From what I've read, the video was recorded by Dr. Gary Weinstein. He was one of Nina Pham's treating physicians and worked with all three of the Ebola patients at Texas Health Presbyterian. He is not an 'administrator' at the hospital. According to the YouTube description for the video Ms. Pham asked Dr. Weinstein to share the video with the public.

On published research:

'Well, here’s a medical expert. For 20 years, she had a front-row seat that very few doctors or researchers ever occupy. Thousands of medical studies arrived at her desk. She was a “queen of judgment.”

She is Dr. Marcia Angell. She was the editor of the most prestigious medical journal in the world, The New England Journal of Medicine.

On January 15, 2009, the NY Review of Books published Dr. Angell’s devastating assessment of medical literature:

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” —(Marcia Angell, MD, “Drug Companies and Doctors: A story of Corruption.” NY Review of Books, Jan. 15, 2009.)'

Sure, I understand the other side of the argument, that a person should be able to do with his body whatever, which I can appreciate, however, we're talking about what rights the fetus has. At a certain point, the fetus has rights, which is why late term abortions are illegal in most places.

A friend of mine once got a girl pregnant, she went to have an abortion. He found out the girl would have had twins. He regretted the decision she made for the rest of his life.

My stepdaughter had a baby out of wedlock. She was pressured to have an abortion by her father.

Yesterday I attended her college graduation, double major, cum laude honors and the sweetest and most beautiful young lady you ever met.

My sister had a baby out of wedlock, she was pressured to get an abortion by the father's family. Now that baby is a physician's assistant, has two beautiful daughters whom my sister loves like nothing else.

So you can go and have an abortion, but what have you denied your own life...

I know a lot of you will just say 'it's her right, blah blah blah', but this world is not enriched by death, only by life.

Yes, of course prescriptions were required. How else were the physicians gonna get in on the crony racket, diagnosing "debility" from everything from a hang-nail to gout?

It's a "good" thing the good ole American government had other ways of managing those who didn't abide with their prohibtions.

Good point; to my recollection, to the frustration of physicians (published article I think last month)--it's people wearing helmets.

BTW, the same date trend (same level of fatalities) applies to bicycles (but not, apparently, motorcycles to my memory)---probably for the same reason

There is some truth in what you've said. For one, the bible says that Christians are the light of the world. Our number one responsibility is not to change the culture, but to allow God to change us so that His light, the light of Jesus Christ will shine forth from our lives and touch those around us. It is the church who retreated from the culture in the preceding decades which has allowed these forces that shape our culture today to slowly encroach on it, and eventually take over. The influence of the church on the culture is minimal because Christians have not been shining their light. Instead, it has largely taken an adversarial position and been engaged in a protracted "culture war". The real business of the kingdom of God is not shaping our culture through legislation, but by showing agape love to all those who cross our path. Jesus said that our unity and love towards one another is the evidence that He was sent by the Father:

Joh 17:21 that they may all be one, just as you, Father, are in me, and I in you, that they also may be in us, so that the world may believe that you have sent me.

Likewise, our lack of love and infighting is evidence to the world that the Father did not send Jesus. Unfortunately, those who are really living for Christ do not stand out as much as those who are not. Before I knew the Lord, I didn't have any positive examples of Christians in my life. I wasn't born into religion and didn't have much exposure to the church aside from what I saw on television. Now that I have seen what is going from the inside I can say that the vast majority of the positive things that Christians do is not reported on. In my town, the churches are all working together to serve the community, despite their differences. Many have been blessed and many lives have been transformed in wonderful ways, but you'll never hear about it unless it comes by word of mouth.

So, when you say Jesus hung out with sinners, this is essentially what the church should be doing, which is not to go a building every week and shout hallelujah, but to get out there and serve your community. To form relationships with people and to meet them where they are at and what their needs may be. Yet, you couldn't really say that Jesus "hung out" with sinners. Certainly He visited with sinners and ate meals with them, because He loved them. This really bothered the pharisees who asked Jesus one day why He did that. This is what He said:

Luke 5:30 And the Pharisees and their scribes grumbled at his disciples, saying, "Why do you eat and drink with tax collectors and sinners?"
Luke 5:31 And Jesus answered them, "Those who are well have no need of a physician, but those who are sick.
Luke 5:32 I have not come to call the righteous but sinners to repentance."

Jesus hung out with sinners because He loved them, and because He loved them He was calling them to repentance. Jesus did teach about hell and the fear of God, in fact Jesus said more about hell than every person in the bible combined. Most of what we know about hell was spoken by the Lord. It is the reality of hell that led Jesus to the cross:

John 3:16 "For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.

John 3:17 For God did not send his Son into the world to condemn the world, but in order that the world might be saved through him.

Jesus did not come to condemn, but save. He shed His innocent blood for our crimes, so that we can be forgiven and have eternal life. This is the gospel of Jesus Christ, the good news for all who are held in the bondage of sin and facing eternal separation from God.

The whole story and the victims lawsuit is found on the local news webpage here

http://www.kob.com/article/stories/S3209305.shtml?cat=500#.UnrmP_msh8H

I took the time to read the entire lawsuit and the step by step detailing of what this guy went through is chilling.

A comment on the the above webpage from a person claiming to be an RN

"I'm an RN. The physicians should not have their licenses suspended. They should be taken away. Committing medical procedures against the will of a patient, regardless of whatever judicial or political pressure is brought to bear on the physician, is a crime. It is unethical, and despicable. What this man went through was nothing less than sexual assault. The physicians should also be ARRESTED and jailed for committing this assault, put in a sex offenders registry, and made to provide financial restitution to him."

I really don't get all the GMO hubbub. I realize it sounds bad - like we are Frankenstein-ing our food, but I'm a biologist and physician and people need to realize that we have been GMO-ing our food since the advent of agriculture/husbandry. The whole POINT of agriculture/farming is to breed crops/animals such that they express certain genetic traits that are valuable to humans. Examples are abundant: bananas, corn, cows, chickens, Scottish fold kittens... Basically anything that humans can grow/raise, we attempt to genetically modify through selective breeding; the fact that we now have the technology to accomplish these changes in a lab is obvious as the next logical step. If you object to GMO then you should be a hunter-gatherer. This is not to say that there are no risks to selective breeding/GM. For one, genetically similar or identical organisms are susceptible to the same pathogens. If we stake our fortunes on a single type of wheat, corn, cow, banana, whatever - we risk losing it forever if there is some sort of infectious outbreak. As far as health risks to consumers, I don't think there is any legitimate science that suggests that GM food is any worse for you than non-GM food (the same goes for irradiated foods).

I have an apology to make
I'm afraid I've made a big mistake
I turned my face away from you, Lord

I was too blind to see the light
I was too meek to feel Your might
I closed my eyes; I couldn't see the truth, Lord

But then like Saul on the Damascus road,
You sent a messenger to me, and so
Now I've have had the truth revealed to me
Please forgive me all those things I said
I'll no longer betray you, Lord
I will pray to you instead

And I will say thank you, thank you
Thank you, God
Thank you, thank you
Thank you, God...

Thank you, God, for fixing the cataracts of Sam's mum
I had no idea, but it's suddenly so clear now
I feel such a cynic, how could I have been so dumb?
Thank you for displaying how praying works:
A particular prayer in a particular church
Thank you Sam for the chance to acknowledge this
Omnipotent ophthalmologist

Thank you, God, for fixing the cataracts of Sam's mum
I didn't realize that it was so simple
But you've shown a great example of just how it can be done
You only need to pray in a particular spot
To a particular version of a particular god,
And if you pull that off without a hitch,
He will fix one eye of one middle-class white bitch

I know in the past my outlook has been limited
I couldn't see examples of where life had been definitive
But I can admit it when the evidence is clear,
As clear as Sam's mum's new cornea
(And that's extremely clear! )

Thank you, God, for fixing the cataracts of Sam's mum
I have to admit that in the past I have been skeptical
But Sam described this miracle and I am overcome!
How fitting that the sighting of a sight-based intervention
Should open my eyes to this exciting new dimension
It's like someone put an eye chart up in front of me
And the top five letters say: I C, G O D

Thank you, Sam, for showing how my point of view has been so flawed
I assumed there was no God at all but now I see that's cynical
It's simply that his interests aren't particularly broad
He's largely undiverted by the starving masses,
Or the inequality between the various classes
He gives you strictly limited passes,
Redeemable for surgery or two-for-one glasses

I feel so shocking for historically mocking
Your interests are clearly confined to the ocular
I bet given the chance, you'd eschew the divine
And start a little business selling contacts online

Fuck me Sam, what are the odds
That of history's endless parade of gods
That the God you just happened to be taught to believe in
Is the actual one and he digs on healing,
But not the AIDS-ridden African nations
Nor the victims of the plague, nor the flood-addled Asians,
But healthy, privately-insured Australians
With common and curable corneal degeneration

This story of Sam's has but a single explanation:
A surgical God who digs on magic operations
No, it couldn't be mistaken attribution of causation
Born of a coincidental temporal correlation
Exacerbated by a general lack of education
Vis-a-vis physics in Sam's parish congregation
And it couldn't be that all these pious people are liars
It couldn't be an artefact of confirmation bias
A product of groupthink,
A mass delusion,
An Emperor's New Clothes-style fear of exclusion

No, it's more likely to be an all-powerful magician
Than the misdiagnosis of the initial condition,
Or one of many cases of spontaneous remission,
Or a record-keeping glitch by the local physician

No, the only explanation for Sam's mum's seeing:
They prayed to an all-knowing superbeing,
To the omnipresent master of the universe,
And he quite liked the sound of their muttered verse.

So for a bit of a change from his usual stunt
Of being a sexist, racist, murderous cunt
He popped down to Dandenong and just like that
Used his powers to heal the cataracts of Sam's mum
Of Sam's mum

Thank you God for fixing the cataracts of Sam's mum!
I didn't realize that it was such a simple thing
I feel such a dingaling, what ignorant scum!

Now I understand how prayer can work:
A particular prayer in a particular church
In a particular style with a particular stuff
And for particular problems that aren't particularly tough,
And for particular people, preferably white
And for particular senses, preferably sight
A particular prayer in a particular spot
To a particular version of a particular god

And if you get that right, he just might
Take a break from giving babies malaria
And pop down to your local area
To fix the cataracts of your mum!

Is he still hooked-up with the hottie-Brit red-head freak??

Hell yeah, North Ockendon's Lizzy Jane Harpers' still hangin' with ol Kuchie and acting Director of public affairs for the Physicians Committee for Responsible Medicine!

What a couple of wild ones...

Lyrics:
Im gonna smoke some weed, only got 20 dollas in my pocket
Imma huntin, looking for a pot shop, this is fucking awesome!

Walk into my house like what up, i got some good pot
I'm just pumped up got some herb from the pot shop
Ice in my fridge it used to be frosty
My friends like "Damn, that's a stoned ass donkey!"
Rollin' in hella high, looking like it's fifa time
Dominating all my friends, as I eat some chili fries
Draped in a snuggie with my girl sitting next to me
Probably shouldn't have had a big gulp full of ice tea
PISS!
But shit it was 99 cents!

I be blazin and smokin it
Bout to go and get some munchie snacks, passing up on those cracker jacks
Reeces Pieces are where it's at, Gotta get me some soda pop
Cotton mouth has been creeping up
But can't remember where I put my keys,
Yeah, that's what's up.
Imma take your grandpa's ride, Imma take your grandpa's ride
No for real, ask your grandpa, Can I take his 65?
Deville Cruisin to my local Publix
Nothing better than rolling with 2 super fly chicks!
They had frozen burritos, I bought frozen burritos
I bought some Ben and Jerry's, then I bought some Cheetos
Hello, Hello, my main man Obama
A couple states have just reformed their laws on marijuana
Whatcha gonna do, send the feds there? Hell no!
The DEA's would be like "Ah, they got Volcano"

What you know about the science of marijuana?
What you know about people suffering from glaucoma?
They need it, they need it, it helps them with their condition
If don't believe me, then just ask some eye physicians
Thank your granddad for voting for that guy Richard
Nixon is the President who made the plant illegal
But science is now showing that its medicine for people
And the private sector's fighting to keep all of that illegal
Alcohol and Tobacco, Pharmaceutical, Prisons
I'll take those four major lobby groups and fight those motherfuckers
They making money day and night, all those motherfuckers
And bribing congress out of sight, all those motherfuckers
They be like, "Oh, it's immoral and unhealthy"
I'm like how many people are you making wealthy
Anti-marijuana lobbies are making all kinds of profits
And they don't want you to stop it cause of all the special interests
I call that getting swindled and pimped, shit
I call that getting tricked by the government, that law's hella old
So its time to update it, regulate it, and then get it under state control
Peep Game, look into my political telescope
Think it's going to stay like this forever, nah, it hella won't, nah, it hella won't.

Let's end the war on drugs, It's time to pull the plug
These special interest groups are nothing more than corporate thugs
Let's end the war on weed, the people have agreed.
These special interest groups have kept these laws with bribery

Imma smoke some weed, only got 20 dollas in my pocket
Imma huntin, looking for a pot shop, this is fucking awesome!

http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.
Related

Upstairs, my 85-year-old father, Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that helped his heart outlive his brain. The size of a pocket watch, it had kept his heart beating rhythmically for nearly five years. Its battery was expected to last five more.

After tea, I knew, my mother would help him from his narrow bed with its mattress encased in waterproof plastic. She would take him to the toilet, change his diaper and lead him tottering to the couch, where he would sit mutely for hours, pretending to read Joyce Carol Oates, the book falling in his lap as he stared out the window.

I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.

Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound. When I was a child, he woke me, chortling, with his gloss on a verse from “The Rubaiyat of Omar Khayyam”: “Awake, my little one! Before life’s liquor in its cup be dry!” At bedtime he tucked me in, quoting “Hamlet” : “May flights of angels sing thee to thy rest!”

Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.

Until 2001, my two brothers and I — all living in California — assumed that our parents would enjoy long, robust old ages capped by some brief, undefined final illness. Thanks to their own healthful habits and a panoply of medical advances — vaccines, antibiotics, airport defibrillators, 911 networks and the like — they weren’t likely to die prematurely of the pneumonias, influenzas and heart attacks that decimated previous generations. They walked every day. My mother practiced yoga. My father was writing a history of his birthplace, a small South African town.

In short, they were seemingly among the lucky ones for whom the American medical system, despite its fragmentation, inequity and waste, works quite well. Medicare and supplemental insurance paid for their specialists and their trusted Middletown internist, the lean, bespectacled Robert Fales, who, like them, was skeptical of medical overdoing. “I bonded with your parents, and you don’t bond with everybody,” he once told me. “It’s easier to understand someone if they just tell it like it is from their heart and their soul.”

They were also stoics and religious agnostics. They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Things took their first unexpected turn on Nov. 13, 2001, when my father — then 79, pacemakerless and seemingly healthy — collapsed on my parents’ kitchen floor in Middletown, making burbling sounds. He had suffered a stroke.

He came home six weeks later permanently incapable of completing a sentence. But as I’ve said, he didn’t give up easily, and he doggedly learned again how to fasten his belt; to peck out sentences on his computer; to walk alone, one foot dragging, to the university pool for water aerobics. He never again put on a shirt without help or looked at the book he had been writing. One day he haltingly told my mother, “I don’t know who I am anymore.”

His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.

Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.

My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.

As we shuffled through the fallen leaves that day, I thought of my father’s father, Ernest Butler. He was 79 when he died in 1965, before pacemakers, implanted cardiac defibrillators, stents and replacement heart valves routinely staved off death among the very old. After completing some long-unfinished chairs, he cleaned his woodshop, had a heart attack and died two days later in a plain hospital bed. As I held my dad’s soft, mottled hand, I vainly wished him a similar merciful death.

A few days before Christmas that year, after a vigorous session of water exercises, my father developed a painful inguinal (intestinal) hernia. My mother took him to Fales, who sent them to a local surgeon, who sent them to a cardiologist for a preoperative clearance. After an electrocardiogram recorded my father’s slow heartbeat — a longstanding and symptomless condition not uncommon in the very old — the cardiologist, John Rogan, refused to clear my dad for surgery unless he received a pacemaker.

Without the device, Dr. Rogan told me later, my father could have died from cardiac arrest during surgery or perhaps within a few months. It was the second time Rogan had seen my father. The first time, about a year before, he recommended the device for the same slow heartbeat. That time, my then-competent and prestroke father expressed extreme reluctance, on the advice of Fales, who considered it overtreatment.

My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state.

When Rogan suggested the pacemaker for the second time, my father was too stroke-damaged to discuss, and perhaps even to weigh, his trade­offs. The decision fell to my mother — anxious to relieve my father’s pain, exhausted with caregiving, deferential to doctors and no expert on high-tech medicine. She said yes. One of the most important medical decisions of my father’s life was over in minutes. Dr. Fales was notified by fax.

Fales loved my parents, knew their suffering close at hand, continued to oppose a pacemaker and wasn’t alarmed by death. If he had had the chance to sit down with my parents, he could have explained that the pacemaker’s battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state. He could have discussed the option of using a temporary external pacemaker that, I later learned, could have seen my dad safely through surgery. But my mother never consulted Fales. And the system would have effectively penalized him if she had. Medicare would have paid him a standard office-visit rate of $54 for what would undoubtedly have been a long meeting — and nothing for phone calls to work out a plan with Rogan and the surgeon.

Medicare has made minor improvements since then, and in the House version of the health care reform bill debated last year, much better payments for such conversations were included. But after the provision was distorted as reimbursement for “death panels,” it was dropped. In my father’s case, there was only a brief informed-consent process, covering the boilerplate risks of minor surgery, handled by the general surgeon.

I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic — where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor — things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.

And so on Jan. 2, 2003, at Middlesex Hospital, the surgeon implanted my father’s pacemaker using local anesthetic. Medicare paid him $461 and the hospital a flat fee of about $12,000, of which an estimated $7,500 went to St. Jude Medical, the maker of the device. The hernia was fixed a few days later.

It was a case study in what primary-care doctors have long bemoaned: that Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all. The incentives for overtreatment continue, said Dr. Ted Epperly, the board chairman of the American Academy of Family Physicians, because those who profit from them — specialists, hospitals, drug companies and the medical-device manufacturers — spend money lobbying Congress and the public to keep it that way.

Last year, doctors, hospitals, drug companies, medical-equipment manufacturers and other medical professionals spent $545 million on lobbying, according to the Center for Responsive Politics. This may help explain why researchers estimate that 20 to 30 percent of Medicare’s $510 billion budget goes for unnecessary tests and treatment. Why cost-containment received short shrift in health care reform. Why physicians like Fales net an average of $173,000 a year, while noninvasive cardiologists like Rogan net about $419,000.

The system rewarded nobody for saying “no” or even “wait” — not even my frugal, intelligent, Consumer-Reports-reading mother. Medicare and supplemental insurance covered almost every penny of my father’s pacemaker. My mother was given more government-mandated consumer information when she bought a new Camry a year later.

And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits.

Shortly after New Year’s 2003, my mother belatedly called and told me about the operations, which went off without a hitch. She didn’t call earlier, she said, because she didn’t want to worry me. My heart sank, but I said nothing. It is one thing to silently hope that your beloved father’s heart might fail. It is another to actively abet his death.

The pacemaker bought my parents two years of limbo, two of purgatory and two of hell. At first they soldiered on, with my father no better and no worse. My mother reread Jon Kabat-Zinn’s “Full Catastrophe Living,” bought a self-help book on patience and rose each morning to meditate.

In 2005, the age-related degeneration that had slowed my father’s heart attacked his eyes, lungs, bladder and bowels. Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen. Long partly deaf, he began losing his sight to wet macular degeneration, requiring ocular injections that cost nearly $2,000 each. A few months later, he forgot his way home from the university pool. He grew incontinent. He was collapsing physically, like an ancient, shored-up house.

In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking.

When bioethicists debate life-extending technologies, the effects on people like my mother rarely enter the calculus. But a 2007 Ohio State University study of the DNA of family caregivers of people with Alzheimer’s disease showed that the ends of their chromosomes, called telomeres, had degraded enough to reflect a four-to-eight-year shortening of lifespan. By that reckoning, every year that the pacemaker gave my irreparably damaged father took from my then-vigorous mother an equal year.

When my mother was upset, she meditated or cleaned house. When I was upset, I Googled. In 2006, I discovered that pacemakers could be deactivated without surgery. Nurses, doctors and even device salesmen had done so, usually at deathbeds. A white ceramic device, like a TV remote and shaped like the wands that children use to blow bubbles, could be placed around the hump on my father’s chest. Press a few buttons and the electrical pulses that ran down the leads to his heart would slow until they were no longer effective. My father’s heart, I learned, would probably not stop. It would just return to its old, slow rhythm. If he was lucky, he might suffer cardiac arrest and die within weeks, perhaps in his sleep. If he was unlucky, he might linger painfully for months while his lagging heart failed to suffuse his vital organs with sufficient oxygenated blood.

If we did nothing, his pacemaker would not stop for years. Like the tireless charmed brooms in Disney’s “Fantasia,” it would prompt my father’s heart to beat after he became too demented to speak, sit up or eat. It would keep his heart pulsing after he drew his last breath. If he was buried, it would send signals to his dead heart in the coffin. If he was cremated, it would have to be cut from his chest first, to prevent it from exploding and damaging the walls or hurting an attendant.

On the Internet, I discovered that the pacemaker — somewhat like the ventilator, defibrillator and feeding tube — was first an exotic, stopgap device, used to carry a handful of patients through a brief medical crisis. Then it morphed into a battery-powered, implantable and routine treatment. When Medicare approved the pacemaker for reimbursement in 1966, the market exploded. Today pacemakers are implanted annually in more than 400,000 Americans, about 80 percent of whom are over 65. According to calculations by the Dartmouth Atlas research group using Medicare data, nearly a fifth of new recipients who receive pacemakers annually — 76,000 — are over 80. The typical patient with a cardiac device today is an elderly person suffering from at least one other severe chronic illness.

Over the years, as technology has improved, the battery life of these devices lengthened. The list of heart conditions for which they are recommended has grown. In 1984, the treatment guidelines from the American College of Cardiology declared that pacemakers were strongly recommended as “indicated” or mildly approved as “reasonable” for 56 heart conditions and “not indicated” for 31 more. By 2008, the list for which they were strongly or mildly recommended expanded to 88, with most of the increase in the lukewarm “reasonable” category.

The research backing the expansion of diagnoses was weak. Over all, only 5 percent of the positive recommendations were supported by research from multiple double-blind randomized studies, the gold standard of evidence-based medicine. And 58 percent were based on no studies at all, only a “consensus of expert opinion.” Of the 17 cardiologists who wrote the 2008 guidelines, 11 received financing from cardiac-device makers or worked at institutions receiving it. Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.

This pattern — a paucity of scientific support and a plethora of industry connections — holds across almost all cardiac treatments, according to the cardiologist Pierluigi Tricoci of Duke University’s Clinical Research Institute. Last year in The Journal of the American Medical Association, Tricoci and his co-authors wrote that only 11 percent of 2,700 widely used cardiac-treatment guidelines were based on that gold standard. Most were based only on expert opinion.

Experts are as vulnerable to conflicts of interest as researchers are, the authors warned, because “expert clinicians are also those who are likely to receive honoraria, speakers bureau [fees], consulting fees or research support from industry.” They called the current cardiac-research agenda “strongly influenced by industry’s natural desire to introduce new products.”

Perhaps it’s no surprise that I also discovered others puzzling over cardiologists who recommended pacemakers for relatives with advanced dementia. “78-year-old mother-in-law has dementia; severe short-term memory issues,” read an Internet post by “soninlaw” on Elderhope.com, a caregivers’ site, in 2007. “On a routine trip to her cardiologist, doctor decides she needs a pacemaker. . . . Anyone have a similar encounter?”

By the summer of 2007, my dad had forgotten the purpose of a dinner napkin and had to be coached to remove his slippers before he tried to put on his shoes. After a lifetime of promoting my father’s health, my mother reversed course. On a routine visit, she asked Rogan to deactivate the pacemaker. “It was hard,” she later told me. “I was doing for Jeff what I would have wanted Jeff to do for me.” Rogan soon made it clear he was morally opposed. “It would have been like putting a pillow over your father’s head,” he later told me.

Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?”

Then came the autumn day when she asked for my help, and I said yes. I told myself that we were simply trying to undo a terrible medical mistake. I reminded myself that my dad had rejected a pacemaker when his faculties were intact. I imagined, as a bioethicist had suggested, having a 15-minute conversation with my independent, predementia father in which I saw him shaking his head in horror over any further extension of what was not a “life,” but a prolonged and attenuated dying. None of it helped. I knew that once he died, I would dream of him and miss his mute, loving smiles. I wanted to melt into the arms of the father I once had and ask him to handle this. Instead, I felt as if I were signing on as his executioner and that I had no choice.

Over the next five months, my mother and I learned many things. We were told, by the Hemlock Society’s successor, Compassion and Choices, that as my father’s medical proxy, my mother had the legal right to ask for the withdrawal of any treatment and that the pacemaker was, in theory at least, a form of medical treatment. We learned that although my father’s living will requested no life support if he were comatose or dying, it said nothing about dementia and did not define a pacemaker as life support. We learned that if we called 911, emergency medical technicians would not honor my father’s do-not-resuscitate order unless he wore a state-issued orange hospital bracelet. We also learned that no cardiology association had given its members clear guidance on when, or whether, deactivating pacemakers was ethical.

(Last month that changed. The Heart Rhythm Society and the American Heart Association issued guidelines declaring that patients or their legal surrogates have the moral and legal right to request the withdrawal of any medical treatment, including an implanted cardiac device. It said that deactivating a pacemaker was neither euthanasia nor assisted suicide, and that a doctor could not be compelled to do so in violation of his moral values. In such cases, it continued, doctors “cannot abandon the patient but should involve a colleague who is willing to carry out the procedure.” This came, of course, too late for us.)

In the spring of 2008, things got even worse. My father took to roaring like a lion at his caregivers. At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night. My frayed mother began to shout at him, and their nighttime scenes were heartbreaking and frightening. An Alzheimer’s Association support-group leader suggested that my brothers and I fly out together and institutionalize my father. This leader did not know my mother’s formidable will and had never heard her speak about her wedding vows or her love.

Meanwhile my father drifted into what nurses call “the dwindles”: not sick enough to qualify for hospice care, but sick enough to never get better. He fell repeatedly at night and my mother could not pick him up. Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house. His chest grew wheezy. My mother did not request antibiotics. In mid-April 2008, he was taken by ambulance to Middlesex Hospital’s hospice wing, suffering from pneumonia.

Pneumonia was once called “the old man’s friend” for its promise of an easy death. That’s not what I saw when I flew in. On morphine, unreachable, his eyes shut, my beloved father was breathing as hard and regularly as a machine.

My mother sat holding his hand, weeping and begging for forgiveness for her impatience. She sat by him in agony. She beseeched his doctors and nurses to increase his morphine dose and to turn off the pacemaker. It was a weekend, and the doctor on call at Rogan’s cardiology practice refused authorization, saying that my father “might die immediately.” And so came five days of hard labor. My mother and I stayed by him in shifts, while his breathing became increasingly ragged and his feet slowly started to turn blue. I began drafting an appeal to the hospital ethics committee. My brothers flew in.

On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing.

After his memorial service in the Wesleyan University chapel, I carried a box from the crematory into the woods of an old convent where he and I often walked. It was late April, overcast and cold. By the side of a stream, I opened the box, scooped out a handful of ashes and threw them into the swirling water. There were some curious spiraled metal wires, perhaps the leads of his pacemaker, mixed with the white dust and pieces of bone.

A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.

The surgeon was forthright: without open-heart surgery, there was a 50-50 chance my mother would die within two years. If she survived the operation, she would probably live to be 90. And the risks? He shrugged. Months of recovery. A 5 percent chance of stroke. Some possibility, he acknowledged at my prompting, of postoperative cognitive decline. (More than half of heart-bypass patients suffer at least a 20 percent reduction in mental function.) My mother lifted her trouser leg to reveal an anklet of orange plastic: her do-not-resuscitate bracelet. The doctor recoiled. No, he would not operate with that bracelet in place. It would not be fair to his team. She would be revived if she collapsed. “If I have a stroke,” my mother said, nearly in tears, “I want you to let me go.” What about a minor stroke, he said — a little weakness on one side?

I kept my mouth shut. I was there to get her the information she needed and to support whatever decision she made. If she emerged from surgery intellectually damaged, I would bring her to a nursing home in California and try to care for her the way she had cared for my father at such cost to her own health. The thought terrified me.

The doctor sent her up a floor for an echocardiogram. A half-hour later, my mother came back to the waiting room and put on her black coat. “No,” she said brightly, with the clarity of purpose she had shown when she asked me to have the pacemaker deactivated. “I will not do it.”

She spent the spring and summer arranging house repairs, thinning out my father’s bookcases and throwing out the files he collected so lovingly for the book he never finished writing. She told someone that she didn’t want to leave a mess for her kids. Her chest pain worsened, and her breathlessness grew severe. “I’m aching to garden,” she wrote in her journal. “But so it goes. ACCEPT ACCEPT ACCEPT.”

Last August, she had a heart attack and returned home under hospice care. One evening a month later, another heart attack. One of my brothers followed her ambulance to the hospice wing where we had sat for days by my father’s bed. The next morning, she took off her silver earrings and told the nurses she wanted to stop eating and drinking, that she wanted to die and never go home. Death came to her an hour later, while my brother was on the phone to me in California — almost as mercifully as it had come to my paternal grandfather. She was continent and lucid to her end.

A week later, at the same crematory near Long Island Sound, my brothers and I watched through a plate-glass window as a cardboard box containing her body, dressed in a scarlet silk ao dai she had sewn herself, slid into the flames. The next day, the undertaker delivered a plastic box to the house where, for 45 of their 61 years together, my parents had loved and looked after each other, humanly and imperfectly. There were no bits of metal mixed with the fine white powder and the small pieces of her bones.

Katy Butler lives in Mill Valley, Calif., and teaches memoir writing at the Esalen Institute in Big Sur.

I'm glad you did this. You can say what you'd like about you trying to "rehabilitate" a person, but when you use tactics this extreme, is it backed by overwhelming scientific data to be successful with minimal side-effect? I'm not going to research it, but I'm pretty sure this is an archaic superstitious psychiatric ritual akin to lobotomies and phrenology.>> ^vaire2ube:

We warn you, this footage may severely increase our ratings and invoke empathy and anger. Fox News out.
hmmm context..
"JRC educates and treats the most difficult behaviorally involved students in the country and administers the GED to treat severe behavior disorders only after other treatments have failed and a court order is obtained to do so at the request of the student’s parents and doctor.
The treatment plan must also be approved by a Human Rights Committee, a Peer Review Committee and a physician.
These students predominantly exhibit behaviors that are dangerous to themselves and others and have been resistant to previous treatments. Students parents or guardians, along with their school districts and medical personnel are involved in developing care plans and in most cases, before coming to JRC have tried several residential programs and psychiatric facilities and found them unsuccessful. Often students are chemically restrained with medications and their guardians either remove them from those programs or the students are asked to leave.

On the issue of the video tape, the sole reason a recording exists is because JRC maintains cameras in every room where a student may receive treatment. It is the only such facility to do so. This is for the protection of the students in our care and is precisely to enable us to review every application of the GED."

It's not exactly an easy situation by any stretch... does the shock therapy ever actually work?

We warn you, this footage may severely increase our ratings and invoke empathy and anger. Fox News out.

hmmm context..

"JRC educates and treats the most difficult behaviorally involved students in the country and administers the GED to treat severe behavior disorders only after other treatments have failed and a court order is obtained to do so at the request of the student’s parents and doctor.

The treatment plan must also be approved by a Human Rights Committee, a Peer Review Committee and a physician.

These students predominantly exhibit behaviors that are dangerous to themselves and others and have been resistant to previous treatments. Students parents or guardians, along with their school districts and medical personnel are involved in developing care plans and in most cases, before coming to JRC have tried several residential programs and psychiatric facilities and found them unsuccessful. Often students are chemically restrained with medications and their guardians either remove them from those programs or the students are asked to leave.


On the issue of the video tape, the sole reason a recording exists is because JRC maintains cameras in every room where a student may receive treatment. It is the only such facility to do so. This is for the protection of the students in our care and is precisely to enable us to review every application of the GED."


It's not exactly an easy situation by any stretch... does the shock therapy ever actually work?

You mean David missed the point, or I did?>> ^Payback:

>> ^messenger:
Way to miss the point, idiot.
Physician, heal thyself.