“The argument here is not about whether nurses should be held accountable for their errors; everyone I spoke with about Vaught’s case agrees she bears responsibility for her actions and should face consequences. The real issue is that criminalizing a nurse’s error lets hospitals off the hook for the systemic changes that would improve patient safety.
“Almost no mistakes happen in a hospital by just one person,” said Gatter. Systems exist to prevent medical errors, he said. If those systems don’t work or exist only on paper, errors will happen.
In this case, the system failures were clear: During an unannounced visit to Vanderbilt University Medical Center in late 2018, federal investigators found multiple deficiencies, some of which placed patients at “serious and immediate threat,” according to the 105-page memo documenting the details. For example, hospital policies didn’t require that a second nurse sign off on the use of a highly dangerous medication like vecuronium, nor did it require that patients receiving sedatives be hooked up to a heart and lung monitor. Focusing the blame on one nurse’s error shifts the attention away from those deficiencies.
“I’m quite concerned that this nurse is getting thrown under the bus, and in the hubbub of giving her a jail sentence, that the system itself will escape close examination,” said Gatter.
Even if a nurse were solely responsible for a medical error resulting in patient harm, the way to prevent that nurse from causing further harm is to revoke their license, said Gatter. It’s much harder to explain how punishing a nurse with jail time further prevents them from endangering others.
However, it’s easy to see how that type of punishment can itself create and compound safety risks, he said.
That’s because severely punishing individuals for systemic problems has a chilling effect on others’ willingness to report mistakes.”
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“Less transparency in error reporting also means hospitals have fewer opportunities to correct big problems. That means faulty systems stay in place, which translates into more vulnerability and stress for health care providers and less safety for patients.”
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“The consequences for professional malpractice should ideally deter wrongdoing without discouraging people from entering the profession altogether — but finding that balance is challenging.”
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“American nursing was under enormous strain well before the pandemic. But with the US population aging, surging retirements among bedside nurses and nurse educators, and nurse staffing levels reduced ever lower to contain costs, the pandemic has tipped parts of the country into a full-on nursing shortage.
The last thing the profession needs is another reason for nurses to leave jobs providing direct patient care, but that’s exactly the effect the Vaught ruling is having”
“The Supreme Court, in an increasingly familiar development, handed a victory to a Christian conservative organization on Monday. The Court’s decision in Shurtleff v. Boston establishes that this organization, Camp Constitution, should have been allowed to fly a Christian-identified flag from a flagpole outside Boston’s city hall.
But Shurtleff is unlike several other high-profile victories for religious conservatives that the Court has handed down in recent years because the justices did not need to remake existing law in order to reach this result. The decision was unanimous (although the justices split somewhat regarding why the plaintiffs in this case should prevail), with liberal Justice Stephen Breyer writing the majority opinion.
The case involves three flagpoles standing outside of Boston’s city hall. The first flagpole displays the US flag, with a smaller flag honoring prisoners of war and missing service members below it. The second pole features the Massachusetts state flag. And the third typically — but not always — displays the city’s own flag.
This third flagpole, and the city’s practice of sometimes allowing outside groups to display a flag of their choice from it, is the centerpiece of Shurtleff. Since at least 2005, the city has permitted outside groups to hold flag-raising ceremonies on the plaza during which they can raise a flag of their choosing on the third flagpole.
At various times, the third flagpole has displayed the flags of many nations, including Brazil, China, Ethiopia, Italy, Mexico, and Turkey. It has displayed the rainbow LGBTQ pride flag, a flag commemorating the Battle of Bunker Hill, and a flag honoring Malcolm X.
But when Harold Shurtleff, head of an organization called Camp Constitution, asked to fly a flag associated with the Christian faith, the city refused — claiming that displaying such a flag could be interpreted as “an endorsement by the city of a particular religion,” in violation of “separation of church and state or the [C]onstitution.”
Justice Breyer’s majority opinion concludes that the city erred. Relying on a bevy of cases establishing that the government typically cannot discriminate against a particular viewpoint, Breyer notes that “Boston concedes that it denied Shurtleff’s request solely because the Christian flag he asked to raise ‘promot[ed] a specific religion.’” Under the facts of this case, that’s a form of viewpoint discrimination and it’s not allowed.
While it’s notable that Justices Neil Gorsuch and Brett Kavanaugh each wrote separate opinions indicating that they are eager to let government get cozy with religion, and they have two opportunities to do so this term, this case is a straightforward decision that follows current law — in short, nothing remarkable.”
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“The general rule in free speech cases is that the government may not discriminate against any particular viewpoint. Boston could not, for example, have a rule that Democrats are allowed to gather in the city hall plaza but not Republicans. Or that people who support restrictive immigration policies may do so, but not people who oppose them.
But there’s an exception to this general rule when the government speaks in its own voice. That is, the government is allowed to express its own opinion on a subject without also providing a forum for dissenting voices. If a public school principal tells her students to “say no to drugs,” she’s not required to give equal time to the grungy guy in the junior class who sells weed out of his 1997 Subaru Legacy.
The primary question in Shurtleff is whether, when Boston’s city government permitted a wide range of private groups — but not Camp Constitution — to display a flag of their choice outside of city hall, these flags represented the city’s speech or the private groups’ speech. Again, if the flags were a form of government speech, then Boston is allowed to exclude viewpoints it does not share.
But the Court concluded that the city did not use the third flagpole to express its own views, and that it effectively created “a forum for the expression of private speakers’ views.” As Breyer notes, Boston does not appear to have made any effort whatsoever to control which flags are displayed from this flagpole until it denied Shurtleff’s request to fly a Christian flag.”
“Amid the many extraordinary revelations at the January 6 committee’s first primetime hearing Thursday, one stood out for its sheer depravity: that during the assault, when rioters chanted “hang Mike Pence” in the halls of the Capitol, President Donald Trump suggested that the mob really ought to execute his vice president.
“Maybe our supporters have the right idea,” he said, per a committee source. “[Mike Pence] deserves it.”
Endorsing violence is hardly new for Trump; it’s something he’s done repeatedly, often in an allegedly joking tone. But the reported comment from January 6 is qualitatively worse given the context: coming both amid an actual violent attack he helped stoke and one he did little to halt. The committee found that the president took no steps to defend the Capitol building, failing to call in the National Guard, or even speak to his secretaries of Defense and Homeland Security.
While he was de facto permitting the mob’s rampage, he was privately cheering the most violent stated objective of people he acknowledged as “our supporters.””
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“when a leader whips up a mob to attack democracy with the goal of maintaining his grip on power in defiance of democratic order, then privately refuses to stop them while endorsing the murderous aims of people he claims as his own supporters, it’s hard to see him as anything but a leader of a violent anti-democratic movement with important parallels to interwar fascism.
This doesn’t prove that fascism is, in all respects, a perfect analogy for the Trump presidency. Yet when it comes to analyzing January 6, both Trump’s behavior and the broader GOP response to the event, [the] hearing proved that the analogy can be not only apt but illuminating.”
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“Events like the 1922 March on Rome or 1923 Beer Hall Putsch help us understand the way in which attempts to forcefully seize power — even failed ones like the Putsch — can play a role in the rise of radical far-right movements. They help us understand the clarifying and organizing power of violence, the way in which banding together to hurt others can help solidify dangerous political tendencies.
And it helps us understand the potential for violence to recur, especially given the mainstream Republican Party’s continued whitewashing of January 6.
One of the defining elements of the interwar fascist ascendancy is the complicity of conservative elites — their belief that they could manipulate fascist movements for their own ends, empowering these movements while remaining in the driver’s seat. This is precisely how the mainstream Republican Party has approached Trump, even after a violent attempt to seize power exposed just how far he’s willing to go to hold power.”
https://www.vox.com/science-and-health/2022/6/9/23160055/monkeypox-outbreak-immunocompromised-pregnant-hiv
“cynicism. It’s crucial because it allows people to say, “They’re all the same, it’s all bullshit, isn’t it? It’s just politics, isn’t it?” What cynicism allows you to do is be gullible and disbelieving at the same time.”
“Barr, along with other administration officials, described playing “whack-a-mole” with Trump’s false claims of fraud.
Every time one false claim was dispelled, they said, the former president would bring up another. Aides repeatedly intervened to tell Trump that he had lost the election, and described taking each claim seriously, investigating it until they had the facts and reporting back to Trump. Former acting Attorney General Richard Donoghue described one meeting during which Trump seemed to accept the gathered evidence, but for each conspiracy theory aides were able to explain away, he had another he’d latch onto.
Barr described one popular conspiracy theory around the 2020 election, that it had been rigged by voting machine malfeasance, as “idiotic.” Other Justice Department officials testified that they repeatedly insisted to Trump that other conspiracy theories around the election were simply “not true,” including viral claims of ballot box stuffing in Georgia promoted by Giuliani or Trump’s false claims of “big massive dumps” of illegal votes.
Essentially, the committee suggested, Trump knew or should have known that his lies about the election were, as Barr put it, “bullshit.” But he repeated them anyway, which helped lead to the violence on January 6.”
“In the second January 6 hearing, House lawmakers argued Monday that former President Donald Trump not only engaged in the “big lie” — promoting the false narrative that the election was stolen from him — but also what they dubbed the “big ripoff.” Effectively, they said, Trump conned his supporters into giving him $250 million to contest the election results, while actually funneling many of those funds elsewhere, including to a nonprofit led by former chief of staff Mark Meadows and to Trump’s own hotels.
“We found evidence that the Trump campaign and its surrogates misled donors as to where their funds would go and what they would be used for,” Rep. Zoe Lofgren (D-CA) said in a closing statement for the hearing. “So not only was there the big lie, there was the big ripoff.”
As video testimony from former Trump campaign officials revealed, small-dollar donors were bombarded with emails to donate to an official “Election Defense Fund” in the wake of the 2020 election. Those donors were told that fund was aimed at combating (nonexistent) election fraud. In reality, however, no such fund existed, according to the House committee investigating the January 6, 2021, Capitol riot.
“I don’t believe there was actually a fund called the Election Defense Fund,” Hanna Allred, a former Trump campaign staffer, testified to the committee. Ultimately, the fund was what another staffer categorized as a “marketing tactic” to bring in more money, most of which did not go to election-related litigation.
Instead, many of the funds were directed to a newly created Save America PAC, which has contributed millions to other pro-Trump groups. That includes $1 million to the Conservative Partnership Institute, a charity foundation helmed by Meadows, $5 million to Event Strategies Inc., the vendor that put on Trump’s January 6 rally, and $204,857 to the Trump Hotel Collection.”
“More than a million Americans have died of Covid-19, and the World Health Organization estimated this Thursday that the global death toll is around 15 million — a horrifying, and largely unnecessary, tragedy.
But for all that the world has lost in the last few years, the history of infectious disease has a grim message: It could have been even worse. That appalling death toll resulted even though the coronavirus kills only about 0.7 percent of the people it infects. Imagine instead that it killed 30 percent — and that it would take centuries, instead of months, to develop a vaccine against it. And imagine that instead of being deadliest in the elderly, it was deadliest for young children.
That’s smallpox.”
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“Before modern vaccine development, humans had to get creative in slowing the spread of infectious disease. It was known that people who’d survived smallpox didn’t get sick again. In China, as early as the 15th century, healthy people deliberately breathed smallpox scabs through their noses and contracted a milder version of the disease. Between 0.5 percent and 2 percent died from such self-inoculation, but this represented a significant improvement on the 30 percent mortality rate of the disease itself.
In England, in 1796, doctor Edward Jenner demonstrated that contracting cowpox — a related but much milder virus — conferred immunity against smallpox, and shortly after that, immunization efforts began in earnest across Europe. By 1813, the US Congress passed legislation to ensure the availability of a smallpox vaccine that reduced smallpox outbreaks in the country throughout the 1800s.”
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“By 1900, smallpox was no longer quite as much of a scourge in the world’s richest countries. In the 1800s, about 1 in 13 deaths in London were caused by smallpox; by 1900, smallpox caused only about 1 percent of deaths. Several countries in Northern Europe had also declared the disease eradicated. Over the next few decades, more of Europe, and then the US and Canada, joined them.
But as long as smallpox ravaged other parts of the globe, continual vaccination was necessary to make sure it wasn’t reintroduced, and millions of people continued to die of it. Data is spotty — this is before there was any international authority on infectious disease statistics worldwide — but it is estimated that 10 to 15 million people caught smallpox annually, with 5 million dying of it, during the first half of the 20th century.
It was not until the 1950s that a truly global eradication effort began to appear within reach, thanks to new postwar international institutions. The World Health Organization (WHO), founded in 1948, led the charge and provided a framework for countries that were not always on friendly terms to collaborate on global health efforts.”
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“A 1947 outbreak in New York City, traced back to a traveler from Mexico, resulted in a frantic effort to vaccinate 6 million people in four weeks. Europe, Henderson says, repeatedly saw the virus reintroduced by travelers from Asia, with 23 distinct importations (different occasions of someone bringing smallpox into the country) in five years.
As we face down Covid-19, with effective vaccinations finally in hand, we’re encountering the same challenge that the world faced with smallpox in the 1950s: It doesn’t matter if a vaccine exists unless there also exists the international will and creativity to get it to all the people who need it, many of whom will be reluctant and skeptical.”
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“features of smallpox made it easier to eradicate than many other diseases. For one thing, it didn’t have animal reservoirs; that is, unlike diseases like Ebola, smallpox doesn’t live in animal populations that can reintroduce the disease in humans. That meant that once it was destroyed in humans, it would be gone forever. And, once a person has survived it, they are immune for life. Only one vaccine is needed for immunity in almost all cases.
Additionally, it largely doesn’t have asymptomatic transmission and has a fairly long incubation period of about a week. That made it possible for public health officials to stay on top of the disease with a strategy of “ring vaccination” — whenever a case was reported, vaccinating every single person who may have come into contact with the affected person, and ideally everyone in the community could keep the disease at bay.”
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“Humanity’s triumph over smallpox should stand out as one of our proudest moments. It called on scientists and researchers from around the world, including collaborations between rival countries in the middle of the Cold War.
Unfortunately, we’ve never replicated that success against another virus that affects humans. With some, such as polio, we’re drawing close. Wild polio has been eradicated in Africa and remains only in conflict-torn regions of Afghanistan and Pakistan. “Ring vaccination,” as practiced in the smallpox battle, has been successfully used in public health efforts against other diseases, most recently with the new Ebola vaccine, used against outbreaks in the Democratic Republic of Congo.
But in other cases, like HIV and Covid-19, we’ve let new diseases grow to pandemic proportions. And while those diseases have had devastating effects, it’s worth keeping in mind that they could have been even worse. Some viruses with the potential to escape laboratories or make the jump from animals to humans are as deadly and transmissible as smallpox, and Covid-19 has made it clear that we’re not prepared to handle them.”
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“The devastation of Covid-19 has hopefully made us aware of the work public health experts and epidemiologists do, the crucial role of worldwide coordination and disease surveillance programs (which are still underfunded), and the horrors that diseases can wreak when we can’t control them.
We have to do better. The history of the fight against smallpox proves that we’re capable of it.”