Friday, February 27, 2015

Circumcision and Herpes Infection in New York

Flash!! The City of New York has just instituted a new regulation that permits the performance of female circumcision (more-often referred to as female genital mutilation.)  If, however, the procedure results in major genital deformity, pain, and/or permanent painful uro-genital complications, the person responsible for the procedure will be permanently banned from future performance of the procedure.

Of course, female genital mutilation is a banned procedure in New York, as well as in the entire United States, and the above paragraph is total fantasy, but, believe it or not, would parallel what New York City has now decided is the correct way to cope with the issue of transmission of the potentially fatal Herpes virus to orthodox Jewish male newborns undergoing ritual circumcision, including the horror of MBP (metzitzah b'peh) - the oral sucking of penile blood by a Herpes-infected mohel (ritual performer of the circumcision).

The City has decided to permit MBP to go forward unchecked.  If the infant develops Herpes, the infected mohel will be banned from performing future procedures.  The city, then, has decided not to proactively attempt to prevent the infection of newborns, but to allow the infection to take place and  to punish the perpetrator retroactively.

Among radical orthodox Jewish sects, the rabbis have come to play the major role in the health and welfare of the community's infant children.  They are convinced that their religious beliefs outweigh medical risks and will not even permit the screening for the virus among the MBP performers.  It is disquieting to see them play such a negative role in the politics of New York City - and it brings to mind the negative role they exert on the politics of Israel.

These communities vote as blocs and have major political clout in New York City, similar to the  clout they exert in the State of Israel.  The mayor of New York, Bill DeBlasio, has chosen to ignore what is clearly in the best medical interest of these infants and to proceed with what is in the best political interest of DeBlasio and the rabbis.

Netanyahu Addresses Congress - Really??

Benjamin Netanyahu, Prime Minister of Israel, will be addressing Congress next week in order to "enlighten" it on Iranian nuclear development, and the potential effect on its sharing of future developed nuclear weaponry with Hamas and Hezbollah - terrorist organizations dedicated to the elimination of the State of Israel.  Can there be anyone in Congress who is not aware of these potential threats?  Will Netanyahu really be presenting anything new?  Does he really believe that such an address will alter the foreign policy of the United States, which is primarily initiated and 
executed by the President?

He could easily have addressed his views on Iran to the American Israel Political Action Committee (Aipac) or some other such organization.   He could easily have addressed his views on Iran to the Knesset (Israeli Parliament) and had it telecast world-wide for all Americans to watch.  Instead, in a manner disrespectful to our President, arranged the unprecedented act of addressing the legislature of the United States without the courtesy of proper notification and discussion with the executive.

Diplomacy requires certain behavior, and like it or not, there are reasons for such behavior if human beings are to relate well to one another.  When one dispenses with diplomacy and cordiality, one is either ignorant of proper behavior or unconcerned with the feelings of others.

His speech will change nothing.  Though the safety and well-being of the State of Israel are always considered in the formation of U.S. foreign policy - they will never, and should never, be the sole determinate of such policy

So, fully aware that his address to the Congress of the United States will have no significant effect whatsoever on American policy towards Iran, why does Netanyahu risk the enmity of its most important ally by such a divisive and clearly undiplomatic (even unfriendly and discourteous) approach?  Politics - Israeli and American!!

Not nice, Bibi!

Tuesday, February 17, 2015

Obama, The Crusades and Islamic Fundamentalism

"Humanity has been grappling with these questions throughout human history, and lest we get on our high horse and think this is unique to some other place, remember that during the Crusades and the Inquisition, people committed terrible deeds in the name of Christ. In our home country, slavery and Jim Crow all too often was justified in the name of Christ."

This recent comment by President Obama, attempting to somehow minimize the horrors of 21st Century Islamic fundamentalism by comparing them to the Crusades and other historical evils perpetrated in the "name of Christ," is inappropriate to say the least.  Lecturing Americans and other members of Western civilization about "getting on our high horse" when being outraged at the indescribably unspeakable acts of beheadings and immolations of conscious human beings in the 21st Century, is disgraceful.

First of all, drawing immoral equivalents never minimizes the immorality of an act.  The immorality may be equivalent, but using such equivalents to somehow explain or minimize an outrage is just wrong!  

Secondly, it is a poor historian who attempts to compare acts committed during the 11th century, 15th century, 19th century, or for that matter, during  Biblical times, or the times of the Neanderthals with the acts of brutality committed today.  The cruelty of human beings never disappears, but today's world will not abide the hacking and burning to death of human beings.  The Crusades were then - this is now!  Humans may have wantonly slaughtered humans back then (they even burned people at the stake!) but to say that the acts of Biblical Hebrews, or 11th Century crusading Christians, or 15th Century Spanish inquisitors, or club-wielding cavemen can be used to somehow minimize the barbarously brutal acts of 21st Century Islamic fundamentalists, is a contemptible use of history and an unfortunate example of deplorable moral leadership.

Monday, February 16, 2015

Gay Rights and God - This World and the Next

"Do not lie with a male as one lies with a woman; it is an abhorrence. (Lev 18:22)
"But you must keep My laws and My rules, and you must not do any of those abhorrent things...."(Lev 18:26)
"All who do any of those abhorrent things -- such persons shall be cut off from their people..." (Lv 18:29)

So God admonishes his people in the Bible.  If you are a true Bible-believer and that the Bible is the word of God - the "word" about homosexuality (just male homosexuality, by the way) is quite clear - God is against it.  It is an "abhorrence."  

The Bible, however, does not constitute the laws of the United States.  Follow it to the letter if you are so inclined, but do not impose it on others.  No "sharia" law here.  You must respect the legal rights of your fellow citizens.

Homosexuality is genetic - but even if it were not - even if it were a choice - all of us are free to live as we please so long as we cause no harm to others.  Gay marriage hurts no one.  No government should have the right to limit the values and lifestyles of consenting adults whose activities injure no one.  Whom one loves, whom one is intimate with, whom one wishes to marry are not its business.  

The Declaration of Independence's endows us with certain "inalienable rights."  Freedom of sexual association between consenting adults, including freedom to marry whom you wish is such a right, and though the Declaration is not a system of laws, it is a system expounding the basic principles of freedom upon which this nation was founded.

Legalizing gay marriage will injure no one.  Individuals have every right to view it unfavorably, but no rights to legally prevent it. If you share the opinions attributed to God in Leviticus, so be it - but you must agree that only God can decide how gays will be "cut off from their people" - not you.  God has no legal representation in this world - maybe in the world to come (as some would believe), but not in these United States!

Tuesday, February 3, 2015

Miracles in Medicine - Not Everyday Events

"You can't make up a story like T.F.'s  She arrived in the St. Francis ER with a ruptured aorta.  If that weren't bad enough, she immediately went into cardiac arrest.  Doctors knew they only had seconds to react.  They opened her chest and massaged her heart, miraculously they brought T. back right there in the Emergency Room.  They continued with extensive cardiothoracic surgery in the operating room to repair the aorta.  They saved T's life......................."

This message, under the headline "This is NOT Science Fiction," comprised the body of a full-page ad (undoubtedly extremely expensive) on the back page of the Science Section of the NY Times on February 3, extolling the virtues of St. Francis Hospital, The Heart Center, in Roslyn, NY.

Here am I, a physician, reading about this truly "miraculous" result - imagine that - a person in cardiac arrest due to a ruptured aorta -  an aorta so destroyed that it required subsequent "extensive" repair - saved in the emergency room with open chest massage!  Wow!!  I won't burden readers with all the questions I would pose as to how this "miracle" was effected.

Such "miracles" are extremely rare.  That's why they're called "miracles."  Don't believe for a second that the next patient with a similar devastating life-threatening emergency is going to have the same "miraculous" result - not at St. Francis - not anywhere.

The public should not evaluate hospitals based on advertised heroics.  Hospitals should be rated by a proper and thorough research of results as well as by appropriate evaluations by recognized authorities.

"Parents Own Their Children!" Do They?

"The state doesn't own your children.  Parents own the children," said Senator Rand Paul when asked about his views of immunizations, which he considered a "question of freedom."

How far does freedom actually extend.  How free are parents to "own their children?"  Parents do not own their children.  Parents are not free to physically abuse their children, they are not free to decide how their children are seated and belted in a moving vehicle, they are not free to decide whether or not their children are to don helmets when biking, parents are not free to leave their children unattended at home or in a car.

Parents are not always a child's best friends!  The government doesn't "own" your children, but it has a vested and moral interest in their welfare and takes on the responsibility of insuring that all children are provided a degree of protection - decisions about which they are too young to make on their own.  A parent, though perhaps free to make decisions concerning his own health and welfare, ( i.e. foregoing certain medications, or smoking) does not have the moral or legal right to subject his minor child to ill health and danger!

There have been many situations where the state has assumed control of a child's care in cases where parental decisions were deemed injurious to minor children.  As a hospital-based pediatric cardiologist, I have witnessed such proceedings, and have testified in such proceedings.

Parents do not own their children.  Minor children are too young to make informed decisions.  Parents, though free to decide their own fates, should not be permitted to put their children at risk in the face of a safe, well documented, and proven preventive or therapeutic practice that protects or overcomes such risks to life and to health.