Tragic death of woman wanting to abort, denied, thus killing her too, in Ireland is stirring controversy

I'm very impressed with the entirety of Eilís Mulroy's article and his concern that the Irish people don't use the young woman who needed an abortion to save her own life, when the unborn had no chance of coming to term, concerned that the public doesn't use her sad case to fuel the partisan ideologies of pro-abortion vs anti-abortion.  It was a choice for the doctors to either abort the child (which the mother wanted as the circumstances became clear to her), or both she and her child woud die.  May the Lord have mercy on us all.

-- Albert Gedraitis

Independent Dublin, Ireland (Nov 29)

Eilís Mulroy: Pro-choice side must not hijack this terrible event

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THE case of Savita Halappanavar should make us all stop and reflect. Anyone who shares a concern for the protection of life extends their deepest sympathies to the Halappanavar family.Thursday November 15 2012

The question that needs to be asked is: was Ms Halappanavar treated in line with existing obstetrical practice in Ireland? In this kind of situation the baby can be induced early (though is very unlikely to survive). The decision to induce labour early would be fully in compliance with the law and the current guidelines set out for doctors by the Irish Medical Council

Those guidelines allow interventions to treat women where necessary, even if that treatment indirectly results in the death to the baby. If they aren't being followed, laws about abortion won't change that.

The issue then becomes about medical protocols being followed in hospitals and not about the absence of legal abortion in Ireland.

Professor John Bonnar, then chairman of the Institute of Obstetricians and Gynaecologists, spoke about the matter to the All Party Oireachtas Committee's Fifth Report on Abortion, saying: "In current obstetrical practice, rare complications can arise where therapeutic intervention is required at a stage in pregnancy when there will be little or no prospect for the survival of the baby, due to extreme immaturity.

"In these exceptional situations failure to intervene may result in the death of both the mother and baby. We consider that there is a fundamental difference between abortion carried out with the intention of taking the life of the baby, for example for social reasons, and the unavoidable death of the baby resulting from essential treatment to protect the life of the mother."

With this medical practice Ireland, thankfully, has one of the lowest death rates of mothers in pregnancy anywhere in the world.

Our generally excellent record on maternal care doesn't of course help Praveen Halappenavar, who is today dealing with the loss of his beautiful wife and the baby they expected together. Yet this terrible situation should not be used to push an ideological agenda to introduce abortion. Any debate on the issue of abortion should be carried out in a reasonable manner. It does no service to Savita's memory to use her tragic death as an impetus for legislation that is bad for both women and their babies.

Any investigation into the circumstances surrounding Savita's death will happen against the backdrop of another investigation into the practices of health professionals when dealing with pregnant women in Ireland.

As a result of an undercover investigation published by the Irish Independent last month, the Health Service Executive has launched an investigation into crisis pregnancy counselling services in Ireland that were found to be giving illegal and life-threatening advice.

The Oireachtas Committee on Health and Children has also asked for answers from the HSE. The undercover investigation was carried out at 11 state-funded Crisis Pregnancy Counselling services and revealed that some pregnancy counsellors in certain services, including the Irish Family Planning Association, were giving women dangerous and illegal advice, including telling them they could hide their abortions from their own doctors -- a practice that can endanger lives.

Incredibly, some counsellors advised women how to illegally smuggle an abortion pill into Ireland and take it without medical supervision.

A prompt investigation must take place into the death of Savita Halappanavar to best serve her memory and ensure a tragedy like this does not reoccur. The investigation into the dangerous practices being employed by some state-funded crisis pregnancy counsellors must also happen.

HealthNigeria: 1/5 infant deaths: Childhood mortality

A technique that has proved helpful in Colombia, Haiti, and Vietnam, is now being introduced in Nigeria -- it aims at reducing the loss of premature babies who have been elsewhere, and are now dying in Nigeria.  It's called "Kangaroo Mother Care" because it requires keeping the premature newborn close to the mother's skin (skin-to-skin touch) 24 hours a day except when a surrogate is used for part of that time.  It also includes breastfeeding every two hours, and keeping the infants warm and upright between the mother's breasts and her clothes -- a simulated kangaroo mom's pouch.

-- Albert Gedraitis


Think Africa Press (Nov28,2k12)

Close For Comfort: Rolling Out Kangaroo Mother Care in Nigeria

With over a quarter of a million newborn babies in Nigeria dying before they reach one month, could Kangaroo Mother Care be part of the solution?

ARTICLE | 22 NOVEMBER 2012 - 5:07PM | BY ANTHEA GORDON

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A woman in Nepal practising Kangaroo Mother Care for new prematurely-born baby. Photograph by Save the Children.

Abuja, Nigeria:

At Maitama Government Hospital in Abuja, a newborn baby lies surrounded by its mother and other female family members. With nearly a fifth of children dying before the age of five in Nigeria, the child needs all the help it can get.

Reducing childhood mortality is a millennium development goal that often gets overlooked. In Nigeria, according to UN mortality estimates, there has been only an average of 1.2% reduction in under-five mortality per year since 1990. Insufficient support for babies born prematurely, which includes children born at 37 weeks or earlier, is one of the main causes of newborn death.

In more developed countries, the protection and support of prematurely born children is commonly achieved through the use of incubators. However, in Nigeria, where lack of funds and unreliable power supplies are a problem, incubators are not a viable resource for the care of premature babies.

Roo to the rescue?

One solution to this is Kangaroo Mother Care (KMC). The method originated in Colombia in 1978, and has since proved successful in countries ranging from Haiti to Vietnam. Using mothers as natural incubators, it involves skin-to-skin contact between mother and child 24 hours a day in a strict vertical position with the child held between the breast of the mother and her clothes. It has recently been implemented in Nigeria as part of the UK Department for International Development-run ‘Partnership for Reviving Routine Immunisation in Northern Nigeria; Maternal Newborn and Child Health Initiative’. This partnership aims to address the prevalence of polio and problems with primary healthcare. The introduction of Kangaroo Mother Care is therefore one part of a wider initiative to improve maternal and newborn health, from immunisation to available transport to health services.

KMC is a successful aspect of the project, and it has been found that reaching all premature babies with Kangaroo Mother Care would save 19,000 lives by 2015. It is also cost-effective and accessible, as it does not require complicated facilities. Another benefit is that mothers suggest it makes them feel closer to their child, and it also increases the likelihood of continued and successful breastfeeding, which in turn has other health benefits for the child.

Nevertheless, the demands of holding a baby 24 hours a day are understandably found to be difficult for some mothers. And, for a method which appears fairly straightforward, even natural, there are still particular requirements that must be followed. These include training regarding how to hold the baby in a way which achieves the most thorough insulation and support, breastfeeding every two hours, and special clinics to introduce the method to mothers and families. This means the method is in fact less accessible than it could be across Nigeria. The requirement for mothers to stay in clinic until their baby has grown to a more acceptable weight, can also be problematic as mothers often like to leave the hospital and return home soon after giving birth.

Even so, Kangaroo Mother Care is something which mothers can practise without expensive equipment. It is also possible to use a surrogate, giving the mother a break while the baby’s temperature remains regulated and its body supported. Although it is not yet a policy itself, it has been included recently in the national child health policy, as well as infant and young child feeding guidelines. With increased awareness and accessibility, KMC could help more premature children through the earliest stages of life, thereby significantly reducing Nigeria’s newborn mortality rate as a whole.

Death with Dignity: Trying to plan for the end of your life with facility and dignity

Bravo to New York Times for this editorial stance in favour of options which make Death with Dignity in a place and at a time I choose, more possible.  And another bravo to Gundersen Lutheran Health System in Wisconsin where "among the lowest-cost hospitals in the nation in treating patients at the end of life."

— Albert Gedraitis


NYT (Nov25,2k12)

EDITORIAL

Care at the End of Life

Published: November 24, 2012 159 Comments

Three years ago, at the height of the debate over health care reform, there was an uproar over a voluntary provision that encouraged doctors to discuss with Medicare patients the kinds of treatments they would want as they neared the end of life. That thoughtful provision was left out of the final bill after right-wing commentators and Republican politicians denounced it falsely as a step toward euthanasia and “death panels.”

Fortunately, advance planning for end-of-life decisions has been going on for years and is continuing to spread despite the demagogy on the issue in 2009. There is good evidence that, done properly, it can greatly increase the likelihood that patients will get the care they really want. And, as a secondary benefit, their choices may help reduce the cost of health care as well.

Many people sign living wills that specify the care they want as death nears and powers of attorney that authorize relatives or trusted surrogates to make decisions if they become incapacitated. Those standard devices have been greatly improved in recent years by adding medical orders signed by a doctor — known as Physician Orders for Life Sustaining Treatment, or POLST — to ensure that a patient’s wishes are followed, and not misplaced or too vague for family members to be sure what a comatose patient would want.

Fifteen states, including New York, have already enacted laws or regulations to authorize use of these forms. Similar efforts are under development in another 28 states. The laws generally allow medical institutions to decide whether to offer the forms and always allow patients and families to decide voluntarily whether to use them.

With these physician orders, the doctor, or in some states a nurse practitioner or physician assistant, leads conversations with patients, family members and surrogates to determine whether a patient with advanced illness wants aggressive life-sustaining treatment, a limited intervention or simply palliative or hospice care.

The health care professional then signs a single-page medical order telling emergency medical personnel and other health care providers what to do if the patient is incapacitated. In most states, the patient or surrogate must also sign the medical order to indicate informed consent. The orders are conspicuously highlighted in a patient’s electronic medical record and follow patients from one setting to another — such as a hospital emergency room or nursing home — so that any health professional handling the case will know what interventions the patient might want.

This comprehensive approach to end-of-life decisions started in Oregon in the early 1990s and is now used voluntarily by virtually all hospices and skilled nursing homes in that state. At least 50,000 Oregonians with advanced illness are covered by orders signed by a nurse or doctor. The program has provided care consistent with a patient’s wishes to limit treatment more than 90 percent of the time and has significantly reduced unwanted — and costly — hospitalizations, presumably reducing the overall cost of care.

The Oregon model has been adopted by the Gundersen Lutheran Health System in Wisconsin, where the forms now cover virtually all patients in facilities for long-term care or hospice care. Families are pleased and costs have come down. The Dartmouth Atlas of Health Care, which compares Medicare costs among various regions of the country, found that, in 2010, Gundersen was among the lowest-cost hospitals in the nation in treating patients at the end of life.

The Wisconsin Medical Society moved to organize voluntary pilot projects with doctors using Gundersen’s approach in other areas of the state. But the society backed down from using the physicians’ order forms because of opposition from the state’s Roman Catholic bishops, who contended that the orders might raise the risk of euthanasia. As a result, the pilot projects will only encourage healthy adults to do advance planning and create powers of attorney well before they face a medical crisis.

No matter what the death-panel fearmongers say, end-of-life conversations and medical orders detailing what care to provide increase the confidence of patients that they will get the care they really want. In some cases, that could well mean the request to be spared costly tests, procedures and heroic measures that provide no real medical benefit

.

Usher's Syndrome is an affliction with deafness and blindness at the same time

Kirstin's Visit is a video about "a woman living with Usher syndrome and therefore is deaf and blind.  This is a documentary about her visit from Finland to Florida, USA."


YouTube (Nov25,2k12)
<iframe width="560" height="315" src="http://www.youtube.com/embed/zLrI1fGt5BY?rel=0" frameborder="0" allowfullscreen></iframe>

Yellow Fever (or something like it) has broken out in North Darfur, Sudan; vaccination program launched

Radio Dabanga (Nov23,2k12)

New cases of disease ‘resembling yellow fever’

KABKABIYA

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21 Nov

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Activists and residents from Kabkabiya locality, North Darfur, have informed Radio Dabanga on Tuesday November 20, about the alleged arrival of four new cases of a disease resembling yellow fever from Jebel 'Aamer and Sref Beni Hussein localities.

The patients were taken to the hospital in Kabkabiya for treatment, but remain in critical condition, sources told Radio Dabanga. A local resident said one of the patients was referred to the hospital in El-Fasher but died during the trip.

The resident explained that another patient passed away on Monday, as a result of the disease. At the same time, one of the remaining patients was taken to El-Fasher hospital on Tuesday morning, after his condition became more critical.

He stressed that residents are living in fear, as the disease can cause a sudden death, adding that doctors withhold information on the patients' conditions from their relatives, which causes even more fear and panic, he added to Radio Dabanga from Kabkabiya.

Radio Dabanga (Nov23,2k12)

Yellow fever vaccination campaign to start

EL-GENEINA

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19 Nov

.) -

The Federal Health Minister, Bahr Abu Garda, announced the start of the vaccination campaign against the yellow fever epidemic in Darfur on Tuesday November 20, targeting 2.4 million people in Central, West and South Darfur, Radio Dabanga has learned.

Bahr Abu Garda, who arrived in El-Geneina on Saturday to visit the affected areas, announced to Radio Dabanga in an interview that the vaccination campaign will begin on Tuesday after arrival of the vaccines to Darfur.

The minister appeals to citizens in the states of Central and West Darfur, where the campaign will be started, to go to the vaccination centers and follow the necessary health instructions, he added to Radio Dabanga from El-Geneina.

On the other hand, he disclosed that the number of deaths as a result of the yellow fever epidemic has reached 110 on Saturday, adding that the total number of cases in West and South Darfur is now 358.

Abu Garda stated that all preparations were done in cooperation with the World Health Organization, including the preparation and equipment of blood banks in Nyala, El-Fasher, Zalingei and El-Geneina.

The minister noted that the disease seemed to be declining and appealed to citizens to go to the nearest health center as soon as any symptom of the disease emerges, he added to Radio Dabanga.

Photo: Minister of Health, Bahr Abu Garda (Radio Dabanga file photo)

Related: Dozens die of yellow fever in Darfur (16 November 2012)

New book: Questioning today's medicine on Dementia: A strongly theological perspective

Here's a notice of an important new book that stresses a theological view rather than the traditional medical view of a disease that afflicts especially older people, our Seniors.  I'm so impressed by the commendations of this new title that I'm running the commercial details as well.  The publisher is Eerdmans.

Look inside the book:

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Dementia

Living in the Memories of God

John Swinton

PAPERBACK; Published: 11/19/2012

ISBN: 978-0-8028-6716-2

308 Pages

Trim Size, in inches: 6 x 9

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Dementia is one of the most feared diseases in Western society today. Some have even gone so far as to suggest euthanasia as a solution to the perceived indignity of memory loss and the disorientation that accompanies it.

In this book John Swinton develops a practical theology of dementia for caregivers, people with dementia, ministers, hospital chaplains, and medical practitioners as he explores two primary questions:

• Who am I when I've forgotten who I am?
• What does it mean to love God and be loved by God when I have forgotten who God is?

Offering compassionate and carefully considered theological and pastoral responses to dementia and forgetfulness, Swinton's Dementia: Living in the Memories of God redefines dementia in light of the transformative counter story that is the gospel.

REVIEWS

Stanley Hauerwas
— Duke Divinity School; author of God, Medicine, and Suffering
"John Swinton has clearly become the premier pastoral theologian of our time. In this book he approaches the troubled topic of dementia with his usual thoroughness, engaging the science with an unapologetic theological voice. Dementia: Living in the Memories of God will become a classic."

Stephen G. Post
— Stony Brook University; author of The Hidden Gifts of Helping
"Swinton offers us the best constructive theology yet written on the important place for the deeply forgetful in our communities and our lives. His ability to elevate the most significant Christian scholarship on this topic to the level of a compelling new synthesis is clear on each thoughtful page. Those who want to reflect deeply on where individuals with dementia fit into our world will benefit from this breath of fresh air. It is a brilliant book that stays true to everything meaningful in Christian ethics, theology, and care."

Stephen Sapp
— University of Miami; author of When Alzheimer's Disease Strikes!
"Engagingly written and thoroughly researched, Swinton's Dementia is a ringing challenge to current thinking (and speaking and acting) about dementia. Especially significant is the author's insistence that Christians always consider dementia from a theological perspective and move beyond the dominant (and limited) medical model."

David Keck
— author of Forgetting Whose We Are
"This vigorous yet gentle book is changing the way I practice theology. It deserves a broad audience of both theologians and pastors since it challenges fundamental habits of thought, prayer, and service. Indeed, this book — this offering — provides hope. It demonstrates the power of faithful theology to engage very difficult, even frightening topics."

John Goldingay
— Fuller Theological Seminary; author of Remembering Ann
"For the last decade of her life my first wife, Ann, couldn't speak, not because she couldn't move her lips but because she could no longer work out what to say. She had dementia. . . . I would worry over how she and God could relate if she couldn't think straight, so I love Swinton's statement that people such as Ann 'remain tightly held within the memories of God' and I resonate with this description of the church as 'a living body of remembering friends.' Indeed, as I read this book, I kept saying, 'Yes, Yes, Yes!' "

Elizabeth MacKinlay
— Charles Sturt University; author of Spiritual Growth and care in the Fourth Age of Life
"This groundbreaking book tells a counter-story of dementia that brings hope and challenges the fears that are so dominant within society and the church."

Mayo Clinic: Proton beam therapy: Alternative to radiation therapy in some types of cancer with high recurrence

This article interests me from the contruction and tech viewpoints, but also and even more importantly from the viewpoint of building and technology aimed to reduce the cases of recurrent cancer treatments that two of my friends have been undergoing for years.  We have no such facility in Canada, so were my friends interested in such an advanced-tech treatment they woud have to travel south to the USA, I understand.  Machinery for just one of the proton beam treatment rooms requires two-floors of space to obtain "the proper treatment direction," I presume, in order to pinpoint the precise position of the cancerous cells in the patient's body.   In the long-run this medical-technological building is expected to reduce financial costs as well, in comparison to expenses of recurrent treatments for stricken patients.

— Albert Gedraitis

PostBulletin.com (Rochester, Minnesota USA) Nov13,2k12

$185 million Mayo Clinic proton beam therapy center marks construction milestone

Posted: Nov 13, 2012, 8:37 am

by Jeff Kiger The Post-Bulletin, Rochester MN Mayo Clinic's proton center by the numbers  • 2.9 million pounds of steel in the building. • 6,000 truckloads of dirt and rock excavated/removed. That's equal to 74,000 cubic yards. • 19,419 cubic yards of concrete. • 2.34 million pounds of rebar. • 500 construction jobs. By putting the final steel beam in place, Mayo Clinic in Rochester marked another milestone in its journey toward offering proton beam therapy on Monday. Despite the cold temperatures with a dusting of snow, many Mayo Clinic doctors and executives came out to sign the beam, which was painted white with a Christmas tree attached to it. John Black, the co-chairman of Mayo Clinic's proton beam center project, described the construction of the $185 million proton therapy treatment center as "online, on time and within budget." He said "the physics project with a beautiful appearance on the outside" should be able to start treating patients by mid-2015. The Rochester building will be named in honor of Richard O. Jacobson, in recognition of his $100 million gift to Mayo Clinic's Proton Beam Therapy Program. Jacobson founded the Jacobson Companies, a Des Moines corporation that operates public warehouses and trucking and packaging businesses. Mayo Clinic studies have predicted that about 1,240 patients per year will come to Rochester for treatment at the facility. The clinic also is building a second $185 million proton center on its Arizona campus. Black told the crowd huddled against the cold wind at the beam raising that the center is expected to "lower health care costs in the long term." Dr. Robert Foote, Mayo Clinic's chairman of Radiation Oncology, later elaborated on that. "The costs that will be lowered will be the costs associated with treating the acute side effects and long-term complications typically associated with conventional radiation therapy and the costs associated with treating recurrent cancer," Foote said. "The initial treatment costs will be lowered for some specific types of cancer in which the number of treatments can be substantially reduce." There are 10 such facilities in operation in the U.S. There are seven, including the two being built by Mayo Clinic, under construction. However, Mayo Clinic says the growing number of such facilities does not affect the drive to open the Rochester center. "There's no competitive pressure. The only pressure and urgency is for our patients with cancer," says Foote. The Rochester facility will feature four pencil-beam cancer treatment rooms. Each will be equipped with machinery that requires two floors of space to rotate to the proper treatment direction. When Mayo Clinic broke ground for the project, it was mentioned that a possible Phase II had been sketched out to add as many as 17 floors on top of the proton facility. Mayo Clinic officials say they have nothing to publicly report on a possible 17-floor addition.