Another Turn of the 25th Amendment – And Still Not The Answer For Trump’s Mental Illness.

Posted on | January 3, 2024 | 4 Comments

Mike Magee

On May 16, 2017 New York Times conservative columnist, Russ Douthat, wrote “The 25th Amendment Solution for Removing Trump.” That column was the starting point for a Spring course I taught on the 25th Amendment at the President’s College in Hartford, CT. I will not summarize the entire course here, but would like to emphasize four points:

1. The American public was adequately warned (now 7 years ago) of the risk that Trump represented to our nation and our democracy.
2. Douthat’s piece triggered a journalistic debate which I summarize below with four slides drawn from my lectures.
3. Had Pence and the cabinet chosen to activate the 25th Amendment, as it is written, Trump would have had the right to appeal “his inability”, forcing the Congress to decide whether there was cause to remove the President.
4. Judging from the later impeachment of Trump in the House, but failure to convict in the Senate, it is unlikely a courageous Pence and Cabinet would have been backed by their own party.

Let’s look at four archived slides from the 2017 lecture, and then discuss our current options in the case of 2024 Trump against Democracy.              

Slide 1. Russ Douthat

• 

• Slide 4. The 25th Amendment

In 2017, Scott Bomboy, chief of the National Constitution Center, wrote:

“Section 4 is the most controversial part of the 25th Amendment: It allows the Vice President and either the Cabinet, or a body approved ‘by law’ formed by Congress, to jointly agree that ‘the President is unable to discharge the powers and duties of his office.’ This clause was designed to deal with a situation where an incapacitated President couldn’t tell Congress that the Vice President needed to act as President.”

“It also allows the President to protest such a decision, and for two-thirds of Congress to decide in the end if the President is unable to serve due to a condition perceived by the Vice President, and either the Cabinet or a body approved by Congress. So the Cabinet, on its own, can’t block a President from using his or her powers if the President objects in writing. Congress would settle that dispute and the Vice President is the key actor in the process.” What might have been (but was not) would have played out this way according to Constitutional scholars:

“… scholars Brian C. Kalt and David Pozen explain the problematic process if the Vice President and the Cabinet agree the President can’t serve.”

1. “If this group declares a President ‘unable to discharge the powers and duties of his office,’ the Vice President immediately becomes Acting President.
2. If and when the President pronounces himself able, the deciding group has four days to disagree.
3. If it does not, the President retakes his powers.
4. But if it does, the Vice President keeps control while Congress quickly meets and makes a decision…
5. The Vice President continues acting as President only if two-thirds majorities of both chambers agree that the President is unable to serve.”

Had our leaders followed Russ Douthat’s advice seven years ago, it is highly unlikely that a 2/3rds majority of both chambers of Congress would have had their back. Instead, they went for Impeachment and failed, as Republicans chose rather to let voters decide. And they did, in 2020. Few likely envisioned that mentally deranged (now former President) would launch a January 6th insurrection, embolden white nationalists militia across the nation, and follow thru on threats to run and win a 2nd term in 2024, and then free his followers from jail cells, only to be filled with those who attempted to hold him accountable for his historic misdeeds. The 25th Amendment is no more a solution today than it was in 2017. Instead citizens loyal to our form of government, rely in 2024 on two protective backstops:

1. Our third pillar of government – The Courts (most especially the Supreme Court.
2. The voter, whose second day of reckoning fast approaches.

Some believe we are once again engaged in a great Civil War. In its’ summary of the Gettysburg Address, National Geographic states that “Despite (or perhaps because of) its brevity, since (Abraham Lincoln’s) speech was delivered, it has come to be recognized as one of the most powerful statements in the English language and, in fact, one of the most important expressions of freedom and liberty in any language.”

The last paragraph of that two minute speech, delivered now 180 years and two months ago, reminds us that Americans died on “the battlefield” on January 6, 2021 defending our democratic government, and Lincoln’s words are today, more relevant than ever.

As described by historians, Lincoln made it clear that the stakes could not have been higher, well before the Dobbs decision and the appropriation of Hitler’s words by Trump. “Lincoln tied the current struggle to the days of the signing of the Declaration of Independence, speaking of the principles that the nation was conceived in: liberty and the proposition that all men are created equal. Moreover, he tied both to the abolition of slavery—a new birth of freedom—and the maintenance of representative government.

As they were spoken, November 19, 1863, here are Lincoln’s final words, ones that deserve a most careful reading: “It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us—that from these honored dead we take increased devotion to that cause for which they here gave the last full measure of devotion—that we here highly resolve that these dead shall not have died in vain—that this nation, under God, shall have a new birth of freedom, and that government of the people, by the people, for the people, shall not perish from the earth.”

2024 Prediction – Society Will Arrive At An Inflection Point in AI Advancement.

Posted on | December 21, 2023 | 4 Comments

Mike Magee

For my parents, March, 1965 was a banner month. First, that was the month that NASA launched the Gemini program, unleashing “transformative capabilities and cutting-edge technologies that paved the way for not only Apollo, but the achievements of the space shuttle, building the International Space Station and setting the stage for human exploration of Mars.” It also was the last month that either of them took a puff of their favored cigarette brand – L&M’s.

They are long gone, but the words “Gemini” and the L’s and the M’s have taken on new meaning and relevance now six decades later.

The name Gemini reemerged with great fanfare on December 6, 2023, when Google chair, Sundar Pichai, introduced “Gemini: our largest and most capable AI model.” Embedded in the announcement were the L’s and the M’s as we see here: “From natural image, audio and video understanding to mathematical reasoning, Gemini’s performance exceeds current state-of-the-art results on 30 of the 32 widely-used academic benchmarks used in large language model (LLM) research and development.

Google’s announcement also offered a head to head comparison with GPT-4 (Generative Pretrained Transformer-4.) It is the product of a non-profit initiative, OpenAI, and was released on March 14, 2023. Microsoft’s AI search engine, Bing, helpfully informs that, “OpenAI is a research organization that aims to create artificial general intelligence (AGI) that can benefit all of humanity…They have created models such as Generative Pretrained Transformers (GPT) which can understand and generate text or code, and DALL-E, which can generate and edit images given a text description.”

While “Bing” goes all the way back to a Steve Ballmer announcement on May 28, 2009, it was 14 years into the future, on February 7, 2023, that the company announced a major overhaul that, 1 month later, would allow Microsoft to broadcast that Bing (by leveraging an agreement with OpenAI) now had more than 100 million users.

Which brings us back to the other LLM (large language model) – GPT-4, which the Gemini announcement explores in a head-to-head comparison with its’ new offering. Google embraces text, image, video, and audio comparisons, and declares Gemini superior to the OpenAI/Microsoft GPT-4.

Mark Minevich, a “highly regarded and trusted Digital Cognitive Strategist,” writing this month in Forbes, seems to agree with this, writing, “Google rocked the technology world with the unveiling of Gemini – an artificial intelligence system representing their most significant leap in AI capabilities. Hailed as a potential game-changer across industries, Gemini combines data types like never before to unlock new possibilities in machine learning… Its multimodal nature builds on yet goes far beyond predecessors like GPT-3.5 and GPT-4 in its ability to understand our complex world dynamically.”

Expect to hear the word “multimodality” repeatedly in 2024 and with emphasis. But academics will be quick to remind that the origins can be traced all the way back to 1952 scholarly debates about “discourse analysis”, at a time when my Mom and Dad were still puffing on their L&M’s. Language and communication experts at the time recognized “a major shift from analyzing language, or mono-mode, to dealing with multi-mode meaning making practices such as: music, body language, facial expressions, images, architecture, and a great variety of communicative modes.”

Minevich believes that “With Gemini’s launch, society has arrived at an inflection point with AI advancement.” Powerhouse consulting group, BCG (Boston Consulting Group), definitely agrees. They’ve upgraded their L&M’s, with a new acronym, LMM, standing for “large multimodal model.” Leonid Zhukov, Ph.D, director of the BCG Global AI Institute, believes “LMMs have the potential to become the brains of autonomous agents—which don’t just sense but also act on their environment—in the next 3 to 5 years. This could pave the way for fully automated workflows.”

BCG predicts an explosion of activity among its corporate clients focused on labor productivity, personalized customer experiences, and accelerated (especially) scientific R&D. But they also see high volume consumer engagement generating content, new ideas, efficiency gains, and tailored personal experiences. 

This seems to be BCG talk for “You ain’t seen nothing yet.” In 2024, they say all eyes are on “autonomous agents.” As they describe what’s coming next: “Autonomous agents are, in effect, dynamic systems that can both sense and act on their environment. In other words, with stand-alone LLMs, you have access to a powerful brain; autonomous agents add arms and legs.”

This kind of talk is making a whole bunch of people nervous. Most have already heard Elon Musk’s famous 2023 quote, “Mark my words, AI is far more dangerous than nukes. I am really quite close to the cutting edge in AI, and it scares the hell out of me.”  BCG acknowledges as much, saying, “Using AI, which generates as much hope as it does horror, therefore poses a conundrum for business… Maintaining human control is central to responsible AI; the risks of AI failures are greatest when timely human intervention isn’t possible. It also demands tempering business performance with safety, security, and fairness… scientists usually focus on the technical challenge of building goodness and fairness into AI, which, logically, is impossible to accomplish unless all humans are good and fair.”

Expect in 2024 to see once again the worn out phrase “Three Pillars”. This time it will be attached to LMM AI, and it will advocate for three forms of “license” to operate:

1. Legal license – “regulatory permits and statutory obligations.” 
2. Economic license – ROI to shareholders and executives.
3. Social license – a social contract delivering transparency, equity and justice to society.

BCG suggests that trust will be the core challenge, and that technology is tricky. We’ve been there before. The 1964 Surgeon General’s report knocked the socks off of tobacco company execs who thought high-tech filters would shield them from liability. But the government report burst that bubble by stating “Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action.”  Then came the Gemini 6A’s 1st attempt to launch on n December 12,1965.  It was cancelled when its’ fuel igniter failed.

Generative AI driven LMM’s will “likely be transformative,” but clearly will also have its up’s and down’s as well.  As BCG cautions, “Trust is critical for social acceptance, especially in cases where AI can act independent of human supervision and have an impact on human lives.”

A Speech For The Ages – 83 Christmases Ago.

Posted on | December 18, 2023 | 2 Comments

Mike Magee

On the evening of December 29, 1940, with election to his 3rd term as President secured, FDR delivered these words as part of his sixteenth “Fireside Chat”: “There can be no appeasement with ruthlessness…No man can tame a tiger into a kitten by stroking it.”

Millions of Americans, and millions of Britains were tuned in that evening, as President Roosevelt made clear where he stood while carefully avoiding over-stepping his authority in a nation still in the grips of a combative and isolationist opposition party. 

That very evening, the Germans Luftwaffe, launched their largest yet raid on the financial district of London. Their “fire starter” group, KGr 100, initiated the attack with incendiary bombs that triggered fifteen hundred fires that began a conflagration ending in what some labeled the The Second Great Fire of London. Less than a year later, on the eve of another Christmas, we would be drawn into the war with the bombing of Pearl Harbor.

Now, 83 Christmases later, with warnings of “poisoning the blood of our people,” we find ourselves contending with our own Hitler here at home.  Trump is busy igniting white supremacist fires utilizing the same vocabulary and challenging the boundaries of decency, safety and civility. What has the rest of the civilized world learned in the meantime?

First, appeasement does not work. It expands the vulnerability of a majority suffering the “tyranny of the minority.”

Second, the radicalized minority will utilize any weapon available, without constraint, to maintain and expand their power.

Third, the battle to save and preserve democracy in these modern times is never fully won. We remain in the early years of this deadly serious conflict, awakened from a self-induced slumber on January 6, 2020.

Hitler was no more an “evil genius” than is Trump. But both advantaged historic and cultural biases and grievances, leveraging them and magnifying them with deliberate lies and media manipulation. Cultures made sick by racism, systemic inequality, hopelessness, patriarchy, and violence, clearly can be harnessed for great harm. But it doesn’t take a “genius.” Churchill never called Hitler a “genius.” Most often he only referred to him as “that bad man.”

The spectacle and emergence of Kevin McCarthy, followed by Mike Johnson, as Speaker of the House, and the contrasting address by House Minority Leader Hakeem Jeffries as he handed over the gavel, represent just one more skirmish in this “War for Democracy.”  

If our goal is a “healthier” America – one marked by compassion, understanding and partnership; one where fear and worry are counter-acted by touch and comfort; one where linkages between individuals, families, communities and societies are constructed to last – all signals confirm that the time is now to fight with vigor. 

As Churchill vowed on his first day as Prime Minister, “I have nothing to offer but blood, toil, tears, and sweat.” At about the same time, FDR offered this encouragement, “We have no excuse for defeatism. We have every good reason for hope — hope for peace, yes, and hope for the defense of our civilization and for the building of a better civilization in the future.”

The re-emergence of white supremacists and nationalists, theocratic and patriarchal censorship, and especially post-Dobbs attacks on women’s freedom and autonomy, are real and substantial threats to our form of government. They indeed are minority views, but no more so than the minority in 1940 which allowed a small group of “bad men” to harness a relatively small nation of 70 million people into a force that very nearly conquered the world.

Following the December 7, 1941 attack on Pearl Harbor. Churchill packed his bags and headed directly to a British battleship for the 10-day voyage in rough seas (filled with German U-boats) to Norfolk, VA. Hours after arrival he was aboard a U.S. Navy plane for the 140 mile trip to the White House which he entered in a double breasted peacoat and a naval cap, chomping on a cigar. He would remain the guest of the Roosevelts for the next three weeks, heading home on January 14, 1942.

On Christmas Eve, he joined the President on the South Portico of the White House for the lighting of the White House Christmas tree. Here is what Churchill said to the President’s guests and 15,000 onlookers: “Let the children have their night of fun and laughter. Let gifts of Father Christmas delight their play. Let us share to the full in their unstinted pleasures before we turn again to the stern tasks and formidable year that lie before us. Resolve! – that by our sacrifice and daring, these same children shall not be robbed their inheritance and denied their right to live in a free and decent world.”

He spent the following day working on a speech to be delivered to a Joint Meeting of Congress on December 26, 1941, the kind of a Pep talk all good and decent people of America could benefit from today.  As we ourselves have learned since January 6, 2021, Churchill was right to warn us of complacency and caution, and that “many disappointments and unpleasant surprises await us.”  

He was clear and concise when he warned that day that Hitler and his Nazis (whom Trump so openly admires) possessed powers that “are enormous; they are bitter; they are ruthless.” But these “wicked men…know they will be called to terrible account…Now, we are the masters of our fate…The task which has been set is not above our strength. Its’ pangs and trials are not beyond our endurance.”

“Trump will be defeated,” he would say were he with us today. “You may be sure of that!” But we must be up to the task – brave, organized, and strategic. Now is the time, and as the British Times of London editorial reminded in 1942, as Churchill set foot once again on homeland after his American visit, timing is everything. “His visit to the United States has marked a turning-point of the war. No praise can be too high for the far-sightedness and promptness of the decision to make it.”

Tech Ethicist Says, “AI impact on society and culture will be unimaginable.”

Posted on | December 12, 2023 | Comments Off on Tech Ethicist Says, “AI impact on society and culture will be unimaginable.”

Mike Magee

His biography states, “He speaks to philosophical questions about the fears and possibilities of new technology and how we can be empowered to shape our future. His work to bridge cultures spans artificial intelligence, cognition, language, music, creativity, ethics, society, and policy.”

He embraces the title “cross-disciplinary,” and yet his PhD thesis at UC Berkeley in 1980 “was one of the first to spur the paradigm shift toward machine learning based natural language processing technologies.” Credited with inventing and building “the world’s first global-scale online language translator that spawned Google Translate, Yahoo Translate, and Microsoft Bing Translator,” he is clearly a “connector” in a world currently consumed by “dividers.” In 2019, Google named De Kai as “one of eight inaugural members of its AI Ethics Council.”

The all encompassing challenge of our day, as he sees it, is relating to each other. As he says, “The biggest fear is fear itself – the way AI amplifies human fear exponentially…turning us upon ourselves through AI powered social media driving misinformation, divisiveness, polarization, hatred and paranoia.”  The value system he embraces “stems from a liberal arts perspective emphasizing creativity in both technical and humanistic dimensions.”

Dr. De Kai is feeling especially urgent these days, which is a bit out of character. As a 7 year old child of Chinese immigrants in St. Louis, he spoke little English, saying what needed to be said on the family’s piano. Summers were spent back and forth between Hong Kong and the states. Others noticed he’d sneak in some blues to the classical pieces, causing his grandfather to remark that the synthesis pieces sounded “Chinese” to him. This led the budding linguist/musicologist to later reflect that “That got me thinking. I realized that the way we understand music is really dependent on the cultural frame of reference we adopt.”

Music and technology married during his PhD work at UC Berkeley, and eventually grounded four decades of research in “natural language processing and computational creativity.” He has earned the right to chill, but is anything but at ease these days, and the cause of his anguish is existential artificial intelligence.

As he said recently, “We are on the verge of breaking all our social, cultural and governmental norms…Our social norms were not designed to handle this level of stress.”

De Kai has morphed into an AI Ethicist. He is on a personal quest and anxious to bare his soul. The questions that keep him up at night all consider whether he is parenting his “AI children” properly. “Am I setting a good example? Am I a good role model? Do I speak respectfully to AI and teach them to respect diversity, or do I show them that it’s okay to insult people online?” Surprisingly, he is not alone, as the New York Times reported today on an initiative by high school students to expand (rather than diminish) high school AI literacy in their school in northern New Jersey.

His focus is solidly on the here and now, because he doesn’t believe time is on our side. “We have more AIs today that are part of our society. These are functioning, integral, active, imitative, learning, influential members of society more than most — probably more influential than 90 percent of human society — in shaping culture…Even though these are really weak AI’s, the culture that we are jointly shaping with our artificial members of society is the one under which every successive stronger generation of AI’s will be learning and spreading their culture. We are already in that cycle and we don’t realize it because we don’t look at machines from a sociological standpoint… This is unprecedented, given the ways we have created to develop and relate, both good and bad, will be exponentially increased by AI. In this way, the impact it will have on society and culture will be unimaginable.”

Raising “mindful AI’s” in the age of Trump is no small feat. It demands that AI children be “mindful of their ethical responsibilities.” Pulling this off in the developed world with an increasingly fractured educational system that pits science/technology against humanities will be a remarkable challenge. As De Kai puts it, “It is the single worst possible time in history to have an education system that cripples people to be unable to think deeply across these boundaries, about what humanity is in the face of technology.

To accomplish “A.I. alignment with the goals of humanity,” may require Americans to examine their own health and wellness in a manner that could be profoundly uncomfortable. Population welfare, philosophical treatises, and political compromise are not exactly our cultural strong suits. 

How will we do with these competing priorities, wonders De Kai in a recent New York Times Op-Ed:  “Short-term instant gratification? Long-term happiness? Avoidance of extinction? Individual liberties? Collective good? Bounds on inequality? Equal opportunity? Degree of governance? Free speech? Safety from harmful speech? Allowable degree of manipulation? Tolerance of diversity? Permissible recklessness? Rights versus responsibilities?” 

“Culture matters. A.I.s are now an everyday part of our society”,says De Kai. Changing culture, as health professionals know, is a tall order. It is about compassion, understanding and partnerships. It is about healing, providing health, and keeping individuals, families and communities whole. And – most importantly – it is about managing population-wide fear, worry and anxiety. 

What De Kai is setting out to do is to change our historic culture (one built on self-interest, hyper-competitiveness, and distrust of good government). This is a tall order – something that parents, pastors, politicians and physicians equally recognize. Things evolve, and difficult things take time.

But the New Jersey students seem up to the challenge. As 10th grader, Tessa Klein told the Times, “A.I. is actually a huge human rights issue because it perpetuates biases. We felt the need for our students to learn how these biases are being created by these A.I. systems and how to identify these biases.” 12th grader, Naomi Roth, added, “I think kids need to be able to critique it and assess it and use it.”

The Terri Schiavo Case Once Again Exploited – This Time By The Left.

Posted on | December 3, 2023 | 2 Comments

Mike Magee

The case spanned 15 years, and was rejected by the Supreme Court for a hearing four times. Hijacked from doctors and patients by political opportunists and Right-to-Life activists, it rode the poor health and disability of one unfortunate woman literally into her grave with devastating consequences for all concerned.
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Having lived it, known some of the primary players, taught it in classes on medical journalism, medical history and medical ethics, the name Terri Schiavo understandably triggers something close to PTSD. She certainly has earned the right to “rest in peace.”

And yet, this past weekend, MSNBC Films ran “Between Life & Death,” an NBC News Studios production. As the promo stated “The documentary retraces the tragic story of Terri Schiavo from the 1990s and early 2000s, going beyond the headlines of the national debate over her life that reverberates in today’s culture wars. Watch Between Life & Death: Terri Schiavo’s Story.”

It would be easy to attribute this to “Florida-man” culture and the state’s peculiar predilection for right wing campaigns. After all, this is the state that Paul Weyrich and Jerry Falwell chose for the Moral Majority driven, Anita Bryant “Save Our Children” anti-gay campaign. That supported marches and speeches and book banning from 1977 to 1980 before burning itself out.

And now, as Gov. DeSantis’s culture wars have fallen flat in his home state, and his presidential prospects appear dim, the Schiavo case once again has been surfaced (this time by the left), and its advertising trailer (not surprisingly) completes the loop. The 60 second promo ends with these words delivered somberly by a legalistic male voice, “Reproductive Health and the Right to Die. It’s two sides of the same coin.”

Recent history has indeed “flipped the coin.” On June 24, 2022, the Justices on the Supreme Court allowed the government to “muscle out” the patient-physician relationship in the Mississippi abortion case (Dobbs v. Jackson Women’s Health Organization). “What possibly could go wrong if we remove doctors from delicate life and death decisions?”, I asked (fictitiously) at the time. The answer for Republicans arrived a few months later in the 2022 Midterm elections as multiple states abandoned the party to support women’s autonomy over their own medical decisions.

We’ll see how many viewers decided to tune in this past weekend. But in the meantime, for context and historic accuracy, here is a summary of the Schiavo case from my Fall, 2021 course, “The Right to Health Care and the U.S. Constitution” at the President’s College of the University of Hartford.

Schiavo Case: Summary and Timeline 

•Theresa Marie Schindler was born in a Philadelphia suburb on December 3, 1963. She and her bother Richard and sister Suzanne attended local schools. Terri struggled with weight and had an eating disorder.

•Terri married her husband, Michael in 1984 and moved to Florida to be close to her parents. Terri apparently continued to struggle with her eating disorder, a condition left 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 26 years old. She was resuscitated, and taken to the local hospital, Humana Northside, where she was determined to have had a cardiac arrest brought on by a cardiac arrhythmia caused by hypokalemia with a blood potassium of 2.0 mEq’L (normal 3.5 – 5.0 mEq/L).

•Michael received a court order on June 18, 1990 making him legal guardian and director of future medical decisions related to his wife. Two physicians independently declared her in a “permanent vegetative state.” A gastric feeding tube was surgically placed to provide regular nutritional feedings.

•When she developed a urinary tract infection in mid-1993, he signed a Do Not Resuscitate (DNR) order on her behalf.

•In May, 1998, Michael filed a petition to remove the feeding tube, providing some evidence that his wife would not have wanted to continue to live this way. He refused her parents request that he divorce his wife and hand over decisions, and money garnered from a successful malpractice suit for ongoing care of Terri.

•The parents challenged the removal of the feeding tube that her doctors supported. The case went to Court and a decision to remove the tube was upheld in Florida Second District Court of Appeal in February 2000. After multiple legal maneuvers, the tube was finally removed on April 24, 2001. Terri was now 37 years old.

•The Schindler’s charged Michael Schiavo with perjury, and a judge ordered the tube reinserted 2 days later.

•Claims and counter-claims ate up two more years. On September 17, 2003, as Terri approached her 40th birthday, a frustrated presiding Judge George Greer declared the actions of the Schindler parents was “an attempt to re-litigate the entire case”, and ordered the feeding tube to be removed for a second time, which it was on October 15, 2003.

•With encouragement from Republican operatives in Florida, the Schindler’s joined by their son, Bobby, engaged anti-abortion Operation Rescue/Right to Life extremist Randall Terry in a very public campaign with daily demonstrations at the care facility.

•The Florida legislature in emergency session granted then Gov. Jeb Bush (filled with Presidential aspirations), the authority to intervene in the case. Citing the new “Terri’s Law”, Bush ordered the feeding tube surgically reinserted for the third time.

• In the meantime the ACLU lined up with Terri’s husband. On May 5, 2004, “Terri’s Law” was declared unconstitutional.

•Senator Mel Martinez’s (R-FL) political career was damaged irreparably when he called for federal government intervention in the case. His top aide, Brian Darling’s memo was leaked to the public. It read, “This is an important moral issue, and the pro-life base will be excited…This is a great political issue, because Senator Nelson of Florida has already refused to become a co-sponsor and this is a tough issue for Democrats.”

•A second Republican casualty was the future political career of doctor turned politician, Senator Bill Frist, who had Presidential aspirations but couldn’t resist weighing in as a physician. Breaking a well accepted medical media code of ethics for the medical profession, without every seeing the patient, he challenged the decision to remove Terri’s feeding tube, proclaiming on the floor of the Senate on March 17, 2005,  “I question it based on a review of the video footage which I spent an hour or so looking at last night in my office.”

•The United States Congress held hearings on the case, and then President George W. Bush brokered a compromise transferring the case to Federal Courts. The Federal Court agreed with prior State Court Appeals.

•Terri Schiavo’s feeding tube was removed a final time on March 24, 2005. She died at a Pinellas Park hospice on March 31, 2005.

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“AI god Tells Medical-Industrial Complex: ‘Your Health Care System Is Perfect!’”

Posted on | December 1, 2023 | 1 Comment

Mike Magee

One of the top ten headlines of all time created by the satirical geniuses at The Onion was published 25 years ago this December. It read, “God Answers Prayers Of Paralyzed Little Boy. ‘No,’ Says God.”

The first paragraph of that column introduced us to Timmy Yu, an optimistic 7-year old, who despite the failures of the health system had held on to his “precious dream.” As the article explained, “From the bottom of his heart, he has hoped against hope that God would someday hear his prayer to walk again. Though many thought Timmy’s heavenly plea would never be answered, his dream finally came true Monday, when the Lord personally responded to the wheelchair-bound boy’s prayer with a resounding no.”

But with a faith that rivals the chieftains of today’s American health care system who continue to insist this is “the best health care in the world,” this Timmy remained undeterred. As The Onion recorded the imagined conversation, “‘I knew that if I just prayed hard enough, God would hear me,’ said the joyful Timmy,., as he sat in the wheelchair to which he will be confined for the rest of his life. ‘And now my prayer has been answered. I haven’t been this happy since before the accident, when I could walk and play with the other children like a normal boy.’”

According to the article, the child did mildly protest the decision, but God held the line, suggesting other alternatives. “God strongly suggested that Timmy consider praying to one of the other intercessionary agents of Divine power, like Jesus, Mary or maybe even a top saint,” Timmy’s personal physician, Dr. William Luttrell, said. ‘The Lord stressed to Timmy that it was a long shot, but He said he might have better luck with one of them.’”

It didn’t take a wild leap of faith to be thrust back into the present this week. Transported by a headline to Rochester, Minnesota, the banner read, “Mayo Clinic to spend $5 billion on tech-heavy redesign of its Minnesota campus.” The “reinvention” is intended “to present a 21st-century vision of clinical care” robust enough to fill 2.4 million square feet of space.

The Mayo Clinic’s faith in this vision is apparently as strong as little “Timmy’s”, and their “God” goes by the initials AI. Only six months earlier, they announced a 10-year collaboration with Google to create an “AI factory” described as “an assembly line of AI solutions that are developed at scale and incorporated into clinical workflows.” They added that they are “looking beyond foundational development.”

Cris Ross, CIO of Mayo Clinic, imagines crowded hallways. He says, “I think it’s really wonderful that Google will have access and be able to walk the halls with some of our clinicians, to meet with them and discuss what we can do together in the medical context.” No small dreamer, Ross sees bright skies ahead – “an assembly line of AI breakthroughs… being able to do the kinds of things that people are doing in little bits all over the planet, to be able to do the same kinds of things but at scale and repeatedly.”

Luckily, the “AI god” will provide management infrastructure in the form of the new Mayo Clinic Platform, a group of digital and long-distance health care initiatives under the direction of physician executive missionary, John Halamka MD. As a fully registered Medical Industrial Complex (MIC) professional, he has touched all the bases – graduate of hallowed Stanford University, member NAM, wrote econometrics software for Milton Friedman, medical informatics at MIT and Harvard, birthed the software startup Ibis Research Labs, CIO at Beth Israel Deaconess, and influencer on multiple government panels.

The venture he directs will not rely on spirit alone. Venture capital dollars have helped launch two joint ventures – one intended to collect deindentified clinical data from patients far and wide, and the second “to commercialize algorithms for the early detection of disease.”

The “AI god” is wise enough not to reinvent the wheel. His/Her plan comes directly from the MIC playbook, originally designed in 1950 by Arthur Sackler.  Create an integrated career ladder for academic medical scientists that will seamlessly carry them from Medicine to Industry to Government and back again, reward all parties with exclusive patents and hidden incentives, and trust that the little “Timmy’s” of the world will find some way to survive.

Of course, the “AI god”, to reach this level of power so quickly, has had to make certain sacrifices, notably replacing one of the two bedrock commandments that have served to guide human behavior for several thousand years:

The first – “Love the Lord your God with all your heart and with all your soul and with all your mind” – can stand, as we transfer loyalty to an over-arching artificial intelligence.

But we must toss the second, “Love your neighbor as yourself.”  And embrace instead, “Love technology as yourself”, and all the riches will follow.

And for the patients? Have faith that when science and technology finally “defeats disease,” your health will follow.

Giving Thanks to Women, and Children, and Lives Filled With Promise.

Posted on | November 20, 2023 | Comments Off on Giving Thanks to Women, and Children, and Lives Filled With Promise.

Mike Magee

As Thanksgiving Day approaches, let’s give thanks for women, and children, and lives filled with promise.

One President who understood the power of promise more than many others was FDR. When he structured up “a series of programs, public work projects, financial reforms and regulations…”, he memorably packaged the plan under the label, “The New Deal.”

With a heavy dose of humility and learned wisdom, he rose again eleven years later, on January 11, 1944, fifteen months before his death, and delivered the State of the Union Address as a Fireside Chat from the Oval Office in the White House.

His words once again were clear and ever lasting. He stated that the original Bill of Rights was “inadequate to assure us equality in the pursuit of happiness.” One of the missing elements, he affirmed was a national health care system.

 “Necessitous men are not free men.”  The nation needed, he said,  “a second Bill of Rights under which a new basis of security and prosperity can be established for all—regardless of station, race, or creed.” 

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 admits is to this day “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.”

The Roosevelts’ definition of “health” continues to guide the work of the March of Dimes , whose latest report on maternal and childhood health in America is disturbing, and sends an arrow through the heart of Article 25 in the Declaration which reads:

“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.”

As the March of Dimes reported, “the U.S. remains among the most dangerous developed nations for childbirth with early data from the CDC showing a 3% increase in infant mortality in 2022.” 10.4% of babies last year were born prematurely before 37 weeks gestation. Compare that with the U.K. (7.6%), Italy (6.8%), or Japan (5%). To make matters worse, U.S. numbers reveal remarkable racial disparity with 14.6% of Black babies born prematurely compared to 9.4% of White babies.

As for mothers health in the post-Dobbs era, the 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.

For Neiman,  the vacuum left by an erosion of justice is always filled with power – and specifically, power over someone. As the March of Dimes report so well illustrates,  the targets of this power play are clear. They are women, children, and people of color in America.  They deserve more than our thanks this Thanksgiving. They deserve unimpeded and complete access to health services, and to their doctors and nurses throughout the land.

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