Bioethicists Weigh In On the Healthcare Reform Vote (updated)

As the readers of this blog know, both myself and several of our bloggers have posted about universal health care coverage many, many times as an ethical and moral imperative. In the last year, my hopes (along with many other bioethicists, I'm sure ) of attaining universal coverage have gone up, down and sideways, like a roller-coaster ride, exhilarating and frightening, with emotions ranging from inspiration to resignation.   Now that the US House of Representative has finally passed a health reform bill, I've requested several bioethicists (and friends of the WBP) to share their thoughts on the ethical implications of the passage of this bill:

Art Caplan of UPenn:  "The passage of this bill, flaws and all, represents the elimination of the single greatest failure in American health care -- a lack of universal insurance coverage.  With this legislation in place America can finally say after decades of failure that it has honored its responsibility to create equal opportunity for every citizen."

Tom Murray, President and CEO of the Hastings Center:

 "I liked Nancy Pelosi’s comment that being female will no longer be considered a preexisting condition.

As I tried to say in my essay in the Connecting American Values to Health Reform collection, and reiterated in my Perspective in the New England Journal of Medicine, any serious and responsible health reform had to include universal participation along with means for insuring that we could be good stewards of our finite health care resources.

The “universal participation” piece was not fully accomplished, but very significant progress was made. Already today, however, news reports say that it will be under attack in several states. We will have to see whether it survives.

Perhaps the least appreciated aspect of the legislation is the set of strategies to make stewardship a reality (most commentators lump it under “cost containment”). Ezra Klein offers a very useful, brief summary here." 



Ruth Faden, Executive Director of Johns Hopkins Berman Institute of Bioethics and Philip Franklin Wagley Professor in Biomedical Ethics  says:  "This historic legislation for the first time enshrines a national commitment to guarantee that all of us in this country have meaningful access to appropriate medical care.  As a consequence, our society is now more just.  Our people have a greater prospect of securing for themselves and their families not only more health, but also more of everything that is essential to human well-being, including personal security, respect and self determination."

Hilde Lindemann, Professor of Philosophy and Immediate Past President of the ASBH says: 

"Can one be happy and angry at the same time? The passage of the health care reform package is cause for rejoicing: it helps the poor and dispossessed—a disproportionate number of whom are women and children--gain access to health care. But it was achieved at the cost of both parties’ affirming in very loud tones that if a woman is pregnant unwillingly, she has recourse to abortion only if she can pay for it privately. That so much of the rhetoric surrounding reform was given over to underscoring what has been the case since the Hyde Amendment was passed many years ago, leaves me furiously frustrated."

I am waiting for several other bioethicists to respond to my inquiries, and will post them upon receipt.

As for my own feelings and thoughts, I think Nancy Giles of CBS Sunday Morning said it best:

"So I'm a progressive, and I don't consider this bill, or Dennis Kucinich (D-Ohio), or anyone who supports this legislation to be "selling out" because it doesn't go far enough. The bottom line is 30 million more people will get health care coverage, and that will save lives now. Voting "yes" gets a foot in the door.

Change takes serious effort, but progress happens. The fight for women's rights didn't end when we got the right to vote in 1920; the Lily Ledbetter Fair Pay Act signed just last year was another move toward true gender equality. Civil rights didn't end with the Emancipation Proclamation or the Voting Rights Act of 1964.

HR 4872 is a crucial first step, and can be amended and improved, but doing nothing is not an option. Health care should be a basic human right. And no one should be uninsured, or underinsured, or go broke paying their medical bills in the richest country in the world."  

Amen to that. 

[Cross-posted on IEET's blog]

Iron-Jawed Angels: A Reminder of the Hard-Fought Right to Vote

We are a non-partisan blog, and so we cannot comment on individual political candidates' stances -- However, we can remind our readers about the issues at stake and remind everyone about why women should vote. Re-posted in part from the social networking site Gather.com, Deloris Wright poignantly explains why:

This is the story of our Grandmothers, and Great-grandmothers, as they lived only 90 years ago. It was not until 1920 that women were granted the right to go to the poles and vote. The women were innocent and defenseless. And by the end of the night, they were barely alive. Forty prison guards wielding clubs and their warden's blessing went on a rampage against the 33 women wrongly convicted of 'obstructing sidewalk traffic.'

They beat Lucy Burn, chained her hands to the cell bars above her head and left her hanging for the night, bleeding and gasping for air. They hurled Dora Lewis into a dark cell, smashed her head against an iron bed and knocked her out cold. Her cellmate, Alice Cosu, thought Lewis was dead and suffered a heart attack. Additional affidavits describe the guards grabbing, dragging, beating, choking, slamming, pinching, twisting and kicking the women.

Thus unfolded the 'Night of Terror' on Nov. 15, 1917, when the warden at the Occoquan Workhouse in Virginia ordered his guards to teach a lesson to the suffragists imprisoned there because they dared to picket Woodrow Wilson's White House for the right to vote.

For weeks, the women's only water came from an open pail. Their food--all of it colorless slop--was infested with worms. When one of the leaders, Alice Paul, embarked on a hunger strike, they tied her to a chair, forced a tube down her throat and poured liquid into her until she vomited. She was tortured like this for weeks until word was smuggled out to the press.

So, refresh my memory. Some women won't vote this year because--why, exactly? We have carpool duties? We have to get to work? Our vote doesn't matter? It's raining?

Last week, I went to a sparsely attended screening of HBO's movie 'Iron Jawed Angels.' It is a graphic depiction of the battle these women waged so that I could pull the curtain at the polling booth and have my say. I am ashamed to say I needed the reminder...




HBO released the movie on video and DVD. I wish all history; social studies and government teachers would include the movie in their curriculum. I want it shown anywhere else women gather. I realize this isn't our usual idea of socializing, but we are not voting in the numbers that we should be, and I think a little shock therapy is in order.

It is jarring to watch Woodrow Wilson and his cronies try to persuade a psychiatrist to declare Alice Paul insane so that she could be permanently institutionalized. And it is inspiring to watch the doctor refuse. Alice Paul was strong, he said, and brave. That didn't make her crazy.

The doctor admonished the men: 'Courage in women is often mistaken for insanity.'

Please, if you are so inclined, pass this on to all the women you know.

We need to get out and vote and use this right that was fought so hard for by these very courageous women. Whether you vote democratic, republican or independent party - remember to vote.

History is being made.

[The full post can be found here.]

Birth Control to Reduce HIV in Africa

I don't know which to be more horrified about in this article entitled the 'Best-Kept Secret' for HIV-Free Africa:

- that researchers realize that birth control can have a great impact on reducing the number of children born with HIV in Africa, but they can't do anything about it, because of the PEPFAR's ban on distribution of contraceptives or family planning;

or the sentence where women are treated like a piece of property: "The man who, in accordance with local tradition, inherited her after her husband died refused to use condoms";

or the comments to the article that say that this is not 'our' (read 'America's') problem. As if we lived in a bubble.

It is a painful reminder of just how far we still have to go when it comes to basic human rights and mankind's inhumanity to man (and woman).