Classic Memories

Nathan was brushing Hannah's teeth and Isabella was in the bathroom too and I heard her ask "Daddy, are you going to be here tommorrow when i wake up?" This was the third time in the past hour she had asked this. He told her no, honey, I'm going to be at work. She replied "But, Daddy, your not going to die, are you? You were just kidding?"
He asked her what she was talking about and she, in all seriousness answered "You said your back was killing you!

BITTER

I'm a bitter women lately. I got so caught up in being shocked at this whole new (?) futile care law, and the rhetoric, that i was missing the flaw in the arguments I've been hearing against it. Most people that are writing against it that are angry are upset because the hospital is trying to kill toddler Emilio Gonzales against the wishes of his mother. But it seems to me, after some reflection, that it's a tiny step from a decision that was made in this country years ago. The decision to place the life of a child in the hands of his/her mother. ABORTION. I wonder why it seems so horrifying to these people that are spouting off about how horrible it is. Is it because the mother isn't it control? Would it be alright if the mother was all for it and wanted her toddler to die? The decision for someone to live or die should never rest in human hands. It belongs in the hands of the Lord. And the sick thing is this issue isn't just about being hooked up to a machine that breathes for you and makes your heart breathe-it's about withdrawing food and water, too. If you withdraw food from any toddler, they'll die. They can't go get food on their own. They talk about giving only comfort care. What, patting their hand as they are starving to death? Dying of thirst? I'm so, so angry right now.
I heard a song yesterday that ripped my heart up and made me burst into tears.

Justice, by Seeds

They've got millions of dollars
still their greed's not met
So they build another factory
and they fill it with the labor
of little children in some far off foreign land
Keeping them out of sight
and out of mind
as the market place expands

When will Justice come upon the earth
When will the cries of the innocent be heard
When will power not be used for selfish gain
When will Justice Come?
When will Justice Come?

A generation of babies
have carelessly been slain
In the name of money
and convenience

While the poor and the elderly
are left alone to die
Keeping them out of sight
and out of mind
in the convenience of our times

An entire race of people forced
to leave their land
for the sake of someone elses' freedom
While another is enslaved cuz the color of his skin

TELL ME, WHEN WILL IT END?

We got Bosnia and Sudan
Rwanda and Iraq
Nations ripped apart before our eyes
Although we stand for justice
Although we fight the cause

In the end
I'm asking

When will Justice come?
When will Justice Come?
when will power not be used for selfish gain?
When will Justice Come?
When will Justice Come?
When will Justice Come?

While there's a Man who knows the pain of life
in the very deepest way
and He's coming soon to claim His rightful power
His kingdom it shall stand upon the righteousness He has
He'll give sight to our minds
as His kingdom comes at last

Then will Justice Come
Then will Justice Come
Then will Justice Come
Then will Justice Come
Then will Justice Come
Then will Justice Come
Then will Justice Come
Then will Justice Come

Come Lord Jesus Come

How did you get so big?


Hannah left the ink pad on the floor


you love hanging out with the girls

you love your mommy

Birthday girl

can't believe it'll be a year tomorrow, sweet baby girl.

best friends #?

NAZI GERMANY, OR AMERICA?
It's becoming more and more difficult to figure out.

here's an article i found online.

Imagine visiting your 85-year-old mother in the hospital after she has a debilitating stroke. You find out that, in order to survive, she requires a feeding tube and antibiotics to fight an infection. She once told you that no matter what happened, she wants to live.

But the doctor refuses further life-sustaining treatment. When you ask why, you are told, in effect, "The time has come for your mother to die. All we will provide is comfort care."

Sound far-fetched? It's not. It's already happening.

Just as doctors once hooked people up to machines against their will, now many bioethicists advocate that doctors be permitted to refuse life-sustaining treatment that a patient wants but that they deem "futile" or "inappropriate."

Alarmingly, hospitals in California and throughout the country have begun to implement these "futile-care" policies that state, in effect: "We reserve the right to refuse service."

Medical and bioethics journals for several years kept up a drumbeat advocating the implementation of medical futility policies that hospitals -- for obvious reasons -- don't publicize. The mainstream news media have generally ignored the threat.

As a consequence, members of the public and their elected representatives remain in the dark as "futilitarians" become empowered to hand down unilateral death sentences.

Indeed, futile-care policies are implemented so quietly that no one knows their extent. No one has made a systematic study of how many patients' lives have been lost or whether futile-care decisions were reached according to hospital policies or the law.

The idea behind futile care goes like this: The patient wants life- sustaining treatment; the physician does not believe the quality of the patient's life justifies the costs to the health institution or the physical and emotional burdens of care; therefore, the doctor is entitled to refuse further treatment (other than comfort care) as "futile" or "inappropriate."

Treatments withheld under this policy might include antibiotics to treat infection, medicines for fever reduction, tube feeding and hydration, kidney dialysis or ventilator support.

Of course, physicians have never been -- nor should they be -- required to provide medical interventions that provide no medical benefit.

For example, if a patient demands chemotherapy to treat an ulcer, the physician should refuse. Such a "treatment" would have no medical benefit.

But this kind of "physiological futility," as it is sometimes called, is not what modern futile-care theory is all about. Treatments are not refused because they don't provide any medical benefit, as in the case of chemotherapy to treat an ulcer. Rather, they are refused because they actually sustain life -- such as a feeding tube does for a persistently unconscious patient.

It isn't the treatment that is deemed futile but, in effect, the patient.

Early attempts to impose futile care upon unwilling patients and families were often ad hoc. For example, a few years ago I received an urgent phone call from a distraught woman who told me that her 92-year-old mother's doctor was refusing to give the woman antibiotics for an infection.

When I asked why, she said, "He told me my mother was going to die of an infection sooner or later, so it might as well be this one."

I advised the woman to get an attorney and threaten suit. That apparently did the trick. She later called to tell me her mother was being treated and was well on the way to recovery.

In 1994, the parents of a premature infant sued to prevent the imposition of futile care upon their son, "Baby Ryan" Nguyen, after doctors told them they were ending his kidney dialysis.

Ryan would have died, but the Nguyens' attorney obtained a temporary court order forcing doctors to provide continued life-sustaining care pending a full trial.

The doctors and hospital did not take the Nguyens' defiance lying down. They filed an affidavit requesting the right to refuse to provide treatment, claiming that Ryan's condition was "universally fatal" and that continuing life-sustaining treatment was a violation of their ethics and autonomy.

Astonishingly, a hospital administrator even went so far as to report the Nguyen family to Child Protective Services for "physical abuse and physical neglect" of Ryan based on the parents' success in obtaining the injunction to keep their child from death.

The case could have had a major legal impact on the entire futile care debate. But the trial judge never decided who had the ultimate right to determine Ryan's fate. The case ended when Ryan was transferred to a Portland hospital, where a different physician successfully weaned him off dialysis. Ryan lived four years, a happy if sickly child who gave high-fives and was the delight of his parents' hearts.

Cases like Baby Ryan's led futilitarians to pursue a more sophisticated approach to securing their agenda. Rather than have doctors act on their own accord or file lawsuits seeking permission to refuse wanted care, which had been attempted on several occasions with mixed results, many futilitarians began to argue that hospitals adopt written futile-care policies establishing formal procedures by which wanted life-sustaining treatment could be refused.

Although given little attention in the news media, these policies have been extensively described in medical and bioethical publications, such as the Journal of the American Medical Association, the New England Journal of Medicine and Health Progress.

Most policies set up internal hospital procedures that work like this:

-- If a patient wants life-sustaining treatment that the physician wishes to refuse, social workers, chaplains and hospital staff attempt to mediate the dispute.

-- If the patient and physician cannot resolve their differences informally,

the matter is referred to the hospital ethics committee for adjudication.

-- If the ethics committee determines that the treatment is inappropriate, a decision based on the institution's own futile-care standards, life- sustaining treatments may be terminated even if the patient or family find another doctor willing to provide the desired care at that hospital.

-- At that point, the patient or family have three options. Acquiesce, which means the patient probably dies. Find another hospital -- not likely in our managed-care environment, since life-sustaining treatment treatment to continue, as did Baby Ryan's parents.

Futile-care protocols are designed to thwart legal action by patients or their families. The strategy is to stack the deck by convincing judges that they, mere lawyers, are ill-equipped to gainsay what doctors and bioethicists have decided is best.

In the Cambridge Quarterly of Health Care Ethics, authors urging implementation of futility policies wrote last year: "Hospitals are likely to find the legal system willing (and even eager) to defer to well-defined and procedurally scrupulous processes for internal resolution of futility disputes. "

Considering that California legislators recently enacted a statute that appears to authorize futile-care impositions upon the sickest patients, that may be a winning strategy. Section 4735 of the California Probate Code states that a doctor or hospital "may decline to comply with an individual health care instruction" that runs contrary to "generally accepted health care standards." This means that once futile care becomes mainstream, the law will permit doctors to refuse wanted treatment that runs contrary to their values --

even if such care is necessary to keep the patient alive.

This little-noticed law raises an urgent question: How many California hospitals have already promulgated futile-care policies? Unfortunately, no one knows. But there is little doubt that the number is growing fast.

Authors of the Cambridge Quarterly article surveyed 26 California hospitals,

including UCSF, Kaiser Permanente, Stanford, UCLA and Cedars-Sinai. Without identifying the hospitals, they reported 24 had protocols in place that "defined nonobligatory treatment" in terms that were not "physiology based" -- in other words, a treatment that has no medical benefit.

Of these, "nine policies assigned the final decision-making authority to the responsible physician."

Other policies gave the power to hospital committees, the chief of staff or the hospital administration. Tellingly, only seven protocols permitted the patient or patient representative to have the final say.

As if this weren't enough cause for alarm, Sen. Arlen Specter, R-Pa., has introduced federal legislation to let doctors deny life-sustaining treatment against the will of the patient or the patient's family.

The Health Care Assurance Act (S24) is a 171-page bill with noble ambitions to expand health coverage for children and disabled people. Buried in the bill's bowels is a provision that permits hospitals to withhold care that is determined to be "either futile or otherwise not medically indicated."

The bill would be a disaster for the most vulnerable, disabled and defenseless among us -- patients who are too often dehumanized and callously viewed as parasites on limited health care resources.

Then there is the very real potential that bigoted doctors would apply futile-care policiesin a discriminatory fashion. Indeed, a 1996 study published by the Mayo Clinic found that "CPR was more likely to be considered futile if the patient was not white."

Implementing futile care to control health care costs doesn't add up. Since only about 10 percent of the nation's entire health care budget goes to end-of- life care, little would actually be saved.

But cost control isn't the ultimate point for futilitarians.

As many of them see it, if the nation were to swallow futile care theory, it would establish the principle that health care can be explicitly "rationed" -- a euphemism for discrimination against people who are elderly, disabled, chronically ill, dying or otherwise "expensive to care for."

Seen in this light, medical futility is the foot in the door that would begin the step-by-step descent from a health care system based on Hippocratic principles -- "First, do no harm" -- to a system in which access to medical care is restricted to some but open to others.

Futile care is not the finishing line of this important ethical and legal struggle, but merely the starting gate of a far longer race.

Wesley J. Smith is the author of "Culture of Death: The Assault on Medical Ethics in America."

This article appeared on page D - 1 of the San Francisco Chronicle

How very Hallmark of you.

Excerpts from a book by Max Lucado

Our hearts are not large enough to contain the blessings that God wants to give

So try this
The next time a sunrise steals your breath.....
or a meadow of flowers leaves you speechless
remain that way

Say nothing and listen as heaven whispers "do you like it? I did it just for you."

Flooded by emotion, overcome with pride, the Starmaker turns to us, one by one, and says
"you are my child, and I love you dearly"


Find your answer on a splintered cross, on a craggy hill.

Worship the potato? The idea seemed silly to me. But then I thought, what else is more deserving of worship? It's simple, it comes from the Earth, and it can kill you if you disobey it.

Jack Handy

I heard just about the best sales pitch in my life last night-simple me, I didn't know it was a sales pitch until I told Nathan about it, but anyways, here is what happened.

I was sitting in the car waiting for Nathan to get off work, and a street kids walked up. He made the usual icebreaking comment by complimenting my dreads, then leaned over and said "hey, I got a question for you"
I said "yes?" He said "What would you do if someone gave you an eighth of a bag of weed and 3 ounces of hash? I just don't know what to do with it"
I thought for a second and said "I'd throw it away. Drugs are evil. Just go throw it away, man.
As if he hadn't heard me he said again "I just don't know what I'm going to do with it.

I thought that this encounter was rather strange. Did he want me to buy it? Tell him to smoke it?
If it really was a sales pitch, he should become a businessman.

Sometimes I think you have to march right in and demand your rights, even if you don't know what your rights are, or who the person is you're talking to. Then, on the way out, slam the door.

jack handy