been pulled inexorably into a vortex of amorality. This is because they are trained in an environment whereby the scourge of free market ideology has distorted their thinking and debased any sense of morality. Indeed, many young physicians are inculcated with the shameful idea that unless a patient has an excellent commercial plan privacy, consent, and confidentiality should have no bearing on the care they will receive.

Medical schools compel undergraduate pre-med majors to shadow a physician for a significant number of hours. This practice should be banned, as these students are not officially medical students. Consequently, they are totally unvetted. Allowing high school students to shadow a physician, or observe medical personnel at work in an emergency room or operating room, is an outrage. Having a secretary serve as a “chaperone” – deemed desirable by some physicians, as this can protect them from lawsuits – is likewise unethical and thoroughly repugnant.

The dismantling of the humanities has played a significant role in fomenting dehumanization and moral bankruptcy in health care, because without the humanities, many health care professionals have lost their ability to be compassionate and empathetic. Indeed, without a humanities education, what separates a urologist from a plumber, or an auto mechanic from a gastroenterologist?

In an online discussion on forums.studentdoctor.net titled “Isn’t Shadowing Intrusive?” doctors and medical students nonchalantly discuss physician shadowing. One philistine writes, “If you agree to the student being in the room, how is your privacy being violated? Everyone should stop being so hysterical – if the patients don’t like something, they can speak up.”

While another defends the right of undergraduates to shadow: “Medical training has to start somewhere. There is not (or shouldn’t be) a glaring divide between premedical and medical education. Better to make sure our students are better prepared for medical school and know what they are getting themselves into. And if anything, many patients are happy to have someone else to talk to. It never was a problem when I shadowed.”

Actually, many patients are interested in talking with a physician in private – and without interlopers barbarically violating their privacy. In all the many times I have experienced this at Weill Cornell and Sloan Kettering, never was my consent first obtained. In fact, at Memorial I had to complain dozens of times before my request to meet with my various doctors in private was finally granted. There are certain departments at Cornell where you can issue complaints ad nauseam, yet they will still not allow a patient with inferior insurance to meet with an attending physician in private.

Another morally bankrupt knave writes: “I’ve seen at least 100 patients in shadowing experiences. Not one asked me to leave. If you’re at a teaching hospital, and the patient has been there before, they know the deal.”

“The deal” is that there is a crisis in American health care, where all too often patient privacy is nonexistent. Also, the notion that patients can easily object is deeply fallacious. Would this hold true with the under-insured, who are acutely aware of how limited their options are? Even a patient with the finest insurance may have a hard time objecting to unwanted observers at Sloan Kettering, as Memorial has a policy of denying patients the right to change from one oncologist to another within whatever department they are ensconced in. Moreover, as these comments demonstrate, the cavalier dismissal on the part of many medical students, residents, and attending physicians that nonconsensual physician shadowing could leave patients with real emotional scars, is indicative of an extraordinary degree of insouciance regarding the delicate nature of the doctor-patient relationship, as well as a deep-seated callousness and moral bankruptcy that has metastasized throughout our entire health care system like a cancer.

Once the callow are inculcated with the idea that nonconsensual physician shadowing is an acceptable and everyday part of learning how to be a doctor, what follows? Catheterizing anesthetized patients without their knowledge? Having medical students do practice pelvic and rectal exams on anesthetized patients? Willful nondisclosure of long-term chemotherapy side effects, such as cognitive difficulties and early menopause? Over-prescribing opioids? Psychiatrists overprescribing psychotropic drugs? Indeed, these are things that have already come to pass.

It is unequivocally true that the principal devils in the American health care crisis are the private insurance companies, the pharmaceutical industry, and the hospital administrators. Yet throughout my many long and arduous years as a patient, I have witnessed medical students, residents, and fellows instructed by attending physicians to do things that are undeniably unethical. All too often their medical training is corrupted by the two-tier system and the moral bankruptcy that this spawns.

What kind of doctors will medical students and residents become, when every day they are immersed in an environment where do no harm applies to a privileged few? Where the haves are endowed with an endless array of good options, and the have nots are commodified and railroaded into resident clinics which prey on the under-insured, and which coerce patients into surrendering all vestiges of privacy? Privacy, confidentiality, and consent are foundational to any humane health care system, and once they become a privilege for the few, the very basis of medical ethics is torn asunder.

Capitalism has distorted and inverted our sense of morality – so that rights such as good health care, a good education, equality under the law, safe drinking water, affordable housing, etc. – have become privileges, whereas privileges, paradoxically, have become rights.

Once at Cornell Dermatology, I was subjected to an examination with a resident present and a nurse going in and out of the room, despite my requests to meet with a dermatologist in private. As I am at risk for melanoma and was overdue for a checkup, I deemed the visit to be medically necessary. Moreover, had I elected to go somewhere else (a specious argument frequently posited by anti-privacy ideologues), the other dermatology departments in Manhattan that take my insurance are run in a similar fashion. This is not a coincidence, as those who manage resident clinics are acutely aware of the fact that many of the under-insured who walk through their doors have few if any options.

I often think about this resident, and whether she was cognizant of the fact that she played a role in egregiously violating my privacy, as well as the oath that she took to do no harm. Did she fail to see the double standard – that she was participating in an assault on a patient’s privacy that she would vehemently object to – indeed be mortified by, herself? She has since completed her residency at Cornell, and is now ensconced at the dermatology department at The University of Pennsylvania. While these things may look nice on one’s resume, I can’t help but wonder how many hours she had to spend shadowing, and how much of this shadowing was done without the patients’ consent. I can only hope that now that she is an attending physician, she can use her influence to give patients a choice in regards to whether observers are present during their doctor’s visits, and that this will be done regardless of what type of insurance these patients may have. It is regrettable that for many ambitious young doctors privacy and consent matter little in the face of blind obedience, authoritarianism, and careerism.

Doctors know much more today than they’ve ever known before. Yet ironically, they are trusted and respected less than was the case in the 50’s and 60’s. Losing their autonomy to the private insurance companies, as well as being forced to see an increasing number of patients each day, have undoubtedly played a role in the diminishing of the doctor’s prestige. However, a growing number of patients are acutely aware of how morally compromised many doctors have become, as unfettered capitalism and the profit motive have come to permeate and defile the very soul of our society. Indeed, many physicians that ardently defend nonconsensual physician shadowing, are the first to use their superior health insurance plans to avoid this very thing when it is time to see a doctor themselves.

It is deeply disturbing watching medical students and residents being instructed to obey unethical orders from an attending physician. Only with a single-payer system will we disenthrall ourselves from the barbarism of the two-tier system – a system which destroys the souls of doctors and patients alike.

The Exsanguination of Medical Ethics

For thousands of years physicians took oaths to always act in the patient’s best interest when providing care. At the heart of medical ethics, this moral code was passed down through the centuries and reaffirmed by The World Medical Association (WMA) in 1949 and again in 2006. Additionally the WMA specified: “A physician shall not allow his/her judgment to be influenced by personal profit or unfair discrimination,” and “shall not receive any financial benefits or other incentives solely for referring patients or prescribing specific products”.

Medical ethics ran head long into The HMO (Health Maintenance Organization) Act of 1973.  The passage of this act set the stage for the undermining of long established medical ethics. The HMO Act was designed specifically to reduce costs, by charging patients a monthly fee for a set package of health care.  The Act was passed with the knowledge that there had been no systematic analysis done to show that it would not negatively impact health care.  Nonetheless, the Government gave millions of dollars in direct financial assistance to develop the HMO which was designed to be a profit making business.

This HMO economic arrangement put the physicians and other health care providers’ financial interest into conflict with the needs of their patients. The monthly pot of money must provide for profit, salaries, wages and health care.  If too much is spent on the patients, there is less available for profit and wages. So began the Health Insurance, Corporate Medicine assault on medical ethics.

Did the Medical Profession fight to hold on to its ethics so as to always “act in the patient’s best interest when providing medical care”?  No. Tragically the Medical Profession succumbed to the rise of Corporate Health Care by betraying their core medical ethic and became complicit “stewards” of an economic system that puts profits before people—The AMA’s (American Medical Association) Principles of Medical Ethics: V11, gives the following ethical guidelines for physicians:

Mitigate possible conflicts between physicians financial interests and patient interests by minimizing the financial impact of patient care decisions and the overall financial risk for individual physicians.

We have experienced four decades of HMO’s negative effect on health care while they became the darlings of Wall Street earning billions of dollars for investors as health care was rationed by denial of service, restricted benefits, cost cutting, patients dumping, overworked and underpaid staff, and plunging physician’s incomes.

The author D.H. Lawrence (1880-1930) appears to have anticipated these horrors, when he wrote:

The mosquito knows full well, small as he is he’s beast of prey. But after all he only takes his bellyful, he doesn’t put my blood in the bank.

Fast Forward to the ACA (Affordable Care Act) of 2010. One of its chief goals was to “reduce the cost of health care” by giving “financial incentives” to providers for the “Value” they provide in health care. A value-based payment incentive was to be established by bundling payment for certain types of care. Forbes Magazine, advertised as ‘The Capitalist Tool’ stated:

Bundled payments are just price controls by another name—and as such will yield subpar care by encouraging insurers and providers to put their own financial interests above the medical needs of patients.

The ACA was passed with very little known about its effectiveness or risks to Patient Care. Once again it is all about cost cutting. But now with the so called “Value Based Purchasing”, it is no longer about making profits for corporations, but spending less government money — it is about getting more for the Government’s shrinking dollars going to health care spending for Medicare, Medicaid and Social Security Disability.

The politicians want to “save” money, which, in reality, means to redistribute money, but the economics is similar. With some ten trillion dollars in tax cuts for the rich over the last seventeen years, the US treasury has less available for social services as politicians continue to redirect a trillion dollars per year to the military war industry without concerns that it is “costing the government too much”.

The latest Republican Tax Reform Bill of 12/17 will suck out of Medicare an estimated thirty billion dollars. Bundled payments will shrink and the giant vice of shrinking payments, combined with rising costs (hospital profits, rising prices for supplies, drugs, medical equipment, etc.) will inevitably squeeze the life blood out of both the patients and the health care providers.

The exsanguination of medical ethics has helped bring us to this dangerous moment in history.  We have witnessed a craven transformation of medical ethics when physicians, nurses and other health providers are clamoring to sign up for “Value-Based Bundled Care”. The AMA has betrayed their ancient oath as healers, in service to an economic system that puts profits before people.  While deadly epidemics of cancer, heart disease, obesity, diabetes, violence and addiction haunt the nation, we have been led into a partnership with Dracula.

Without Single-Payer American Health Care is Doomed

Of all the forms of inequality, injustice in health is the most shocking and inhuman.

— Dr. Martin Luther King, Jr., Second National Convention of the Medical Committee for Human Rights, Chicago, March 25, 1966.

It is the year 2018, and yet not a day goes by when a patient is unable to receive good care or a doctor questions their career choice.  How have we arrived at this tragic state of affairs? The answer is that our for-profit health care system is the principal cause, not only of poor patient care, but also of physician burnout. Only with a single-payer system, anchored not in the mores of capitalist plunder, but with the understanding that quality government-funded health care is an inalienable right, can both doctors and patients extricate themselves from this suffering.

Even amongst patients that are insured, restrictive health care plans force millions of Americans to work with doctors that they do not wish to work with. No less disconcerting is the fact that Americans are often compelled to stop working with doctors that they have known for years and do not wish to leave. In conjunction with a complicated health condition I have seen dozens of different doctors over the past two years. Should my insurance suddenly change, this painstakingly constructed system of specialists could come crashing to the ground. Moreover, being forced to leave a doctor that you have known for years is a shame, not only because no one will know your medical problems quite like they do, but because once a good doctor-patient relationship is lost it is gone forever.

This revolving door is also very harmful for physicians, because if a doctor has a practice with patients incessantly coming and going, this will invariably foment alienation which can be a driving force behind physician burnout.

The argument that a single-payer system would be impossible to implement in practice, is contradicted by the fact that the overwhelming majority of countries in the West from Vancouver to Vladivostok, have nationalized health care systems that guarantee universal coverage for all of their citizens. The GDP of Cuba is mere pennies compared to that of the United States, and yet all of their citizens enjoy excellent free health care, with an infant mortality rate lower than that of the United States. (They also enjoy superior literacy rates). How can we call ourselves a civilized nation when millions of Americans with serious illnesses are more fearful of bankruptcy and losing their insurance, than they are of death from widespread disease?

A single-payer system recognizes that it is deeply immoral and inhumane to give superior care to the upper middle class and affluent, while denying good care to vast segments of the population. In the absence of a nationalized health care system, do no harm will continue to be applied increasingly to the haves – and not to the have nots.

Liberals have embraced the Affordable Care Act (the very name of which would make Orwell blush) as if it brought about the successful implementation of a single-payer system, when the power of the private insurance companies has, in fact, been bolstered. Moreover, the premiums and deductibles of the new plans are often considerably higher than the plans they replaced, and the number of doctors that take these plans extremely limited. Obamacare also failed to address the sinister problem whereby health insurance is tied to one’s job, as many Americans have found themselves in the Kafkaesque predicament of having good insurance when they are well, but not when they are unwell. This barbarous state of affairs underscores the fact that this inhumane for-profit system is more entrenched than ever before.

This two-tier system also results in preposterous and inane contradictions, such as when I once asked the chair of Dermatology at a prestigious Manhattan teaching hospital whether there were certain situations where he would object to observers being present during any of his doctor’s appointments, to which he replied without hesitation, “Of course!” Yet patients that have Medicaid and community health plans are denied this right when they seek treatment at his very department, and are quite willfully treated as second-class citizens. A morally bankrupt physician that supports privatization and the two-tier system would argue that if a patient is dissatisfied with a particular physician or department they should simply seek care at another clinic. However, the under-insured invariably have extremely limited options – hence they are often at the mercy of such loutishness and knavery.

There is no logical reason why a New Yorker should be denied the right to see any doctor that they wish at Lenox Hill, Mount Sinai, Weill Cornell, Columbia, NYU or Sloan Kettering. Is it not preposterous that millions of Americans live either within walking distance or a reasonable subway ride from these renowned medical institutions, and yet their health insurance prevents them from seeing the majority of physicians that actually work at these institutions? As is the case with the Manhattan rentals market, there is no shortage of five thousand dollar one bedrooms, yet they are accessible to only a small fraction of the population.

The question of who will foot the bill should be asked, not in regards to who will pay for single-payer, but in regards to how we can continue to maintain a system of nine hundred military bases all across the globe. According to that great bastion of Marxist heresy The Washington Post, “The U.S. wars in Afghanistan and Iraq will cost taxpayers $4 trillion to $6 trillion.” And this was written in March 28, 2013. How many hundreds of billions of taxpayer dollars have we spent on sustaining this bloated empire over the past four years? Instead of using this money to establish a health care system that we can be proud of the great beacon of liberty and freedom is arming death squads, and dropping depleted uranium, cluster munitions, and white phosphorus on mostly defenseless human beings. Think about that, the next time someone says we can’t afford a single-payer health care system.

The astounding waste that can be associated with just one new (and deeply flawed) fighter aircraft can boggle the mind, as Mike Fredenburg writes in the curiously subversive July, 2015 issue of National Review:

Indeed, it could be argued that the biggest threat the U.S. military faces over the next few decades is not the carrier-killing Chinese anti-ship ballistic missile, or the proliferation of inexpensive quiet diesel-electric attack subs, or even Chinese and Russian anti-satellite programs. The biggest threat comes from the F-35 — a plane that is being projected to suck up 1.5 trillion precious defense dollars. For this trillion-dollar-plus investment we get a plane far slower than a 1970s F-14 Tomcat, a plane with less than half the range of a 40-year-old A-6 Intruder, a plane whose sustained-turn performance is that of a 1960s F-4 Phantom, and a plane that had its head handed to it by an F-16 during a recent dogfight competition. The problem is not just hundreds of billions of dollars being wasted on the F-35; it is also about not having that money to spend on programs that would give us a far bigger bang for the buck.

Such as a single-payer health care system, for instance. That would give us a nice bang for the buck!

Lamentably, the most pressing problem in this debate is the fact that millions of Americans insist on looking at health care as yet another business. Moreover, the extreme inequality that is glaringly on display in education, where our public schools continue to churn out some of the most illiterate and dehumanized creatures ever to walk the face of the earth, in contrast with the outrageously expensive and infinitely more rigorous prep schools that the affluent are sending their children (granted, not without their own problems), may one day be the destiny of our privatized health care system.

The astronomical cost of college tuition has resulted in over a trillion dollars in student loan debt, while the quality of education has been steadily deteriorating since the end of the 1960’s. As with education, we can either choose to have a good health care system, or we can continue to allow a corrupt few to make staggering amounts of money while generating the most abject misery and suffering for millions of their fellow countrymen.

Tying health insurance to one’s job constitutes one of the most diabolical abuses of corporate power, as the overwhelming majority of Americans with full-time jobs can be fired at the drop of a hat, should they be compelled to take a significant amount of time off from work due to illness. Moreover, primary care physicians that elect not to take insurance at all will neither be able to provide patients with critical in-network referrals, nor will they be able to write prescriptions that will be covered by any health insurance plan.

How can do no harm be implemented in practice when vitally important health care decisions are routinely made by hospital administrators, pharmaceutical CEOs, and insurance executives whose only reason for getting involved in health care in the first place was to maximize the greatest possible profit? Remove the profit motive and compassion, logic, and dignity will be reclaimed. Indeed, no less than our very humanity will be restored.

Why must we continue to allow charlatans and con artists to dictate to doctors how they can treat patients, dictate to patients which doctors they can and cannot see, while also using health care as a financial weapon to wage war on the poor and what is left of our country’s once formidable middle class? Good doctors that are forced by hospital administrators and soul-obliterating insurance companies to provide under-insured patients with inferior care will be prone to feelings of guilt, shame, remorse and depression. Some have even taken their own lives. Indeed, this barbarous and unconscionable state of affairs is indefensible, and cannot hold water in any rational or civilized conversation.

The time has come for Americans to put an end to this foolishness, and to disenthrall themselves from these corrupt elements, that straitjacket and humiliate both doctors and patients alike.

Death by a Thousand Cuts: When the Cures of Big Pharma are Worse than the Diseases

The vaccine debate and prying into Planned Parenthood’s Standard Operating Procedure are two arenas I have not gravitated toward. Genetically-engineered crops, industrial farming, confined feeding operations (CAFOs), dams killing wild salmon, these are my fortes.

The news daily is like death by a thousand cuts for me tied to new studies on collapsing ecosystems, indigenous people fighting against mines and other extractive industries, and more and more on climate change/global warming.

I never thought I’d be embroiled in a fight for my livelihood because I questioned the rampant vaccination of girls (and now boys) with the Merck marketed HPV vaccine, Gardasil. To date, more than 270,000,000 doses have been distributed worldwide, this HPV vaccine (World Health Organization’s Global Advisory Committee on Vaccine Safety) distributed by both GlaxoSmithKline and Merck versions. There are scientists who say the human papillomavirus is not the cancer threat posited by the drug manufacturers and their paid-off doctors;  that most immune systems can fight off the HPV; that the vaccine only hits two of the more than 40 different HPV phenotypes.

My story with HPV vaccine started when I was in a Planned Parenthood training last month, a mandatory course for social workers titled Fundamentals of Sex Ed. For a total of possibly 30 seconds out of a 16-hour two-day training (I was kicked out after day one, eight hours worth), I voiced my opinion about the potential risks associated with Gardasil.

The opinion was put down on a slip of paper, then, and thrown in with dozens of other comments from the 40 participants. This is in Seattle, one of the bigger Planned Parenthood locations, and the comments I made were specifically sold to us all as “an anonymous forum.” I went further with two more comments on the slips of paper — about 60 words answering this first day evaluation question: “What could Planned Parenthood have done differently today in the training?”

I am really disappointed that Planned Parenthood in Seattle is so lock-step in line with Big Pharma. Especially in the case of Gardasil, which is a vaccine that has gotten tens of thousands complaints about it. Anyone, including my 16- to 21-year-old clients, could easily Google ‘Gardasil Dangers’ and find a plethora of very disturbing and legitimate information about its dangers. I wish Planned Parenthood showed more critical thinking and independent pedagogical standards, including informed consent.

Less than two hours after the training, I was called at my hotel room by my supervisor from Portland, who let me know:

The Planned Parenthood trainers said they do not want you back for the second day of training. I am putting you on administrative leave. I am looking into what happened in Seattle. Do not return to the office until further notice.

That was October 15, and I have since been terminated, have been on the job market, am attempting to collect a few weeks of unemployment assistance, have a lawyer investigating my case, and started writing about my case on multiple forums. You can read my posts “My Fate as a Social Worker Sealed by a Vaccine Named Gardasil“; “Planned Parenthood, A VaccineDouble-think Alive and Well in the World of Non-profits“; “Gardasil and the American Bald Eagle – What Would Rachel Carson Do?

The Sordid History of the HPV Vaccine

I have collected a hundred reports, articles, documentaries and blogs tied to the HPV vaccine, which has been in use since 2006. Here are just few: How Much Does the Vaccine Cost?, Sacrificial Virgins, Gardasil Did It/ Fue el Gardasil. The treasure trove is enlightening, intimidating, depressing and validating. Every drug and chemical in the world should have this amount of scrutiny, and yet, the depressing part is that once something is introduced into our systems of medicine, food production/ processing, and modern industrial existence, the unintended consequences and synergistic downsides are more difficult to elevate to a level of grave public concern.

The PR firms, legal teams, government agencies, law makers, and politicians all have a stake in the game with trillions of dollars in profits at stake. In fact, the pharmaceutical industry is the single largest contributor (number two being insurance industry) to congressional accounts in the United States, spending almost 2.5 billion dollars the past decade in lobbying efforts, more than double the spending of the defense industry. This is, of course, in addition to the many billions more spent on marketing their products to both consumers and directly to physicians.

The issues whirling around Gardasil represent a microcosm of all that is wrong with our healthcare industry. It is difficult at best and impossible for most to speak out against the power purchased with these multi-billion dollar budgets; in many cases, Big Pharma is killing us with their practices, marketing and products. If you are a citizen, a consumer group, a watchdog agency or journalist going against the grain, the road to hell is paved with threats, lawsuits, and vitriol. We are labeled conspiracists, Luddites, anti-science extremists and crazies or nuts. Death by a thousand cuts!

Here is an anonymous comment emailed to me, and it’s endemic of the HPV vaccination controversy involving thousands of victims (and deaths) ascribed to the vaccination doses given these young girls and women:

I’ve been extensively investigating vaccines for 23 years and I believe that vaccines are one of the biggest contributors to the childhood epidemics of chronic disease. Over half of the kids in this country have been diagnosed with a chronic illness. Not only is it not prudent to mandate vaccines, it is in violation of informed consent and an affront to parental rights. The rush to get Gardasil (and all vaccines) approved is about one thing: $$$. Gardasil is not mandatory though in any state. It’s recommended but not mandatory – yet. It’s one of the most dangerous vaccines and should be completely avoided.

Whether it is vaccines, medications, agricultural or industrial chemicals, questions of safety are rarely tolerated. I knew this from my background in environmental studies, writing and activism. Even so, I was caught off guard by these recent events.

Toxic History and Citizen Action: The Fight Never Ends

I cut my teeth as a budding reporter in Arizona working on issues tied to sprawl, city and county politics, the cop shop, and more as a community journalist for several dailies. I also ate up journalism from other great venues, including one that links tangentially to the Gardasil story. It was on the Love Canal case (a neighborhood near Niagara Falls, NY) in the 1970s. Love Canal’s toxic history began when Hooker Chemical Co. used an abandoned canal from 1942 to 1953 to dump 21,800 tons of industrial hazardous waste (‘Love Canal’ still oozing poison 35 years later).

Later, the slurry was “capped,” and then hundreds of homes and a school were built on top of it. A harsh winter in 1977 with several meters of snow resulted in a spring melt seeping into the buried 16-acre canal which forced chemical waste into groundwater and to the surface, oozing into yards and basements (Superfund).

Residents began complaining of miscarriages, urinary and kidney problems and mental disabilities in their children. A quiet mother and homemaker began putting pieces together and contacted scientists and state government agencies.

Headlines like this anchor what she did as just a common person: “Lois Gibbs, a housewife leads the charge for evacuation, compensation and warns against resettling the area.”

That case led to the formation in 1980 of the Superfund program, which helps pay for the cleanup of toxic sites (From homemaker to hell-raiser in Love Canal).

As I have set up this series with environmentalist-scientist Rachel Carson’s book, Silent Spring, this fourth article around this controversy (for DV) dovetails with environmentalist Lois Gibbs. How insane is it that she revisited the Love Canal site on the 35th anniversary in November 2013 and witnessed a new generation of mothers and fathers locked into lawsuits with Occidental Petroleum Corp., the new caretaker of the land, again, because of the toxic soil and health implications for them and their families (Happy Birthday, Love Canal). Rashes, stomach sickness, fainting, seizure. Insanity, the ooze that Gibbs tied to birth defects was recapped (mitigated) with new homes built where those in Gibbs’ old neighborhood had been demolished.

It was so weird to go back and stand next to someone who was crying and saying the exact same thing I said thirty-five years ago, Gibbs said.

More than 1,000 tons of contaminated soil are being now being shipped to an incinerator in Lincoln, Nebraska (Love Canal soil going to Kimball incinerator). We don’t know who said, “Insanity is doing the same thing over and over and expecting different results,” but Albert Einstein did say, “We cannot solve our problems with the same thinking we used when we created them.”

Like Carson, Gibbs penned a few books – Dying from Dioxin (1995); Love Canal The Story Continues (1998); Love Canal: and the Birth of the Environmental Health Movement (2010) – and founded an organization fighting toxins:

The Center for Health, Environment & Justice which supports a nationwide network of more than 300 local community groups to achieve critical policy impacts at the local, regional, statewide and national levels. The communities we serve are largely rural, low-wealth or working class—the kind of areas where toxic chemicals, polluting facilities and other environmental dangers are sited.

Get Lit with Literature!

The biggest influences for me in regard to social justice and the power of collective action came to me through the arts, poetry and literature, at a young age. For me, the game changer was considering Herman Melville’s short story, Bartleby the Scrivener, or Joseph Conrad’s Heart of Darkness.

Imagine my surprise, nay, my consternation, when without moving from his privacy, Bartleby, in a singular mild, firm voice, replied, ‘I would prefer not to.’

— Herman Melville

The mind of man is capable of anything–because everything is in it, all the past as well as all the future. What was there after all? Joy, fear, sorrow, devotion, valor, rage–who can tell?—but truth–truth stripped of its cloak of time.

— Joseph Conrad

This very concept of those willing to kill and maim and conquer for a profit came to bear quickly after reading Conrad and so many other thinkers. The idea, though, of this strange man, Bartleby, basically intoning his manager, “I would prefer not to,” symbolizes one of the world’s most powerful phrases. “I would prefer not to.” How many among us can say the same when faced with ethical challenges.

Fact is Stranger than Fiction

What I am finding in my own nascent life tied to Gardasil and Planned Parenthood is a type of bearing witness, knowing there are deeper and more layered and nuanced ways of looking at the mad men in advertising, marketing, propaganda and more existential ways of contemplating the insanity of unlimited growth, the consumer assault and battery from the merchants of death.

The leap from literary/poetic to environmental and science writing was not a high one. I was still reading  writers like Eduardo GaleanoVonnegut Ursula Le GuinDenise Levertov and  Jorge Luis Borges, but I did devour Carson’s Silent Spring when I was 16, and that too put me on a course toward writing literary works, and poetry, as well as becoming a journalist hoping to cover science. Carson was on the staff of the U.S. Fish and Wildlife Service for 16 years and was highly cognizant of the fact the government played a huge role in promoting and defending chemical poisons.

“The crusade to create a chemically sterile, insect-free world,” Carson wrote, “seems to have engendered a fanatic zeal on the part of many specialists and most of the so-called control agencies.”

She believed that she was living in an era

dominated by industry, in which the right to make a dollar at whatever cost is seldom challenged. When the public protests, confronted with some obvious evidence of damaging results of pesticide applications, it is fed little tranquilizing pills of half-truth. We urgently need an end to these false assurances, to the sugar coating of unpalatable facts.

The cross-pollination of a huge marketing campaigns with scientists and medical companies and pharmaceuticals is both bizarre and business as usual. Here, in 2006, from one of those marketing firms:

More than 95 insurance plans–covering 94 percent of insured individuals–have decided to reimburse Gardasil, according to Merck. The Centers for Disease Control and Prevention has also added the vaccine to its Vaccines for Children Contract, making it available to Medicaid-eligible, uninsured, under-insured, or Native American children up to the age of 18.

Analysts are optimistic about the vaccine’s market potential. ‘It’s very clear that patients are going to be interested in it,’ said John Lebbos, MD, therapeutic area director of infectious diseases at market research firm Decision Resources. ‘From what I’ve seen, it’s going to be a blockbuster.’

Education about the vaccine is going to be a critical piece–due both to a lack of understanding about HPV as well as early controversy that vaccination might lead to teen promiscuity.

Note the terminology of the purveyors of capital and profit-making health care: “vaccine’s market potential” and “it’s going to be a blockbuster.” Words from an MD whose Hippocratic oath states first do no harm!

From the onset of Gardasil, after the fast-tracked shoddy FDA approval (Examining the FDA’s HPV Vaccine Records), Merck deployed the services of one of the world’s propaganda firms, AKA PR outfits:

The PR genius behind all stages of Merck’s HPV and Gardasil campaigns is the PR giant Edelman. The world’s largest independent PR firm, Edelman boasts more than 2,100 employees working in 46 wholly owned offices worldwide, plus the additional resources of more than 50 affiliates. Apparently Merck is hoping that most, if not all the states in the US, will mandate a vaccine against HPV as a pre-requisite for school attendance. And beat rivals to it, before GlaxoSmithKline gets FDA approval for its Cervarix.

In the dozens and dozens of articles in the New York Times, in reports by PR Watch and Judicial Watch, scant few mentioning of the untold physical incapacitation, chronic illness and deaths tied to Gardasil by many citizen groups with some scientists behind the calls to stop the Gardasil-Cervarix mass vaccination program (TruthWiki   US Court Pays $6 Million to Gardasil Victims    Judicial Watch:  a,   b,  c    Are You Concerned Over Genetically Modified Vaccine?  HPV Researchers, Planned Parenthood Win Prestigious Lasker Medical Awards).

But, 11 years ago, even before FDA approval, Merck and Edelman were on the PR war-path beating the cervical cancer drums:

Merck used its deep pockets to make sure that even before the FDA had approved Gardasil, there was a growing awareness of and concern about HPV and its link to cervical cancer. According to Bloomberg News, Merck spent $841,000 for Internet ads alone relating to HPV in the first quarter of 2006 — months before the FDA had even approved Gardasil (Part One: Setting the Stage).

Again, this series on Gardasil-Merck-Planned Parenthood-and-my-termination looks at the funding and ties to non-profits, but also at the new documentaries and court cases illuminating the young girls and women who say they have been injured (and many family members of deceased girls say killed) by the HPV vaccine.

Here’s just one tip of the iceberg in this non-profit collusion with the funders, health care for-profits, and this is a three-part series written for PR Watch in 2017 by journalist Judith Siers-Poisson:

According to their website, “Women in Government is a national 501(c)(3), non-profit, bi-partisan organization of women state legislators providing leadership opportunities, networking, expert forums, and educational resources to address and resolve complex public policy issues.” The campaigns that they feature on their home page deal with kidney health, Medicare preventive services, higher education policy, and the “Challenge to Eliminate Cervical Cancer,” which was publicly launched in 2004.

On February 2, 2007, Texas Governor Rick Perry, against the wishes of his conservative base and to the surprise of critics, signed an executive order mandating HPV vaccination for girls entering seventh grade. Then, unfortunately for Perry and Merck, details of his many connections with both Merck and Women in Government became public.

Ellen Goodman of the Boston Globe noted, “It turned out that Perry’s former chief of staff is now a lobbyist for Merck. Did that look bad? Whoa, Nellie. Did it look bad that Merck had funded an organization of women legislators backing similar bills? Whoa, Merck.” USA Today reported that Perry’s current chief of staff’s mother-in-law, Texas Republican State Representative Dianne White Delisi, is a state director for Women in Government. Perry’s wife, Anita, a nurse by training, addressed a WIG summit on cervical cancer in Atlanta in November 2005. Perry also received $6,000 from Merck’s political action committee during his re-election campaign.

In 2004, more than 20 WIG funders were pharmaceutical companies or entities heavily invested in health care issues that could come before state legislators. A short list includes both Merck & Co., Inc and Merck Vaccine, GlaxoSmithKline (which will soon have the second HPV vaccine on the market), and Digene Corporation (which manufactures an HPV test). Other drug interests listed as donors to WIG include Novartis, Eli Lilly, AstraZeneca, Bayer Healthcare, Pfizer, Bristol-Myers Squibb (both the company and their foundation), and Pharmaceutical Research and Manufacturers of America, also known as PhRMA, one of the largest and most influential lobbying organizations in Washington representing 48 drug companies.

The funders of Women in Government today, as I am looking at their website, are still those big ones listed above and others in the for-profit health care fields.

What comes next will be articles tying Planned Parenthood to the makers of Gardasil, and how the science behind the HPV vaccine is not only faulty, but in some ways corrupted. The influence of these private for-profit drug makers to ruin scientists lives is also a big part of the story coming up (Biologist Peter Duesberg was all but banished from science for his views on HIV)  The next part of the series will look at the cases of young girls damaged and killed and whose cases are being highlighted in documentaries and added to class action and personal liability cases against Merck and GSK.

Part one of the series over at Hormones Matter & DV was getting the reader’s feet wet effort: Gardasil and the American Bald Eagle.  What I am hoping to elicit from this second part is reader’s feedback on the collusion of marketing and science. How do readers see that interplay affecting what they eat, consume, use and purchase? How can a citizen get a handle on all the complicated findings and PR spin and manufactured consent the for-profit world enlists as their marketing schemes?

GMOs, Genetic Engineering, Recombinant Drugs, Vaccines

I end with a lament, since I opened this piece around my background researching and writing about mostly environmental and social justice issues (certainly forced vaccinations in USA and other countries is a social injustice issue). I have many friends and sources in the arena of GMO — genetically modified (engineered) organisms and that giant, Monsanto. In fact, Gardasil is a genetically-engineered virus. The news today exploded with mainstream media touting a new study “clearing” Round-up, also known as glyphosate, of any definitive cancer-causing links.

Of course, this one study is not the final word on cancer and Round-up. One study, versus thousands linking Round-up to all sorts of problems in humans and animals. But then Monsanto is a giant with connected politicians, Supreme Court Justices and PR firms. Monsanto and others like Bayer subsidize entire university programs and departments. Autism and Round-up? HereGlyphosate in vaccines?

It all ties together, this better living through chemistry-plastics-GE drugs. Even Stephen Hawkins is weighing in on this Genetic Engineering of vaccines.

My friend, who is now deceased, Mae-Wan Ho, submitted to an interview by me a few years ago, and this passage from it elegantly discusses the inherent dangers of GMOs:

The new genetics, for example, is enchanting; it is completely different from the old obsolete genetics that motivated genetic engineering and genetic modification. It has turned conventional genetics upside down. Instead of a one-way flow of information from DNA (the genetic material) to traits (biological function) to the environment, there is a circular feedback from the environment and the organisms’ experience that marks out which genes are to be expressed or not, even changing the genes themselves. I call this natural genetic modification. It is an intricate molecular dance of life that is essential for survival. Natural genetic modification is done with finesse and precision by the organisms themselves, without damaging the genome. In contrast, artificial genetic modification done in the laboratory by genetic engineers is crude, imprecise, uncontrollable, and ends up scrambling and damaging the genome with totally unpredictable effects on safety. It also interferes inevitably with the natural genetic modification process, and that is ultimately why artificial genetic modification is inherently hazardous.

Some writers say “vaccines are the Third Rail for writers. Otherwise totally progressive sites have drunk the Pharma Kool-Aid and [shut down] journalists for simply suggesting that vaccines are neither all safe or all unsafe! Imagine!” (a recent email from a writer answering my questions, preferring to stay anonymous).

Add to my dilemma as a white male, Marxist, 60, dare to complain about anything to do with Planned Parenthood, even this bizarre personal attack on me, as Planned Parenthood Seattle ended up pressuring the former non-profit I worked for to sack me because of my recalcitrance, aggressiveness and non-compliance of a “zeig heil” to all vaccines, manufactured and distributed (sold) by Merck and GlaxSmithKline, not exactly the angels in Big Pharma.

I’ve got compatriots, luckily, at DV, in the writing and voice of Martha Rosenberg

Of course there are many reasons women may veto the vaccine for themselves or their children. Even though the vaccine is nearly 100 percent effective in preventing precancerous cervical lesions and protects against the two HPV strains that cause 70 percent of cervical cancers and 90 percent of genital warts, it isn’t effective against all HPV strains. It is also not more effective against cervical cancer than a Pap smear and even when it does work, may require a booster. Nor do researchers know how long protection lasts.

The HPV vaccine is also the most expensive of all recommended vaccines at $359.25 for all three doses says Pew Research.

And then there’s the morality issue.

“I was greatly offended that Merck suggest I vaccinate my nine-year-old daughter against an STD,” says Kelley Watson, a mother of two in the Chicago suburb of Oak Park. “Especially insulting to me was that there was never any mention of HPV as being a sexually transmitted disease. It was presented as something women can contract through tampons or nylon stockings — as if men played no part.”

Actually, men’s part in transmitting HPV is beginning to be acknowledged. Last year FDA also cleared the vaccine for boys, in whom the virus can cause genital warts and anal cancer. Even when an individual declines vaccination, his or her chances of infection are lessened as more people, both men and women, vaccinate — a concept called herd immunity.

Thanks to intrepid and thick-skinned writers like Rosenberg, the public might have a chance at getting real news about pharmaceuticals and all the other snake oil and PT Barnum shell games Big For-Profit Medicine pedals. I’ll attempt to be part of that phalanx of writers skeptical of capitalism’s parasitic infestation of things that should not be given to millionaires, billionaires and their financial vultures for profits and rip-offs — education, health, social security, energy, the commons, banking, and community rights to public health, safety and protection. Add the incarceration complex to the mix, and then also think about how infected farming, food, transportation, and telecommunications and media have become through the perversions of big capital and bigger profit schemes of the financial hit men (and women).

Just a year ago, here, Martha’s Counterpunch piece:

They Aren’t All Safe: Pharma is Willing to Look “Unscientific” to Sell Vaccines

Pharma is unwise to cast such parents, of whom there are many, as “nuts.” The degeneration of their child is not their imagination. Also, there is no defensible reason for vaccines to be given all at once to a child, which many say heightens risks. Administering clusters of vaccines–once not given to children–has been called a major, new profit center for pediatricians.

But anti-vaccination activists should also not be absolutist. Would anyone refuse a rabies vaccine after being bitten by a rabid raccoon? A tetanus shot after a serious wound? Would responsible parents deny their child a whooping cough or polio vaccine?

Like all drugs aggressively marketed these days, patients and parents need to do their own research and weigh benefits and risks—never forgetting Pharma’s spotty safety record.

Seems like sanity to me, as a parent, patient and press member!

Financial Tyranny: “We the People” Are the New Permanent Underclass in America

When plunder becomes a way of life for a group of men in a society, over the course of time they create for themselves a legal system that authorizes it and a moral code that glorifies it.

― Frédéric Bastiat, French economist

Americans can no longer afford to get sick and there’s a reason why.

That’s because a growing number of Americans are struggling to stretch their dollars far enough to pay their bills, get out of debt and ensure that if and when an illness arises, it doesn’t bankrupt them.

This is a reality that no amount of partisan political bickering can deny.

Many Americans can no longer afford health insurance, drug costs or hospital bills. They can’t afford to pay rising healthcare premiums, out-of-pocket deductibles and prescription drug bills.

They can’t afford to live, and now they can’t afford to get sick or die, either.

To be clear, my definition of “affordable healthcare” is different from the government’s. To the government, you can “afford” to pay for healthcare if your income falls above the poverty line. That takes no account of rising taxes, the cost of living, the cost to clothe and feed a household, the cost of transportation and communication and education, or any of the other line items that add up to a life worth living.

As Helaine Olen points out in The Atlantic:

Just because a person is insured, it doesn’t mean he or she can actually afford their doctor, hospital, pharmaceutical, and other medical bills. The point of insurance is to protect patients’ finances from the costs of everything from hospitalizations to prescription drugs, but out-of-pocket spending for people even with employer-provided health insurance has increased by more than 50 percent since 2010.

For too many Americans, achieving any kind of quality of life has become a choice between putting food on the table and paying one’s bills or health care coverage.

It’s a gamble any way you look at it, and the medical community is not helping.

Healthcare costs are rising, driven by a medical, insurance and pharmaceutical industry that is getting rich off the sick and dying.

Indeed, Americans currently pay $3.4 trillion a year for medical care.  We spent more than $10,000 per person on health care in 2016. Those attempting to shop for health insurance coverage right now are understandably experiencing sticker shock with premiums set to rise 34% in 2018. It’s estimated that costs may rise as high as $15,000 by 2023.

As Bloomberg reports:

Rising health-care costs are eating up the wage gains won by American workers, who are being asked by their employers to pick up more of the heftier tab… The cost of buying health coverage at work has increased faster than wages and inflation for years, pressuring household budgets.

Appallingly, Americans spend more than any developed country on healthcare and have less to show for it. We don’t live as long, we have higher infant mortality rates, we have fewer hospital and physician visits, and the quality of our healthcare is generally worse. We also pay astronomical amounts for prescription drugs, compared to other countries.

Whether or not you’re insured through an employer, the healthcare marketplace, a government-subsidized program such as Medicare or Medicaid, or have no health coverage whatsoever, it’s still “we the consumers” who have to pay to subsidize the bill whenever anyone gets sick in this country. And that bill is a whopper.

While Obamacare (a.k.a. the Affordable Care Act) may have made health insurance more accessible to greater numbers of individuals, it has failed to make healthcare any more affordable.

Why?

As journalist Laurie Meisler concludes:

One big reason U.S. health care costs are so high: pharmaceutical spending. The U.S. spends more per capita on prescription medicines and over-the-counter products than any other country.

One investigative journalist spent seven months analyzing hundreds of bills from hospitals, doctors, drug companies, and medical equipment manufacturers. His findings confirmed what we’ve known all along: health care in America is just another way of making corporations rich at consumer expense.

An examination of an itemized hospital bill (only available upon request) revealed an amazing amount of price gouging. Tylenol, which you can buy for less than $10 for a bottle, was charged to the patient at a rate of $15 per pill, for a total of $345 for a hospital stay. $8 for a plastic bag to hold the patient’s personal items and another $8 for a box of Kleenex. $23 for a single alcohol swab. $53 per pair for non-sterile gloves (adding up to $5,141 for the entire hospital stay). $10 for plastic cup in which to take one’s medicine. $93 for the use of an overhead light during a surgical procedure. $39 each time you want to hold your newborn baby. And $800 for a sterile water IV bag that costs about a dollar to make.

This is clearly not a problem that can be remedied by partisan politics.

The so-called Affordable Care Act pushed through by the Obama administration is proving to be anything but affordable for anyone over the poverty line. And the Trump administration’s “fixes” promise to be no better. Indeed, for too many Americans who live paycheck to paycheck and struggle just to get by, the tax penalty for not having health insurance will actually be cheaper than trying to find affordable coverage that actually pays for care.

This is how the middle classes, who fuel the nation’s economy and fund the government’s programs, get screwed repeatedly.

When almost 60 percent of Americans are so financially strapped that they don’t have even $500 in savings and nothing whatsoever put away for retirement, and yet they are being forced to pay for government programs that do little to enhance their lives, we’re not living the American dream.

We’re living a financial nightmare.

We have no real say in how the government runs, or how our taxpayer funds are used, but that doesn’t prevent the government from fleecing us at every turn and forcing us to pay for endless wars that do more to fund the military industrial complex than protect us, pork barrel projects that produce little to nothing, and a police state that serves only to imprison us within its walls.

We have no real say, but we’re being forced to pay through the nose, anyhow.

George Harrison, who died 16 years ago this month, summed up this outrageous state of affairs in his song Taxman:

If you drive a car, I’ll tax the street,
If you try to sit, I’ll tax your seat.
If you get too cold I’ll tax the heat,
If you take a walk, I’ll tax your feet.

Don’t ask me what I want it for
If you don’t want to pay some more
‘Cause I’m the taxman, yeah, I’m the taxman

Now my advice for those who die
Declare the pennies on your eyes
‘Cause I’m the taxman, yeah, I’m the taxman
And you’re working for no one but me.

In other words, in the eyes of the government, “we the people, the voters, the consumers, and the taxpayers” are little more than indentured servants and sources of revenue.

If you have no choice, no voice, and no real options when it comes to the government’s claims on your property and your money, you’re not free.

Consider: The government can seize your home and your car (which you’ve bought and paid for) over nonpayment of taxes. Government agents can freeze and seize your bank accounts and other valuables if they merely “suspect” wrongdoing. And the IRS insists on getting the first cut of your salary to pay for government programs over which you have no say.

It wasn’t always this way, of course.

Early Americans went to war over the inalienable rights described by philosopher John Locke as the natural rights of life, liberty and property.

It didn’t take long, however—a hundred years, in fact—before the American government was laying claim to the citizenry’s property by levying taxes to pay for the Civil War. As the New York Times reports, “Widespread resistance led to its repeal in 1872.”

Determined to claim some of the citizenry’s wealth for its own uses, the government reinstituted the income tax in 1894. Charles Pollock challenged the tax as unconstitutional, and the U.S. Supreme Court ruled in his favor. Pollock’s victory was relatively short-lived. Members of Congress—united in their determination to tax the American people’s income—worked together to adopt a constitutional amendment to overrule the Pollock decision.

On the eve of World War I, in 1913, Congress instituted a permanent income tax by way of the 16th Amendment to the Constitution and the Revenue Act of 1913. Under the Revenue Act, individuals with income exceeding $3,000 could be taxed starting at 1% up to 7% for incomes exceeding $500,000.

It’s all gone downhill from there.

Unsurprisingly, the government has used its tax powers to advance its own imperialistic agendas and the courts have repeatedly upheld the government’s power to penalize or jail those who refused to pay their taxes.

Irwin A. Schiff was one of the nation’s most vocal tax protesters. He spent a good portion of his life arguing that the income tax was unconstitutional. He paid the price for his resistance, too: Schiff served three separate prison terms (more than 10 years in all) over his refusal to pay taxes. He died at the age of 87 serving a 14-year prison term. As constitutional activist Robert L. Schulz noted in Schiff’s obituary, “In a society where there is so much fear of government, and in particular of the I.R.S., [Schiff] was probably the most influential educator regarding the illegal and unconstitutional operation and enforcement of the Internal Revenue Code. It’s very hard to speak to power, but he did, and he paid a very heavy price.”

It’s still hard to speak to power, and those who do are still paying a very heavy price.

All the while the government continues to do whatever it likes—levy taxes, rack up debt, spend outrageously and irresponsibly—with little thought for the plight of its citizens.

The national debt is $20 trillion and growing. The amount this country owes is now greater than its gross national product (all the products and services produced in one year by labor and property supplied by the citizens). We’re paying more than $270 billion just in interest on that debt annually. And the top two foreign countries who “own” our debt are China and Japan.

To top it all off, all of those wars the U.S. is so eager to fight abroad are being waged with borrowed funds. As The Atlantic reports:

For 15 years now, the United States has been putting these wars on a credit card… U.S. leaders are essentially bankrolling the wars with debt, in the form of purchases of U.S. Treasury bonds by U.S.-based entities like pension funds and state and local governments, and by countries like China and Japan.

If Americans managed their personal finances the way the government mismanages the nation’s finances, we’d all be in debtors’ prison by now.

Still, the government remains unrepentant, unfazed and undeterred in its money grabs.

While we’re struggling to get by, and making tough decisions about how to spend what little money actually makes it into our pockets after the federal, state and local governments take their share (this doesn’t include the stealth taxes imposed through tolls, fines and other fiscal penalties), the police state is spending our hard-earned tax dollars to further entrench its powers and entrap its citizens.

For instance, American taxpayers have been forced to shell out $5.6 trillion since 9/11 for the military industrial complex’s costly, endless so-called “war on terrorism.” That translates to roughly $23,000 per taxpayer to wage wars abroad, occupy foreign countries, provide financial aid to foreign allies, and fill the pockets of defense contractors and grease the hands of corrupt foreign dignitaries.

Mind you, that staggering $6 trillion is only a portion of what the Pentagon spends on America’s military empire.

That price tag keeps growing, too.

The 16-year war in Afghanistan, which now stands as the longest and one of the most expensive wars in U.S. history, is about to get even longer and more costly, thanks to President Trump’s promise to send more troops over.

In this way, the military industrial complex will get even richer, and the American taxpayer will be forced to shell out even more funds for programs that do little to enhance our lives, ensure our happiness and well-being, or secure our freedoms.

As Dwight D. Eisenhower warned in a 1953 speech:

Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed. This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children. The cost of one modern heavy bomber is this: a modern brick school in more than 30 cities. It is two electric power plants, each serving a town of 60,000 population. It is two fine, fully equipped hospitals. It is some fifty miles of concrete pavement. We pay for a single fighter plane with a half million bushels of wheat. We pay for a single destroyer with new homes that could have housed more than 8,000 people. This is, I repeat, the best way of life to be found on the road the world has been taking. This is not a way of life at all, in any true sense. Under the cloud of threatening war, it is humanity hanging from a cross of iron. […] Is there no other way the world may live?

This is still no way of life.

Yet it’s not just the government’s endless wars that are bleeding us dry.

We’re also being forced to shell out money for surveillance systems to track our movements, money to further militarize our already militarized police, money to allow the government to raid our homes and bank accounts, money to fund schools where our kids learn nothing about freedom and everything about how to comply, and on and on.

Are you getting the picture yet?

The government isn’t taking our money to make our lives better. Just take a look at the nation’s failing infrastructure, and you’ll see how little is being spent on programs that advance the common good.

We’re being robbed blind so the governmental elite can get richer.

This is nothing less than financial tyranny.

“We the people” have become the new, permanent underclass in America.

It’s tempting to say that there’s little we can do about it, except that’s not quite accurate.

There are a few things we can do (demand transparency, reject cronyism and graft, insist on fair pricing and honest accounting methods, call a halt to incentive-driven government programs that prioritize profits over people), but it will require that “we the people” stop playing politics and stand united against the politicians and corporate interests who have turned our government and economy into a pay-to-play exercise in fascism.

We’ve become so invested in identity politics that label us based on our political leanings that we’ve lost sight of the one label that unites us: we’re all Americans.

As I make clear in my book Battlefield America: The War on the American People, the powers-that-be want to pit us against one another. They want us to adopt an “us versus them” mindset that keeps us powerless and divided. Trust me, the only “us versus them” that matters anymore is “we the people” against the police state.

We’re all in the same boat, folks, and there’s only one real life preserver: that’s the Constitution and the Bill of Rights.

The Constitution starts with those three powerful words: “We the people.”

The message is this: there is power in our numbers.

That remains our greatest strength in the face of a governmental elite that continues to ride roughshod over the populace. It remains our greatest defense against a government that has claimed for itself unlimited power over the purse (taxpayer funds) and the sword (military might). As Patrick Henry declared in the last speech before his death, “United we stand, divided we fall. Let us not split into factions … or … exhaust [our strength] in civil commotions and intestine wars.”

This holds true whether you’re talking about health care, war spending, or the American police state.

My Fate as a Social Worker Sealed by a Vaccine named Gardasil

Largest U.S. Charities for 2016, with private donations received — #37. Planned Parenthood Federation of America, $354 million.

I’m writing about this paid forced paid leave (suspension, administrative leave) leading up to my termination within the last hours of Monday because speaking up about injustice is a core belief. Plus, the loss of a job, one of the big TEN life altering and trauma inducing events, ties into who I am in my life, and for god’s sake, this is my livelihood, and my reputation is on the line, and my word is being maligned, and my caseload of youth in crisis is now being given the short shrift from a very big Portland non-profit. This is also a case of the non-profits in social services here or anywhere that have a super high turnover rate, pay rates that are obscene, worker respect that’s non-existent, and a general feeling that clients are the money trough, and the more on our caseloads, the merrier.

Maybe places that are unionized have a better chance of negating these negatives, or negotiating with the bosses to create sane wages. For the non-profit I currently work for and the previous one, both are in the midst of discontent brewing from within, which always leads to organizing twitches (as in a union).

I also write this piece because mine is a tale of many perspectives, or as the psychologist I am seeing because of the anxiety this administrative leave, says, “we all use filters and have confirmation biases.” It’s a tale of three cities, many cities, really, tied to a huge national birth control and abortion services company, Planned Parenthood, and even a larger player in Big Pharma and its attendant actors. The creators and distributors of Gardasil are directly tied to my sacking from, get this, pennyante wage slaving job as a social worker. Imagine, Merck and Planned Parenthood, both having their hands on my future.

The charge? I dared to voice some concerns (anonymous) that already have been voiced about this vaccine for 10 years on so many platforms, including by medical authorities, international science panels, and the individuals who are suffering disabilities directly associated with the vaccine.

Questioning a Vaccine in an Anonymous Forum Comes Back to Bite Me

I learned yesterday (October 23) that Planned Parenthood told my HR Director that I questioned vaccines – a much different question along those lines was scrawled on the paper PP gave us all to write down issues we wanted addressed, as the trainers emphasized throughout the seven hours. Told “anything you write and put in a box is anonymous.” Comments that were wholeheartedly solicited by the trainers.

Imagine that, I didn’t even get to ask the question in the class – “Why is Planned Parenthood so hooked into the corporate and Western Medicine line about Gardasil being safe when there are countless stories of harm done to young girls by this vaccine – just look them up on the web?” I gave the trainers the benefit of the doubt and expected my anonymous critique of Planned Parenthood to be taken with an adult attitude, with an open mind and with some sense of the issues of the day – not everyone believes one hundred percent of the time the efficacy of Big Pharma’s products. Imagine that!

Instead, I was called on the carpet for my behavior (based on anonymous comments) and now I’m on the ropes because Planned Parenthood has contacted my employer saying I am incorrigible, with all three trainers colluding to say that I am not capable of “giving evidence based birth control information to his [Paul’s] clients using the Planned Parenthood curriculum” (my clients are 16 to 21 years old)!

This is what I found out in my half hour visit with a driveling HR person for L—W, a woman clearly not in the game to help an employee or ally his fears of retaliation, but rather “in it” – this investigation of my behavior — to validate an outside agency’s spurious charges against me. “You don’t go up against Planned Parenthood” is the message, and if you are being trained by them, and even if you are as level headed as anyone in the training, if one iota of doubt leaves the mind of anyone, in my case written down on unsigned notes, supposedly protected space with no fears of reprisal (that’s what the trainers repeated several times), you will be subject to not only censoring, but termination.

This was all carried out through the sacred safe space of a learning environment, in the terminology of social workers, “safe space where what’s said and expressed there stays there.”

Tale of the City Called Unfettered Out-of-Control Capitalism

The next tale of this city is, of course, the concept of Capitalism and the horrors of that abusive system exponentially increased in a non-profit that is not organized (no union) which is run as an outfit supposedly on the premise of helping people. It’s my word against the behemoth’s, secretive Planned Parenthood of America’s, or in my case: the secretive Planned Parenthood of the Great Northwest and another branch, the Oregon one, the secretive Planned Parenthood of Columbia Willamette. How is it that my job is on the line because of three trainers colluding to make up a story of my supposed intransigence at a training?

I am being sacked because of the technicality that I did not complete a two-day training because the company, the secretive Planned Parenthood, dis-invited me from Day Two. So, without the day two completed, my place of employment, L—W, states that I am both out of compliance and also suspect because the trainers for Planned Parenthood told her that I am unable to deliver birth control, family planning, STI and contraceptive advice complying with the secretive Planned Parenthood curricula.

There is no evidence I am incapable of informing youth of birth control options and how to deal with Sexually Transmitted Infections/Diseases. Obviously, there is no evidence, and to predict I am incapable of —  as a double master’s degree holding experienced (34 years) college, university, alternative school, K12 teacher — giving legitimate birth control and family planning information to clients this is not only absurd but Orwellian and defamatory.

We Know – There is No Free Speech at Work, or Even in a Planned Parenthood Training

This tale of another city is all tied to my word in a world that now does not see free speech as part and parcel as integral of the learning process, and if one doubts the mainstream narrative – again in writing with no byline, one I have not admitted to within the HR Director’s investigation – that Gardasil is the best thing since penicillin, with no scientific evidence dispelling this, he gets put on administrative leave.

Imagine, a society – the secretive Planned Parenthood – telling me that I am incapable of talking about condoms, the pill, STDs because I dared question the efficacy of Gardasil. Imagine, this dark society, the secretive Planned Parenthood, telling me and then others (my supervisors) that anyone on our caseloads who might question this vaccine for themselves or loved ones will be told that this vaccine or any product promoted by the secretive Planned Parenthood is beyond reproach or criticism, the evidence be damned!

Imagine, Big Pharma driving this paranoia by my non-profit through the draconian approach to teaching, which is not just a dictatorial pedagogy by the secretive Planned Parenthood but an outright fascist way of dealing with individuals, trained in fields of social work, way beyond the pale of these trainers’ expertise: I’ve worked with homeless, with re-entry adults, with US military, with alternative high school students, with gang-influenced youth, with myriad of youth and adult learners as a community college teacher in five states and two countries, with PK12 rural youth as a substitute teacher, with adults living with developmental disabilities, with agencies managing group homes for youth and adults with developmental disabilities. I have been a journalist with seven daily newspapers and with a monthly magazine and several weeklies. I have traveled and worked in every state in Mexico, every country in Central America.

Imagine this secretive Planned Parenthood which knows zero about me, my background, my socialist roots tied to humanism/communitarianism/anti-Capitalism, my extensive teaching background, proclaiming I am unfit to teach youth about the secretive Planned Parenthood’s birth control, family planning and STD/STI services! Never did I tell anyone that I would not be teaching evidence-based birth control information.

Who Woulda Thunk: Non-profits Are as Mean and Arbitrary and Paranoid of Workers as the For-profits!

Finally, the other tale of another city is how the non-profit social services world is run by a cadre of people who fight transparency at every step. Here we have non-profits – these LLC’s as 501c3’s or quasi-corporations – covering up shady or shoddy balance sheets, and fighting tooth and nail against modest raises while citing economic/funding reasons while at the same time railing against transparency bills before the state legislature to demand an accounting of their big bucks from grants, government sources, corporations, and philanthropies. Exactly how much does the driveling HR director make, or my boss makes, who has 21 years at L—W? And this culture implores us to never ever ask for a raise, an act that also is “concerning” to bosses. A concern these people say, when a human being asks about a raise, as if this is malfeasance or insubordination. ASKING for a hike in pay, how insubordinate!

This constant paranoia by the non-profits to show us the books creates a pay scale that stays consistent throughout the industry (it’s the prevailing wage so all the non-profits collude and say it’s what the market can bear) because they all agree to pay the same low wage. And, here we are – firing employees, or forcing employees to quit or move on. We are in an unethical corporate culture, one where counselors and therapists and social workers move from agency to agency because of the mayhem the non-profits create — antithetical to anything a good social worker practices to create a safe space, anonymity, and a culture of giving and cooperation.

Instead, these leaders in the non-profit world create a culture of secrecy, fear, retaliation and a management style whose precipitous behavior puts employees at risk of trauma and daily workplace harassment/anxiety. This is the fight-flight-stay (freeze) culture where we are in a constant flight-or-stay mode due to overloading our work, the low pay, the lack of voice in corporate policies and caseload management. We love the work but need to be recognized that it involves a lot of traumatized and difficult human cases of mental health, suicidal patients, drug abused youth and adults, and homeless and near-homeless individuals who many times are up against a criminal injustice system that makes innocent citizens pay through legal financial obligations and the threat of imprisonment.

Key Findings — United We Heal campaign

Overworked

Care providers juggle caseloads of 100 clients or more, making it impossible to provide consistent care.

Frequent Burnout

With huge caseloads and very little support, burnout is the norm, resulting in high rates of turnover.

Inconsistent Care

Clients regularly wait months for a follow-up appointment, and they’re forced to start over with new providers as often as every three months.

Underpaid

With stagnant pay and poor benefits, providers earn far less than other workers with similar levels of education.

More Funding, Poor Care

The six largest behavioral health agencies in Multnomah County have seen a 30% increase in funding in the past five years, but this increase in revenue has not resulted in better care.

Problems like these are why Oregon ranks 51st in the country for mental health outcomes, behind every other state and Washington DC.

We need respite, real paid personal time for self-care, and we need managers who care about us, are concerned about their entire workforce, rather than put some funding stream/agency like the secretive Planned Parenthood and their hucksterism tied to Gardasil above all else.  Read the report, The Unheard Voices in the Conversation about Behavioral Health in the Portland Metro Area

It seems nothing can be simple in a world of capitalist abuse, in a world of careerism and bureaucracy tied to a vicious world of HR directors and compliance managers running roughshod over well-educated and experienced workers. We are in a world of non-profits profiting from federal, state, county, and municipal dollars in the form of grants and one where other non-profits like Planned Parenthood send more money into the non-profit pipeline through grants that have some heavy metal strings attached.

In the case of the non-profit I work for – L—W – I have been put on administrative leave since October 17, and now after a half hour visit to the company’s HR director, I am still in limbo, this administrative leave, with a cascading process toward my termination.

I am on leave because of the secretive Planned Parenthood, the trainers at the Seattle event – three of them – and their word is taken over mine, even though I have two colleagues who also attended and who have not been contacted by the L—W HR Director to corroborate my say/story.

In the end, looking at my non-profit’s demographics, I am certainly square jawed now after all of this bullshit to see I am being discriminated against because of my age, my gender and my non-mainstream views against the propagandists of the world, whether they be people calling for poor people to be jailed or health care taken away from undocumented immigrants or bans on people from Muslim countries or Big Pharma’s/Big Medicine’s obscene profits at the expense of real health care or racism-sexism-cultural bias in the workplace.

I espouse cultural practices by Native American healers or indigenous shamanic practices or those in my old workplace, curanderas ( healers). I espouse diversity in thinking, including holistic healing and naturopathic options. I advocate CHOICE. And I advocate FREE speech. I have been put on termination notice for these conceptual and philosophical beliefs.

I promised a second part to yesterday’s (October 22, DV article) which fills in the gaps of where I left off. Unfortunately, a non-profit circling the proverbial wagons fulfills a diversionary tactic that one might expect from lawyers defending a Harvey Weinstein, but instead I am working for a mental health deliverer, more than fifty years in business in Oregon, charging me with insubordination at a Planned Parenthood training. Instead of getting, “Okay, Paul, go back to work and we will ask your co-coworkers their impression of your behavior at this training, and take care of yourself, please,” I get, “We have concerns raised by Planned Parenthood calling us telling L—W you cannot finish the two day sex ed training because they won’t let you attend.”

A Vision and Mission Statement Only on Paper, Not in Practice

This is a company – the non-profit I work for — that professes on its website and in brochures how it honors all people and takes care of people’s needs, both emotional and mental health needs. This is a company that has put me into the proverbial “one-more-day-sweating-it-out-on-administrative-leave-before-termination” or whatever the HR department conjures up in their antithetical to due process monkey court. I am not being treated in a human or humane way.

“Touch a single life, and make a whole community stronger. We touch nearly 19,000 lives each year—because life works when you get the support you need.”

Our mission at L—W is to promote a healthy community by providing quality and culturally responsive mental health and addiction services across the lifespan.

Our Core Values — L–W values and believes in providing high quality prevention, mental health and addiction services to build a healthy community. Our core values are:
 Recovery and Resilience: We know that life works when people receive the help they need.
 Relationships: We work in partnership with the community and within L—W to improve the lives of those touched by mental health or addiction issues.
 Results: We provide services that we know work to change people’s lives.

Imagine, my life has been torn upside down, and this non-profit’s cavalier attitude that my job is easily terminated and my life even more easier to move on. This company doesn’t care about one of its own; is duplicitous when the secretive Planned Parenthood puts pressure on them to eliminate me from training; is in some dubious alliance with the secretive Planned Parenthood; and this company is freezing me out in this bullshit administrative leave with no resolution solicited by me or my coworkers. I am in the lurch one more day, as of opening today, and this limbo has caused mental duress and hardships beyond some bean counter’s or HR’s directives and hell-bent process to get rid of an employee.

They don’t practice trauma informed care at L—W.

This is a problem of two tales – the tale of the employee – one old male social worker – going up against a non-profit cadre of female upper echelon who have given their employee, me, no recourse, no redress and no way to challenge the secretive Planned Parenthood’s banning. No matter how these people look at this, this is an employer-employee dispute precipitated by an outside entity, the secretive Planned Parenthood. It’s about them not following some sort of sane and tangible due process, and no matter how much the HR Director and this non-profit want to squeeze their eyes shut, and throw caution to the wind this still is a quasi-judicial investigation demanding fair treatment, fair discovery by both parties and a consensus resolution.

This is what I found out October 24:

a. three trainers from the secretive Seattle Planned Parenthood and one of their observers (three females and one male) told the HR director of my company that “we feel Paul cannot deliver evidence-based contraception and birth control information to his youth on his caseload.”

I stated that there was nothing of the sort voiced by me at the classroom that indicated I did not understand the curriculum. What is this projection that they feel I can’t in the future deliver curriculum? Why not ask me what I think: I know condoms work, that STIs are a big issue with the age group I support, and that birth control works, from hormones to IUDs to sponges to condoms.

b. Paul questioned Western Medicine several times.

First, I am science based. It’s clear from my daily activities, my writing and my background. Questioning Western medicine on things like the FDA-approved and deadly Vioxx or over-prescribing of antibiotics and Western Medicine’s role in the opioid crisis is not only scientific, but it’s evidence-based science to challenge a hypothesis. And, having young and old patients question their doctors about x or y procedure or a or b drug regimen is not only evidence-based and practical, it’s in the American Medical Association’s recommendation: get a second or third opinion.

“Paul questioning Western Medicine and vaccines” really wasn’t what happened in the classroom: not out of the blue, and not in some enraged anti-Medicine rant. Here, when asked about other contraception procedures, from one of the trainers, we all put in ideas, and then I spoke up and mentioned Queen Anne’s lace and other abortifacients that native cultures have used time immemorial: Antelope Sage, and other abortifacients such as Pennyroyal, Rosemary, Skullcap, Slippery Elm.

The very idea that this secretive Planned Parenthood team would not honor a culturally important and in so many ways super legitimate thesis about other methods of healing to be both listened to and adopted is a form of overt racism and prejudice, and for me to be singled out because I brought up some other methods of contraception is insanity. I come from a culturally informed background working with Apaches, Navajo, Tigua, Spokane, Colville, Coeur d Alene and other First Nations groups, including Winona La Duke and her White Earth Reservation. To accuse me of insubordination broaching other cultural frames is not only abhorrent, but speaks volumes about this highly secretive, rich white woman run organization called Planned Parenthood.

Imagine my African American colleague and the four others in the training by the secretive Planned Parenthood advancing the Black Community’s abhorrence of Western Medicine and a shaky relationship with this secretive Planned Parenthood:

Sanger was a supporter of now-discredited eugenics movement, which aimed to improve humans by either encouraging or discouraging reproduction based on genetic traits.

At one point, in 1934, she even crafted a proposed law that included this provision: “Feeble-minded persons, habitual congenital criminals, those afflicted with inheritable disease, and others found biologically unfit by authorities qualified judge should be sterilized or, in cases of doubt, should be so isolated as to prevent the perpetuation of their afflictions by breeding.” Sanger said she wanted “to give certain dysgenic groups in our population their choice of segregation or sterilization,” which some have interpreted as a reference to concentration camps.

Yet one of the most thorough looks at the connection between American eugenicists and Germany Nazis, The Nazi Connection, by German professor Stefan Kuehl, makes no mention of Sanger (though Stoddard is featured). Sanger is briefly mentioned in another of one of Kuehl’s books, “For the Betterment of the Race,” mostly in connection with her efforts to assemble an international conference of birth control specialists to combat overpopulation.

“She was very positive about eugenically motivated sterilization,” Kuehl said in an e-mail. But he said “the typical mistake is linking eugenics in general too closely to Nazi race policy. There have been very different strands of eugenics – national socialist, racist, liberal, socialist, Catholic, Jewish, and so on.”

The U.S. Holocaust Memorial Museum says that “Nazi Germany was not the first or only country to sterilize people considered ‘abnormal.’ Before Hitler, the United States led the world in forced sterilizations. Between 1907 and 1939, more than 30,000 people in twenty-nine states were sterilized, many of them unknowingly or against their will.”

Sanger in 1938 appeared to speak positively about the German program undertaken by the Nazis. “Reports in medical journals state that the indications laid down in the German law are being carefully observed. These are congenital feeble-mindedness; schizophrenia, circular insanity; heredity epilepsy; hereditary chorea (Huntington’s); hereditary blindness or deafness; grave hereditary bodily deformity and chronic alcoholism,” she said. “The rights of the individual could be equally well safeguarded here, but in no case should the rights of society, or which he or she is a member, be disregarded.”

Of course, this is from the Washington Post, not an honorable publication now owned and operated by Jeff Bezos, CEO of Amazon. Here is an interesting quote from the creator of this secretive and largely white women-run secretive Planned Parenthood:

The main objectives of the [proposed] Population Congress is to…apply a stern and rigid policy of sterilization and segregation to that grade of population whose progeny is already tainted, or whose inheritance is such that objectionable traits may be transmitted to offspring.

— Margaret Sanger, “Plan for Peace”, 1932 Senate hearings

Here, another piece our youth could easily access on the Internet around the Secretive Planned Parenthood questioned by the African American community:

DOCUMENTARY

In 1939, Margaret Sanger, the founder of Planned Parenthood announced the organization’s new “Negro Project” in response to requests from southern state public health officials—men not generally known at that time for their racial equanimity. “The mass of Negroes,” her project proposal asserted, particularly in the South, still breed carelessly and disastrously, with the result that the increase among Negroes, even more than among Whites, is from that portion of the population least intelligent and fit.” The proposal went on to say that “Public Health statistics merely hint at the primitive state of civilization in which most Negroes in the South live.”

Imagine if these African American women at the training I was banned from, confronting the secretive Planned Parenthood’s early roots/history and questioning these modern roots pushing Gardasil.

c. Fact three: I was told by my HR director that these three trainers with 50 years of combined sex Ed training all said in unison that I was discounting of western medicine.

I wasn’t, to be sure, discounting Western Medicine by any measure, just the PR campaigns of Big Pharma and For-profit Medicine and this Gardasil — Just look at my uncle the surgeon’s practice, cousin’s urology practice, aunt’s nursing background, cousin’s psychiatric practice, and my own utilization of plenty of Western medicine practices, from MRI’s to ultrasounds to acid reflux meds and on and on. This blanket statement is both not proven in my classroom demeanor, actions and discussion, nor in my life on planet earth.

d. The HR Director with my immediate supervisor in the room with us, mute and fuming as her face signaled, tried to make some larger issue of concerns about my work – I have questioned an undercover county deputy sheriff in a public meeting making jokes about drug addiction and young people, and by doing so, I asked the crowd to also reconsider and refrain from the laughs and giggles in this county presentation by many speakers.

I was told by my supervisor a DHS worker at that meeting with the deputy mentioned my confronting the cop, to her, in an aside (no written complaint). Another concern was that I publicly discounted a Trump supporter social worker who told more than 60 case managers that Trump was responsible for the great employment rates by youth in Oregon. I did it with tact and with confidence.

Here’s how these people work – I was sent to a secretive Planned Parenthood training, had two nights in a hotel at $170 a night paid for, plus 52 cents a mile for my personal vehicle (up to $200 for that drive), plus flex time (seven hours), plus a per diem for food. Now, is that a non-profit that legitimately has concerns with his employee? I was at the training by the secretive Planned Parenthood and did what all participants did – engaged in the material, listened to the trainers and showed composure and decorum. I was then summarily disinvited to the day two training.

This triggered L—W to put me on paid administrative/suspended leave. This triggered an investigation by this driveling HR director, who was on vacation until a week after my forced leave, yesterday. I am now being called into question about “these concerns” only because the secretive Planned Parenthood triggered this brouhaha. Think readers: I am being rejected by the secretive Planned Parenthood and that then this triggers my termination.

e. Unfortunately for L—W, the HR Director stated to me that the secretive Planned Parenthood trainers said I questioned a vaccine. Imagine, I never once stated an objection to a vaccine, the only one of which mentioned by the trainers is the Gardasil HPV vaccine. What this driveling HR Director exposed is that my anonymous written comments were attributed to me, as if no one else in that room would have stated reservations about Gardasil.

I am fighting for my job in a universe created by the secretive Planned Parenthood that is not governed by the laws of physics or humanism or fairness. My driveling HR Director failed to see this reveal. Instead, she has told me that, after I asked her how I might make up the second day of training, “I do not have an answer to that, Paul.” Imagine, no other way for me to sit through another training that would keep me on the job, in compliance.

Moving On Means Filing for Unemployment, Looking for a Lawyer, Looking for Work, and . . . Writing 

Part Three of this piece is titled, The Seal has been Broken on Gardasil – A Story of Incapacitation, Chronic Pain, and Death.

I never thought that an insipid training in Seattle at the secretive Planned Parenthood would open up this Pandora’s Box of a vaccine that is beyond a doubt the cause of many lifelong incapacitating diseases and deaths according to many who tie the HPV virus to their pain and relatives’ deaths.

Part three of this is like a page ripped from eugenics books and a Joseph Mengele nightmare around Gardasil: what the reader might find is both disturbing and indicative of social engineering and medical overreach by anyone’s standards of what the right thing to do for young girls — our sisters, cousins, friends, nieces — and now young boys.

Here, a prelude to Part Three:

Gardasil is Sterilizing Young Women

Scott Field, M.D., FCP, who currently serves on American College of Pediatricians’ board of directors, was the primary author on the warning released on behalf of ACP titled Primary Concerns About the Human Papillomavirus Vaccine which states:

“It has recently come to the attention of the College that one of the recommended vaccines [HPV] could possibly be associated with the very rare but serious condition of premature ovarian failure (POF), also known as premature menopause.”

Although ACP’s paper states that POF is a “very rare but serious condition,” their own investigative findings in the paper seem to hint at a more widespread problem by stating:

“Most primary care physicians are probably unaware of a possible association between HPV4 and POF and may not consider reporting POF cases or prolonged amenorrhea (missing menstrual periods) to the Vaccine Adverse Event Reporting System (VAERS).”

ACP’s paper goes on to state that, despite the medical community’s ignorance of a possible association between the HPV shot and POF, there have been 213 cases reported to the Vaccine Adverse Events Reporting System (VAERS). The report continues by making a case to concluded that:

“The overwhelming majority (76%) of VAERS reports since 2006 with ovarian failure, premature menopause, and/or amenorrhea are associated solely with Gardasil®.”

Is there a possible culprit contributing to POF that is specific only in the Gardasil shot? ACP’s paper stated:

“Few other vaccines besides Gardasil® that are administered in adolescence contain polysorbate 80.”

The Material Safety and Data Sheet (MSDA) does not address the effects of polysorbate through injection. Yet, in MSDA’s toxicology section under special remarks on chronic and toxic effects on humans states that Polysorbate 80:

“May cause adverse reproductive effects based on animal studies.”

A conclusion of ACP’s study states:

“A causal relationship between human papillomavirus vaccines (if not Gardasil® specifically) and ovarian dysfunction cannot be ruled out at this time.”

Additionally, this is another peak into Part Three of my piece upcoming ASAP —  Abnormal Pap Smears, Cervical Dysplasia and Cervical Cancer Spike Post-HPV Vaccination

by Leslie Botha, Women’s Health Freedom Coalition Coordinator, Natural Solutions Foundation, and Janny Stokvis, VAERS Research Analyst

In 2006, the HPV vaccine Gardasil touted to prevent cervical cancer was introduced to a public generally unaware of the Human Papillomavirus or its threat to adolescent girls and women. However, the public was quickly informed of the dangers of the virus when Merck launched an aggressive advertising campaign designed to capture the attention of girls/women ages 9 to 26 with a catchy jingle and their now famous line: “One Less Girl to Get Cervical Cancer.” Adolescent girls were dancing and singing that they will be “one less girl” in unison with the award-winning TV commercial.

According to Neon Tommy, the online publication for the Annenberg School for Communication and Journalism, USC, the promotion was successful. In 2008 Merck’s marketing techniques even earned Gardasil a “pharmaceutical brand of the year” award from Pharmaceutical Executive for its ‘savvy disease education,” and for building “a market out of thin air.”

Six years later, it appears that “one less” is now turning into “one more” as reports of abnormal pap smears, cervical dysplasia and cervical cancer are appearing in the HPV vaccine targeted market.

As of May 12, 2012 the Vaccine Adverse Event Reporting System (VAERS) showed there have been 26,050 reports of adverse events (including 849 reports from boys/men ages nine to 26) post-HPV vaccination. The National Vaccine Information Center (NVIC) estimates only 1 to 10% of the vaccine-injured are reporting.

Of concern is the significant increase in reporting for cervical abnormalities reported to VAERS each month. Of even more concern is that the American College of Obstetrics and Gynecology has raised pap testing guidelines to age 21 leaving many adolescents without proper cervical screening tools post-vaccination. Yet a significant number of events are being reported by an age group that typically does not develop cervical cancer until age 50 or older. According to Stokvis, some of the reports of cervical abnormalities are occurring four to five years post-vaccination.

This a tale of both girls and boys, young men and young women, being adversely affected by Gardasil! The voice of the voiceless up against Big Pharma and a Secretive Planned Parenthood.

American Teaching Hospitals: Where Pelvic Exams Under Anesthesia Happen

Before undergoing a liver biopsy at Memorial Sloan Kettering Cancer Center in New York City, I asked my surgeon’s nurse whether I was to be catheterized for the procedure. In response to this perfectly legitimate question the knave sardonically replied: “I’m really not supposed to say this, but what difference does it make? You’re going to be under general anesthesia.”

It was at that moment that I started to wonder: With an attitude like that, what do they really do to us when we are under anesthesia? And thus a little Internet surfing was most certainly in order.

In my journey into the subterranean depths of cyberspace, I was startled to come across a most terrifying sea monster indeed: a disturbing discussion where medical students debate, often favorably, the ethics of doing practice pelvic exams on anesthetized women undergoing surgery. The thread is here.

Apparently, there is no shortage of medical students, interns, residents, and attending physicians who feel they are entitled to penetrate the vaginas and anuses of anesthetized patients that lie paralyzed and helpless on the operating table, and who feel that they have the right to do this without first obtaining the patient’s consent. This naked display of barbarism and sociopathic behavior speaks volumes about the moral unraveling that is so glaringly on display in the West today.

This scandalous practice is evidently not uncommon in Australia, as this article attests.

The forum is fascinating in that it allows the reader to be a fly on the wall, giving one a glimpse into how many American medical students think – if that is, in fact, the appropriate word. (Some spelling corrections have been made in the following quotations. Hopefully, these Ivy League superstars will take more care in looking after their patients than they do with the written word. Considering the attitudes on display here, I am not optimistic).

The discussion opens with a medical student named Unregistered Abuser, who, like a kind of postmodern Socrates struggling with an existential conundrum, puts forth the following question:

Let me pose a question. I am on gynecological surgery and several different residents and attendings have told me that prior to surgery it is a great idea to perform a pelvic exam on the anesthetized woman in order to get practice. Many have said it is not traumatic to the patient and you get a more technically adequate exam since the patient is not guarding. Sure enough, before every procedure the attending and resident…perform a quick pelvic exam. Is this wrong? The attending does it for one last chance to feel for any previously undiagnosed masses or other abnormalities, but the resident and student do it primarily for educational purposes. The patient has consented to the surgery, but not for the pelvic exam. Does consent to surgery of the uterus, vagina, vulva, ovaries, etc. also imply consent to manual palpation of these structures during the surgery?

A medical student named Starayamoskva comments: “It is standard procedure. How else do you think the residents and students are going to learn?” A student named Gauss replies: “Pelvics on anesthesized women prior to surgery is routine – informed consent was obtained as part of the surgical consent.”

Doc Ivy chimes in, “As a woman I have to say that I really don’t have a problem with this. If I am at a teaching hospital it’s what I would expect.” A medical student named tupac_don flippantly remarks, “Been there done that, it’s A okay.” And not to be outdone, one student who could be the very devil himself says, “Patients…have rights? This phrase is thrown around by every damn idiot…but where does it come from? Hey Mr. lawyer, does the Bill of Rights say ‘Medical students shall not examine a patient’s vagina prior to vaginal surgery?’ This patient’s have rights bull**** came from lawyers…. Healthcare isn’t even a right.”

So how did we arrive at this cesspit of degeneracy and the most abject moral bankruptcy? And where did these despicable monsters come from?

They came from our schools, our press, and our mass media. They came from our consumerism, our materialism, our barbarism abroad, and the totalitarianism of our prison system. They were born out of the ashes of post-New Deal America, where our nation’s once proud middle class now lies in ruins, and we are increasingly trapped in a world of the affluent living in their gated communities on one side, and the miserable wretched masses – the oppressed, the destitute, and the debt-ridden on the other.

The dismantling of the humanities has also played a significant role in fomenting this dehumanization. This is because most colleges and universities presently exist for only two reasons: to maximize the greatest possible profit, while also serving as vocational institutes that mold young people into becoming automatons trained to perform increasingly specialized jobs. (Jobs which, particularly outside of health care, do not even exist).

This absence of a proper humanities education has undoubtedly contributed to the inculcation of many medical students with the pernicious idea that patients are mere objects and teaching tools. And the danger of significant numbers of young people receiving an advanced scientific and technical education that is utterly devoid of any foundation in the humanities, lies in the fact that the soullessness and amorality that follow will inevitably usher in an age of authoritarianism and absolute unchecked barbarism.

Many medical students are also made acutely aware of which patients have money and good health care plans, and which don’t. This two-tier system is well on display in many medical institutions across the country, as patients are separated into the haves and the have nots. (And lest we forget, there are also the “have mores,” as George W Bush was once kind enough to point out). One student writes on this thread: “At my school, the rule is that it’s ok to do [pelvic exams on anesthetized women] on welfare patients but not on private patients.”

The oligarchy’s mass media brainwashing apparatus has been relentless in spreading the virus of neoliberal free market dogma. And this has also exacerbated commodification, dehumanization, desensitization, as well as contributing to a profound loss of compassion, empathy, and a sense of self.

The attitude of the attending physician will unequivocally have a profound impact on the behavior and thinking of the medical students, interns, and residents that they mentor. And their philosophy and approach to patient care will shape and mold the moral character (or lack thereof) of their charges in profound ways, and for many years to come.

The physician Peter Ubel writes on the website kevinmd.com:

Moral attitudes are often a function more of our experience than of our training. When some colleagues and I surveyed medical students and asked them how important it was to ask permission before conducting a pelvic exam on an anesthetized woman, brand new medical students almost universally stated that permission was vital but by the time the students finished their OB/GYN rotations three years later, they didn’t see permission as being important anymore. Despite the lectures they’d received about ‘informed consent’ during the first two years of medical school, six weeks of an OB/GYN rotation was enough to change their moral attitudes.

Men under anesthesia are not immune to this barbarous practice, as the attending physician can order medical students to line up and perform practice prostate exams on anesthetized male patients.

How ironic, that if a student passes out while intoxicated at a party and their body is vaginally or anally penetrated while they are unconscious, the law states unequivocally that this is illegal. However, if a student gets a 4.0 GPA, aces the MCAT, and goes to medical school they can actually do this all day long and to their heart’s content.

Many medical students will feel in their heart that this practice is unethical, yet proceed with the unauthorized exam as they wish to get a good grade and don’t want to anger their attending physician. And like soldiers in the military, the pressure to conform will be overwhelming. It will take great courage to say no.

There is also an inextricable connection between nonconsensual physician shadowing and nonconsensual rectal and pelvic exams performed on anesthetized patients. With the former, once this Rubicon has been crossed it becomes ingrained in the minds of everyone on the medical “team” that the patient is more of a primate than a human being, and is consequently undeserving of any right to privacy whatsoever. Moreover, once these civilized norms of morality and ethics have been breached, it will be easy for a medical student to take things just one step further, and violate a patient’s body on the operating table “for practice.”

It is vitally important that medical students, residents, and fellows be inculcated with an understanding that both observing a patient’s session with their doctor as well as examining a patient’s body, constitute a privilege and not a right. And they must be made to understand that this privilege can only be granted when both the attending physician  and the patient sign off on it.

There may be some medical students who are angrily reading this, and who have concluded that I am somehow attempting to sabotage their efforts at becoming doctors. As one who has taken a lot of photographic portraits on the streets of New York City, never have I taken someone’s portrait without first obtaining their consent. If a photographer makes the case that there is an ethical and an unethical way of taking portraits, does it then somehow follow that they are of the opinion that photographic portraiture should be banned altogether?

Every teaching hospital in this country has a website where they speak ad nauseam of their profound respect for patient privacy. The problem is that their conception of the term applies only to protecting the digitalization of your medical records.

It is noteworthy that not all the medical students who participated in this discussion were in favor of this practice. Souljah1 says: “Lining up 4-6 medical students to do pelvics on anesthetized women is totally ****ed up in my opinion. Not giving clear information regarding students lining up to examine their genitalia and reproductive organs is incredibly unethical in my opinion.”

And one brave medical student going by the name Mumpu argues, “Think about the absolute trust the patient places in your skills and professionalism when they go under anesthesia. They are paralyzed and unconscious and it is grossly unprofessional of you to violate that trust by violating their body. There’s no ‘greater good’ clause here. To do an unconsented exam is assault (any firefighter/EMT who ever worked on the streets knows this), to do an unconsented pelvic is sexual assault.”

And so perhaps we can take heart in knowing that even in this dark age of book burning and the most appalling ignorance, there are still those who live their lives with a powerful sense of morality and ethics, who have retained their humanity in the face of stifling reactionary dogmas, and who have resisted the call of dark forces that lie in wait behind every shadow and every unlocked door.