AMA Family Ethics



Hospitals & Asylums 

   

Family Opinions on the Patient Physician Relationship HA-14-4-11

By Anthony J. Sanders

sanderstony@

Rendered for the Passover Seder sunset 18-25 April and Easter Egg Hunt 24 April 2011

To better respect the AMA Code of Medical Ethics 10.00-10.05 Opinions on the Patient-Physician Relationship, Opinions 10.06-10.10 are appended to espouse the ideals of family medicine, caregiving, social work, family law and victim compensation[i]. The Secretary of State instantly got the AMA Code of Medical Ethics back online after a report of censorship was made in 2009. Whereas she has spared her husband adultery on several memorable occasions, the Secretary of State may opt to oversee this e-Motion regarding the hypocrisy of the “Personal Medical Home” of the American Academy of Family Practitioners in elaboration upon the Patient-Physician Relationship as it pertains to the Family to the AMA Council on Ethical and Judicial Affairs[ii] by law (1 Timothy 3:2), (Proverbs 5:8) and (Mark 10). I adjure you by God, do not torture us (Mark 5:7)[iii].

While writing this document I achieved 50 non-consecutive pull-ups, to compliment 100 push-ups, 100 sits ups and 4 mile run daily, took a short course of Ampicillin 500 mg, ordered Doxycycline 100 mg, the once a day antibiotic, for 15 cents a pill, and stopped eating sugar in 2011, after giving up animal products in 2010. Said the wisdom teeth to the first maxillary molar, “drink your coffee black or not at all” like my mother, the unemployed family physician, who paid for my recent visit to the dentist. To honor her father, Will, I wish to dedicate this document to the free, automatic and permanent use of the Maiden name for professional practice after divorce as commanded by Moses in (Exodus 20:7 & 12) and (Deuteronomy 5:11 & 16) directed in (Deuteronomy 24:1-4) and inspired by the Good News regarding the Virgin Mary (Mathew 1:18-21) (Luke 1: 26-55) (Matthew 28), (Mark 16) and (Luke 24).

Opinions on the Patient-Physician Relationship 10.06-10.10

Opinion 10.06 Family Medicine, In General

Opinion 10.07 Caregiving for Children, Elders and the Disabled

Opinion 10.08 Social Work, the Psychiatric Inheritance

Opinion 10.09 Family Law: Maiden Name, Support and Probate Avoidance

Opinion 10.10 Compensation for Torture, Biological Experimentation and Work

Endnotes

Opinion 10.06 Family Medicine

Family medicine is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body. It is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion. According to the World Organization of Family Doctors (Wonca), the aim of family medicine is to provide personal, comprehensive and continuing care for the individual in the context of the family and the community[iv]. The American Academy of Family Practitioners (AAFP) defines quality healthcare in family medicine as the achievement of optimal physical and mental health through accessible, safe, cost-effective care that is based on best evidence, responsive to the needs and preferences of patients and populations, and respectful of patients’ families, personal values, and beliefs[v]. Until antibiotics are made available Over-the-counter the role of the family physician, other than administering childhood vaccines, shall be primarily to prescribe broad spectrum antibiotics, the best medicine of the 20th century, and to evaluate and implement the best practice of specialties and discard the endless symptom treating and unnecessary operations of high priced specialists[vi].

The portion of the Hippocratic Oath (late 5th century B.C.) relevant to family practice is: To consider dear to me, as my parents, those who taught me this art; to live in common with them and, if necessary, to share my goods with them; To look upon the children of others as my brothers, and to teach them this art. I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. Family medicine has moved to the office, house calls are rare and hospital visitations are performed by hospitalists rather than family physicians. This decadence is reflected in the AAFP definition of personal medical home that is so immoral as to incite homicide, a crime of genocide (18USC(50A)§1091(c)), and needs to be prohibited[vii] by incorporating into the AAFP definition of personal medical home, the clause from the Hippocratic Oath whereby, In every house where I come I will enter only for the benefit of my patients, keeping myself far from all intentional ill-doing and seduction… furthermore, the practice of sending medical bills to people’s homes is frowned upon and the practice of serving patients as a personal medical mailing address for hospital bills, laboratory results, Internet pharmacy purchases and medicine related correspondence, is promoted[viii].

Family medicine is the natural evolution of historical medical practice. The first physicians were generalists. For thousands of years, generalists provided all of the medical care available. They diagnosed and treated illnesses, performed surgery, and delivered babies. Germ Theory developed in the 1600s by Dr. Girolamo Fracastoro was proven with the application of the microscope to observe microscopic organisms by Antoni van Leeuwenhoek in 1674. Sterilization advanced one step with Louis Pasteur beginning in 1857 and took two steps back with the disgrace, wrongful imprisonment and death in a psychiatric institution of hospital hygienist Dr. Ignaz Philipp Semmelweis in 1965. With World War II, despite the marketing of broad spectrum antibiotics, discovered by Alexander Fleming in 1929, specialization began to flourish. In the two decades following the war, the number of specialists and subspecialists increased at a phenomenal rate, while the number of generalists declined dramatically. The concept of the generalist has been reborn and has yet to learn to walk to visit patients in hospitals and their homes and make recommendation to ensure their living environment is hygienic[ix].

When flour was first ground around 10,000 BC the number of caries in the dental record rose from 2% to 10%. Since sugar was introduced in the 1600s the number of people with significant caries rose to 95%. Tobacco, salt, sugar, baked goods, caffeine, alcohol, fat, particularly trans-fat, all animal products, namely dairy and eggs and other unnecessary recreational, addictive and dangerous substances should be avoided completely[x]. The consumption of fat, protein and carbohydrate macronutrients should be eliminated or minimized to speed up digestion and absorption from 3 weeks for beef, 1 week for chicken and 3 days for fish, to less than one day for the micronutrients found in fruit, vegetables and whole grain. The preference for fresh fruit, vegetables and whole grains is that they do not betray the animal kingdom to flesh eating bacteria and their fiber is excreted efficiently[xi]. Clean water, sanitation, antibiotics and vaccines were successful in eliminating or reducing the danger from most infections[xii]. Since the decadence of the automobile and television the number of people struggling with obesity and the related chronic diseases of diabetes, heart disease and cancer have risen[xiii]. Some progress has been made in reducing cancer deaths with public knowledge regarding environmental carcinogens, diet, exercise and religious aftercare. Public knowledge regarding the bacterial, dietary and sedentary causes of diabetes and endocarditis must be disseminated to the public with refillable prescriptions for antibiotics, vegan diet and exercise[xiv].

The basic regimen prescribed for longevity is to be vaccinated by a physician as a child, take antibiotics to treat infections, sleep on your side, drink purified water, brush your teeth at least twice a day, shower daily and after exercise, maintain good personal and environmental hygiene, wash your hands and food before eating, wear proper protective gear and use disposable gloves when touching patients, eat only fresh fruits, vegetables and whole grains, with rice for digestion, and exercise daily. Exercise can be minimized by running a 3 mile cross country course daily or two hours walking will be needed, especially if you are employed in a sedentary occupation, like watching television. Elders often use anti-fungal foot powder. Stretches are useful for treating rheumatism, reducing injury from more energetic exercises, and getting some exercise throughout the day[xv]. Strength exercises such as push-ups, sit-ups, pull-ups and weight lifting are popular[xvi]. To afford a sedentary lifestyle the human body must be engaged in some sort of physical activity no less than 24 hours a week including cooking, cleaning and gardening. One should be exposed to sunlight for around 30 minutes a day or a multivitamin containing Vitamin D should be taken to prevent and treat osteoarthritis[xvii]. Vitamin C, found in in high quantity in citrus, is highly effective at preventing and treating viral infections[xviii].

The pneumococcal vaccine for 24 of 97 serotypes of Streptococcus invented in 1977 is the most promising experimental treatment for American sufferers of pneumonia, meningitis and endocarditis[xix]. Pneumococcal sensitive bacterial endocarditis is ten to twenty times more prevalent than cancer, and in the new millennium, edged ahead of viral and chemical sensitive cancer, as the leading cause of death. Pneumonia is the leading cause of the innocent transmission of disease vectors from one human to another. Bacterial infections can be treated with antibiotics whose resistance is mitigated by the practice of metronidazole, the unfortunately carcinogenic antibiotic of first resort in dentistry and abdominal infection. Chronic disease results from necrotic tissue that is susceptible to bacterial infection and must be sterilized with courses of antimicrobial agents, as needed, while the wound heals over extended periods of perfect living that might be hastened when stem cell treatments come into use[xx]. The Author-Doctors of the Hippocrates shall sterilize their medical libraries, cite their sources and email prescriptions for the benefit of the sick, with an absolute minimum of non-medically necessary physical and social contact, in pursuit of the restoration of hospital visits, house calls and mutual financial freedom from well written legal briefs that cite both statute and medical literature to ensure immunity from all forms of epidemics[xxi].

Opinion 10.07 Caregiving for Children, Elders and the Disabled

The goals of caregiving are (1) to maintain a healthy lifestyle, (2) to promote independent physical functioning to the highest level possible, (3) to promote independent mental functioning to the highest level possible, (4) to promote a feeling of self-worth, (5) to provide a safe environment, (6) to provide for privacy, (7) to provide for social contact with friends and relatives, (8) to provide for a nurturing and caring environment. These goals serve to emphasize and enhance the overall mission of caregiving. Establishing specific plans to meet these general goals will do much to foster the functioning and well-being of the person[xxii]. Caregivers help the elderly, disabled, ill, and mentally disabled to live in their own homes or in residential care facilities instead of in health facilities.  Most personal and home care aides work with elderly or physically or mentally disabled clients who need more extensive personal and home care than family or friends can provide.  Caregivers are domestic partners, also called personal and home care aides, homemakers, companions, and personal attendants, they provide house-keeping and routine personal care services.  Caregivers clean client's houses, do laundry, change bed linens, plan meals (including special diets), shop for food, and cook, a vegan diet is prescribed for longevity.  Weekly manicures and pedicures are given and the liberal use of antifungal foot powder is recommended for elders. When necessary caregivers help clients get out of bed, bathe, toilet, groom, dress and eat.  Caregivers often accompany clients to doctors' appointments or on other errands and provide instruction and physical education to their patients and may also advise families on nutrition, exercise, cleanliness, contagious disease and household tasks[xxiii] . 

Talking with understanding is fundamental to creating a nurturing and loving home environment, particularly when dealing with dementia, where everyone is informed and reminded of problems and opportunities, on a daily basis. Talking about health matters in the home is of primary importance to healthy cohabitation. Caregivers, in consultation with physician, should be able to diagnosis and treat the common cold (rotovirus) with Vitamin C, influenza with Theraflu, pertussis and pneumonia with antibiotics to fend off new infections. They say pneumonia is an elder’s best friend and caregivers must always be on the alert for contagious disease. Caregiving begins in utero when the mother eschews vices, eats healthy food and consumes a folic acid multivitamin, in consultation with a doctor. Births in America are usually performed under the supervision of an obstetrician in a hospital however skilled midwives can perform home births. Nursing mothers, famed for post-partum depression, do most of the caring for babies. As the child develops the body grows, baby teeth come in, crawls, walks, talks, is weaned and the father becomes more important. Vaccines are administered by pediatricians and family physicians until age 7. Permanent teeth begin coming in around age five when children start their formal schooling and the wisdom teeth arrive when it is over, around age 18. Through this entire period of childhood parents, as caregivers, are expected to provide a nurturing and loving home. Children of low income families are entitled to free medical and dental care until age 18[xxiv].

Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which may hinder their full and effective participation in society on an equal basis with others. The family is the natural and fundamental group unit of society and persons with disabilities and their family members, are entitled to receive necessary protection and assistance by society and the State, to enable families to contribute towards the full and equal enjoyment of the rights of persons with disabilities. Persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. State shall take effective and appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life [xxv]. For the purposes of social security disability insurance, An individual shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy (Title II §223(d)(1)(A) of the Social Security Act (42USC(7)II§423(d)(1)(A))

The American Association of Homecare Code of Business Ethics assures the prompt and reliable provision of homecare products and services, appropriate for each individual’s needs, health and safety for copay or deductible unless waived due to financial hardship”[xxvi]. The National Council on the Aging defines home health agency as "a company that provides many professional health care services, in the home, under the direction of a physician”[xxvii]. To help home health care professionals receive federal funds the National Association for Home Care and Hospice (NAHC) offers national certification for personal and home care aides that requires the completion of a standard 75 hour course and written exam and are evaluated on 17 different skills by a registered nurse[xxviii]. Physicians should not be reluctant to certify hardworking caregivers under their supervision for government home health care subsidies (Title XIX §1929 of the Social Security Act (42USC§1396t)), including social security disability and retirement insurance (Title II §202 of the Social Security Act (42USC(7)II§402). Nearly one third of persons with dementing illness exhibit signs of depression. Significantly, caregivers display symptoms of depression in even higher percentages than do those with dementia[xxix]. Caregivers, mothers and domestic partners are notoriously economically depressed must be treated well with respect and praise, improving wages, corporate responsibility, companionship and physical exercise, because they must be in optimal physical and mental health to heal their patient.

Opinion 10.08 Social Work, the Psychiatric Inheritance

Social work is the mental health profession whose Code of Ethics states “The primary mission of the social work profession is to enhance human well-being and help meet the basic human needs of all people, with particular attention the needs and empowerment of people who are vulnerable, oppressed and living in poverty”[xxx]. Family law is religious law that was usurped by lawyers during the Enlightenment and in the 20th century social workers emerged to inherit responsibility for archiving the administration of social welfare, probate, divorce, tenant-landlord relations, small claims, and mental health and substance abuse cases. Social workers must become competent to write and archive well written case law, confidentially and on the Internet. The Workforce Investment Act of 1998 defines literacy as "an individual's ability to read, write, speak in English, compute and solve problems at levels of proficiency necessary to function on the job, in the family of the individual and in society." Social workers, as a class, are developmentally disabled by (1) the need for a bachelor of the law equivalency as foundation for their graduate degree in social work, and/or funeral direction for probate, to ensure they know how to write a civil brief, that cites relevant statute, on just about any topic that might arise. E.g. the Mental Health Bill of Rights (42USC((102)IV§9501) (2) the transfer of psychiatric education from the medical campus to the college of social work, (3) abolition of civil commitments and the termination of all psychiatric hospital licenses, (4) the need for a comprehensive Social Work Administration (SWA) to administrate socially supervised community mental health shelters and (5) the need for sado-masochism to be defined in the DMS-V[xxxi].

The care of the mentally ill and poor has had a mixed record in the United States. Colonial Americans utilized county almshouses to care for the poor, dispossessed and mentally ill. In the 1840s Dorothea Dix went on an interstate psychiatric hospital construction spree and almshouses were condemned as unsanitary. A brief resistance provided supervised home care and art therapy in a rural environment for the mentally ill regardless of ability to pay. After the Civil War the psychiatric hospitals became very large and the charity curdled as relief organizations proudly promised that the poor would not get one red cent as a condition for donations and grants to their non-profit organization. After World War II the deinstitutionalization movement closed many institutions in favor of community mental health care. The cruelty adapted into tortuous antipsychotic and hypnotic drugs while the false arrests sped up so four times as many people were hospitalized in half the beds. Zyprexa causes diabetes, particularly when accidentally or intentionally mixed with alcohol. Antipsychotics, including Lithium, cause potentially deadly extrapyramidal side effects that are easily cured with 1 g Cogentin and the right to refuse antipsychotic treatment under (42USC((102)IV§9501(1)(A)(i)(D)). Like Lithium, Prozac can cause birth defects; Prozac is otherwise a safe and effective anti-depressant. Psychiatric hospitals have been condemned by the State and World Health Organization and must terminate all inpatient psychiatric hospitals, other than forensic, to reinvest in residential treatment that must be supervised by licensed social workers employed by a Social Work Administration (SWA). The psychiatric education shall be transferred to the College of Social Work and psychiatric wishing to continue practicing shall be expected to apply for a social work license to continue to be eligible for federal subsidies. In the interim first responders and prospective patients are advised to boycott general hospitals with psychiatric hospitals, until Psychiatric Emergency Services and civil commitments have been abolished[xxxii].

Dr. Richard Cabot introduced a medical social services department at Massachusetts General Hospital in 1905. Seven years later, a specialty in medical social work was offered by the Boston School of Social Work. A number of hospitals, mainly in the Northeast, established medical social work departments. In 1918, hospital social workers formed the American Association of Hospital Social Workers. Mental institutes also began to see the benefit of social services. Adolf Meyer, a prominent leader in the mental hygiene movement, believed that psychiatry needed to focus more of its efforts outside the asylum. He identified the social worker as a primary agent in providing a better understanding of the patient's social environment. In 1920, leading Psychiatric social workers formed the Psychiatric Social Workers Club[xxxiii]. The International Federation of Social Workers is a successor to the International Permanent Secretariat of Social Workers, which was founded in Paris in 1928 and was active until the outbreak of World War II. After much preliminary work, the Federation was finally founded in 1956 at the time of the meeting of the International Conference on Social Welfare in Munich, Germany. The IFSW updated their previous definition of social work from 1982 in their General Meeting in Montreal, Canada in July 2000 adopting the definition that “The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Principles of human rights and social justice are fundamental to social work”[xxxiv].

Relationism practiced by social workers and human rights advocates, is a different perspective on law that is more sympathetic to people’s feelings as they relate to one another, than either the adversarial or inquisitorial legal systems lawyers practice in[xxxv]. Physicians who retain legal counsel, for any reason, are highly advised to employ a social worker to ensure the richest of the rich capitalize upon the law to administrate wisely to the poor. The parable of the Good Samaritan (Luke 10:30-37) is a powerful Biblical inspiration for this idea of neighborly love. The essence of neighborliness is that the Good Samaritan and the victim he helped did not know each other, and probably never had a chance to become acquainted. The Good Samaritan does good, what he can see is simply right to do, without seeking recompense or advantage for himself, and then goes on his way. This kind of love is an essential component of a modern community. In Old English, love is contrasted with lagu, law. The latter involves litigation, the former an amicable settlement. The phrase under law and love in ancient Anglo-Saxon usage was used to denote the position of being a member of a "frankpledge' which in turn was a system of free engagement of neighbor for neighbor[xxxvi]. Dignity of the human person is the ethical foundation of a moral society.  The measure of every institution is whether it threatens or enhances the life and dignity of the human person.  Social workers respect the inherent dignity and worth of all individuals.  Social workers treat each person in a caring, respectful manner mindful of individual differences and cultural and ethnic diversity.  Social workers seek to promote the responsiveness of organizations, communities and social institutions to individuals’ needs and social problems.  Social workers act to prevent and eliminate domination of, exploitation of, and discrimination against any person or group on any basis[xxxvii].

Opinion 10.09 Family Law: Maiden Name, Support and Probate Avoidance

A physician shall never dispute a will or divorce. A physician who disputes a will or divorce shall have their license suspended until they cease to burden the Court. A physician is advised to avoid probate by never filing a will or destroying any previously made will in favor of intro vivo transfers such as pay on death accounts, joint tenancy, caregiving agreements, etc. whereas a person should own nothing when they die[xxxviii]. A practicing physician is responsible for making good faith support payments to any immediate family member or caregiver of that family member, of theirs, living below the family poverty line. To avoid infringing it is highly advised that a female (physician) who gets divorced immediately fill out the paperwork to change the name of her medical practice to use her Maiden name to avoid the semblance of contempt[xxxix]. The struggle against the stigma of illegitimacy and un-marriageability pertaining to the Agunah: Jewish chained wife, and her children[xl], is so eloquent when portrayed by a woman using her Maiden name, as to aspire to require by professional ethics the use of the Maiden name between marriages, for female physicians, who would otherwise be devoid of any statutory guidance, but the Good News pertaining to the Virgin Mary in (Mathew 1:18-21) (Luke 1: 26-55) (Matthew 28), (Mark 16) and (Luke 24). Children inherit their name from their father, perhaps until such a day that mothers are equally generous with their heritage. Female physicians are not obligated to use their married name but may choose to. Physicians may not use their divorced name, if it is other than their name of birth or current marriage. State Boards shall provide their members, their member’s spouses and family members, an alternate venue for the amicable resolution of divorce and estate administration of physicians and learn to treat patients like family, without residency requirements, by email.

A physician, with an above poverty line income, who is delinquent in their support payments, or violently abuses their children or spouse in any way, stalks, defrauds or who civilly commits any of their immediate family members to a psychiatric hospital against their will, or subjects them to cruelty or fear of biological experimentation shall practice medicine only if they pay reasonable compensation sufficient to be forgiven by the victim, or the estate of the victim. A patient who has an ethical complaint with a physician shall be treated like family by the State Board, by name and email and no residency requirement shall be imposed on the email correspondence. Adultery is known a deadly sin (Exodus 20:14) and (Deuteronomy 5:18) that may require avoidance of her door (Proverbs 5:8). Jesus defined, everyone who divorces his wife and remarries commits adultery, and he who marries a woman divorced from her husband commits adultery. (Luke 16:18) (Mark 10:2-12). It would be irresponsible for the State Board to discriminate against divorcees whose families were ruined, at least in part, as the result of their “membership” to a professional society. It would be unfair to appoint adulterers to positions of oversight without the recommendation of their extended family, and forbidden to positions of religious authority (1 Timothy 3:2). Health is not religion but the concept of health theology is so intriguing as to demand religious law be liberally applied to achieve the highest attainable degree of medical ethics, particularly at the intersection of family medicine and family law.

The Old Age and Survivor Insurance (OASI) Trust Old (Sec. 201 of the Social Security Act 42USC(7)II§401) was begun with the original Social Security Act of 1935. Survivor insurance provides for the spouse and dependent children should the beneficiary die. One month after an insured person dies a sum of not less than $255 is made payable to the widow or widower of the deceased. Should the deceased have been eligible or receiving disability or old age insurance and the spouse was not eligible but dependent upon the deceased income the surviving spouse and dependent children are eligible for 75% of normal benefits of the deceased. Divorced spouses, and those without sufficient service, are often given, 50% of normal benefits. A person will not be eligible for full benefits for such a time they have a monthly income above $2,500.00[xli].

Probate avoidance is the primary purpose of estate planning. Blessed are the meek, who avoid probate, for only they will inherit the earth (Matthew 5:5). Since probatable assets include only those assets owned at the time of death, the simplest way to reduce their value is to give them all away while still alive. The most widely used strategy for avoiding probate is joint ownership. Joint ownership applies to any type of property. For a bank account it involves only the signing of a new Pay on Death (POD) signature card. Transfer on death (ToD) securities registrations are used for stocks and bonds held in a brokerage account. For real estate the preparation and recording of a new deed recognizing joint ownership is best. There is a gift tax on up to half of the transferred assets to joint ownership with people who did not contribute, other than a spouse, depending on the length of the marriage. Like wills trust funds are vulnerable to state laws mandating filing with probate and are therefore not the recommended method of family administration – administrate a regular bank account in writing. Wills and testamentary documentation can appoint a personal representative to balance the debts of the decedent with the needs of the descendants. Never pay a student loan that failed to employ or medical b(k)ill that failed to heal. Do not pre-appoint a lawyer or file a will with probate. Respect the rights of the surviving personal representative. Do not hesitate to dispose of the wardrobe and death bed, host a funeral for the family friends and refurnish with the proceeds of an estate sale under (24USC(10)§420(a)(2)(A-E)(b)). Credit cards often offer free life insurance to settle your debt if you die. So as not be ensnared by the right of the creditors valued over $1,000 to file for probate collection, the personal representative should explain their circumstances in writing to all creditors and administrate a settlement that is fair. People who have been tortured into disclosing the identity of their family to the will of the Probate Bar have only to revoke their will by crossing out the signature[xlii]. A beneficiary may opt disclaim an interest in an estate for estate tax purposes under (26USC(B)(12)(B)§2518). State Medical Boards shall help the intestate inheritors of the estates of physicians to avoid probate, with dignity, in the safety and security of the state board, in writing[xliii].

Opinion 10.10 Compensation for Torture, Biological Experimentation and Work

Compensation for victims of torture, biological experimentation and unpaid or underpaid work is a fundamental responsibility of physicians-patient relationship. The basic rights to compensation for false arrest and torture may be the only guiding rights and the many rights to life, home, health, work and education, left the government for the free market. Art. 7 of the International Covenant on Civil and Political Rights 1976 guarantees; No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation. Art. 14 of Convention against Torture, Cruel, Inhuman and Degrading Punishment and Treatment (CAT) of 1985 requires Each State Party shall ensure in its legal system that the victim of an act of torture obtains redress and has an enforceable right to fair and adequate compensation including the means for as full rehabilitation as possible. In the event of the death of the victim as a result of an act of torture, his dependents shall be entitled to compensation. The International Ethical Guidelines for Biomedical research Involving Human Subjects of 1993 codifies at Guideline 19 the Right of injured subjects to treatment and compensation. Investigators should ensure that research subjects who suffer injury as a result of their participation are entitled to free medical treatment for such injury and to such financial or other assistance as would compensate them equitably for any resultant impairment, disability or handicap. In the case of death as a result of their participation, their dependents are entitled to compensation. Subjects must not be asked to waive the right to compensation[xliv].

The US has been ultra vires Arts. 2, 4 and 14 of the Convention against Torture (CAT) since 2009, when the criminal penalties for torture were exempted for acts committed in the geographic US, after a lengthy period without the exclusive remedy of the civil tort. Physicians must oppose and must not participate in torture for any reason. Participation in torture includes, but is not limited to, providing or withholding any services, substances, or knowledge to facilitate the practice of torture. Physicians must not be present when torture is used or threatened. Physicians may treat prisoners or detainees if doing so is in their best interest, but physicians should not treat individuals to verify their health so that torture can begin or continue. Physicians who treat torture victims should not be persecuted. Physicians should help provide medical and financial support for victims of torture and, whenever possible, strive to change situations in which torture is practiced or the potential for torture is great (AMA Opinion on Torture 2.067). To prevent interference with medical practice the medical community and all good citizens must dissolves their association with the poison of their alma mater[xlv], nosocomial infections of the hospital laboratory, the corruption of the Democratic and Republican (DR) two party system, the nosocomial infections delivered by government health insurance. To foster sovereign immunity health institutions must learn to respect, protect and fulfill the human right of victims of torture and biological experimentation to compensation, as a self-determinate institution, that employs those patients who turn in their written homework to Ethics committees in health institutions under Opinion 9.11[xlvi].

Medical malpractice is so common, and litigation over it so rare, that between three and seven Americans die from proven medical errors for every-one who receives a payment for any malpractice claim. Most victims of medical malpractice quietly find another doctor or lose faith in the health and justice system entirely; leaving malpracticing doctors and defective procedures in place for decades. The major problem is that the money invested in malpractice insurance companies generates an interest to prevent lawsuits, settlements, and most of all to avoid formal disciplinary action by the State Medical Board, more than to improve patient safety. The medical malpractice liability and insurance system needs to be improved, to better protect witnesses against retaliation, to better protect society against the very real and present danger of medical malpractice and to increase the utilization of State Medical Disciplinary Boards rather than Courts. The medical establishment, for their part as a self-interested capitalist system, is interested in increasing the number and severity of sick people by infecting more people and providing ineffective treatment to profit from “disease care” without losing their license to practice[xlvii]. To end the domination of health care by conflict of interest and begin to read consumer responses, impartially and effectively for the entire 25 percent of the hundred million patient care episodes with grievances or well-written medical research, maybe 10 million of whom are due speedy compensation because of their poverty[xlviii]. The primary purpose is to encourage the patient to do the medical library and legal research needed for them and other like them to recover thereby reducing the burden on health care professionals struggling with their peculiar antibiotic resistant nosocomial infection. Patient ownership of their medical records and applied research papers should be redeemed as minimum wage work for the disabled. Institutional Ethics Committees settle civil actions against employees (42USC(6A)IA§233).

Endnotes

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[i] Sanders, Tony J. Community Health Center Ethical Review Board. A Bill for 24 Hours Reading and Writing. HA-15-10-10 pp. 3

[ii] American Medical Association Code of Medical Ethics. AMA Council on Ethical and Judicial Affairs. (1847) ceja@ama-

[iii] Sanders, Tony J. Customs House Act, St. Elizabeth. Hospitals & Asylums. HA-26-2-11

[iv] World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (Wonka) admin@.sg

[v] American Academy of Family Physicians (AAFP). Definition of Family Medicine. Quality Health Care in Family Medicine. (2006)

[vi] Sanders, Tony J. Best Medicine Monographs. Hospitals & Asylums. HA-14-2-11

[vii] Art. 20 International Covenant on Civil and Political Rights of 1976 1. Any propaganda for war shall be prohibited by law. 2. Any advocacy of national, racial or religious hatred that constitutes incitement to discrimination, hostility or violence shall be prohibited by law.

[viii] American Academy of Family Physicians (AAFP). Personal Medical Home (2006)

[ix] American Academy of Family Physicians (AAFP). Family Medicine, Scope and Philosophical Statement. (1992), (2006). (2011) contactcenter@

[x] Smith, Rebecca W. The Columbia University School of Dental and Oral Surgery’s Guide to Family Dental Care. W.W. Norton & Company. New York. 1997

[xi] Biddle, Wayne. A Field Guide to Germs. Henry Holt and Company New York. 1995 pp. 1-17

[xii] Sanders, Tony J. Cholera Kit. Hospitals & Asylums. HA-30-1-11 pp.11

[xiii] Sanders, Tony J. Public Health Department (PHD) Book 9. Hospitals & Asylums. 5th Draft. 26 September 2009

[xiv] Fisher, Margaret C. MD. Immunizations and Infectious Diseases: An Informed Parent’s Guide. American Academy of Pediatrics. 2006 pp.330-334

[xv] Chang, Edward C. Knocking at the Gate of Life and other Healing Exercises from China. Translation of the Official Manual of the People’s Republic of China. Rodale Press. Emmaus, Pennsylvania. 1985 Pp. 57-60

[xvi] Bridges, Barbara J. R.N. Therapeutic Caregiving: A Practical Guide for Caregivers of Persons with Alzheimer’s and Other Dementia Causing Diseases. BJB Publishing. Mill Creek, Washington. 3rd Printing. 1998

[xvii]Vitamin D deficiency may hamper lung function. Foodconsumer. January 29, 2011

[xviii] Pauling, Linus. How to Live Longer and Feel Better. W.H. Freeman and Company. New York. 1986

[xix] World Health Organization (WHO). Streptococcus pneumoniae (Pneumococcus). Decision making and Implementation of Pneumococcus Vaccines. November 2009

[xx] DeNoon, Daniel J. Martin J. Laura, MD. Failing Hearts Healed With Stem Cells. WebMD Health News. March 17, 2011

[xxi] Sanders, Tony J. Public Health Department (PHD). Book 8. 5th Draft. Hospitals & Asylums. 26 September 2009

[xxii] Bridges, ‘98 pp. 20

[xxiii] Damp, Dennis V. Health Care Job Explosion! High Growth health Carea Careers and Job Locator. Bookhaven Press LLC. MCKee Rocks, PA. 5th printing. 1996-2006 pp 287

[xxiv] Omnibus Budget Reconciliation Act of 1990 P.L.101-508

[xxv] Art. 2 Convention on the Rights of Persons with Disabilities 6 December 2006

[xxvi] American Association of Homecare. Code of Business Ethics. May 1, 2010

[xxvii] Lazell, E. Benefield, PhD, RN Are You Really for Home Health Nursing American Journal of Nursing Jan. 1998 pp. 17-18

[xxviii] Home Care Aide Certification Program information call (202) 547-7424

[xxix] Bridges ’98 pp. 134

[xxx] National Association of Social Workers. Professional Code of Ethics

[xxxi] Sanders, Tony J. State Mental Institution Library Education (SMILE). Book 4. 6th Draft. Hospitals & Asylums. HA-16-3-11

[xxxii] SMILE ’11 Millennium Reports Section 165. pp. 560-565

[xxxiii] Huff, Dan. Progress and Reform: A Cyberhistory of Social Work’s Formative Years. Boise State University. 2000

[xxxiv] International Federation of Social Workers. History 2009

[xxxv] Barsky, Allan E. Florida Atlantic University. The Virtuous Social Work Researcher. Journal of Social Work Values and Ethics. Volume 7 Number 1 (2010)

[xxxvi] Regasamy, S. Evolution of Social Welfare/Work in UK, US and India. Madurai Institute of Social Sciences. 2009 pp 70

[xxxvii] University of St. Thomas School of Social Work. Principles of Social Justice. July 2006

[xxxviii] Sanders, Tony J. National Cemetery Organization (NCO) Section 278 Probate Avoidance Estate Planning. Book 7. 4th Draft. Hospitals & Asylums. HA-16-8-10

[xxxix] Dickie v. Dickie [Canada] 1 S.C.R. 346, 2007 SCC 8

[xl] Bruker v. Marcovitz, [Canada] 3 S.C.R. 607, 2007 SCC 54

[xli] NCO ’10: Sec. 283 Social Security Survivors. Pp. 1014-1015

[xlii] Board of Trustees of the University of Alabama v. Calhoun, 514 So.2d 895 (Ala.1987)

[xliii] NCO ’10: Art. 3 Family Law. Sec. 284 Intestate estate. Pp. 1015-1016

[xliv] International Ethical Guidelines for Biomedical research Involving Human Subjects. Council for International Organizations of Medical Sciences (CIOMS); World Health Organization. 1993

[xlv] Sanders, Tony J. Human Rats Amendments to Human Research Protection. Hospitals & Asylums. HA-25-10-09

[xlvi] Sanders, Tony J. Tort Reform Act of 2009 Hospitals & Asylums. HA-9-9-9

[xlvii] Wolfe, Sidney M; Resnevic, Kate. Public Citizen’s Health Research Group Ranking of the Rate of State Medical Boards’ Serious Disciplinary Actions, 2006-2008 (HRG Publication #1868) April 20, 2009 January 2007

[xlviii] CHC ’10: pp. 23-24

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