Abortion in NC

As you may have heard, in a bit of stealth political maneuvering yesterday, the NC Senate sprang substantial abortion restrictions into legislation with basically no warning (it was part of the absurd anti-sharia bill).  The restrictions are pretty similar to what you may have heard about in the Texas case that had the famous filibuster last week:

RALEIGH, N.C. — With the gallery packed by abortion rights supporters and a protest waged outside the Legislative Building, the state Senate on Wednesday gave its blessing to a series of abortion restrictions.

The bill, which originally prohibited the recognition of foreign law, such as Islamic Sharia law, in family courts, was overhauled Tuesday with little public notice and converted into an omnibus bill titled the Family, Faith and Freedom Protection Act by adding the contents of various anti-abortion legislation pending in the General Assembly.

Senators voted 29-12 to approve House Bill 695, which now returns to the House for a final vote on the changes…

It’s also unclear whether Gov. Pat McCrory would veto the bill or allow it to become law without his signature. He has said he opposes new restrictions on abortion in North Carolina. Republicans have large enough majorities in both the House and Senate to override a veto.

Senate Democrats criticized the bill during nearly two hours of debate Wednesday morning, offering amendments that were quickly defeated and questioning the need to interfere with what they said is a private medical matter.

Mostly, however, they were incensed that the bill was pushed through with little advance notice during the July 4th holiday week.

This is just no way to move major legislation in a democracy.  Sure, the NC Senate clearly has the votes, but this is not how democracy should work.  Many Republicans claimed that Democrats used to do stuff like this.  You know what?  They did.  And it was wrong then, too.  Kudos to McCrory on this point:

The hasty process clearly displeased McCrory, however.

“When the Democrats were in power, this is the way they did business. It was not right then and it is not right now,” the governor said in a statement. “Regardless of what party is in charge or what important issue is being discussed, the process must be appropriate and thorough.”

What just kills me, though, is Republican so transparently pretending that they are doing this because they care about women’s health.  That is decidedly not the case.  I just wish they would flat-out admit that they are doing this to limit abortion as an end-run around settled Constitutional law.

Under the legislation, abortion clinics would have to meet the same standards as ambulatory surgical centers. Abortion providers also would have to be present with the patient throughout the procedure, whether surgical or drug-induced. Also, abortion clinics would have to have “transfer agreements” with nearby hospitals, which are roughly equivalent to the hospital granting the physicians admitting privileges.

“We’re not here today taking away the rights of women. What we’re taking away is the rights of an industry to have substandard conditions,” said Sen. Warren Daniel, R-Burke.

Only one of the 36 abortion clinics now in North Carolina would be able to meet the new requirements, according to advocates. A similar law in Mississippi closed every abortion clinic in that state except one, and its fate is being settled in federal court.

It’s okay with me that Republicans want fewer abortions.  Heck, I’d like fewer abortions.  But the Supreme Court has held for 40 years now that a woman has a Constitutional right for an abortion early in her pregnancy and this is very clearly an attempt to limit that Constitutional right without saying so.

Imagine what all these same legislators would say about a bill that required all gun owners to keep their guns locked up in their home and to use trigger locks.  Or heck, that they could only be sold in stores that met certain expensive parameters.

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How to die

Nice post on how physicians vs ordinary people feel about end of life care.  Short version, the vast majority of physicians say “not for me” to most end-of-life interventions.  Nicely summarized in this chart:

Screenshot_1

Amazing.  So, what’s going on here?

First, few non-physicians actually understand how terrible undergoing these interventions can be.  He discusses ventilation.  When a patient is put on a breathing machine, he explains, their own breathing rhythm will clash with the forced rhythm of the machine, creating the feeling that they can’t breath.  So they will uncontrollably fight the machine.  The only way to keep someone on a ventilator is to paralyze them. Literally.  They are fully conscious, but cannot move or communicate.  This is the kind of torture, Murray suggests, that we wouldn’t impose on a terrorist.  But that’s what it means to be put on a ventilator.

A second reason why physicians and non-physicians may offer such different answers has to do with the perceived effectiveness of these interventions.  Murray cites a study of medical dramas from the 1990s (E.R., Chicago Hope, etc.) that showed that 75% of the time, when CPR was initiated, it worked.  It’d be reasonable for the TV watching public to think that CPR brought people back from death to healthy lives a majority of the time.

In fact, CPR doesn’t work 75% of the time.  It works 8% of the time.  That’s the percentage of people who are subjected to CPR and are revived and live at least one month.  And those 8% don’t necessarily go back to healthy lives: 3% have good outcomes, 3% return but are in a near-vegetative state, and the other 2% are somewhere in between.  With those kinds of odds, you can see why physicians, who don’t have to rely on medical dramas for their information, might say “no.”

The paradox, then — the fact that people want to be actively saved if they are near or at the moment of death, but also want to die peacefully — seems to be rooted in a pretty profound medical illiteracy.  Ignorance is bliss, it seems, at least until the moment of truth. Physicians, not at all ignorant to the fraught nature of intervention, know that a peaceful death is often a willing one.

I’ll bookmark mark this post and bring it to the hospital with me in maybe (hopefully) another 40+ years or so.  

Photo of the day

Love this recent photo of the day from National Geographic:

Picture of the Kremlin and the Moscow River, Russia

Moscow, Russia

Photograph by Dara Pilugina, National Geographic Your Shot

On the day that I made this photo, it was really cold. It was the beginning of March, but in Russia it seemed like it was the middle of winter. I was lucky and unlucky with the weather at the same time. I was standing on the Bolshoy Moskvoretsky Bridge, and a cold strong wind was blowing, but the same wind drove the clouds in the sky and the ice on the river.

The scandal illusion

Last week at dinner the restaurant I was at had Fox News on a TV near my table.  I couldn’t help watching some and just being utterly amazed at the alternate reality Fox is in.  This was the main evening “news” cast and it was all about the IRS scandals and Benghazi.  As if these were the big stories and as if there was actually any evidence of Obama administration malfeasance in either case.  Just totally bizarre.

Anyway, Jon Chait ran a great summary of these “scandals” last week and how the media couldn’t resist a scandal narrative even when it clearly didn’t fit.  Worth reading the whole thing, but:

But then the IRS inspector general, a Republican, reported that the entire program came from within the agency, with no direction at all from Obama or any members of his team. It was just an agency scandal. Subsequent revelations have made the matter look even more benign. Apparently, the agency also targeted liberal groups for possible violations, using terms like progressive to flag political groups. In other words, there may be no scandal here at all. The IRS was looking to make sure political groups weren’t abusing the tax code by pretending to be nonpolitical, and it tried to search for such abuses by using terms like tea party and progressive that would signal partisanship.

Why did we think the agency was targeting only conservatives? Because apparently Darrell Issa, chairman of the House Oversight Committee, ordered the agency to audit its treatment of tea-party groups, and only tea-party groups. The IRS dutifully reported it was indeed targeting tea-party groups; everybody assumed it was doing no such thing to liberal groups. The IRS inspector general is defending its probe, but the IRS’s flagging of conservative groups seems, at worst, to be marginally stricter than its flagging of liberal groups, not the one-sided political witch hunt potrayed by early reports…

The whole Obama scandal episode is a classic creation of a “narrative” — the stitching together of unrelated data points into a story. What actually happened is this: House Republicans passed a twisted account of a hearing to ABC’s Jonathan Karl, who misleadingly claimed to have seen it, creating the impression that the administration was caught in a major lie. Then the IRS story broke, which we now see was Republicans demanding a one-sided audit and thus producing the impression of one-sided treatment. In that context, legitimate controversies over Obama’s civil-rights policies became the “three Obama scandals,” exposing a government panopticon, if not a Nixonian administration bent on revenge…

Now that the IRS scandal has turned into a Darrell Issa scandal, we’re left with … an important dispute over domestic surveillance, which has nothing to do with scandal at all. The entire scandal narrative was an illusion.

Yep.  Somehow I don’t think Fox News is going to get the memo on this.

Boys and chores

What do you know, it turns out that the addition of Sarah to our family has made her older brothers likely to be worse husbands when they grow up.  That’s disturbing.  Via Eleanor Barkhorn in the Atlantic:

According to a paper in the latest issue of theJournal of Politics, siblings can have a noticeable impact on how a person sees the world as an adult. The paper, “Childhood Socialization and Political Attitudes: Evidence from a Natural Experiment” by Andrew Healy and Neil Malhotra, analyzes decades of longitudinal data on families and finds that the effect sisters have on their brothers is particularly striking.

Brothers with sisters are more likely to have traditional expectations for gender roles on a variety of metrics, the paper found. They’re more likely to agree with the statement “Mothers should remain at home with young children and not work outside the home.” As adults, they’re more likely to place the burdens of cooking, cleaning, and other chores on their wives. (They’re also more likely to become Republicans, probably as a result of their views on gender roles, according to Malhotra: “Gender roles are a big part of the way the parties have sorted themselves these days.”)

“Men with sisters appear to do less household work, even in middle age,” the authors wrote. “Men with sisters were 17 percentage points (p=.063) more likely to say that their spouse did more housework, suggesting that the gendered environment from childhood may have permanently altered men’s conception of gender roles.”

Why does this happen? The paper suggests that parents treat their sons and daughters differently. Boys with sisters are less likely to be asked to help with chores than boys without sisters. The difference is largest with one chore in particular, for whatever reason: doing the dishes. Boys with sisters are about 13 percent less likely to do the dishes than boys with brothers.

“It’s almost like boys and girls get treated as husband and wife,” said Malhotra.

When these boys grow up, then, they’re conditioned to expect women to be in charge of housework. Boys with brothers, on the other hand, are more likely to do so-called “feminized housework” while growing up and are therefore less likely to associate it with “women’s work.”

Fascinating.  The data is probably lacking, but I’d also like to know how birth order fits into all this.  By the time Sarah is old enough to help with the dishes, David will have been doing so for 10 years and Evan for 5.  And I recognize that these data are built on statistical averages but I will have done something really wrong if this happens to my own boys.  And I really think it will not.

My mom was an ardent feminist who was pretty bad at making either myself or my sister help with housework.  In many ways, I think her greatest accomplishment as a feminist mom was not raising a daughter who is a feminist (not that my sister is particularly moved by these issues, but a son who is one.  Fortunately, I did have the opportunity to make her proud on that score before she passed away.

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