- The Washington Times - Friday, July 30, 2004

A ‘quixotic quest’

“Swerves on stem cells,” (Editorial, Wednesday) traces the hypocrisy of political protests against President Bush’s stem-cell research funding policy.

Ron Reagan unveiled at the Democratic convention the party’s apparent determination to use our tax dollars to clone human beings for the harvesting of embryonic stem cells.

The ballet dancer/pseudo-scientist explained that to obtain human embryonic stem cells, “The nucleus of one of your cells is placed into a donor egg whose own nucleus has been removed.” Of course, Mr. Reagan didn’t candidly label this unethical process as human cloning, didn’t address the exploitation of women for the massive numbers of “donor eggs” required, and didn’t mention the cancerous tumors embryonic stem cells can produce.

Mr. Reagan must employ liberal license to link his father to the embryo-destroying research that experts concede offers scant hope for curing Alzheimer’s. President Reagan’s 1988 presidential proclamation asserted “the unalienable personhood of every American, from the moment of conception until natural death.”

President Reagan also reasoned: “Unless and until it can be proven that the unborn child is not a living entity, then its right to life, liberty, and the pursuit of happiness must be protected.”

Nor did Mr. Reagan acknowledge that while overhyped, speculative embryonic stem cell research still wallows in rat and mouse research, the Bush administration last year wisely invested $190.7 million to further research adult stem cells, which have already demonstrated proven healing and restorative successes in human patients.

Mr. Reagan can bask in his father’s name and 15 minutes of fame. American taxpayers will judge whether we would should fund the cloning and destruction of nascent human life in a quixotic quest for cures — or whether we should invest in proven, life-honoring adult stem cell research that is already providing healing and hope for real people.

JONATHAN IMBODY

Senior policy analyst

Christian Medical Association

Washington Bureau

Ashburn, Va.

Edwards and malpractice

The editorial “The science of malpractice” (July 25) criticizes Sen. John Edwards as using “dubious” science to win malpractice cases for children with cerebral palsy. The Times points out that in addition to deprivation of oxygen as a cause of the brain damage known as cerebral palsy, there are many other known causes. The editorial complains that “[t]he trial lawyer carefully screened potential plaintiffs.”

Mr. Edwards did what every competent trial lawyer does in screening malpractice cases before filing suit. It is well known in medical science that persistent and substantial deprivation of oxygen for a substantial time during labor and delivery can, indeed, cause brain damage to the fetus that can result in cerebral palsy. Cord blood testing shows when the fetus’s blood supply has become acidotic and deprived of oxygen, a state that, when severe, correlates nicely with brain damage or cerebral palsy.

The competent trial lawyer knows that there are many other known causes of cerebral palsy and must carefully screen the cases to make sure that sustained substantial oxygen deprivation has caused the brain damage, rather than something else. The obstetric profession has devised guidelines to determine whether the cerebral palsy or brain damage was caused by oxygen deprivation or something else.

My first experience with prosecuting a malpractice case for a child with cerebral palsy was in 1976, in Moore v. Washington Hospital Center. It was the first multimillion-dollar obstetric negligence verdict in the nation. Mr. Edwards at that time was a law student in North Carolina.

The 1976 case involved a baby who was in a breech, or feet-first, position. The hospital record indicated that the resident obstetricians pulled down the baby’s feet in the labor room. The nurse made the note. The two residents testified in depositions (questioning under oath) that the record was wrong, that they pulled down the feet in the operating room and not in the delivery room. The nurse was nowhere to be found, and for good reason. She was in England training to be a nurse-midwife.

Through a lot of luck, we were able to locate her when she came back to this country, and she testified under oath that she remembered the case very well and that the young resident obstetricians did, indeed, pull the baby’s feet down and out in the labor room and that she admonished them for it.

Pulling the baby down before they were prepared to deliver caused the umbilical cord to be compressed for such a long period of time that oxygen-rich blood was unable to be circulated to the brain, causing horrendous brain damage. After the verdict, a hospital administrator noted that the jury’s verdict was the best thing that ever happened to help clean up the obstetrics department.

Since that trial, there have been many, many more children born with cerebral palsy. In many instances, the cause of cerebral palsy is totally unrelated to anything that the physicians, nurses and medical personnel did or didn’t do. In many cases, the cause is unknown. In other cases, the cause is demonstrated to be improper action or inaction by the medical personnel.

When scientific evidence proves a causal relationship between malpractice and cerebral palsy, the law should and does mandate compensation for the innocent child injured for life by the malpractice. To do otherwise would ignore personal responsibility for righting a wrong and place the burden on the innocent child with cerebral palsy and his or her family, instead of on the malpractitioner, where it belongs.

If The Times wants to attack our justice system on philosophical, value-related grounds, that is fine; that’s why we have freedom of speech in our blessed country. However, to malign scientific medical evidence that is available and used today in the proof of malpractice cases is to insult Mr. Edwards and his clients and all the cerebral-palsied children and their families and their lawyers who have had the courage to present their cases to juries and judges.

JACK H. OLENDER

Washington

Now that we have a celebrated medical-malpractice lawyer as a running mate on the Democratic ticket, a few questions are in order.

Why does Mr. Edwards think that physicians in the United States need the kindly help of trial lawyers to practice quality medicine when physicians in most other countries of the world do not practice under the constant threat of a medical-malpractice suit?

Are U.S. doctors trained more poorly? Is our technology inferior? On the contrary. The United States is a magnet for medical education around the world, with the best medical schools and residency programs and more technology per capita than anywhere else in the world. So why have 40 percent of U.S. doctors been named in a medical malpractice lawsuit? In spite of the best training and equipment, are almost half of American physicians bad doctors?

With our unique system of suing doctors, we must have the best health care system in the world. What statistic can Mr. Edwards show that suing doctors produces better-quality outcomes?

In general, compared to most other demographically similar countries, the United States has lower life expectancy; higher infant mortality; and much, much higher health care costs. Could it be that the threat of malpractice lawsuits drives unnecessary costs by increasing the number of blood tests, X-rays, procedures and treatments, and reduces the available funds that could otherwise be spent on the uninsured?

Of course, there are a very small number of doctors who are incompetent. State licensing boards need to be aggressive in identifying and delicensing this small group. However, the current system of malpractice litigation punishes every doctor and unnecessarily drives up costs.

As a physician, I believe that the threat of malpractice lawsuits in the U.S. health care system is like water to a fish in a fish tank. It pervades every aspect of the system, and we often don’t realize it is there. The overall cost of defensive medicine is grossly underestimated. Most academic estimates of the cost of defensive medicine are around 5 percent. Over the years, I have informally surveyed medical colleagues on the question: How much of the overall cost of health care is based on defensive medicine? Most clinicians say about 20 percent. I think the estimate is low.

DR. WILLIAM H. RICE

Austin, Texas


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