Alabama disaster plan would deny treatment to those with "severe mental retardation"

[LutherBlisset]

@DukeTrout

You imply that was me.

I did not at all want to imply you did.

@Melizmatic

It means taking action

Yes it does.
It does not mean that legal principles are worthless.
You seem to imply that following legal proceedings, that the rule of law itself leads to a

@Melizmatic

fucking travesty, not “justice.”

I read many of your posts and I can feel your justified and righteous anger, but in this case I am willing to stand up against you.

I know it is hard to get justice in a satisfactory way in any legal system, but our human rights are held up by the law. When the state changes laws to damage human rights we have what I called a constitutional crisis above. German language has the term of Unrechtsregime for that, as opposed to Rechtsstaatlichkeit. And I am definitely not talking legal positivism here. Fuck this shit, Nazi Germany has never been under a rule of law, and what the Nazis did wasn’t “technically legal”, it was Unrecht. Formality is something different than legality. English can’t properly express this, “unjust” is probably the closest. It is against basic human rights, so it cannot stand.

There is simply no way that a government, that the state can be allowed to dictate who lives and who dies.

It destroys the reason to it’s existence of it does.

@Melizmatic

channeling that anger

Productive channeling is the whole reason why I wrote, in multiple topics, on this matter.

Never again means to uphold the normative order of human rights. It means upholding a just and legal rule of law.

Smack the fascists wherever you may find them. And while you are at it keep record of what they are doing.

@DukeTrout

My point was that, now that he’s killing thousands of New Yorkers, we get to test it, and should hold him accountable.

Non sequitur arguing.

I’m far to tired to try in full, but:

@DukeTrout

Also, you’re getting a lot of mileage with the “murder” thing, when you’ve divorced it from the context in which I used the word. It was Trump himself who made the comparison, when he said he could shoot someone on 5th Avenue and his followers would still support him. My point was that, now that he’s killing thousands of New Yorkers, we get to test it, and should hold him accountable.

You are comparing a statement talking about actual murder (intent to kill someone with a gun, on purpose, on the street, under witnesses) with a bunch of policy decisions which of course are stupid and wrong, but which you are implying are deliberately intended to kill people by these decisions.

By all means, again, document the wrong decisions at the fucking sources, and oppose them, try to correct them. But stop telling everyone that this is murder and you have proof. This is not the same thing. The policy decisions made are clearly wrong in hindsight, and I am also of the opinion that the current decisions are heading for more disaster, but FFS this is politics, not science. Those people are very probably accepting casualties, but that’s politics. This has been always the case, but now it hits you in the face? Politics, and yes also politics in our democracy is weighting different options against each other, and we are for the first time since the second world war (and for US Americans for the first time since what do I know when, the secession?) are in the hard place between horrible options.

I am not saying the decisions made are good or even ok.

Very much the opposite.

You all don’t know me. If you think that I am downplaying this madness, you are entirely mistaken.
I strongly object to this accusation:

@Melizmatic

smacks of denialism

Fuck this whole madness. Document your cases against the state, the president, the senators and congresspeople. Sue them. If necessary, remove them by all legal means. But do not fall for populism on any side.

Get your shit together, and bloody hell: don’t start a civil war over it.

I am exhausted.
We will not recognise our world in a couple of months.
I hope we will recognise each other. I hope we will recognise ourselves.

I’m out.

[smulder]

@LutherBlisset

Fuck this shit, Nazi Germany has never been under a rule of law

@LutherBlisset

Sue them. If necessary, remove them by all legal means.

You might want to look up “No True Scotsman” and “Just World Fallacy”

[Melizmatic]

@LutherBlisset

It does not mean that legal principles are worthless.

When the actual fuck did anyone here say or imply that?

Dude, I think it’s probably best if we just stop engaging one another for awhile, at least until the world isn’t on fucking fire anymore.

[GulliverFoyle]

No offense, but if you really meant that as an attempted joke then I gotta tell you it failed to launch and @anon67050589 isn’t the one missing the ball.

[GulliverFoyle]

@orenwolf

These discussions aren’t theoretical anymore. The avalanche has already started. It’s too late for the pebbles to vote.

- YouTube

[DukeTrout]

@LutherBlisset

By all means, again, document the wrong decisions at the fucking sources, and oppose them, try to correct them. But stop telling everyone that this is murder and you have proof. This is not the same thing. The policy decisions made are clearly wrong in hindsight, and I am also of the opinion that the current decisions are heading for more disaster, but FFS this is politics, not science. Those people are very probably accepting casualties, but that’s politics . This has been always the case, but now it hits you in the face? Politics, and yes also politics in our democracy is weighting different options against each other, and we are for the first time since the second world war (and for US Americans for the first time since what do I know when, the secession?) are in the hard place between horrible options.

You’re not paying attention. Withholding ventilators from states where people need them and shipping them to states that don’t is not politics. Sending states that need working ventilators broken ones (as he did to Washington) is not politics. It’s petty and it’s selfish and it’s intentional. He’s already been told what the result will be (thousands of unnecessary deaths) and he’s doing it anyway. That’s not policy.

Those aren’t bad decisions in hindsight. They are bad decisions in foresight. He was told what would happen and he did it anyway.

Even if you go back to the origins of the California outbreak; the CDC advised not to send 36 people who were not infected from the Diamond Princess on the same airplane as the 14 people who were infected; the State Department over-ruled them, then while those 14 people were held in quarantine, the other 36 were sent home. These were known devastating decisions; the administration was warned by their own experts; they were warned about the outcome and did it anyway.

[anon59592690]

@DukeTrout

He was told what would happen and he did it anyway.

I’m not so concerned that the Shit Gibbon thinks this way; it’s that people in power follow through on his hideous suggestions every time even when it will directly lead to thousands of deaths.

[DukeTrout]

Right? They should be (Andrew) Johnsoning his ass. Instead, they’re kissing it.

[anon59592690]

Fear makes people do stupid things but this, and the actions of some other countries, feels almost sociopathic.

[Wanderfound]

@DukeTrout

He’s already been told what the result will be (thousands of unnecessary deaths) and he’s doing it anyway. That’s not policy.

Death as ‘Deterrence’: the Desert as a Weapon - Alliance for Global Justice

A March 2010 Congressional Research Service report entitled “Border Security: the Role of the Border Patrol” candidly details government policy goals and strategies in recent history. In 1994, the report explains, the U.S. adopted a “new policy” of militarizing urban border areas in order to reroute and steer anticipated human migration into “geographically harsher,” “more remote and hazardous border regions” (mostly through the Arizona desert), as a way of “deterring” migrants from crossing.

The new “vision” of the deterrence strategy to bring the border “under control” is outlined in a July 1994 Border Patrol planning document entitled “Border Patrol Strategic Plan: 1994 and Beyond”. The perception of the border environment is explicitly used to demonstrate that migrants “crossing through remote, uninhabited expanses of land and sea along the border can find themselves in mortal danger.” The document bases the strategy on the “prediction” that migrant “traffic will be deterred, or forced over more hostile terrain, less suited for crossing and more suited for enforcement.”

Forgoing any subtlety, “enforcement,” in this instance, is a euphemism for “mortal danger” as a premeditated method of death by example to deter human beings from crossing unauthorized into the US.

The strategic use of the “hazardous” border environment is not obscured by government officials. Six years after the strategic plan appeared, former Commissioner of Immigration and Naturalization Service (INS), Doris Meissner, admitted that “we did believe that geography would be an ally to us. It was our sense that the number of people crossing the border through Arizona would go down to a trickle once people realized what it’s like.”

On the policy’s fifteenth anniversary, the American Civil Liberties Union (ACLU) wrote in its landmark Oct. 2009 report, “Humanitarian Crisis: Migrant Deaths at the U.S.-Mexico Desert,” that at least 6000 people have died in the desert as a “predictable and inhumane” consequence of these so-called “deterrence” strategies, eliciting a continental humanitarian crisis. The month following the release of the ACLU report, the American Public Health Association (APHA) released its own report, “Border Crossing Deaths: A Public Health Crisis Along the U.S.-Mexico Border.” The APHA likewise concluded that the Border Patrol’s policy of “prevention through deterrence” has “resulted in the purposeful displacement and diversion of migrants into more treacherous and dangerous zones to cross…” The APHA echoed the total number of desert deaths cited by the ACLU in its report the previous month, but added that “[t]hese statistics are merely the number of known deaths, and do not include those border crossers who have never been found or were reported missing, thereby underestimating the actual number of migrants who have died attempting to cross the border.”

The darkly euphemistic language of “controlling” (in contrast to stopping) unauthorized immigration is crucial in understanding the enforcement management system of death as a measure of deterrence capacity. A “key assumption” of the 1994 Strategic Plan was that migrant apprehensions “will decrease as Border Patrol increases control of the border.” Having observed the actual consequences of anticipated effects of blunt “control” efforts, the APHA report cited above notes that “despite a nearly 50 percent drop in Border Patrol apprehensions”—as coolly predicted by Border Patrol in 1994—and despite “the recent economic downturn, and a decrease in border crossings, migrant deaths along the border continue to increase ” (my emphasis).

This morbid trend over the past two decades is acutely evident. According to state medical examiners and human rights groups 14 deaths in the year of the strategy’s fateful onset, 1994, jumped to 90 deaths in 2000, to 145 deaths in 2001, to 163 deaths in 2002. The next year, in one of those rare moments of candor that occasionally crop up from retired government officials, former Tucson Border Patrol sector chief, Ron Sanders, was quoted an article in The Nation magazine on U.S. border militarization policy: “By every measure, the strategy is a failure. All it’s accomplished is killing people….If you had airplanes crashing in this country with the same numbers [of deaths], you’d have everybody after the FAA. But since these people [dying] are Mexicans, no one seems to care.”

And then we consider foreign policy and trade policy and healthcare policy and…

[teapot]

I love a good Alabama pile on, but this just sounds like the brutal reality of triage to me. Thanks for the info.

Hope everyone is staying safe.

[BobDobbs]

What’s wrong with leftwing populism?

[Franklin]

Only those who require around the clock care and can’t feed themselves. So - Stephen Hawking?

[skiptheBS]

Please contact carpet industry representatives in Dalton, GA, where 90% of America’s carpet is made. One of their founding members , Jack Bandy, died yesterday of COVID-19. His granddaughter is Annalee Harlan and is a Dalton city councilwoman. Once the funeral arrangements are over, she might be the person to contact.

[lumbercartel]

@anon61221983

Yet advocates for people with intellectual disabilities are expressing concerns, and I’d suggest they might have a point here.

They should be raising the issue. I would hope that they do it often enough to have a fair number of false positives, because otherwise (in our imperfect universe) they would be getting false negatives. I prefer to err on the side of caution in matters like this, and perhaps the protocol could stand a few extra safeguards. Or maybe it’s as close as we can get without killing other patients.

It’s just that leaving mental status out of consideration altogether will kill other patients, so it’s not quite as bad as it’s being portrayed here.

[anon61221983]

@lumbercartel

It’s just that leaving mental status out of consideration altogether will kill other patients

How so? Again, we might not to have to have these sorts of state-backed directives if we had been prepared in the first place.

Why does the government of Alabama get to decide who is worth saving and who is not?

[beschizza]

@Skeptic

I’m wondering how Rob would write the triage rules?

Not that I should be writing them… but I would not include within them vague, unscientific, politically-mediated descriptions of mental disability or disorder as criteria for treatment.

Let them put it precisely: what IQ do you need to have to be worthy of treatment? Do they mean F72 diagnosis or will a letter from the principal do?

[lumbercartel]

@anon61221983

How so?

Because in at least several of the cases described the same quality of care requires a lot more resources, for one. Please observe Docosc’s experience above. For another, “advanced dementia” is generally associated with poor outcomes regardless. It is, in fact, an irreversible terminal condition, no different from Stage 4 lung cancer. The most recent data has a 0% chance of actually leaving ICU alive for the latter. If there is limited ICU capacity, who do you admit?

Again, we might not to have to have these sorts of state-backed directives if we had been prepared in the first place.

I quite agree. However, that’s not the situation we’re in. Besides which, who would you nominate to (in real time) gather the available data on differential prognoses, collate them, summarize them, and distribute them? ICU docs are, by the nature of the situation, not doing a whole lot of journal reviews at the moment. Perhaps the Heritage Foundation?

@beschizza

I would not include within them vague, unscientific, politically-mediated descriptions of mental disability or disorder as criteria for treatment.

“Retarded” isn’t a good sign. On the other hand, “persistent vegetative state” is pretty clear, and while “advanced dementia” might be more precise it’s not bad for an umbrella description of late-stage Alzheimer’s and several other syndromes that have poor-to-very-poor prognoses combined with high resource requirements.

Suggestion: have a look at the widely used SOFA scoring that is a pretty good fast guide used to assess whether someone is a candidate for ICU in the best of times. Several of the items mentioned above would rule out ICU on the Glasgow score alone.

[Mister44]

OK, for anyone curious, I got some short replies from an ER doc and a heart nurse. Oddly the ER doc said they really don’t usually need to follow guidelines in place, but probably would if they got overwhelmed. She was aghast at the thought of metal ability being a factor in whether someone gets care or not.

The heart nurse did have triage guidelines and she was able to elaborate some. Mainly when they have to ration care, it is based on survive-ability. She too was aghast at the idea of mental ability being used as a guide to issue care or not. However, if a mental impairment would be a factor on if someone is more or less likely to survive, then it may be used as part of the overall determination on care. Part of this is because people with severe mental issues also usually have physical issues as well. But say someone who is otherwise healthy but has Downs, Downs would not be a factor on whether they get care or not.

I did run a few hypotheticals that she didn’t have time to run through, but I think the take away is that the average healthcare facility shouldn’t be actively denying care due to mental impairment. Between shitty state guidelines and their oath to provide care, they are sticking to their oath. That said, if the resources are stressed to the point hard decisions come into play, someone with an underlying issue maybe put behind someone else if it meant saving more lives. (This would be physical as well as mental.) I suppose they can’t be beholden to the sunk cost fallacy if they don’t have enough resources.

[smulder]

@lumbercartel

syndromes that have poor-to-very-poor prognoses

OK, this might be reasonable. Death cannot be prevented, only delayed. Everybody dies. The question is how far is each death being pushed back. Is every person-year being counted the same, or not?

@lumbercartel

combined with high resource requirements

I’m sure the disabled billionaires will get all the ventilation time they need

If anybody else is COSTING TOO MUCH MONEY TO KEEP ALIVE, take it out of the goddamn defense budget, what the hell else is it for