Medicine – Page 2

Bronze Bikinis for Beneficence

Well, Labor Day weekend is coming up, and if you live in Atlanta and don’t have room to fart in Midtown with the addition of 40,000 tourists dressed like stormtroopers, you know what that means: DragonCon. And if you’ve ever been one of those 40,000 tourists, pressed tit-to-bare-back with a chick in a bronze bikini top and a big, plastic neck chain, you know what that means: Slave Leia Watch 2011.

It’s always a good time. Unfortunately, Slave Leia Watch 2010 ended without an official tally, as the then-new release of Prince of Persia made it difficult to distinguish Slave Leia from Princess Tamina at a quick glance. (Hint: If she’s accompanied by an embarrassed-looking guy in a leather breastplate and Keith Urban’s castoff hairpiece, it’s Tamina.) But seeing as how this year’s sci-fi hottie of choice wears a black leather glow-in-the-dark bodysuit, 2011 should be an easier time.

And for 2011, it’s going to mean something. This year, the traditional count of the traditional (objectifying, not terribly imaginative) go-to sexy cosplay classic will turn into a donation to a deserving charity. I’m having trouble, though, deciding on a charity–I’m really lousy at that part–so I thought I’d put it to the brilliant crowd at Feministe for advice.

Option 1: Planned Parenthood. Obviously a solid call, and certainly they could use the help as the government decides that men’s health care is health care, but women’s health care is something extra that isn’t worthy of federal support.

Option 2: Doctors Without Borders/Medecins Sans Frontieres. I really respect the work they do anyway, but staggering situations like the current one in Somalia make the need for donations that much more urgent.

Option 3: Southern Poverty Law Center. The SPLC is challenging the shameful new “papers, please” immigration law in Alabama. I figure they need all the help they can get.

The pledge: I’ll donate $5US for every woman I see dressed as Slave Leia at this year’s DragonCon, and $10US for every Rebel Leia (or dude Slave Leia), to the charity of your collective choice. Vote for your favorite organization or suggest one of your own in comments, and I’ll provide a final count next Monday night-ish after the dust has settled.

Kansas Should Serve as a Warning to Virginia Women

This is a guest post by Dr. James Kenley.
These regulations, which demanded precise sizes for janitorial closets, no-variance room temperatures, and other ridiculous requirements, were purportedly established to protect the health and safety of women, but in truth had one and only one purpose: to shut down the three existing abortion facilities in the state.

Fat and healthy – not an oxymoron.

Hey there! I know you’re all like “didn’t she say adieu (and spell it incorrectly, too) awhile ago?” Well, I did, but the delightful Powers That Be at Feministe are allowing me to another quick visit, in order to drop some new science on y’all.

So I’m just going to leave this here (along with a small reminder that America’s current conversation surrounding weight and health is shaped, in no small part, by money from the diet industry):

Heavy but healthy? New formula slims down definition of dangerously obese

New Canadian research suggests being obese doesn’t necessarily doom people to an early grave.

Two research teams using a new tool called the Edmonton Obesity Staging System, which ranks overweight and obese people on a five-point scale according to their underlying health, have found that not only can the scale predict who is at greater risk of dying, but that otherwise healthy obese people live as long as those of “normal” weight, and are less likely to die of cardiovascular causes.

The back-to-back studies come as more evidence emerges that a significant proportion of overweight people are metabolically healthy and that the risks associated with obesity do not make for a one-size-fits-all formula.

The Edmonton staging system grades obesity on a scale of zero to four. It uses physical measures such as body mass index, as well as waist-to-hip ratios. But it goes farther by taking into account the presence — or absence — of a spectrum of disease.

Under Stage 0, the person is obese, but has no apparent obesity-related health risks, meaning their blood pressure, blood fats and other risks are all within the normal range. Stage 1 obesity describes people with “sub-clinical” signs of trouble, such as borderline high blood pressure, elevated liver enzymes and occasional aches and pains. Stage 4 is the most severe. At Stage 4, patients have serious, “potentially end-stage” disabilities and illnesses from obesity-related diseases.

In one study published Monday in the Canadian Medical Association Journal, University of Alberta researchers tested the system using data from a survey of 8,143 people in two U.S. national health and nutrition surveys.

They found that although 77 per cent of overweight or obese people in one survey, and 90 per cent of those in another, were classified as Stage 1 or Stage 2, their risk of dying over 20 years of followup was substantially lower than people classified as Stage 3 obesity.

After adjusting for age, history of smoking and metabolic syndrome — a cluster of conditions such as high blood pressure and diabetes —about two per cent of people with scores of O or 1 died during followup, compared to about 40 per cent of Stage 3 patients.

“That’s a huge difference,” said Dr. Arya Sharma, who first proposed the Edmonton classification system.

…

The findings not only challenge the notion that everyone who is obese needs to lose weight. “Just because you’re normal weight doesn’t necessarily mean that you’re healthy,” Kuk said. “You can still have high blood pressure, you can still have diabetes, you can have a poor lifestyle — and all of these contribute to obviously negative health and early mortality risk.”

“You really need to take the emphasis off trying to attain this normal body weight, because lifestyle practices are equally, if not more important.”

The study was published online in Applied Physiology, Nutrition and Metabolism.

…

“If someone comes to my office and their BMI is 35, they have obesity, there’s no question,” Sharma said.

“But if I do the tests and I find that they have no other risk factors, then I can confidently tell them that they are at extremely low risk of dying. There shouldn’t be an urgent need to lose weight just because their BMI is high. The focus really should be on trying to maintain that weight and not get heavier.”

The opposite could hold for people with lower BMI’s who don’t meet criteria for surgery but who are at high risk and should be treated. “And we’re missing those patients,” Sharma said.

Sharma said people who have a history of weight cycling — losing large amounts of weight only to put the weight back on, or more — appear to be at higher risk of obesity-related complications.

“If you’re constantly dieting and trying to lose weight, and you put it back and you diet again, you might actually be causing problems.”

(all emphasis mine)

To read the whole article as it appeared in the Canadian press yesterday, click here. To read the actual research papers, click on the links embedded above. To read me ranting about some of these issues and the harm they can and do cause, you can click here, or here, or here (or just crawl inside my head, where the rant is on a constant loop).

Crossposted at Emily L. Hauser In My Head and Angry Black Lady Chronicles.

Banning Circumcision in San Francisco

There’s a proposed measure in San Francisco, California to ban the circumcising of boys under the age of 18. Various Jewish and Muslim groups and individuals have filed suit, asking the judge to remove the initiative from the November ballot. Supporters of the ban argue that circumcision is genital mutilation that shouldn’t be imposed on a minor child without consent; opponents argue that, first, only the state can make laws restricting medical procedures and, second, circumcision bans are unconstitutional and violate religious liberties.

They might be right about the state law issue, but I’m not so sure they have a great constitutional argument here. Eugene Volokh gets into it.

Some people deserve bad reputations.

Andrew Wakefield is one of them. He’s the guy who promoted faulty research that implicates vaccines in the onset of autism, and encouraged parents not to vaccinate their kids. As a result, diseases that were nearly eradicated have returned, and are putting kids at risk.

Although Wakefield did not claim to have proved that the M.M.R. vaccine (typically given to children at 12 to 15 months) caused autism, his concerns, not his caveats, ricocheted around the world. His belief, based on a paper he wrote about 12 children, is that the three vaccines, given together, can alter a child’s immune system, allowing the measles virus in the vaccine to infiltrate the intestines; certain proteins, escaping from the intestines, could then reach and harm neurons in the brain. Few theories have drawn so much attention and, in turn, so much refutation: a 2003 paper in The Archives of Pediatrics and Adolescent Medicine, which reviewed a dozen epidemiological studies, concluded that there was no evidence of an association between autism and M.M.R., and studies in peer-reviewed journals since have come to the same conclusion. In Britain, the General Medical Council revoked Wakefield’s medical license after a lengthy hearing, citing numerous ethical violations that tainted his work, like failing to disclose financing from lawyers who were mounting a case against vaccine manufacturers. The Lancet, which published the original Wakefield paper, retracted it. In a series that ran early this year, The British Medical Journal concluded that the research was not just unethically financed but also “fraudulent” (that timelines were misrepresented, for example, to suggest direct culpability of the vaccine).

Andrew Wakefield has become one of the most reviled doctors of his generation, blamed directly and indirectly, depending on the accuser, for irresponsibly starting a panic with tragic repercussions: vaccination rates so low that childhood diseases once all but eradicated here — whooping cough and measles, among them — have re-emerged, endangering young lives.

I can understand the desire, on the part of parents, to try to target the cause of autism (and when it’s something like vaccines, it allows parents to blame themselves just a little bit, which I imagine for some people is a burden they want to bear). But the idolization of Wakefield seems to happen primarily because he is so sure of himself and he gives parents an answer, where the more widely-accepted medical truth about what causes autism is “we don’t know yet.”

Wakefield also listens to parents and validates their experiences, which is too rare in the medical field. One mother of an autistic child says, “I don’t care if my son was overtreated or cured — just the validation that we as parents who knew something was wrong got an answer. Just the fact that someone listened and someone tried to do something — someone said, ‘Yeah, this is not just autism; your son has a real medical issue that we can treat.’ I think that validation is all that parents want — just that someone is taking the symptoms we report and looking at them to see what can we do about it.”

It’s too bad that the person who appears to be listening is more interested in preserving his own star status than in actually helping kids, and telling their parents a difficult truth.

Simply Everything: An Interview with Imane Khachani

Last month, Women Deliver – a fantastic organisation dedicated to improving women’s and girls’ health and wellbeing globally – released the Women Deliver 100. It’s a list of inspiring people, well, delivering for girls and women in all kinds of areas: health, politics, the media, and so on. Out of all those people, there was one I very badly wanted to interview, and her name is Imane Khachani. She’s a twenty-nine year old doctor from Morocco, and she’s one of those people who seem to get as much life and amazing activism into as little time as possible. She was a Special Youth Fellow at the United Nations’ Fund for Population, among other work with the UN, and has collaborated with the Department for Gender, Women and Health at WHO, not to mention Oxfam. Taking a particular interest in HIV/AIDS, she’s worked on sexual and reproductive health programs for young people at home and regionally, and has put together guides for addressing these needs in humanitarian settings. She’s just kind of jaw-droppingly amazing, if you will well know if you caught the video I posted recently.

Well, I was lucky enough to get that interview, thanks to Women Deliver, so here is Imane Khachani.

Righteous Providers, Medical Pariahs?

When we talk about the stigma associated with abortion, the conversation is often about the experiences of women who choose the procedure. Sometimes we talk about abortion providers, specifically the harassment and violence they endure to courageously provide women with medical care. But what about the harassment abortion providers receive from within the medical community?

I recently interviewed a friend of mine who performs abortions and other routine reproductive health care. Her words speak for themselves.

Me: Tell me about your experience as an abortion provider within the medical community.

Doctor: Although the majority of physicians favor legal, safe abortion, some tend to think of it as a shameful kind of care to provide. In general, status within the medical community has to do with faculty appointments and research grants. People who provide abortion are frequently excluded from faculty positions at academic universities for political reasons (even at a non-religiously affiliated university, all it takes is one anti-choice department member to keep someone out for good).

It’s hard to be somewhat of an outcast in one’s own community. It’s hard to see the president of the American College of OB/GYN make statements about his personal distaste for abortion, and to see your entire sub-area of expertise nearly entirely excluded from conference programs. It’s hard to know that some of your colleagues disrespect you for what you do and think your job is “dirty” somehow, and while they’re glad you do it, they’re glad they don’t have to.

‘And for how long will we let ideological agendas kill women in silence?’

I want to share with you a speech given by a young Moroccan doctor and sexual and reproductive rights activist by the name of Imane Khachani. I’ve been extremely fortunate in securing an interview with Dr Khachani – ! – which I’ll share with you quite as soon as it’s conducted. This is a video I found during the course of my research, and it’s well worth a viewing. A transcript follows.

Standing with Planned Parenthood

This week, the anti-choice group Live Action released a series of (often heavily edited) videos where an actor posing as a pimp and actresses posing as sex workers went into Planned Parenthood clinics asking for care. Their story made it sound like the fake sex workers were underage and the victims of human trafficking. They visited a dozen clinics, and clinic workers did exactly what they’re supposed to: They told the girls about their legal rights to health care and privacy, they offered them health care resources, and then they not only reported the visits to the local police and the FBI, but contacted Attorney General Eric Holder. One Planned Parenthood employee, of the dozens who were targeted in this sting operation, didn’t follow protocol and was fired as soon as PP found out — even at that PP center, though, the visit was reported to law enforcement.

Live Action says that the videos reveal an “endemic problem” at Planned Parenthood. Jill Stanek, to whom I am not going to link, quotes Live Action founder Lila Rose as saying:

“It is utterly disgusting that Planned Parenthood’s response to this is that their employee reacted ‘professionally,’” said Live Action President Lila Rose. “The only acceptable response to encountering a self-identified sex-trafficker of underage girls is zero tolerance. The only ‘professional’ response is to immediately call law enforcement to the scene and push for an arrest.

Our investigation – and their response – continues to show that an institutional crisis has engulfed the highest levels of PP. If you’re a sex-trafficker of minors or young women, you have a partner in PP. But if you are a minor or a young woman, you are not safe at PP clinics,” Rose continued.

Yeah, but no. I understand that Rose has an agenda, but calling local police in, say, Falls Church, Virginia to deal with what may be an international sex ring involving underage girls, and demanding that they come immediately and make arrests? Is really, really not the way to deal with trafficking situations. The outcome there is arresting the girls, ensuring that sex workers will not use Planned Parenthood’s very necessary services in the future, and giving the traffickers notice so that they can hide their tracks. The best thing that a health care worker can do in that situation is to do their job — to give their patient the health care they’re seeking within the confines of the law — and then to report the situation to law enforcement agencies that will be able to coordinate a comprehensive, sensitive and effective response.

The real story here, though, is how Live Action has made a years-long effort to take down Planned Parenthood. Lila Rose is an anti-choice extremist who thinks that if abortions are legal, they should be “done in the public square” so we can all see what they’re about (I wonder if she would say the same thing about, say, sex between married Christians?). She has collaborated with James O’Keefe (the guy who tapped Sen. Mary Landrieu’s phone and attempted to entrap a CNN reporter) on various anti-PP stings, with remarkably little success. She’s dishonest and thoroughly unethical, and the message she’s attaching to these latest videos is, basically, “Planned Parenthood employees will help girls get birth control, STI tests and abortions without telling their parents.” Which, yeah, is true! And totally legal! And should be legal!

It’s pathetic, but the media is biting, and anti-choice congressmen are pushing bills that would cut federal funds to Planned Parenthood because of PP’s status as an abortion provider. But more than 90 percent of the services offered by Planned Parenthood are preventative; abortion makes up a tiny fraction of what the organization does. PP provides contraception for nearly 2.5 million patients every year; four million tests and treatments for STIs, including HIV; nearly one million life-saving screenings for cervical cancer; and more than 830,000 breast exams. One in four American women has received care from Planned Parenthood. I certainly have — I was able to get an annual exam and contraception for free at a time when I didn’t have insurance. I was very thankful that PP was there when I needed them.

The efforts by Live Action aren’t intended to make Planned Parenthood better, to keep them accountable; they aren’t intended to help trafficking victims or women and girls. They are explicitly purposed to make Planned Parenthood and its employees “not feel safe.” The point is to take away health care from women and girls — not just because Lila Rose and her team dislike abortion, but because they oppose reproductive care generally. They’re against women having access to birth control. They’re against women and men having access to STI testing. They’re against anything that recognizes the reality that people have sex, usually before marriage, and not everyone thinks they should be punished for that sin. They’re against, essentially, any responsible decision-making or self-care when it comes to sex, because that might mean that people could actually enjoy their sexuality outside of the confines of what anti-choice extremists believe to be appropriate.

So they try to punish everyone, and take away basic health care access. It’s disgusting and it’s offensive, and they’re trying to shift the media narrative by claiming that Planned Parenthood helps human traffickers. Planned Parenthood helps all of its patients, regardless of their status. If these fake sex workers were actually trafficked girls, Planned Parenthood’s actions would have helped them much more significantly than Lila Rose’s suggestion to call the local cops and demand arrests. This attack is pathetic, but it’s gotten some traction. Don’t let it. Stand with Planned Parenthood.

New bill will let doctors refuse to save the lives of pregnant women

Sometimes there really aren’t words for what passes as “pro-life” in the United States. The “Protect Life Act” overrides the requirement that ER doctors treat every patient and do what’s necessary to save the patient’s life, regardless of the patient’s identity or ability to pay — the Act allows doctors to refuse necessary care to a pregnant woman if that care will kill the fetus.

In other words, it gives doctors the green light to let pregnant women die if they have a life-threatening condition and need an emergency abortion. We know that women’s lives have been saved by abortion (and that some number of people don’t approve of the whole life-saving thing). It’s not surprising that a few religious blow-hards think it’s better for women to die instead of receiving therapeutic abortions, but to encode the view that you don’t have to save a pregnant woman’s life into federal law? That is truly sick — and shockingly cruel, even for the usual “pro-life” suspects who regularly use their ideology as a tool to punish women.

Also? It’s not like letting the pregnant woman die saves the fetus, so there’s no “protecting life” here. When the woman dies, the fetus dies too. The entire purpose of this bill is to allow ideologues to refuse necessary, life-saving care to patients, if those patients happen to be pregnant. It’s disgusting. I hope, at the very least, that this will be widely publicized, and will show the rest of the country what a far-right “culture of life” really looks like — it’s not particularly life-affirming to anyone with a uterus.

Thanks to Amanda for the heads up.