Wednesday, August 26, 2015

"Anchor Babies and Tourist Babies"

The latest controversial issue raised by Donald Trump is the "anchor baby" - which I believe he defines as a baby born to a mother who entered the United States for the sole purpose of insuring that her infant is born in the United States, thereby guaranteeing her child United States citizenship, by virtue of the 14th Amendment.   Trump is questioning the interpretation of the 14th Amendment.

The pertinent part of the amendment read as follows:

Section. 1. All persons born or naturalized in the United States and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.

This has been interpreted by some to exclude children of non-citizens or non-resident aliens since these children are not "subject to the jurisdiction" of the United States as they are children of citizens of other countries.  In fact current immigration law specifies that a baby born on American soil to a member of the foreign service of another country or a foreign military prisoner is not an American citizen by birth.  Congress can, however, grant citizenship for such excluded persons on a case-by-case basis.

Let's assume that, in fact, the 14th Amendment actually does permit any infant born on U.S. soil to be eligible for automatic U.S. citizenship.   In fact many of these babies, also referred to as "tourist babies," are  not born to "illegal aliens," but to foreign women with tourist visas - often owners of U.S. real estate - who are among the privileged class in their countries, and wish to insure U.S. citizenship for their offspring.

Isn't there something wrong with this concept?  Isn't there something "not right" when pregnant citizens of other countries enter the U.S. for the sole purpose of giving birth to "an American baby?"

By the way, know that the United States is one of the few countries that has such "jus soli" (by right of the soil) citizenship rights.  The vast majority of other countries do not.  Some of examples of "non-birthright" states include Australia, United Kingdom, Germany, Israel, Saudi Arabia, Czech Republic, Japan, Austria, Belgium, Switzerland, Norway, Sweden, Finland, Denmark, France, Greece, Spain, Italy.......and quite a few more.


Wednesday, August 12, 2015

Pounds and Ounces in Prevention and Cures

We're all well aware of the old adage that "an ounce of prevention is worth a pound of cure."  Well, as it turns out - not so!  Margot Sanger-Katz, in a recent New York Times article (Aug 7), has written how the opposite is true.  Turns out, in fact, that "you have to give a lot of people those ounces of prevention to end up with one person who's getting that pound of cure."  As an example, according to the New England Journal of Medicine, 2500 women would have to be screened over 10 years for a single breast cancer death to be avoided.

Prevention is not cheap.  Obamacare mandates prevention coverage.  More and more subscribers are  confirming the status of their general health by taking advantage of these screening options, consequently increasing health care costs.  Providing people with more preventive measures is satisfying and usually reassuring, but expensive and rarely productive.

Early discovery of diseases using preventive screening techniques may result in a longer life - but at a not insignificant expense.  Early intervention for an asymptomatic latent condition results in increased physician visits, increased diagnostic testing,  increased need for the preventive medication, and, of course, an increase in cost. The disease is almost never cured, but its process is prolonged, and death may be delayed.    However, as one survives this condition to live on to an advanced age, the occurrence of other diseases such as Alzheimer's, or other costly illnesses, increases greatly.

Staying healthy is not cheap.  A lot of health care dollars are spent on prevention and a prolonged life.  Preventing diseases is good, new treatments are good.  But none of this occurs without significant cost.

It takes dollars of prevention for one cent of cure!

Thursday, August 6, 2015

Discussing Livers and Hearts Over Lunch

So much of what one says in a private tête-à-tête is dissimilar from what one would otherwise say.

The recent videos of officials from Planned Parenthood discussing the distribution of fetal parts, between bites of salad during a private lunch,  is not a reason to critique the issue or to defund a program.  One may understandably be opposed to late-term abortions or the use of fetal tissue in research efforts to advance medical science, but such a conclusion should not be based on private "intra-professional" conversations.

Physicians often discuss patient-related issues or disease-related issues over coffee or lunch.  Yes, we take bites of hamburgers while discussing illnesses, and may even chuckle or laugh during the conversation as we talk about an unusual situation that may have come up - not always using "appropriate language."  Operating rooms and diagnostic labs are filled with, what some might term,  rather irreverent banter.  It is the nature of our "business."  It is in the nature of any "business" to speak "informally" when "businesss" matters are tossed around among close colleagues.

Saucy collegial conversations regarding medical issues are very common.  One should not use such surreptitiously recorded conversations as a tool to promote or condemn a point of view.

Wednesday, July 29, 2015

Does One Really Need Both a Mom and a Dad?

Since the Supreme Court ruling on gay marriage, much has been posted about the need for children to  be raised in a two-parent traditional family.  Gay parents?  Single parents?  Such "disadvantaged" children are destined for bad outcomes!

There is absolutely no data to support this.  We all know of many children raised by single parents who have had successful and productive lives - Presidents Clinton and Obama being the prime examples!  As a matter of fact, both George Washington and Thomas Jefferson were raised by their moms; their fathers having died when they were quite young.  Andrew Jackson's father died before the future president was born.  Eleanor Roosevelt's parents died when she was very young and the future First Lady and UN Ambassador was raised by her grandmother.

Vanessa Redgrave, Natasha Richardson, Jodie Foster, Robert DeNiro, and Judy Garland, among others, are children of a gay parent.  They became rather successful as well, wouldn't you say?

Interestingly, the three mass murderers of the 20th Century were raised by a father and a mother.  They may have had difficult childhoods, but Adolf Hitler, Joseph Stalin, and Mao Tse-tung had both a mother and a father. The 21st Century villain Osama bin Laden also was raised by a mom and dad! I guess you could call them "successful" if you will, but hardly children their  mothers and fathers could be proud of!

Thursday, June 18, 2015

Get Your Embryos Here!!

An article in a recent edition of the New York Times (June 18) concerns the issue of "leftover embryos."  In addition to enumerating the concerns regarding their preservation versus their disposal, the piece goes on to discuss the subject of the commercialization of in vitro fertilization.  Rather mind-boggling,  I thought.

California Conceptions is a company that deals in "embryo creation."  The "clinic" purchases eggs and sperm from donors "whose profiles are likely to have broad appeal - like those who are tall, thin and well educated."  The "clinic" then proceeds to manufacture embryos for sale to would-be parents.  $12,500 buys you three attempts at implantation, with a money-back guarantee if a 12-week pregnancy does not occur.  

It has been termed by some as "the Costco approach to fertility, with quantity discounts to keep costs down."  The article refers to this approach as "one step removed from a mail-order catalog."

It goes on to describe online sites like "Miracle Waiting", where availability of embryos are posted.  Typical posts:  "4 frozen babies, ready for an active fun-loving home."  "Beautiful, intelligent, athletic Caucasian embryos looking for a home."  (Sound rather like ads for pet adoption, don't they?)

Pretty soon these embryos (? humans) may be available on e-Bay or  Or maybe one will actually be able to go to Costco and pick one or two off the shelf!

Just think of all the future siblings there will be out there that have never met.......and most likely never will.  Be careful not to fall in love and marry your "twin"! 

Tuesday, June 9, 2015

Auschwitz - The Reality Show!

"Grim Reality:  Czech TV Makes Game of Nazi Era", an article in the New York Times, (June 8) describes a new TV reality show in the Czech Republic which puts contestants in situations that existed at the time of the Nazi occupation.  Families have to experience and tolerate Nazi terror and threats, and live the lives of Czech families during that period of Czech history.  Actors portray Nazi SS officers who threaten and harrass participants.  The lucky participating families were selected from over 600 who applied.

Hey, we can do better!

How about a reality show based on life and death in Auschwitz - a show placing contestants in death-camp conditions.  We could watch them arrive in crowded boxcars.  We could enjoy the terror and anticipation as they wait to see whether they are consigned to immediate gas-chamber extinction or to  existence in crowded, disease-ridden, overcrowded unheated barracks.  We could thrill as we witness  beatings, and watch with awe as the participants try to survive on thin, cold soup and week-old potato skins.  We could follow them as they labor untold hours in freezing conditions, dressed only in thin  pajamas.  Levels of participation could include varying age groups - from babies to seniors.

Interested producers may be able to engage actual survivors to serve as consultants.  But they'll have to hurry - there aren't many survivors left!

Thursday, June 4, 2015

Caitlyn Jenner and Competitive Sports

So Bruce Jenner is now Caitlyn Jenner.  Though Caitlyn retains testicles and a penis and is chromosomally male, her present gender identification is female.  So could a younger "Caitlyn" enter a woman's decathlon competition?  Dr. Richard Raskin, a nationally ranked tennis player who competed as a male in the 1950s and 1960s transitioned to the female side of the tour (as Renée Richards) in the 70s after undergoing hormonal therapy,  followed by transexual surgical transformation in 1975  - but only after a court order.

Should we continue to agree that all playing fields should be "level?"  Would allowing a chromosomal male, who has decided to declare himself a woman, in order to compete in the female ranks of organized competitive sports, preserve that "level field."  If so, is it wrong to permit a hypothetical amputee who has been fitted with a futuristic prosthesis, that allows a ball to be thrown at speeds over 120 mph, or to drive a golf ball or serve at tennis at superhuman rates of speed, to enter competitive sports?

Everybody should have the right to live a life of choice.  But when a male chooses to be a female, or a female chooses the life of a male there are certain truisms that are incontrovertible.  You are a male if you are genetically male and born with male genitalia.  You may choose to live otherwise - but you are who you are.  If you are black you cannot decide to be white - if you are white you cannot declare yourself black.  You are who you are genetically.  Call yourself whatever you wish to call yourself, but for purposes such as classification, birth/population statistics and competitive athletics,  genes matter.