Oregon

New bill would allow farmers to sue Monsanto if GMO crops invade their property

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Small farm owners in Oregon have been in a deadlock against the GMO giant Monsanto over legislation concerning their crops.

In the past Monsanto have been able to spread their GMO pesticides wherever they liked, putting non-GMO farmers at risk of selling contaminated produce which would compromise their livelihoods.

GMO’s are also the cause of certain super-powered weeds that take over crops, which the farmers are unable to successfully get under control due to their unnatural strength and resilience.

On the whole, Monsanto have made business for regular farmers particularly tough in recent years, but it might all be about to change.

A bill is under consideration which, if passed, would put into practice the following paragraph (the bill) “Allows cause of action against patent holder for genetically engineered organism present on land without permission of owner or lawful occupant.”

Meaning Monsanto would have no right to carry on their dirty work where they are clearly not wanted by the farmers.

The House Bill 2739 could put an end to the bulling farmers have faced in the past when Monsanto seeds ended up where they shouldn’t have been. Farmers in have been threatened with having their farming license revoked due to unwanted GMO particles.

Oregon are also considering another House Bill this year which concerns GMO farming. Bill 2469 if passed, will allow local governments to restrict the use of GMO’s where they see fit.

Where You Live May Determine How You Die Study Suggests

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Oregon is home to the first death-with-dignity law in the U.S., and a new study shows that this state may have the best approach to allowing terminally ill patients a choice in where — and how — they want to die when it comes to quality of life palliative measures versus aggressive attempts to prolong life no matter what the cost or quality, Stat News reports.

You should always be able to choose what care you want, how you want it delivered and where, no matter at what point you are in your lifespan. Too often, your choices diminish the second you walk in a hospital, especially if you enter through the emergency room (ER).

Unless you have advance directives, once you’re in the ER, it’s too late to make end-of-life or continuing care decisions, as they will probably be made for you, especially if you’re very sick. Nearly 10,000 people who visit emergency rooms die within the first seven days of their visit, with the elderly having a greater risk to suffer a disability in the six months following the visit — which proves that now is the time to plan strategies to help prevent visits to the ER and take defensive steps if you need to use emergency care, such as taking an advocate and choosing a hospital before it is needed.

Other things you can do include embracing choices that reduce your risk of health emergencies, such as reducing your sugar and net carb intake to optimize your mitochondrial health and reduce your risk for insulin resistance, type 2 diabetes and cardiovascular disease. Massive sugar addiction can also result in obesity as well as cancer cell production, depletion of brain power, and shorter lifespans, all of which can end up putting you in the ER.

Surprisingly, your attitude can even keep you out of the ER: Research shows that a positive outlook on life is the most influential factor in longevity studies

Scientists discover another cause of bee deaths.

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So what is with all the dying bees? Scientists have been trying to discover this for years. Meanwhile, bees keep dropping like… well, you know.

Is it mites? Pesticides? Cell phone towers? What is really at the root? Turns out the real issue really scary, because it is more complex and pervasive than thought.

Quartz reports:

Scientists had struggled to find the trigger for so-called Colony Collapse Disorder (CCD) that has wiped out an estimated 10 million beehives, worth $2 billion, over the past six years. Suspects have included pesticides, disease-bearing parasites and poor nutrition. But in a first-of-its-kind study published today in the journal PLOS ONE, scientists at the University of Maryland and the US Department of Agriculture have identified a witch’s brew of pesticides and fungicides contaminating pollen that bees collect to feed their hives. The findings break new ground on why large numbers of bees are dying though they do not identify the specific cause of CCD, where an entire beehive dies at once.
The researchers behind that study in PLOS ONE — Jeffery S. Pettis, Elinor M. Lichtenberg, Michael Andree, Jennie Stitzinger, Robyn Rose, Dennis vanEngelsdorp — collected pollen from hives on the east coast, including cranberry and watermelon crops, and fed it to healthy bees. Those bees had a serious decline in their ability to resist a parasite that causes Colony Collapse Disorder. The pollen they were fed had an average of nine different pesticides and fungicides, though one sample of pollen contained a deadly brew of 21 different chemicals. Further, the researchers discovered that bees that ate pollen with fungicides were three times more likely to be infected by the parasite.

The discovery means that fungicides, thought harmless to bees, is actually a significant part of Colony Collapse Disorder. And that likely means farmers need a whole new set of regulations about how to use fungicides. While neonicotinoids have been linked to mass bee deaths — the same type of chemical at the heart of the massive bumble bee die off in Oregon — this study opens up an entirely new finding that it is more than one group of pesticides, but a combination of many chemicals, which makes the problem far more complex.

And it is not just the types of chemicals used that need to be considered, but also spraying practices. The bees sampled by the authors foraged not from crops, but almost exclusively from weeds and wildflowers, which means bees are more widely exposed to pesticides than thought.

The authors write, “[M]ore attention must be paid to how honey bees are exposed to pesticides outside of the field in which they are placed. We detected 35 different pesticides in the sampled pollen, and found high fungicide loads. The insecticides esfenvalerate and phosmet were at a concentration higher than their median lethal dose in at least one pollen sample. While fungicides are typically seen as fairly safe for honey bees, we found an increased probability of Nosema infection in bees that consumed pollen with a higher fungicide load. Our results highlight a need for research on sub-lethal effects of fungicides and other chemicals that bees placed in an agricultural setting are exposed to.”

While the overarching issue is simple — chemicals used on crops kill bees — the details of the problem are increasingly more complex, including what can be sprayed, where, how, and when to minimize the negative effects on bees and other pollinators while still assisting in crop production. Right now, scientists are still working on discovering the degree to which bees are affected and by what. It will still likely be a long time before solutions are uncovered and put into place. When economics come into play, an outright halt in spraying anything at all anywhere is simply impossible.

Quartz notes, “Bee populations are so low in the US that it now takes 60% of the country’s surviving colonies just to pollinate one California crop, almonds. And that’s not just a west coast problem—California supplies 80% of the world’s almonds, a market worth $4 billion.”

FDA Recommending Schedule II Reclassification for Hydrocodone Combination Products.

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The FDA has announced it will recommend(www.fda.gov) to HHS that hydrocodone combination products be reclassified as Schedule II drugs. These products currently are classified as Schedule III medications. The agency said it will submit a formal recommendation package to HHS by early December.

“We anticipate that the National Institute on Drug Abuse will concur with our recommendation,” said the FDA in its announcement. “This will begin a process that will lead to a final decision by the DEA on the appropriate scheduling of these products.”

According to Alan Schwartzstein, M.D., of Oregon, Wis., chair of the AAFP Commission on Health of the Public and Science, although the change could be viewed as a burden to prescribers and patients — requiring that prescriptions be written for no more than 90 days without an option for refill — the benefits outweigh any potential negatives.

“The AAFP is very concerned about the problem of opiate misuse and pain management, and we are working actively within our organization with the FDA and other organizations to minimize opiate misuse and maximize the treatment of pain relief for our patients,” Schwartzstein told AAFP News Now. “We recognize that the lack of ability to write for refills more than 90 days will require that our members more frequently write these prescriptions, but we understand and accept that this is necessary to achieve our goals.”

Schwartzstein said the FDA move complements the conclusions published in the Academy’s 2012 position paper on the subject of opioid abuse and pain management.

“We want to work with other organizations and with our members to make sure that students and physicians are kept up-to-date on appropriate prescribing of immediate- and long-acting opiates,” he said. “It is also important that (physicians) are using (opiates) in the most effective way to manage pain without contributing to misuse of the substances.”

According to the National Safety Council(www.nsc.org) (NSC), 45 U.S. citizens die each day from an unintentional overdose of prescription pain medication, and one in every 20 Americans age 12 or older reported using prescription painkillers recreationally in the past year.

Moreover, in its latest report on prescription drug abuse(www.nsc.org), the NSC says only three states adequately address the issue.

Meanwhile, the Trust for America’s Health (TFAH) reported in its recent publicationPrescription Drug Abuse: Strategies to Stop the Epidemic(healthyamericans.org) that prescription drug-related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C.

“Misuse and abuse of prescription drugs costs the country an estimated $53.4 billion a year in lost productivity, medical costs and criminal justice costs, and, currently, only one in 10 Americans with a substance abuse disorder receives treatment,” TFAH said in the report.

In an interview with AAFP News Now, NSC medical adviser and family physician Donald Teater, M.D., of Clyde, N.C., said he applauds the FDA move and is pleased with the AAFP’s affirmative stance on the issue.

“(The schedule change) may present some hardships for a few people, but I think that those should be minor,” said Teater. “When you are looking at the overall picture — where greater than 16,000 people are dying every year from prescription pain medications — something has to be done. And, because hydrocodone is the most commonly prescribed opioid, it just makes sense to put more controls on it to prevent those accidental deaths.”

Teater said he believes the FDA’s move will help address the prescription drug misuse issue somewhat, but added that more needs to be done.

“(The proposed schedule change) is certainly not a magic bullet, but it will make some difference,” he said. “In the whole area of prescription drug abuse and overdose, there’s just not going to be one magic solution, but a whole bunch of small steps like this.

“I think we need to be pleased with every positive step and keep going forward.”

The “Oregon Experiment” at 2 Years.

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A lottery for Medicaid enrollment simulates a randomized trial.

In 2008, Oregon modestly expanded its Medicaid program through a lottery. From a list of 90,000 names on a Medicaid waiting list, 30,000 were drawn randomly; ultimately, about 10,000 of the lottery “winners” applied for state Medicaid services and were enrolled. Eligibility was based on age (19–64) and financial need (income, <100% of the federal poverty level; assets,

Researchers compared selected 2-year outcomes for about 6000 people who acquired Medicaid coverage through the lottery and for 6000 controls (people who entered the lottery but weren’t selected). Data were acquired by questionnaires and by limited cardiovascular risk assessments. The following statistically significant outcomes were noted in the Medicaid group, compared with controls:

  • Lower prevalence of positive depression screens (21% vs. 30%)
  • Better self-reported health-related quality of life
  • Fewer financial hardships due to medical expenses
  • Better access to medical care
  • More Pap smears and mammograms completed
  • More outpatient visits but not hospital admissions

Mean blood pressure, lipid levels, and glycosylated hemoglobin (HbA1c) levels were similar in the two groups.

Comment: One month ago, I saw an uninsured 45-year-old woman who had noted an enlarging breast mass for 9 months. She had not sought medical attention because “it wasn’t the cost of the mammogram or biopsy that concerned me . . . it was the cost of what would happen next if I have cancer.” Unfortunately, a biopsy showed breast cancer.

This case exemplifies a key reason for medical insurance — it enables people to access medical care when they need it, without fear of financial ruin. By that standard, the Oregon experiment is a success for Medicaid expansion. The lack of difference in cardiovascular risk factors is not important, given the short follow-up and the relatively normal values: Mean blood pressure, total cholesterol levels, and HbA1c in both groups were about 120/75 mm Hg, 200 mg/dL, and 5.3%, respectively.

 

Source:Journal Watch General Medicine

 

Why China isn’t taking American trash anymore.

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china-garbage-landfill-bw-flickr

Quick, what’s the biggest U.S. export to China?

Soybeans?

Officially, yes, it’s the biggest single product. But combined, the U.S. exports more scrap and waste to China than any other single product — $11.31 billion in 2011. Growth of waste exports has been quick and steep. In 1997, only $182 million worth of waste went to China. But expect that growth to come to a screeching halt.

That’s because China no longer wants all that U.S. waste, as Gwynn Guilford reports at Quartz:

[H]ints are emerging that American cities and the companies that sell trash are in for a rude awakening. A recent sign of this comes from Oregon, where truckloads of plastic are piling up at recycling depots because Chinese buyers cancelled their orders, as Oregon Public Broadcasting reports.

And it’s not just plastic from Oregon. American waste recycling companies are starting to panic. “What I’m hearing from folks in the industry, it’s that just that nothing is going,” the industry insider says. “[China’s] not taking anything anymore. It’s a greenwall.”

More specifically, China’s implemented a policy called Operation Green Fence. The policy cracks down on the amount of contaminants that can be included in a bale of waste, including unwashed plastics and other banned materials, leading to “severe recycling market confusion worldwide.”

It’s hitting the recycling industry especially hard. Global shipments of recovered paper to China are down 18.4 percent. And prices for recovered materials are dropping.

It’s easy to forget that recycling is an industry. As one industry insider told Quartz, “The public doesn’t realize this, but recycling is made possible by technology and markets—they think it’s just a matter of technology. And we don’t have strong enough markets in the US.”

So happens next? One industry source says the initiative will end in November. But for now, other countries could take what the U.S. currently ships to China. Vietnam is a potential source. In the short term it could mean a lot of plastics just end up in the landfill. But in the long term it could lead to more innovation in the industry.

For now, it’s just a mess.

Source: Smart planet

Physician-Assisted Suicide.

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John Wallace is a 72-year-old man with metastatic pancreatic cancer. At time of diagnosis, the cancer was metastatic to his regional lymph nodes and liver. He was treated with palliative chemotherapy, but the disease continued to progress. Recently he has become jaundiced, and he has very little appetite. He has been seeing a palliative care physician and a social worker on an ongoing basis. His abdominal pain is now well controlled with high-dose narcotics, but the narcotics have caused constipation. In addition to seeing the social worker, he has also been seeing a psychologist to help him to cope with his illness.

Mr. Wallace has been married to his wife, Joyce, for 51 years, and they have three children and six grandchildren. He and his wife have lived in Salem, Oregon, for the past 23 years, and most of his family lives nearby. He understands the prognosis of the disease, and he does not wish to spend his last days suffering or in an unresponsive state. He discusses his desire for euthanasia with his wife and family members, and they offer him their support. The next day, he calls his physician and asks for information about physician-assisted suicide.

TREATMENT OPTIONS

Do you believe that Mr. Wallace should be able to receive life-terminating drugs from his physician? Which one of the following approaches to the broader issue do you find appropriate? Base your choice on the published literature, your own experience, and other sources of information.

To aid in your decision making, each of these approaches is defended in the following short essays by experts in the field. Given your knowledge of the patient and the points made by the experts, which option would you choose? Make your choice and offer your comments at NEJM.org.

  • Option 1: Physician-Assisted Suicide Should Not Be Permitted
  • Option 2: Physician-Assisted Suicide Should Be Permitted

 

 

OPTION 1

Physician-Assisted Suicide Should Not Be Permitted

J. Donald Boudreau, M.D., Margaret A. Somerville, A.u.A. (pharm.), D.C.L.

We recognize that a patient in Mr. Wallace’s situation is in a state of grief. We appreciate his desire to be of sound mind at the end of his life and not to have to suffer as death approaches. We also recognize the obligations of physicians to respect a patient’s refusal of treatment, to relieve pain and suffering, and to provide palliative care. However, we believe that the art of healing should always remain at the core of medical practice, and the role of healer involves providing patients with hope and renewed aspirations, however tenuous and temporary. Within the realm of palliative care, there exists a well-recognized paradox that one can die healed.1 Physicians have a duty to uphold the sacred healing space — not destroy it. Therefore, physicians must hear Mr. Wallace’s request for death but never carry it out.

Supporters of physician-assisted suicide justify their position by placing the value of individual autonomy above all other values and ethical considerations. Giving individual autonomy absolute priority runs roughshod over competing values, protections, and needs and ignores the harmful effects on other people, societal institutions (the medical profession in particular), and the general community.

Permitting physician-assisted suicide creates a slippery slope that unavoidably leads to expanded access to assisted suicide interventions — and abuses. Advocates of euthanasia deny that slippery slopes exist, arguing that legal constraints and administrative safeguards are effective in preventing them. But the evidence is clearly to the contrary, as the High Court of Ireland recently affirmed. In upholding the constitutionality of the prohibition on assisted suicide, the justices wrote, “. . . the fact that the number of LAWER (`life-ending acts without explicit request’) cases remains strikingly high in jurisdictions which have liberalised their law on assisted suicide . . . speaks for itself as to the risks involved.”2 Vulnerable communities in our societies — persons who are old and frail and those who are disabled or terminally ill — perceive themselves to be threatened.3Physicians must not be willfully blind to these serious dangers.

Many aspects of physician-assisted suicide breach physicians’ long-standing ethical norms. For instance, the 2011 annual report on the Death with Dignity Act in Oregon shows that physicians were present at fewer than 10% of “assisted deaths.”4 Why might they want to disconnect themselves from what they have enabled? Perhaps they have a moral intuition that intentionally facilitating or inflicting death is wrong. Patients expect an empathic presence from their physicians, and authentic healers commit to accompanying patients throughout the illness trajectory.

Referring to physician-assisted suicide as “treatment” is a new rhetorical tool that is used by the advocates of euthanasia. The goal is to make assisted suicide seem less alarming to the public and to promote the idea that legalizing the practice is just another small step along a path already taken and ethically approved. By intentionally confusing physician-assisted suicide with legitimate palliative care, pro-euthanasia advocates hope that the public will conclude that it is a medically and ethically accepted end-of-life treatment.5

For palliative care to remain a healing intervention, it cannot include “therapeutic homicide.”6Euthanizing and healing are intrinsically incompatible. Involvement of physicians in such interventions is unethical and harms the fundamental role of the doctor as healer.

 

 

OPTION 2

Physician-Assisted Suicide Should Be Permitted

Nikola Biller-Andorno, M.D., Ph.D.

To many of us — physicians and nonphysicians alike — death appears as a menace, as something we fear and want to avoid at all cost. At the same time, most of us know someone for whom death has come as a relief. These deaths were sometimes long-awaited or they were actively sought out, prepared for in secrecy, and endured alone. For those persons, the opportunity to ask a competent professional for assistance in ending their lives in a legally and socially accepted way would be a clear improvement. Mr. Wallace is fortunate that this is an option in the state in which he lives and that he can discuss it openly with his family and his physician.

The role of physicians is not simply to preserve life but also to apply expertise and skills to help improve their patients’ health or alleviate their suffering. The latter includes providing comfort and support to dying patients. Such patients may, after careful consideration, come to the conclusion that in their particular situation, asking a physician for assistance in suicide best reflects their interests and preferences. Responding to such a carefully considered request can be compatible with the goals and ethos of medicine, as well as with a trusting patient–physician relationship.

There is broad consensus about the importance and desirability of palliative medicine and hospice care, and physician-assisted suicide is in no way a repudiation of those practices.7 Yet in some cases, symptoms cannot be sufficiently controlled; in many other instances, what is at stake is a perceived loss of autonomy and dignity.8 Some patients wish to proactively shape the end of their life; to those patients, taking action to end their life is better than passively waiting for death to occur.

Physician-assisted suicide is now legal in a number of states in the United States, including Oregon and Washington State, as well as in Switzerland and in the Netherlands. The data from these places show that the implementation of physician-assisted suicide, when it is accompanied by certain safeguards (including comprehensive screening and informed consent processes), does not lead to uncontrolled expansion or abuse. In Switzerland, the number of assisted suicides has risen steadily over the past decade, but the total number of suicides has declined.9 The data from Oregon and Washington show that the majority of persons who request physician-assisted suicide are white, educated men — not a population that would be considered particularly vulnerable. Also, only a minority of persons who inquire about suicide assistance actually complete the process; this indicates that the option is perceived as a choice that can be abandoned.10

Even in societies with broad public support for physician-assisted suicide, a certain uneasiness and ambivalence remain, particularly among physicians who have to carry the emotional burden and moral responsibility of having enabled someone to end his or her life.11,12 The decision to provide suicide assistance cannot be forced on physicians but needs to be left to their individual conscience. However, if a physician is prepared to respond to a request for assistance in suicide, there are no compelling ethical reasons not to allow that physician to do so. In any case, careful regulation, comprehensive monitoring, and an ongoing critical debate are required to ensure that physician-assisted suicide remains a choice that is based on caring relationships among the patient, the family, and health care professionals.

 

Source: Nejm

Pertussis Immunity Drops Soon After the Last Vaccine Dose Is Given.

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The incidence of pertussis in children rises steadily in the years immediately following receipt of the fifth dose of the diphtheria–tetanus–acellular pertussis (DTaP) vaccine, according to a study in Pediatrics.

Researchers examined the incidence of pertussis among more than 400,000 children in Minnesota and Oregon who’d received all five doses of DTaP, with the fifth dose given between ages 4 and 6 years. In the 6 years after the last dose was received, some 550 pertussis cases were identified. The incidence rose steadily with each passing year.

The authors say their findings “strongly [suggest] waning of vaccine-induced immunity,” which “helps to explain the emergence of an increased burden of disease among 7- to 10-year-olds.” (Currently, the adolescent booster is recommended at ages 11 to 12 years.)

Source: Pediatrics

Considering Death Row for Organs.

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Before Gov. John Kitzhaber of Oregon established a moratorium on his state’s death penalty last year, Christian Longo, a death row inmate, started a campaign to allow the condemned to donate their organs.

Mr. Longo argued that a new execution protocol that many states — including Texas — have adopted leaves inmates’ organs viable for transplantation.

“While I can potentially help in saving one life with a kidney donation now, one preplanned execution can additionally save from 6 to 10 more lives,” Mr. Longo wrote in a plea that Oregon officials denied.

No state allows death row inmates to donate their organs. Although Texas recently abandoned a three-drug cocktail in favor of a single-drug method for execution, the Texas Department of Criminal Justice said it did not intend to change its policy. There are 11,000 Texans on the organ transplant waiting list.

Criminal justice and medical experts say that the idea of recovering organs from willing convicted murderers is fraught with moral, ethical and medical challenges that make it unlikely to ever be an option.

“It’s complicated in ways that are very messy and very fuzzy,” said Richard C. Dieter, executive director of the nonprofit Death Penalty Information Center.

The Criminal Justice Department allows offenders in the general prison population to donate organs, like kidneys, while they are alive in certain cases and after death if they complete a donor form.

The prospect of death row organ donation, though, prompts several questions, said Dr. David Orentlicher, a co-director of the Hall Center for Law and Health at Indiana University’s Robert H. McKinney School of Law. Is an inmate giving free and informed consent, or is he hoping to win favorable treatment? Would a donation affect jurors in murder cases who are weighing the death penalty versus life sentences? Or prosecutors deciding whether to seek the death penalty? Or governors deciding whether to grant clemency?

There is also the possibility that allowing death row organ donation could lead jurors to issue more death sentences, Dr. Orentlicher said.

For prospective recipients, there are emotional and mental considerations, he added.

“People might say, ‘Gosh, I’m walking around with the organ of a murderer,’ ” he said. “It may be irrational, but I suspect that’s lurking there.”

The condemned have a high risk of carrying diseases like hepatitis and H.I.V. And conditions in the death chamber are not conducive to organ recovery, said Mike Rosson, regional director of the Texas Organ Sharing Alliance. To keep organs viable, they must have oxygen after the brain dies, which means the donor must be on a ventilator, and surgery must be done quickly.

“You don’t have the facility for recovery, and you have transplant surgeons whose oath is to do no harm,” Mr. Rosson said. “The situation is just ethically challenging.”

Even if all the moral, ethical and medical questions could be adequately addressed, he said, the yield of usable organs from death row inmates is likely to be small.

“I think there are avenues other than prisoners that the effort expended toward trying to increase donation would be better spent,” Mr. Rosson said.

Source: NY Times.