Monthly Archives: January 2009

Books! Or, life behind the best-seller curve

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blackwater Blackwater: The Rise of the World’s Most Powerful Mercenary Army, by Jeremy Scahill.

This longish book is the kind that gives you the waking quakes — how did we let this happen? Author Jeremy Scahill takes readers on an in-depth tour of the growing empire of Blackwater, the Bush-favored mercenary corporation that is best known for its military roles in Iraq and  post-Katrina New Orleans.

Blackwater, according to Scahill, is willing to go where the money is: war, peace-keeping, spying, financial cover for grasping bureaucrats. Blackwater is a very handy corporation to have around. It allows the government to go places it could not go with conventional forces and do things it could not do — some of which might be considered immoral or illegal to the average voter — with the regular military. Blackwater happily recruits its for-hire soldiers from veteran forces of some of the most human-rights abusing regimes on earth.

Blackwater is everywhere these days, according to Scahill’s book, which was updated last year. Residents of a small California town defeated the company’s efforts to open a “Blackwater West” in their community, but “Blackwater already annually trains more than 25,000 military and state, federal, and local law enforcement personnel at its Moyock (North Carolina) headquarters. It also successfully established ‘Blackwater North’ in Illinois.”

These days, Blackwater is manufacturing military hardware, spying for corporate America, gathering intelligence for the government and fighting our wars, all without the oversight that would accompany more traditional performance of those duties.

Blackwater and other private military companies have made themselves a very important part of the defense establishment. Scahill’s book makes clear just how dependent the Pentagon has become on its for-hire proxies. It will be interesting to see if President Obama will try to rein them in, or whether Blackwater and its ilk already more powerful than the commander in chief.

Jeremy Scahill on Bill Moyers

The Ledbetter law

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The Senate adopted legislation yesterday that would reverse a horrible Supreme Court decision on wage discrimination — the question is, what took so long?

The court ruled in 2007, in a case involving Goodyear Tire & Rubber employee Lilly Ledbetter, that an employee must file a claim of wage discrimination within 180 days of the decision to pay the employee less, even if the employee did not learn of the decision until years later.

Yes, the court said, you must file your suit based on facts of which you are totally unaware.

The ruling was bad enough; that Congress took almost 1 1/2 years — Senate Republicans blocked an earlier fix — to repair such an obvious injustice is just appalling. Better late than never, yeah, but better the obvious wrong never occurred at all.

The stimulus and the supplanting issue

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Some sort of stimulus package is going to pass sooner or later.

Then keep an eye on state and local governments, because they could negate a good piece of potential positive impact by a little cost-shifting from now to the future.

Take, for example, infrastructure projects. If the feds pump an additional $100 million into repairing roads and bridges in Wisconsin and the governor or the Legislature take that as an opportunity to cut $100 million in state funding for road and bridge repair, what’s stimulated? If it is a dollar for dollar trade, we are exactly where we were before in terms of jobs and better roads and bridges.

The state may, of course, be able to use $100 million in saved state money elsewhere, but there is no guarantee that the new expenditures will create jobs and it is more likely the money would just be thrown into one of the gaping budget holes that already exist, producing exactly zero new jobs, but perhaps preserving some existing ones.

It also is possible that using federal money to supplant state funding would lower the state tax burden, at least a little bit. It also increases the future federal tax burden because that debt has to be repaid, and with interest! Our kids and grandkids could end up bowed by a tax burden for a stimulus package that never was allowed to stimulate.

Comments on no-consent studies

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Here are my comments on proposed US Department of Health and Human Services’ “Guidance on Important Considerations for When Participation of Human Subjects in Research is Discontinued.”

The proposed guidelines include inadequate protections for the patient and his or her family. While both these guidelines and FDA guidance protect the research and the researchers, they do not fully protect the patient and family.

The FDA’s guidelines (Guidance for Sponsors, Clinical Investigators, and IRBs: Data Retention When Subjects Withdraw from FDA-Regulated Clinical Trials) cite concerns that allowing data to be deleted from studies will make them scientifically invalid. The guidelines state that “allowing subjects to withdraw data could even provide an opportunity for unscrupulous parties to ‘improve’ study results by selectively encouraging certain subjects to withdraw from a study.”

While that is a valid concern, the guidelines are silent on data that is collected through improper or unethical means. The  stringent prohibition on expunging data could even provide an opportunity for unscrupulous or indifferent parties to deliberately violate notification procedures or be negligent in applying them.

In these instances, patients or families ought to be able to expunge data entirely from the study. There must be consequences for researchers and protections for patients and families when subjects are improperly enrolled in no-consent studies. While it is true that participation in a study cannot be undone, it is also true that a society that can expunge criminal records can expunge improperly obtained medical records as well when circumstances indicate its appropriateness.

HHS guidance should make provision for patients or families to opt out of no-consent studies entirely when enrolling the patient involved negligence or misconduct on the part of the researchers.

This issue has been near and dear since I learned Nov. 26 that my husband was enrolled, without his consent or my consent,  in a medical study after he had a heart attack at home Oct. 19. David died Oct. 25 without regaining consciousness. When I requested that his medical records be expunged, the Medical College of Wisconsin turned me down, citing guidance from the Food and Drug Administration and the the proposed guidance from the Department of Health and Human Services. I’ve written to the FDA to appeal the ruling to seek a waiver from the guidance.

You, too, can comment on the pending HHS guidelines if you wish. The deadline is Jan. 30.

Comments, according to HHS,  may be submitted by any of the following methods: (1) E-mail to discontinueparticipation@hhs.gov and include “Guidance on Discontinuation of Subject Participation” in the subject line; (2) Fax: 301-402-2071; (3) Mail/Hand delivery/Courier [For paper, disk, or CD-ROM submissions]: Michael A. Carome, M.D., Captain, U.S. Public Health Service, OHRP, 1101 Wootton Parkway, Suite 200, Rockville, MD 20852.

More information is available here.