Posted on | April 2, 2024 | 2 Comments
Mike Magee
How comfortable is the FDA and Medical Ethics community with new, super-charged, medical Facial Recognition Technology (mFRT) that claims it can “identify the early stages of autism in infants as young as 12 months?” That test already has a name -the RightEye GeoPref Autism Test. Its’ UC San Diego designer says it was 86% accurate in testing 400 infants and toddlers.
Or how about Face2Gene which claims its’ mFRT tool already has linked half of the known human genetic syndromes to “facial patterns?”
Or how about employers using mFRT facial and speech patterns to identify employees likely to contract early dementia in the future, and adjusting career trajectories for those individuals. Are we OK with that?
What about your doctor requiring AiCure’s video mFRT to confirm that you really are taking your medications that you say you are, are maybe in the future monitoring any abuse of alcohol?
And might it be possible, even from a distance, to identify you from just a fragment of a facial image, even with most of your face covered by a mask?
The answer to that final question is what DARPA, the Defense Advanced Research Projects Agency, was attempting to answer in the Spring of 2020 when they funded researchers at Wuhan University. If that all sounds familiar, it is because the very same DARPA, a few years earlier, had quietly funded controversial “Gain of Function” viral re-engineering research by U.S. trained Chinese researchers at the very same university.
The pandemic explosion a few months later converted the entire local population to 100% mask-wearing, which made it an ideal laboratory to test whether FRT at the time could identify a specific human through partial periorbital images only. They couldn’t – at least not well enough. The studies revealed positive results only 39.55% of the time compared to full face success 99.77% of the time.
Facial Recognition Technology (FRT) dates back to the work of American mathematician and computer scientist Woodrow Wilson Bledsoe in 1960. His now primitive algorithms measured the distance between coordinates on the face, enriched by adjustments for light exposure, tilts of the head, and three dimensional adjustments. That triggered an unexpectedly intense commercial interest in potential applications primarily by law enforcement, security, and military clients.
The world of FRT has always been big business, but the emergence of large language models and sophisticated neural networks (like ChatGPT-4 and Genesis) have widened its audience well beyond security, with health care involvement competing for human and financial resources.
Whether you are aware of it or not, you have been a target of FRT. The US has the largest number of closed circuit cameras at 15.28 per capita, in the world. On average, every American is caught on a closed circuit camera 238 times a week, but experts say that’s nothing compared to where our “surveillance” society will be in a few years.
They are everywhere – security, e-commerce, automobile licensing, banking, immigration, airport security, media, entertainment, traffic cameras – and now health care with diagnostic, therapeutic, and logistical applications leading the way.
Machine learning and AI have allowed FRT to soon displace voice recognition, iris scanning, and fingerprinting. Part of this goes back to Covid – and not just the Wuhan experiments. FRT allowed “contactless” identity confirmation at a time when global societies were understandably hesitant to engage in any flesh to flesh contact.
The field of mFRT is on fire. Emergen Research projects a USD annual investment of nearly $14 billion by 2028 with a Compound Annual Growth Rate of almost 16%. Detection, analysis and recognition are all potential winners. There are now 277 unique organizational investor groups offering “breakthroughs” in FRT with an average decade of experience at their backs.
Company names may not yet be familiar to all – like Megvii, Clear Secure, Any Vision, Clarify, Sensory, Cognitec, iProov, TrueFace, CareCom, Kairos – but they soon will be.
The medical research community has already expanded way beyond “contactless” patient verification. According to HIMSS Media , 86% of health care and life science organizations use some version of AI, and AI is expanding FRT in ways “beyond human intelligence” that are not only incredible, but frightening as well. Deep neural networks are already invading physician territory including “predicting patient risk, making accurate diagnoses, selecting drugs, and prioritizing use of limited health resources.”
How do we feel about mFRT use to diagnosis genetic diseases, disabilities, depression or Alzheimers, and using systems that are loosely regulated or unregulated by the FDA?
The sudden explosion of research into the use of mFRT to “diagnose genetic, medical and behavioral conditions” is especially troubling to Medical Ethicists who see this adventure as “having been there before,” and not ending well.
In 1872, it all began innocently enough with Charles Darwin’s publication of “The Expression of the Emotions in Man and Animals.” He became the first scientist to use photographic images to “document the expressive spectrum of the face” in a publication. Typing individuals through their images and appearance “was a striking development for clinicians.”
Darwin’s cousin, Francis Galton, a statistician, took his cousin’s data and synthesized “identity deviation” and “reverse-engineered” what he considered the “ideal type” of human, “an insidious form of human scrutiny” that would become Eugenics ( from the Greek word, “eugenes” – meaning “well born”). Expansion throughout academia rapidly followed, and validation by our legal system helped spread and cement the movement to all kinds of “imperfection”, with sanitized human labels like “mental disability” and “moral delinquency.” Justice and sanity did catch up eventually, but it took decades, and that was before AI and neural networks. What if Galton had had Gemini Ultra “explicitly designed for facial recognition?”
Complicating our future further, say experts, is the fact that generative AI with its “deep neural networks is currently a self-training, opaque ‘black box’…incapable of explaining the reasoning that led to its conclusion…Becoming more autonomous with each improvement, the algorithms by which the technology operates become less intelligible to users and even the developers who originally programmed the technology.”
The U.S. National Science Advisory Board on Biosecurity recently recommended restrictions on “Gain of Function” research, belatedly admitting the inherent dangers imposed by scientific and technologic advances that lack rational and effective oversight. Critics of the “Wild West approach” that may have contributed to the Covid deaths of more than 1.1 million Americans, are now raising the “red flags” again.
Laissez-faire as a social policy doesn’t seem to work well at the crossroads of medicine and technology. Useful, even groundbreaking discoveries, are likely on the horizon. But profit seeking mFRT entrepreneurs, in total, will likely add cost while further complicating an already beleaguered patient-physician relationship.
Posted on | March 19, 2024 | Comments Off on The Long Tail of Liability For MAGA Republicans
Mike Magee
If legal scholars are right that “forseeability” and “special relationships” are the toxic mix most common in “long liability tails”, then MAGA Republicans should expect a rocky decade ahead. Trump acolytes in federal and state executive, legislative and judicial branches are massively exposed on at least two fronts.
Led by Christian White Nationalists who succeeded in overturning Roe v. Wade via the Dobbs decision, party elites already know they face trouble at the ballot box. But that’s the least of it.
As former Supreme Court Justice Stephen G. Breyer recently wrote in his new book, Reading the Constitution: Why I Chose Pragmatism, Not Textualism, the Dobbs decision was “stunningly naïve in saying it was returning the question of abortion to the political process…The Dobbs majority’s hope, that legislatures and not courts will decide the abortion question, will not be realized…There are too many questions…Are they really going to allow women to die on the table because they won’t allow an abortion which would save her life? I mean, really, no one would do that. And they wouldn’t do that. And there’ll be dozens of questions like that.”
Allowing ultra-conservative state legislators to play doctor with women’s lives in the balance not only endangers them, but also captures compliant hospitals and doctors in spiraling decades long liability as women predictably suffer and die needlessly. As the initial flurry over IVF and Alabama’s “extra-uterine children” embryos clearly illustrates, “God’s will” is unlikely to hold sway in court once the Puritan fever breaks. And until enough Red state ballot initiatives neuter Dobbs, hospital CEO’s and medical staff will find being continuously subpoenaed to be emotionally, physically and financially demanding.
And that’s not all. If “foreseeability” and “special relationship” are the two linchpins here, one could easily argue that characters like Bill Barr, Mike Esper, John Bolton and others in Trump’s inner circle [let alone Jan.6 co-conspirators like Congressmen Andy Biggs (R-AZ), Matt Gaetz (R-FL), Louie Gohmert (R-TX), Paul Gosar (R-AZ), Jim Jordan (R-OH), and Scott Perry (R-PA)] could easily fall within the orbit of “The Tarasoff Rule” for failing to protect us as citizens and our democracy from the criminal behavior of Donald Trump.
“The Tarasoff Rule” is named for Tatiana Tarasoff, a student at University of California who was murdered by a graduate student in 1969. The details of the case are quite simple. On June 5, 1969, University of California at Berkeley graduate student, Prosenjit Poddar, arrived distraught and angry at the office of mental health professional, Dr. Lawrence Moore. Poddar had become infatuated with student Tatiana Tarasoff, and was enraged when she rejected him. Over the next 14 weeks, Poddar was seen seven times by Dr. Moore, and during the final visit on August 20, 1969, confided that he intended to kill Tatiana. He was diagnosed then and there as having a “paranoid schizophrenic reaction,” and police were notified to execute a mandatory psychiatric hospital admission.
Poddar was taken into custody, but soon after released after he promised to avoid further contact with Tatiana. Two months later, on October 27, 1969, he entered her home “while she was alone in her home, shot her with a pellet gun, chased her into the street with a kitchen knife, and stabbed her seventeen times, causing her death.”
Poddar pleaded “guilty by reason of insanity” and was convicted of second-degree murder, which was reduced to manslaughter on appeal. The California Supreme Court concluded even this was too harsh and reversed the conviction. He was freed and he quickly returned to India.
Tatiana’s parents sued, and ultimately the California Court of Appeal reversed itself and found Dr. Moore liable. In making that decision seven years after the crime, on July 1, 1976, the California Supreme Court considered these five factors among others:
- Foreseeability of harm to Plaintiff;
- The degree of certainty that Plaintiff suffered injury;
- The closeness of the connection between Defendent’s conduct and the injury suffered by Plaintiff;
- The moral blame attached to Defendent’s conduct;
- The policy of preventing future harm.
Since 1976, and the California Supreme Court ruling in Tarasoff v. Regents of the University of California, the “duty to protect” has been added to “the duty to warn” for professionals in support relationships. These are two subtly different sides of the same coin.
“The duty to warn” requires that “the mental health professional…make a good-faith effort to contact the identified target of a client’s serious threats of harm, and/or notify law enforcement.”
“The duty to protect”, while encouraging notifying law enforcement and “warning a potential victim,” also considers positively active patient interventions such as “intensifying outpatient treatment, hospitalization, and modification of medication treatment.”
It can be difficult to impossible to determine the dangerousness of a mental unstable individual with 100% certainty. Mental health professionals, in making their assessments, consider a patient’s appearance and general behavior, speech, mood and affect, thought process and content, sensorium and cognition, perceptions and motor activity, and general judgement.
But MAGA allies from Trump’s Cabinet, Congressional allies, and Trump appointed Justices on state and federal levels will have a difficult time convincing courts over the next decade that they didn’t know what was going on. Trump has a way of broadcasting the evidence against himself, and entangling his loyalist supporters in the process.
As for Trump’s current Republican enablers, a potentially “foreseeable” troubled future is in the process of rising to greet them. Disentangling at this point, from Dobbs or “Trump Legal,” will be complicated and prohibitively expensive. But, best get on with it.
As Tarasoff v. Regents of the University of California, which extended from 1969 to 1976 so well illustrated, the tail of liability (and ultimately justice), is a long tail indeed.
Posted on | March 14, 2024 | 4 Comments
Note: Randy Souders and Mike Magee served together on the Board of Jean Kennedy Smith’s Kennedy Center Arts and Disability Program,Very Special Arts (VSA) from 2002 to 2007.
Randy Souders,
Guest Editorial
Professional Artist /Arts & Disability Advocate / Quadriplegic (since 1972)
When I was injured at the age of 17 the world was still quite closed for people like me. That was a year before passage of HR 504 of the Rehabilitation Act of 1973. As I recall that law was the first to mandate access to public places that received federal funds. A year later Jean Kennedy Smith founded VSA (Very Special Arts) which has provided important arts opportunities to literally millions of people with disabilities around the globe. It was a very different world back then and artistic achievement was an important way people such as myself could prove their worth to a society that still saw little evidence of it.
It’s unbelievable to think there are serious threats to roll back many of those hard won gains in the name of deregulation and profitability. Disability is costly and people with disabilities are still woefully underemployed. So when a billionaire presidential candidate repeatedly mocks people with disabilities, how long till the “useless/ unworthy” excuses rise again? The old term describing a person with a disability as an “invalid” has another meaning. The adjective use is defined as “Not valid; not true, correct, acceptable or appropriate.”
Few today are aware that the first victims of the Holocaust were the mentally, physically and neurologically disabled people. They were systematically murdered by several Nazi programs specifically targeting them. The Nazi regime was aided in their crimes by perverted “medical doctors and other experts” who were often seen wearing white lab coats in order to visually reinforce their propaganda.
Branded as “useless eaters” and existing as “lives not worthy of life,” people with disabilities were declared an unbearable burden both to German society and the state. As Holocaust historians have documented, “From 1939 to 1941 the Nazis carried out a campaign of euthanasia known as the T4 program (an abbreviation of Tiergartenstrasse 4 which itself was a shortened version of Zentral Dienststelle-T4: Central Office T4) the address from which the program was coordinated.”
These most vulnerable of humans were reportedly the first victims of mass extermination by poison gas and cheaper CO2 from automobile exhaust fumes. But first “a panel of medical experts were required to give their approval for the euthanasia/ ‘mercy-killing’ of each person.”
In the end an estimated quarter million people with disabilities were killed in gas chambers disguised as shower rooms. This model for killing disabled people was later applied to the industrialized murder within Nazi concentration and death camps such as Auschwitz-Birkenau.”
Much has been written on this topic but few seem to know the chronology and diabolical history of how these “beneficial cleansings” of undesirables often start. The Nazi’s enlisted medical doctors to provide them with a veneer of moral justification for their atrocities.
Throughout history, authoritarian political despots have also worked diligently to silence dissent and co-opt religion in order to assist in their mutual quests for total control and dominance of others. And theocrats are convinced their particular splinter of a schism is the ultimate authority on earth as well as the entire universe. Stonings, beheadings and the hanging of transgressors and non believers are arbitrarily justified by interpretations of their particular holy book.
There is much to fear when politicians exploit the religious beliefs of medical professionals in order to pass laws denying the rights of others to control their own bodies. This blatant pandering for votes by promising to deliver on religious wedge issues creates a positive feedback loop resulting in politicians being deified by their religious influencers. This is aided by a campaign of rationalization absolving them of their obvious failings. Such a campaign of apologetics by religious leaders is active and widespread in America as I type.
Examples include “God doesn’t call the qualified…He qualifies the called” (Exodus Chapter 4) and “God calls imperfect men to do His perfect will.” Is there even a red line where such “imperfect men” becomes an existential threat? Apparently not. I’m sure most citizens of the Third Reich didn’t think so until everything imploded.
The current Republican candidate for President is on the record as being a believer in the “racehorse theory” – the idea that selective breeding can improve a country’s performance, which American eugenicists and German Nazis used in the last century to buttress their goals of racial purity. On September 18, 2020 he told a mostly white crowd of supporters in Bemidji, Minn. “You have good genes. A lot of it is about the genes, isn’t it? Don’t you believe? The racehorse theory. You think we’re so different? You have good genes in Minnesota.”
This is one of many such statements he has made regarding genetics that has resulted in his personal superiority and that of his family. The New York Times reports “Mr. Trump was talking publicly about his belief that genetics determined a person’s success in life as early as 1988, when he told Oprah Winfrey that a person had ‘to have the right genes’ in order to achieve great fortune.”
These statements combined with those “about undocumented immigrants poisoning the blood” of America should equate to a 100 alarm fire.
Posted on | March 11, 2024 | 2 Comments
Jimmy Kimmel and Donald Trump don’t get along. A back and forth about the viability of
Trump’s Truth Social site has been the stuff of legends. But Sunday night, the 96th Academy of Awards host might as well have informed his worldwide audience:
“Donald Trump is mentally ill. Say it out loud!”
As the Awards extravaganza was reaching its final “Best Picture” climax, Kimmel reappeared from stage left at the Dolby Theatre in Los Angeles, California, and said he had an extra minute to burn.
As the spotlight shone, Kimmel said , “This show is not about me, and I appreciate you having me. It’s really about you, and Emma, and all these great actors and actresses and filmmakers, but I was told we had like an extra minute, and I’m really proud of something, and I was wondering if I could share it with you. I just got a review.
“Has there ever been a worse host than Jimmy Kimmel at The Oscars. His opening was that of a less than average person trying too hard to be something which he is not, and never can be. Get rid of Kimmel and perhaps replace him with another washed up, but cheap, ABC ‘talent,’ George Slopanopoulos. He would make everybody on stage look bigger, stronger, and more glamorous. Blah. Blah. Blah. Make America Great Again.”
With the structured timing of a comedic pro, Kimmel waited as the laughter began to fade , and then said, “See if you can guess which former president just posted that on Truth Social. Anyone? No? Well thank you President Trump. Thank you for watching. I’m surprised you’re still up. Isn’t it past your jail time?”
A tragic Donald Trump continues to dig himself into a hole that will eventually lead to some personal hell.
I think we are at a point where Trump’s mental illness is undeniable to most. Those who continue to support his candidacy now do so despite the risk to all of us, and for their own personal gain. There remain a few on the religious right who honestly believe that “God put Trump here for a purpose” (to support patriarchy, outlaw abortion, advance Christian nationalism etc.)
This past Friday Trump hosted hard-line Hungarian leader Viktor Orbán at Mar-a-Lago. Together they celebrated Christian Nationalism, and found common ground in a reconstruction of 20th century European history where former evil strongmen were somehow divinely converted to victims, swimming upstream against liberal NATO currents.
Academics, Jurists, Priests, and Corporate CEO’s have been careful not to label Trump as mentally ill. But mentally ill he is.
Sadly, his words in 2024 remind of another influential essayist, Kenneth Burke, whose 1939 masterpiece, The Rhetoric of Hitler’s Battle, is required reading for graduate students from English to Philosophy, and from Political Science to History and Religious Studies. The piece’s main focus involves a critical analysis of Hitler’s Mein Kampf (“my struggle”) which includes this stark warning.
Leaders of the free world need “to discover what kind of ‘medicine’ this medicine-man…concocted, that we may know, with greater accuracy, exactly what to guard against, if we are to forestall the concocting of similar medicine in America.”
Trump too has written his own fictional story; a despotic force with his own signature “idiolect”.
With the former Republican National Committee under Trump’s control, the new co-chair, daughter-in-law, Lara Trump, proudly announced, “As my father-in-law says, ‘bigly’ … We’re going to win!” The choice of Alabama Senator Katie Britt to deliver a “kitchen table” rebuttal also quickly turned sour. A schizoid of alternating styles and fabulist miss telling of gang rape, fact checkers went wild, including date (2023 vs. 2004), location (Mexico vs. USA), and president at the time (George W. Bush vs. Biden).
Loyal indeed, like zombies, Trump followers and the former Republican Party are following him into a basement, and are heading down a tunnel which has no end. It has been “a virtuoso performance without a grand finale”, unless, that is, it be the destruction of our democratic form of government.
Posted on | March 6, 2024 | 6 Comments
Mike Magee
Britt Cagle Grant, the 47-year old Federal Judge of the U.S. Court of Appeals for the Eleventh Circuit made news this week. The Stanford Law graduate, blessed by the Federalist Society and Leonard Leo, and former clerk of Hon. Brett Kavanaugh, was nominated by Donald Trump and confirmed by the Senate on July 31, 2018.
Now six years later, on March 4, 2024, her words in rejecting DeSantis’s “Stop Woke Act” (otherwise known as the “Individual Freedom Measure”), are particularly crushing to her supporters: “By limiting its restrictions to a list of ideas designated as offensive, …it penalizes certain viewpoints — the greatest First Amendment sin. Banning speech on a wide variety of political topics is bad; banning speech on a wide variety of political viewpoints is worse.”
In a political universe, where choices are particularly binary, the Justice appeared to be exploring middle ground. When still a Presidential candidate in 2022, Ron DeSantis used the bill as the leading edge of a divisive campaign based on white nationalist victimization, stating, “No one should be instructed to feel as if they are not equal or shamed because of their race. In Florida, we will not let the far-left woke agenda take over our schools and workplaces.”
Ron and Casey DeSantis have mirrored in many ways the fictional Barbie and Ken – soon to be featured in the 2024 Academy Awards where they have been nominated for eight Oscars. The comparison of Ron to Ken needs little explanation. And Casey herself is used to the glare of the public spotlight. The former host of PGA Tour Today who met her husband on the golf course and was married at Disney World is beautiful and smart as a whip. She graduated with a degree in Economics from the College of Charleston.
With this most recent turn of events, the DeSantis family seems to be following the plot line (with its twists and turns) of ‘Barbie’– this year’s favorite for 2024 Picture of the Year. And performing in that film you will find a female disrupter at least as prominent as Justice Grant.
I am speaking of the brilliant actress and nominee for Best Supporting Actress, America Ferrera, who played a 39 year old mother and Mattel employee, Gloria, and delivered what one film critique describes as “the ‘Barbie’ monologue we all talked about.” You can find the two minute speech in its entirety here, and it is well worth a listen. Ferrera herself described the big speech this way: “funny and subversive and delightfully weird.”
When I first heard the speech (as a husband of 54 years, father of a grown daughter and three daughters-in-law, grandfather of six granddaughters, and brother of six sisters) I choked up at one specific line – “It’s too hard.” It comes in the next to the last paragraph.
Here is “The Speech” with Gloria speaking to Barbie who is encountering the “real world.”:
“It is literally impossible to be a woman. You are so beautiful, and so smart, and it kills me that you don’t think you’re good enough. Like, we have to always be extraordinary, but somehow we’re always doing it wrong.
You have to be thin, but not too thin. And you can never say you want to be thin. You have to say you want to be healthy, but also you have to be thin. You have to have money, but you can’t ask for money because that’s crass. You have to be a boss, but you can’t be mean. You have to lead, but you can’t squash other people’s ideas. You’re supposed to love being a mother, but don’t talk about your kids all the damn time. You have to be a career woman but also always be looking out for other people.
You have to answer for men’s bad behavior, which is insane, but if you point that out, you’re accused of complaining. You’re supposed to stay pretty for men, but not so pretty that you tempt them too much or that you threaten other women because you’re supposed to be a part of the sisterhood.
But always stand out and always be grateful. But never forget that the system is rigged. So find a way to acknowledge that but also always be grateful.
You have to never get old, never be rude, never show off, never be selfish, never fall down, never fail, never show fear, never get out of line. It’s too hard! It’s too contradictory and nobody gives you a medal or says thank you! And it turns out in fact that not only are you doing everything wrong, but also everything is your fault.
I’m just so tired of watching myself and every single other woman tie herself into knots so that people will like us. And if all of that is also true for a doll just representing women, then I don’t even know.”
But in our binary world, is it enough to agree with Barbie when she suggests that “Naming the problem can break the spell?”
Or must we list again a litany of facts that document the harm done – 1 in 5 women victims of rape or attempted rape; epidemic (41%) domestic abuse and violence; unequal pay; forced birth enacted by male super-dominated Red State legislatures; absurd maternal/fetal mortality rates; no paid maternity leave; no universal preschool; Congress is 72% male; and I could go on. But I and many others have been this way before, in search of the right facts, the right message, to find the elusive “middle ground.”
Justice Grant’s appearance this week drew me back to March 24, 2005, when another Federal Justice from the Eleventh Circuit ruled for sanity in a Florida case, opposing both the Governor (Jeb Bush) and the President (George W. Bush). That Justice allowed Terri Schiavo’s feeding tube to be removed at a Pinellas Park hospice, where she died peacefully on March 31,2005.
Terri had struggled with a hidden eating disorder (a condition shared by 9% of Americans), which went undiscovered when she sought evaluation for infertility. On February 25, 1990, she collapsed in the lobby of their apartment in St. Petersburg, Florida. She was resuscitated but from that day forward remained in a “permanent vegetative state.” A epic 15 year “culture war” ensued before final Judicial relief was grudgingly earned.
Shouting from street side the day she died was Randall Terry, leader of Operation Rescue, who somehow believed that Schiavo had not suffered enough, and what our country needed was a heavy dose of “traditional masculinity,” defined by the American Psychological Association, in 2018 as a blend of “stoicism, competitiveness, dominance and aggression—and on the whole, harmful.”
Is there a middle to be found when it comes to the health of women in America? As our fictional Barbie suggests, if we believe that “naming the problem can break the spell,” perhaps others like Justice Britt Cagle Grant might unexpectedly come along. So let’s remain optimistic and continue to seek out and expand the middle by raising our voices as participants in this democracy. Otherwise, we are likely to witness other Terri Schiavo’s coming along, destined to die because being a woman in a Trumpist America is “just too hard.”.
Posted on | February 28, 2024 | 4 Comments
Mike Magee
For most loyalist Americans at the turn of the 19th century, Justice John Marshall Harlan’s decision in Jacobson v. Massachusetts (1905). was a “slam dunk.” In it, he elected to force a reluctant Methodist minister in Massachusetts to undergo Smallpox vaccination during a regional epidemic or pay a fine.
Justice Harlan wrote at the time: “Real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others.”
What could possibly go wrong here? Of course, citizens had not fully considered the “unintended consequences,” let alone the presence of President Wilson and others focused on “strengthening the American stock.”
This involved a two-prong attack on “the enemy without” and “the enemy within.”
The The Immigration Act of 1924, signed by President Calvin Coolidge, was the culmination of an attack on “the enemy without.” Quotas for immigration were set according to the 1890 Census which had the effect of advantaging the selective influx of Anglo-Saxons over Eastern Europeans and Italians. Asians (except Japanese and Filipinos) were banned.
As for “the enemy within,” rooters for the cause of weeding out “undesirable human traits” from the American populace had the firm support of premier academics from almost every elite university across the nation. This came in the form of new departments focused on advancing the “Eugenics Movement,” an excessively discriminatory, quasi-academic approach based on the work of Francis Galton, cousin of Charles Darwin.
Isolationists and Segregationists picked up the thread and ran with it focused on vulnerable members of the community labeled as paupers, mentally disabled, dwarfs, promiscuous or criminal.
In a strategy eerily reminiscent of that employed by Mississippi Pro-Life advocates in Dobbs v. Jackson Women’s Health Organization in 2021, Dr. Albert Priddy, activist director of the Virginia State Colony for Epileptics and Feebleminded, teamed up with radical Virginia state senator Aubrey Strode to hand pick and literally make a “federal case” out of a young institutionalized teen resident named Carrie Buck.
Their goal was to force the nation’s highest courts to sanction state sponsored mandated sterilization.
In a strange twist of fate, the Dobbs name was central to this case as well. That is because Carrie Buck was under the care of foster parents, John and Alice Dobbs, after Carrie’s mother, Emma, was declared mentally incompetent. At the age of 17, Carrie, after having been removed from school after the 6th grade to work as a domestic for the Dobbs, was raped by their nephew and gave birth to a daughter, Vivian. This lead to her mandated institutionalization, and subsequent official labeling as an “imbecile.”
In his majority decision supporting Dr. Priddy, Buck v. Bell, Supreme Court Chief Justice Oliver Wendall Holmes leaned heavily on precedent. Reflecting his extreme bias, he wrote: “The principle that supports compulsory vaccination is broad enough to cover the cutting of Fallopian tubes (Jacobson v. Massachusetts 197 US 11). Three generation of imbeciles are enough.”
Carrie Buck lived to age 76, had no mental illness, and read the Charlottesville, VA newspaper every day, cover to cover. There is no evidence that her mother Emma was mentally incompetent. Her daughter Vivian was an honor student, who died in the custody of the John and Alice Dobbs at the age of 8.
The deeply embedded roots of the prejudicial idea that inferiority (or otherness) is a biological construct was used to justify indentured servitude and enslaved Africans, and traces back to our very beginnings as a nation. Our third president, Thomas Jefferson, was not shy in declaring that his enslaved Africans were biologically distinguishable from land-holding whites. Channeling Eugenic activists a century later, the President noted his enslaved Africans suitability for brutal labor was based on their greater physiologic tolerance for plantation-level heat exposure, and lesser (required) kidney output.
Helen Burstin MD, CEO of the Council of Medical Specialty Societies, drew a direct line from those early days to the present day practice of medicine anchored in opaque decision support computerized algorithms. “It is mind-blowing in some ways how deeply embedded in history some of this misinformation is,” she said. She was talking about risk-prediction tools that are commercial and proprietary, and utilized for opaque oversight of “roughly 200 million U.S. citizens per year.” Originally designed for health insurance prior approval systems and managed care decisions, they now provide underpinning for new AI super-charged personalized medicine decision support systems.
Documented racially constructed clinical guidelines have been uncovered and some rewritten over the past few years. They include obstetrical guidelines that disadvantaged black mothers seeking vaginal birth over Caesarian Section, and limitations on treatment of black children with fever and acute urinary tract infection, as just two examples. Other studies uncovered reinforcement of myths that “black people have higher pain thresholds,” greater strength, and resistance to disease – all in support of their original usefulness as slave laborers. If racism has found a way historically to insinuate itself into these tools, is it unreasonable to believe that committed Christian Nationalists might do the same to control women’s health autonomy?
Can’t we just make a fresh start on clinical guidelines? Sadly, it is not that easy. As James Baldwin famously wrote, “People are trapped in history and history is trapped in them.” The explosion of technologic advance in health care has the potential to trap the bad with the good, as vast databases are fed into hungry machines indiscriminately.
Computing power, genomic databases, EMR’s, natural language processing, machine based learning, generative AI, and massive multimodal downloads bury our historic biases and errors under multi-layered camouflage, and leave plenty of room for invisible inserts by the Leonard Leo’s of the world.
Modern day Dobb-ists have now targeted vulnerable women and children using carefully constructed legal cases and running them all the way up to the Supreme Court. This strategy was joined with a second approach (MAGA Republican take-over’s of state legislatures). Together they are intended to ban abortion, explore contraceptive restrictions, eliminate fertility therapy, and criminalize the practice of medicine. It is one more simple step to require encodement of these restrictions on medical freedom and autonomy into binding clinical protocols.
In an age where local bureaucrats are determined to “play doctor”, and modern day jurists are determined to provide cover for a third wave of protocol encoded Dobb-ists, “the enemy without” runs the risk of becoming “the enemy within.”
Posted on | February 17, 2024 | 2 Comments
Mike Magee
You would need a mountain of psychiatrists to explain why Trump is the way he is, and an army of scholars to help us understand why Republican leaders, in state and federal positions, have decided to follow this piper’s call.
Which brings me to a well known parable, described below by AI enabled Bing Copilot:
“In the town of Hamelin, during the year 1284, a rat infestation plagued the streets. The townspeople were desperate for a solution. That’s when a mysterious figure appeared—a piper dressed in multicolored (“pied”) clothing. He claimed to be a rat-catcher and promised to rid the town of its vermin.
The mayor, eager to be rid of the rats, struck a deal with the piper. He pledged to pay the piper 1,000 guilders in exchange for his services. The piper accepted and began to play his magic pipe. The enchanting music drew the rats out of their hiding places, and they followed him to the River Weser. There, they drowned, leaving Hamelin rat-free.
However, when it came time to pay the piper, the mayor reneged on his promise. He reduced the payment to a mere 50 guilders and accused the piper of bringing the rats himself as part of an extortion scheme.
Enraged by this betrayal, the piper vowed revenge. On Saint John and Paul’s day, while the adults were attending church, he returned to Hamelin. This time, he was dressed in green like a hunter and played his pipe once more. The haunting melody captivated the town’s children, and 130 of them followed him out of the town and into a mysterious cave.”
In my reading of the parable, the piper is Trump, whose magical tune is addictive, infective, and destructive. He has been hired by the mayor(s), an array of powerful Republican party elite, who, after realizing they couldn’t beat the piper, assumed that they could control him, and use his magnetism to convert long term goals into short term victories. And for four years, from 2016 to 2020, they were right. But the piper’s vision and thirst for revenge, for a million slights and offenses by these fawning elites, never relinquished his dream of ultimate power. Instead, he continued to plow along with his pipe, the one that first attracted the rats (low hanging, ethically compromised, low-lifes like Reps. Chris Collins (R-N.Y.) and Duncan Hunter (R-Calif.) who would soon be indicted), and then returned in 2023, tooting the same song from the same horn, drawing Republican “children” out of their political chambers and into a mysterious cave, unreachable to support immigration reform, oppressed women, or even a beleaguered Ukraine on its soon-to-be last dying breath.
On June 11, 1944, another presidential piper, the supremely popular 4-term leader FDR, knew well how to use his song to bring along our citizens. On that day, he promised a “Second Bill of Rights” stating that the original was now “inadequate to assure us equality in the pursuit of happiness…Necessitous men are not free,” he said.
Harvard-trained moral philosopher Susan Neiman PhD recalled those words recently in calling for “a commitment to universalism over tribalism, a firm distinction between justice and power, and a belief in the possibility of progress.”
She also recalled the work product of Eleanor Roosevelt who guided the creation of the UN’s “Universal Declaration of Human Rights” which she herself admitted is “a declaration that remains aspirational.” Signed by 150 nations, it remains the most translated document in the world.
Embedded in the declaration is a broad and inclusive definition of health. It reads “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Most especially, Eleanor Roosevelt highlighted that “Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”
And yet, as Trump blows his horn from multiple court house steps, in the post-Dobbs era, a recent March of Dimes report states that “maternal deaths are on the rise, with the rate doubling between 2018 to 2021 from 17.4 to 32.9 deaths per 100,000 live births.”
Susan Neiman sees the problem as deeply embedded in America’s culture and politics where guideposts and philosophical values are being dismantled. Cast in this light, the failed U.S. health care system is systematically broken and highly discriminatory at best.
When the piper of Hamelin first led the rats into the river, it was alarmingly easy, and left a wide opening for his next steps. The vacuum left by an erosion of justice is always filled with power – and specifically, power over someone. The targets of Trump’s power play continue to be women, children, and people of color in America, and the established Republican party. But in the next trip to the river, he believes his ultimate target is within his grasp – it is our Democracy.
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