Tuesday, June 5, 2007

Ohio pulled into executioner ID debate

COLUMBUS — Ohio has found itself in the cross hairs of the latest national debate over the death penalty: Should executioners’ identities be protected?

The American Civil Liberties Union of Ohio begged the question with a wide-ranging request for state records seeking information on the May 24 execution of an inmate whose veins took 90 minutes to find and whose death came a record-setting 16 minutes after the toxic drugs began to flow.
Among other things, the ACLU asked for the names of Christopher Newton’s execution team — a group of volunteer medics and guards whose identities are routinely shielded by the state.

Though the hooded executioner is so common as to be iconic, the ACLU and other death penalty opponents say they have new cause for seeking complete information on the people carrying out state-sanctioned deaths by injection.

They point to the case of Dr. Alan Doerhoff, a participant in Missouri’s execution process who was revealed in press reports to have been sued for malpractice more than 20 times.

They also point to the December execution of Angel Diaz in Florida. An autopsy found the needles were pushed through Diaz’s veins into the flesh of his arms, possibly limiting the effectiveness of the drugs. A commission created afterward to study the incident called for more training and better protocols for executioners.

Richard Dieter, executive director of the Washington, D.C.-based Death Penalty Information Center, which opposes the death penalty, said the public can’t properly scrutinize the effectiveness of capital punishment without adequate information on those carrying it out.

“Public executions should be as public as possible,” he said. “They supposedly have nothing to hide, and as with anything government does, it benefits from more scrutiny. For medical personnel, yes, there may be a cost. But that’s sort of like the cost that the state, or all of us, bear.”

Nonsense, said Michael Rushford, president of the pro-death penalty Criminal Justice Legal Foundation in Sacramento, Calif.

“The ACLU, which has staked out its turf as severely against the death penalty, will use this opportunity to out someone involved in an execution, and use it to put these people at risk,” he said. “Unfortunately, that’s how important their cause is to them.”

Rushford said the American Medical Association has threatened to sanction doctors who assist in executions — because it is a violation of their oath to “first, do no harm.” So the push by death penalty opponents to make executioners’ names public, under the auspices of wanting to review their professional credentials, is meant to shrink the pool of willing volunteers and diminish the state’s ability to execute criminals.

“They (the ACLU) were against the gas chamber 30 years ago — they said there was only one humane alternative and that would be lethal injection,” he said. “Now they’re setting up this Catch-22, saying only a doctor can do that, and knowing the doctor’s association won’t let them do it.”

Executions in North Carolina have been temporarily halted after running into just such a hitch. State law that had simply required that a doctor be present during executions was taken further by a federal judge, who said the doctor needed to actively monitor the inmate for pain. Doctors faced disciplinary action by the state medical board for doing so, however, so the process is in limbo.

Missouri and California are caught up in similar legal battles over whether their states can be forced to involve doctors in executions who are prohibited by their profession’s code of conduct from facilitating a death. Though doctors do not currently participate in Ohio’s execution process, their role could also become an issue in the court battle also raging in this state.

Despite the obstacles they’ve faced, most states still balk at revealing the members of execution teams. Most notably, Missouri lawmakers passed a bill May 21 protecting the executioners’ anonymity and allowing them to sue anyone — including a news organization — who discloses their identity.

The Missouri prisons director has said the state welcomes public scrutiny of its lethal injection protocol and the education and work history of its execution team — just not the names and addresses of participants. Doerhoff’s services are no longer being used.

Dieter said he believes protecting the identity of executioners helps anesthetize the public to what takes place in the Death House.

“There is this distance that we want with the process,” he said. “That’s why lethal injection came about, sort of to give a more medicinal, antiseptic feel to it. Now it’s backfired in that it’s not working well.”

But Rushford said executioners have a job that will naturally subject them to attacks and deserve to be protected by government.

“The state should certainly monitor their background and training, but these people should be no more subject to ridicule than an abortion doctor who’s simply doing his job,” Rushford said. “The law should come down hard on anyone who uses someone’s legal profession to raise harm against them. It should be a hate crime.”

State's child car-seat law tightens

Washington state's child car-seat law got tighter Friday, when new rules took effect requiring children to sit in car and booster seats until they are 8 years old or 4 feet 9 inches tall.

Medical experts say there are good reasons for the new law, which is one of the strictest in the nation.

Car crashes are the leading cause of death among children, according to Dr. Beth Ebel, who sees fallout from improper car seats when she works at Harborview Medical Center and at Seattle Children's Hospital and Regional Medical Center.

"It happens so often, emergency department physicians call it 'seat belt syndrome,' " the Washington Traffic Safety Commission said in a statement.

When a child is involved in a car crash at 30 mph, he or she experiences the same force as falling off the third story of a building, Ebel added.

"You have to pick your battles. This is the one their life depends on," said Ebel, who has three children.

"The data suggests that over half of the children (who) are killed in car crashes are unrestrained."

Parents also must do their part and properly fasten car and booster seat belts.

One of the problems is that an adult seat belt can slip off a child's pelvis onto their stomach. In a crash, the belt can crush a child's spleen, liver of intestines.

People caught ignoring the new rules face a $112 fine for each improperly buckled child.

The old rules required children to ride in a car seat until they were 6 or weighed 60 pounds.

Other rules include:

Babies must ride in rear--facing infant seats until they are a year old and weigh 20 pounds.

Placing a shoulder strap under an arm or behind a back is illegal.

People wanting to get a child seat checked out can visit one of the monthly car-seat inspection sites. The next one is Tuesday at St. Francis Hospital in Federal Way

Vaccine-Induced Autism Victims in the Thousands Will Finally Get Day in Court

Hearings will begin on June 11th at the U.S. Federal Claims Court to determine if autism is linked to vaccines and their components, including the mercury-based preservative thimerosal. As the Autism Omnibus Proceeding approaches, parents of children diagnosed with autism are calling attention to the conflicts of interest they believe continue to threaten the safety of vaccines.
Among the concerns cited by parents are the close ties between pharmaceutical companies and government regulatory agencies. A July, 2003 UPI investigation revealed the following:

- In two cases in the past four years, vaccines endorsed by the CDC were pulled off the market after a number of infants and adults appear to have suffered devastating side effects, and some died. Critics now worry about a possible link between vaccines and autism, diabetes, asthma and sudden infant death syndrome, among other ailments.

- Members of the CDC's Vaccine Advisory Committee get money from vaccine manufacturers. Relationships have included: sharing a vaccine patent; owning stock in a vaccine company; payments for research; getting money to monitor manufacturer vaccine tests; and funding academic departments.

- The CDC is in the vaccine business. Under a 1980 law, the CDC currently has 28 licensing agreements with companies and one university for vaccines or vaccine-related products. It has eight ongoing projects to collaborate on new vaccines.
Dr. Paul Offit, MD, former chairman of the Advisory Committee on Immunization Practices, which guides vaccine policy decisions at the CDC, embodies the conflicts of interest concern of parents. Dr. Offit has been a long-time defender of injecting mercury, a known neurotoxin, into infants and pregnant women. He is also co-patent holder of the RotaTeq vaccine with pharmaceutical giant Merck, a funder of his research for over a decade. Offit is speaking against parents today in support of the vaccine program and pharmaceutical companies at a press conference sponsored by Every Child by Two, a group also funded by pharmaceutical companies and supportive of injecting mercury into infants.
"In my opinion, as glaring as Dr. Offit's conflicts are, what's even more disturbing is that such close ties between vaccine policy decision makers and vaccine manufacturers are routine," said parent and National Autism Association board member Scott Bono. "The bottom line has become vaccine profit rather than vaccine safety. Children diagnosed with autism are suffering the consequences of an unprecedented greed, and their parents aren't going away until the public knows the full details of this man-made disaster."

Rip currents blamed for death of Brownsville man

A trip to Boca Chica beach on Sunday turned out to be a deadly experience for one Brownsville family.

Jesus Rodriguez, 30, died after getting caught in a rip current, Sheriff Omar Lucio said.

“He was swimming in a rip current and his brother was able to pull him out and his sister who is CPR trained gave him CPR,” he said.

Lucio said Rodriguez was pronounced dead by Justice of the Peace Tony Torres at Valley Regional Medical Center.

Mark Edward Angel, 42, of Russell Kentucky, and Humberto Espinoza Molina, 18 of Matamoros both drowned at Playa Bagdad in Matamoros Sunday.

Coincidentally, the National Oceanic Atmospheric Association declared Sunday, June 3 to Saturday National Rip Current Awareness Week.

“A rip current is a return flow of water from the beach back out into the ocean,” said Tony Abbott, forecaster for the National Weather Service.

Abbott said the pile up of water causes a rip current to break.

“As the waves come in, you’ve got water coming onshore by wind or tidal activity. As it comes on shore it has to go somewhere,” he said.

Abbott advised the best way to avoid losing your life in a rip current is to swim across, not against the current and stay calm.

For more on this story read Tuesday's Brownsville Herald.

Maine bill extends family leave protections to domestic partners

AUGUSTA, Maine (AP) — A bill on its way to final enactment in the Legislature would broaden Maine's Family Medical Leave Act to include domestic partners.

The law already protects employees who take time off to care for spouses, parents and children with serious health conditions.

The bill given final approval Monday in the House of Representatives also allows employees to take time off from work to care for a sick domestic partner.

Maine's Family Medical Leave law allows those who've been employed for 12 consecutive months by the same employer to receive up to 10 weeks of family medical leave. Leave can be either paid or unpaid. The bill to extend leave to domestic partners faces a final vote in the Senate as early as Tuesday.

During a hearing in March, gay and lesbian advocates spoke in favor of the bill. But it also received support from those who said it doesn't just apply to gays.

State Rep. Troy Jackson, D-Allagash, said he's been registered as a domestic partner with his girlfriend since 2004. While his partner is provided with leave through her employer, Jackson said other similar unmarried couples would stand to gain protection under the bill.

NAIC To Treat 5 Drafts As Models

San Francisco -- NU Online News Service, June 4, 2007, 5:32 p.m. EDT

Members of the executive committee of the National Association of Insurance Commissioners granted full model status to 5 model proposals here Sunday during the NAIC’s summer meeting.

The measures that were allowed to advance as models are:

- Amendments to the Viatical Settlements Model Act.

- The Military Sales Practices Model Regulation.

- The Medical Malpractice Closed Claim Reporting Model Law.

- Changes to the Long Term Care Insurance Model Act, which include new producer training requirements.

- The Uniform Health Carrier External Review Model Act.

The NAIC executive committee deferred action on the Standard Nonforfeiture Law for Life Insurance draft and the Standard Valuation model law draft.

The executive committee was scheduled to vote today on whether it would send each of the proposals with full model status to the plenary -- the body that includes all voting members of the NAIC -- later today.

At press time, the NAIC plenary had approved the Viatical Model amendments.

An update on the progress of the other full-model-status measures was not immediately available.

The NAIC executive committee reviewed the proposals for full model status because of a new NAIC policy supported by Walter Bell, the NAIC president and Alabama insurance commissioner.

Under the new rules, the executive committee decides whether work products should be treated as models or simply as collections of guidance.

Advocates of advancing a measure as a model must show that involves matters that require uniform, national adoption and that many commissioners have made a significant commitment to implementing the model in their jurisdictions.

John Oxendine, Georgia insurance commissioner, and Sandy Praeger, NAIC president-elect and Kansas insurance commissioner, expressed strong support for the military sales draft, and Kentucky Insurance Director Julie McPeak spoke up for the Viatical Settlements model.

Supporters of the Standard Nonforfeiture Law for Life Insurance draft and the Standard Valuation model law draft asked that a decision on those proposals be deferred, because those models will be just 2 components of the work of the NAIC’s principles-based working group.

If the executive committee decided this week to advance the Standard Nonforfeiture Law project and the Standard Valuation projects as models, then the NAIC’s new model project procedural rules would give supporters only 1 more year to complete work on the models, according to Thomas Hampton, the D.C. insurance commissioner, who is chair of the principles-based working group.

The principles-based working group wants to take the time to synthesize the work of several different NAIC groups and then present that work product to the executive committee, Hampton says.


NAIC To Treat 5 Drafts As Models

San Francisco -- NU Online News Service, June 4, 2007, 5:32 p.m. EDT

Members of the executive committee of the National Association of Insurance Commissioners granted full model status to 5 model proposals here Sunday during the NAIC’s summer meeting.

The measures that were allowed to advance as models are:

- Amendments to the Viatical Settlements Model Act.

- The Military Sales Practices Model Regulation.

- The Medical Malpractice Closed Claim Reporting Model Law.

- Changes to the Long Term Care Insurance Model Act, which include new producer training requirements.

- The Uniform Health Carrier External Review Model Act.

The NAIC executive committee deferred action on the Standard Nonforfeiture Law for Life Insurance draft and the Standard Valuation model law draft.

The executive committee was scheduled to vote today on whether it would send each of the proposals with full model status to the plenary -- the body that includes all voting members of the NAIC -- later today.

At press time, the NAIC plenary had approved the Viatical Model amendments.

An update on the progress of the other full-model-status measures was not immediately available.

The NAIC executive committee reviewed the proposals for full model status because of a new NAIC policy supported by Walter Bell, the NAIC president and Alabama insurance commissioner.

Under the new rules, the executive committee decides whether work products should be treated as models or simply as collections of guidance.

Advocates of advancing a measure as a model must show that involves matters that require uniform, national adoption and that many commissioners have made a significant commitment to implementing the model in their jurisdictions.

John Oxendine, Georgia insurance commissioner, and Sandy Praeger, NAIC president-elect and Kansas insurance commissioner, expressed strong support for the military sales draft, and Kentucky Insurance Director Julie McPeak spoke up for the Viatical Settlements model.

Supporters of the Standard Nonforfeiture Law for Life Insurance draft and the Standard Valuation model law draft asked that a decision on those proposals be deferred, because those models will be just 2 components of the work of the NAIC’s principles-based working group.

If the executive committee decided this week to advance the Standard Nonforfeiture Law project and the Standard Valuation projects as models, then the NAIC’s new model project procedural rules would give supporters only 1 more year to complete work on the models, according to Thomas Hampton, the D.C. insurance commissioner, who is chair of the principles-based working group.

The principles-based working group wants to take the time to synthesize the work of several different NAIC groups and then present that work product to the executive committee, Hampton says.

Two City Hospitals Give Up Fight Against Closure

ALBANY — Two Manhattan hospitals targeted for closure by a special state commission are signaling that they have given up the fight to remain open, according to a source in the Spitzer administration.

Cabrini Medical Center in Gramercy Park and St. Vincent's Midtown Hospital, formerly St. Clare's Hospital, have indicated their intention to apply for millions of dollars in state and federal grants that are conditioned on compliance with the directives handed down by Governor Pataki's Commission on Health Care Facilities in the 21st Century.

Through a state program funded in part by the federal government, the Health Department is offering $550 million to 81 hospitals and nursing homes that have been forced to close, downsize, or undergo a major conversion. The money is intended to reimburse the institutions for the costs of complying with the commission's directives.

A spokeswoman for St. Vincent's Midtown, Marlene Bloom, said the hospital tried in vain to convince the Spitzer administration that it should stay open and would soon submit an application for the grants. "We have no choice but to be in compliance with the Berger commission," she said, referring to the commission's chairman, Stephen Berger.

A spokeswoman for Cabrini said the hospital has not applied for the grants and would not comment on whether it plans to do so.

Like many of the cash-strapped institutions that were ordered to close or accept drastic changes by the commission, the two hospitals initially responded with protest, arguing that they provided a critical service in their community and were capable of turning around their finances.


Medical marijuana law expanded

MONTPELIER -- Steve Perry of Randolph Center welcomed news Thursday that a bill expanding eligibility for the state's medical marijuana registry would become law -- even though the governor refused to sign it.

Perry copes with a degenerative joint condition that causes severe pain and muscle spasms. Traditional painkillers fail to provide relief, he said, but marijuana has helped. Now he will be able to register with the Department of Public Safety and have protection from state prosecution while using the otherwise illegal drug.

The bill broadened the eligibility established in Vermont's 2004 law by allowing those with chronic debilitating conditions, not just life-threatening diseases, to participate in the program. It also increases the number of plants that participants may grow at home and reduces the annual registration fee from $100 to $50.

The marijuana bill is the fifth piece of legislation Gov. Jim Douglas has allowed to become law this year without his signature. Jason Gibbs, the governor's spokesman, said that generally Douglas exercises this option when he doesn't agree with the policy but recognizes a measure has strong support in the Legislature.

In the case of the marijuana bill, Gibbs said, "The governor has compassion for people who are suffering from debilitating diseases, but he can't in good conscience sanction a violation of federal law."

"Why wouldn't he veto it if that is the way he really feels?" asked Senate President Pro Tempore Peter Shumlin, D-Windham. "This is a wimp-out position." Shumlin criticized the governor for using the no-sign option so frequently.

Senate Majority Leader John Campbell, D-Windsor, agreed.

"I think what it says is that there was a lack of communication on many of the issues we were dealing with," Campbell said. "I would hope in the next session, if he or his staff have problems, we would have more in-depth conversations."

The four other bills Douglas let become law without his signature are:

H.274: This exempts providers of foster care to adults from counting their payment from this work as household income when calculating how much they owe in school property taxes -- if they pay based on their income. "While I gave serious consideration to vetoing this bill, I do want to support adult foster care providers and the important services they provide," Douglas wrote in a letter explaining his decision. "They should not be forced to bear the consequence of poor public policy developed by the Legislature.

H.78: This allows local voters to increase the number of signatures required on petitions requesting reconsideration or rescission of local votes. Douglas said the law could make it more difficult for towns to revisit decisions, but he let it become law because "it at least leaves to the voters the ultimate decision whether to change this time-honored tradition of local governance."

S.124: This allows the Legislature to hire consultants to review the planning the Douglas administration has undertaken to replace the state psychiatric hospital and to offer lawmakers options for new facilities. Douglas called this bill an infringement on the powers and duties of the executive branch of government and "a counterproductive exercise in micromanagement," but let it become law rather than further politicize the process.

S.39: This requires health insurance plans to cover prostate cancer screenings and services provided by naturopathic physicians. Douglas complained that the new mandates would increase health care costs.
Still restrictive

Vermont is one of 12 states that protect very sick people from prosecution for using marijuana.

Even with the new changes, "it is still going to be very conservative compared to some of the other states," said Dan Bernath, assistant communications director for the Marijuana Policy Project.

Campbell championed the expansion of eligibility and relaxation of the limits on the number of plants. A former police officer, he said he understood the governor's concern about passing legislation contrary to federal law. "We chose to look at the human side, to take a compassionate view."

Mark Tucci of Manchester is one of 35 Vermonters on the state's medical marijuana registry. Afflicted with multiple sclerosis, he said smoking marijuana provides relief from the pain and muscle spasms that awaken him many mornings. He uses about 2 ounces a month.

He had lobbied lawmakers to allow him to grow more marijuana at home. They agreed to a modest increase, but Tucci said Thursday that he still wouldn't be able to grow what he needs.

"It still forces me out on the black market," he said, "but it certainly helps."

Do-it-yourself funeral is one available option

It's legal in Ohio to handle the burial of your loved ones, but you must go by the rules. Other nontraditional alternatives include cremation and donating the body.
Besides a traditional wake and funeral, there are a variety of options for parting with the dead.

Do it yourself

It's rare and not for everybody, but it's legal in Ohio and most states to handle disposition arrangements with no involvement from a funeral home. That includes a viewing, ceremony and burial or cremation.

Here's how, according to local and state health department officials and Lisa Carlson, author of Caring for the Dead — Your Final Act of Love.

• Place of death. If the decedent died in a hospital, the hospital might store the body for you in its morgue until you're ready to pick it up. Miami Valley Hospital will do this for its patients at no charge, a spokeswoman said.

If death occurs in a location other than an institution, it must be reported immediately to the police or emergency medical services. Often the squad or police department will contact the coroner's office, which might send an investigator.

• Death certificate. Death certificates must be filed electronically these days for security and other reasons, and only licensed funeral directors, coroners and a handful of others have access to the state's Web-based filing system.

Some funeral homes might assist you with this process and handle it quickly. There might be a fee, but it's worth asking.

In the absence of a funeral director, call the Ohio Department of Health's help desk at (614) 752-5190.

The caller will be required to send in documentation — such as the police or coroner's report or a statement from a medical provider certifying the death occurred — to verify facts related to the decedent and the disposition of the body.

The state will electronically forward the information to the local health department, where the family can obtain a hard copy to present to the physician or coroner for certification of the cause of death. This must be done within 48 hours after death.

Meanwhile, it's important to keep the body cool to slow decomposition.

"Basically, at 70 degrees or less, you're probably fine for two or three days," said Carlson, the Caring for the Dead author. "So if it's winter, turn off the heat and crack the window. If it's summer, turn on the air conditioning and get dry ice."

Once the death certificate has been completed by the physician or coroner, you must file it with the local registrar (vital statistics division of the health department) of the district in which the death occurred.

• Burial permit. With the death certificate filed, you'll then need a burial or cremation permit from the registrar ($3 in Montgomery County), which allows you to transport the body, as well as bury or cremate it.

Cremations require a completed death certificate and cremation permit. For burials, cemeteries require the burial permit but will inter the body if the death certificate is pending as long as a physician's signature has been obtained.

• Timing. Ohio has no law saying the dead must be buried or cremated within a certain time frame, but the quicker the better.

If the family is trying to bury the remains on private property, most communities require that a form be completed indicating the body is free of infectious or communicable diseases. The family should call the health department in their district as well as local zoning officials to find out specific ordinances governing a home burial.

For more information, see:

• Dealing Creatively with Death — A Manual of Death Education and Simple Burial by Ernest Morgan

• Funeral Consumers Alliance, www.funerals.org

• www.Crossings.net — Provides "do-it-yourself" disposition advice for a fee.


Cremations are on the rise in the United States, growing from 6.5 percent of dispositions in 1975 to 32 percent in 2005, according to the Cremation Association of North America.

"Cremation has become a viable option to burial," said Rick Snider of Baker Hazel & Snider Funeral Home and Crematory, 5555 Philadelphia Drive.

Snider expects to cremate more than 400 bodies this year for his and other funeral homes in the Dayton area, well over twice the number of cremations in 2002, the crematory's first full year of operations.

Families still can have a traditional viewing and funeral before cremation, or they can go with a direct cremation.

In this arrangement, you pay for the funeral director's basic services, a non-metal container for the body, the cost of transporting the body to the crematorium, a crematory fee of around $250 and a container for the ashes. You can provide your own cremation container and urn — a simple cardboard box will do — and you can keep the ashes, scatter them or bury them in a cemetery.

In the Dayton area, funeral homes charge from $700 to more than $3,000 for direct cremations, not including the cremation container, urn and other incidentals.

Direct burial

This option involves no embalming, viewing or ceremony with the body present, except perhaps at the grave site.

A package price for immediate burial would include the funeral director's fee, transportation and care of the body. In most cases, burial containers or caskets are extra. Consumers have the right to furnish their own. Ask the cemetery if a casket is required.

Dayton area funeral homes charge anywhere from $600 to $3,000 for this option, not including the cost of the casket, vault and cemetery charges.

Anatomical donation

The least expensive, and some say most noble, way to go is to leave your body to a medical school to educate students and researchers.

In some cases there might be a transportation fee to the medical school, but generally no charges after that.

Locally, there's the Wright State University Boonshoft School of Medicine's Anatomical Gift Program, the largest such program in Ohio with nearly 15,000 donors registered and more than 5,000 received in its 32-year history.

Dr. Frank Nagy, who leads the program, said most donors are motivated by altruism, not economics.

"These are just people that really care about doing something for somebody else ... to give back, to leave something for the benefit of other people," Nagy said.

The school generally keeps a donor's remains for about a year, Nagy said. All remains are cremated, then returned to the family or interred (for free) at Rockafield Cemetery on Wright State's campus during the annual memorial service for donors.

"We don't sell body parts or anything like that," Nagy said. And rest assured, he added: Medical students don't clown around with donor bodies or parts.

"If there's anything we do here, it's to accord these people the highest level of respect we can," Nagy said.

For more on this option, call (937) 775-3066 or visit www.med.wright.edu/agp

Financial help

Several funeral directors in the area say they'll work with lower-income families to provide a dignified service at an affordable price, so it pays to inquire.

For veterans, financial assistance is available through the U.S. Department of Veterans Affairs and county veterans service commissions.

The VA will contribute at least $300 and up to $2,000, depending on qualifications, toward a veteran's funeral as well as a free headstone and grave at a VA national cemetery, said Jim Knowles, executive director of the Montgomery County Veterans Service Commission. Additional benefits might be available from the county to residents who demonstrate financial need. Call 225-4801 for more information.

Also, a limited amount of burial funds for the indigent may be available through your local government. Contact city or township offices for specifics.


Mother Sues Agency For Medical Costs

RALEIGH, N.C. —The mother of a teen who said she was raped three years ago has sued the state agency that compensates crime victims after it refused to pay medical bills because the girl had used alcohol and marijuana.

An administrative law judge ruled in November the Brunswick County girl was entitled to compensation because the drugs and alcohol were pushed on her as part of the assault.

The North Carolina Crime Victims Compensation Commission dismissed the recommendation in March, saying it wouldn’t pay the more than $8,000 the family owes for the girl’s psychiatric treatment. The lawsuit seeks to reverse that decision.

No charges were brought against the 20-year-old man because of the victim’s unclear memory and conflicting accounts from those at the party.

Lessons in Medical Humanism: The Case of Montaigne

Michel de Montaigne, the great French humanist and inventor of the personal essay, suffered from frequent and severe renal colic. He wrote about his illness in his travel journal and in his last and greatest essay, "Of Experience." In his illness narratives, Montaigne integrated disease and suffering into his life and art. He humanized rather than conquered his disease. A mature humanism replaced his youthful Stoic philosophy of detachment and disengagement and provides a worthy model for our own medical humanism.

The cultivation of medical humanism has become an urgent need. We look to it to ameliorate the problems of contemporary medicine—the untrammeled marketplace, the coldness of scientific materialism, the incivility in the workplace—by grounding us in our humanity and bridging the gap between ourselves and our work. The fundamental science on which we base our care is a world away from the everyday life of our patients and ourselves. Mere humanism sometimes seems no more than a moral afterthought. Does it have a chance of success?
It is instructive to look back at an individual case, that of a man we might call the first modern humanist and, perhaps, the greatest of humanists. His case is especially relevant because chronic illness may have played a decisive role in shaping his outlook. Michel de Montaigne (1533–1592), the great Renaissance writer, had renal colic. His illness challenged his early Stoicism, which required him to conquer his pain and transcend human suffering. Stoicism, an ancient philosophy that became an important current in 16th-century humanism, recommended disengagement from emotion. But Montaigne's kidney stones also challenged him, as a humanist, to retain and embrace his humanity—which is the opposite of "transcending" it. Frame (1) has argued that the experience of nephrolithiasis, among other things, seeded a phase change in Montaigne: a transition from an elitist Renaissance Stoicism to a warmer humanism that, I would argue, anticipates our own. Montaigne's mature humanism replaced an ideology of detachment and disengagement and provides a worthy model for our own medical humanism.

Montaigne wrote in detail about his kidney stones in his travel journal (2) and in his last and greatest essay, "Of Experience" (3). Healy (4) interprets these writings as an illness narrative, a means of gaining control over his illness, a self-healing through language (4). Montaigne certainly sought control over his suffering through language, but in all his essays, he sought control over his soul. The experience of stone disease was yet another occasion for doing so, more difficult but not different in principle. Indeed, in "Of Experience," the passages on stones are seamlessly interwoven with other observations about his habits; his health; and one of his favorite subjects, the instability of the mind. Self-healing is implicit in the broader project of acquiring self-knowledge.

In the Renaissance, humanists looked back to antiquity and found aspirations, values, and pleasures—rationality and free inquiry, love of art and beauty, cultivation of the body—that differed from those of the Church. This humanism had a potentially subversive implication: It stands in contrast to the divine and emphasizes this world rather than the next. Yet Renaissance humanism was not heretical. Humanists labored to reconcile the new learning with Christian faith, and even the Inquisition, which closely guarded the dogma of the church, had no difficulty accepting Montaigne's brand of humanism. People have argued about his belief, but modern scholarship favors the idea that Montaigne was a good and practicing Catholic. Even his Stoicism, potentially heretical in emphasizing rationality rather than revelation, was reconciled with Catholic doctrine by the Flemish scholar Justus Lipsius, with whom Montaigne corresponded (5). Only with the trial of Galileo, and the beginning of experimental science, does the gulf between humanist inquiry and the Church become too wide to bridge.

In this context, our contemporary notion of medical humanism occupies a paradoxical place. Medical humanism can be traced back to Hippocrates, but it assumes its current form only in relation to the ascendancy of biomedical science. Medical humanism has taken on the general humanist sense of being grounded in everyday human experience—interpersonal communication, emotional engagement—in contrast not to the divine, but to science. At least in biomedicine (although not in secular humanism generally), science has replaced religion as the reigning orthodoxy with which humanism has a quarrel. Like our Renaissance forebears, medical humanists do not overtly challenge the reigning orthodoxy. Medical humanists are not against science. We want an accommodation, not a revolution.

Montaigne lived in a time of political and religious turbulence and of periodic epidemics of plague. At 30 years of age, he lost a friend, Étienne de la Boétie, with whom he had an unusually deep bond. As a humanist, he was preoccupied with meeting death courageously, as la Boétie did, in the manner of the ancient Stoics (6). In his earlier writings, Montaigne was concerned with making his life an exemplary preparation for death, transcending the body and the "common way," the everyday life of ordinary people. The ideal of Stoicism was the sage (sophos), whose goal is virtue and whose means are austere rationality and apatheia (disengagement from emotion). In Stoicism, only the sage is free; the rest of humanity is enslaved. Montaigne's early Stoicism was an elitist, rational, and detached humanism, humanist in the Renaissance sense of recovering ancient thought but not in the modern (and medical humanist) sense of sharing in ordinary human experience.

Montaigne's father died of kidney stones, and for a long time, Montaigne dreaded that he, too, would suffer from them (7). In 1578, at 45 years of age, his stone diathesis begins. What an irony: Could there be a greater challenge to the would-be Stoic than the pain of renal colic, the pain that, as we learn in medical school, is most severe of all? Renal colic could have reinforced Stoic withdrawal from the body's exigencies. But in his later essays, demurring from Platonic or Stoic elevation of the soul, Montaigne affirms nature, the body, and common humanity as the basis of a good life. He rejects the pretensions of the mind, whether to knowledge, rationality, or apatheia. He has learned that, in the extremity of renal colic, Stoic disengagement is no more than acting and posturing (1). He also learns that some stones, for whatever reason, pass without much pain at all, and he is thankful for that. He gets on with his life remarkably well, which is perhaps another argument that the stones provide against Stoicism. He has no need to detach himself from his body; although he suffers often and grievously, he finds, to his surprise, that he can live his life between these intervals of pain, and often during them. Nor do the stones kill him, as they did his father; rather, Montaigne dies of a throat infection.

Montaigne's skepticism is well known. Skepticism is in the intellectual air of his time, but it coexists with naive belief. In narratives of exploration, fabulous tales are conflated with the truth, and the recent discovery of the New World shows received opinion to be untrustworthy. Copernicus demonstrates, as will Galileo, that neither the evidence of the senses nor the elaborate productions of reason yields reliable knowledge. In Montaigne's view, the mind is too unstable, and the world too various, to permit certain knowledge; the philosophers' notion that reason is the highest human faculty is a kind of vanity. (Paradoxically, this humility lays the foundations of modern science. Bacon's program for acquiring practical knowledge and Descartes's quest for certainty are, in part, reactions to Montaigne's skepticism.) In this context, Montaigne turns his attention to that which is closest: himself. He follows the Socratic advice to know oneself but, unlike Socrates, believes that the self is the only thing he can try to know. It is worth remembering that the term "essay," a genre that Montaigne invented, is derived from the French word essai, meaning "attempt." Like Socrates, he can try, although he may not necessarily succeed. This attempt at self-knowledge is hard labor. The self may be near at hand, but it is elusive: Mind and memory are unreliable and are the dupes of emotion, vanity, illness, and habit.

Montaigne's skepticism is fed by the failures of his physicians. He claims to have inherited "the antipathy I have for their art" from his father and grandfather (8). No example of the vanity of reason, the substitution of systems and theory for real knowledge, could be more apt than protoscientific medicine. Montaigne delights, he tells us, in pretending to have symptoms that he has had (and gotten over without medical intervention), so that he might laugh at his physicians' prophecies of doom if he does not follow their instructions (3). Montaigne is his own physician. "I do little consulting about the ailments I feel, for these doctors are domineering when they have you at their mercy" (3). A famous Italian physician, a lecturer at Pisa, tells him that "medicine is nothing compared to the baths"—except for bloodletting (2). An Arab whom he befriends at Rome gives him powders to combat the stones (2), but Montaigne never says whether he used them. At one point, he finds it useful to "hold the urine from passing and squeeze the prick a little, so that it may come out more vigorously. The seigneur de Langon showed me this remedy at Arsac" (2).

Montaigne does not believe that there is benefit in noxious medications and restrictive diets. Medical care that diminishes the pleasures of life is inimical to him (3):

I do not like to cure trouble by trouble; I hate remedies that are more nuisance than the disease. To be subjected to the stone and subjected to abstaining from the pleasure of eating oysters, those are two troubles for one. The disease pinches us on one side, the rule on the other. Since there is a risk in making a mistake, let us risk it rather in the pursuit of pleasure. The world does the opposite, and thinks nothing beneficial that is not painful; it is suspicious of ease.

In 1580–1581, Montaigne takes a journey of 17 months, mainly in Italy, briefly in Switzerland and Germany. He is accompanied by his brother, his brother-in-law, several other gentlemen, and numerous servants. His purpose in making the journey is to visit the baths in hope of treatment for his stones (3). He keeps a travel journal, which was not intended for publication and was not discovered until 1774.

He describes his stone episodes in matter-of-fact language that resembles the unadorned narratives of Hippocratic case descriptions. "On Saturday morning, October 21st, I ejected another stone, which stopped a while in the passage but nevertheless came out without pain or difficulty. This one was rather round than otherwise, hard and massive, but harsh and rough, white inside and red outside, much bigger than a grain" (2). He is taking notes on the stones, perhaps to record information that may prove useful in managing them, or at least to reassure himself about them (3). He is a connoisseur of the stones he recovers: "Massive" is obviously the description of a man who has seen many before it. The stones are often red, and he often passes gravel and sludge. These details suggest that he had uric acid stones, as does this observation from "Of Experience" (3): "[The stone is] the commonest ailment of men of my time of life ... it preferably attacks the great, it is essentially noble and dignified." This class distinction is plausible: Only the nobility had access to the high-protein and high-purine diets that predispose to uric acid and calcium stones and that, in modern developed countries, are no longer confined to the rich.

Montaigne describes the waters and baths in great detail, including their temperature and taste, their putative benefits, and their customs of use. He also records the amount of water that he drinks and passes. He seems to regard the water as medicinal when ingested in small amounts, although on occasion he drinks and passes large quantities (which he measures by weight); he also believes that bathing in the water will help him. In general, he does not follow the oldest advice of all, Hippocrates' injunction to drink fluids. We know from the essays that Montaigne was in the habit of drinking only 3 glasses a day. For him, "taking the waters" usually meant bathing in or sipping them rather than forcing them.

In "Of Experience," Montaigne turns his attention to his body—his health—and commends the superiority of experience over reason. If experience has the better of reason anywhere, he says, it must be in health and medicine. In this debate, he anticipates the 18th- and 19th-century opposition of systematization and empiricism. He also exemplifies the premodern idea, well known in ancient Greece, that a layman could be as knowledgeable about medicine as a physician. He reviews the habits and practices that he has adopted to maintain his health and writes of his stones in detail in this context.

Montaigne plays a game: His logical mind must persuade his imagination that the stones are a blessing. The imagination, always ready to take comfort in rationalizations, will be his dupe. He will use the arbitrariness and instability of the mind, its tendency to make its own reality, to his advantage: to show the beneficence of nature and the body, even in pain. He shows an appreciation for the stones for the following reasons (3).

It is natural that the body fail with age. "It is a common necessity—otherwise would it not have been a new miracle performed for me?"

He thinks of the stone not as an affliction but as an honor: It is "the commonest ailment of men of my time of life," and because "it preferably attacks the great, it is essentially noble and dignified."

During stone passage, he can show off his courage in front of his friends. "There is pleasure in hearing people say about you, ‘There indeed is strength, there is fortitude!’"

His enforced suffering keeps "virtue in breath and in practice. Put the case this way, that nature is bearing and pushing you into that glorious school, which you would never have entered of your own free will." That is, the stone provides him with valuable training in Stoicism.

The stone warns him of mortality and leaves him healthy in the interval, to profit from the lesson. "[E]ven if it set before you the picture of imminent death, would it not be a kind service for a man of that age to bring him home to meditations upon his end?" And later: "We have no cause for complaint about illnesses that divide the time fairly with health." This remains true today. Typically, stone passage causes severe pain but not permanent kidney damage. Between episodes, the patient is in good health.

He suspects that age will bring an end to his stone diathesis. "The years have evidently made some of my rheums dry up. Why not these excrements that provide material for the gravel?" A reasonable speculation for which there is some basis: Urinary calcium excretion decreases with age. However, stone diathesis does not abate (8).

The stone brings no other illnesses in its train; indeed, Montaigne believes that it may have chased some others off. It keeps other diseases at bay because of the associated vomiting or the stone passage itself, both being the discharge of bad humors. Unlike fever, it leaves the mind clear.

The stone is entirely obvious to the senses; "it is a disease in which we have little to guess about," an uncertainty that could only lead the mind astray. This is true in the sense that one can hold the stone in hand, an obvious proof of the diagnosis. But as to its causation, even today we have only partial knowledge.

Finally, as in the travel journal, he notes that he can go about his business despite the stone, "play, dine, run, do this and do that too." He calls this "playing my game," while the stone plays its own game.

All of these rationalizations are put so lightly that it is difficult to know what is serious and what is jest. But that is the point: Montaigne's writing is another instance of "playing" with the stone. He keeps suffering at an ironic distance. He exemplifies the Renaissance virtue of sprezzatura, making the difficult look easy.

Playing with the stone is more difficult for us than for Montaigne. Like his grave and humorless physicians, we take physical suffering too seriously to make light of it. Because physicians can now relieve pain and remove stones and prevent their formation, suffering imposes an obligation on us to end it. Anything less is an accusation against our attentiveness or skill. The terms "patient" and "patience" derive from the Latin word pati, to endure, but neither patient nor physician has any patience for suffering. Suffering loses prestige when it is not thought to be necessary.

Illness offered Montaigne opportunities for spiritual growth, in acquainting oneself with and preparing for death while living fully; for writing and irony; and in the simplest, most natural, and yet remarkable way, for pleasure (3).

But is there anything so sweet as that sudden change, when from extreme pain, by the voiding of my stone, I come to recover as if by lightning the beautiful light of health, so free and so full, as happens in our sudden and sharpest attacks of colic? Is there anything in this pain we suffer that can be said to counterbalance the pleasure of such sudden improvement? How much more beautiful health seems to me after illness, when they are so near and contiguous that I can recognize them in each other's presence in their proudest array, when they vie with each other, as if to oppose each other squarely! Just as the Stoics say that vices are brought into the world usefully to give value to virtue and assist it, we can say, with better reason and less bold conjecture, that nature has lent us pain for the honor and service of pleasure and painlessness.

Stone passage typifies the interdependence of pain and pleasure, a favorite theme of Montaigne. Pain enhances pleasure, another argument against Stoic rejection of the body (3).

We must learn to endure what we cannot avoid. Our life is composed, like the harmony of the world, of contrary things, also of different tones, sweet and harsh, sharp and flat, soft and loud. If a musician liked only one kind, what would he have to say? He must know how to use them together and blend them. And so must we do with good and evil, which are consubstantial with our life. Our existence is impossible without this mixture, and one element is no less necessary for it than the other. To try to kick against natural necessity is to imitate the folly of Ctesiphon, who undertook a kicking match with his mule.

Like pleasure and pain, life and death are brought face to face in the experience of the stone. "If you do not embrace death, at least you shake hands with it once a month" (3). As the last of Montaigne's essays, "On Experience" reads like a leave-taking. The stone, Montaigne tells us, weakens the body and leaves it better prepared for death. "Consider how artfully and gently the stone weans you from life and detaches you from the world ... " (3). There is less of life in his aging body to surrender: "God is merciful to those whose life he takes away bit by bit; that is the only benefit of old age. The last death will be all the less complete and painful; by then it will kill only a half or a quarter of a man" (3). The stone is "the picture of imminent death." In his concluding pages, Montaigne endorses natural, well-rounded, everyday life—life that does not slight the body for the sake of the soul (3): "There is nothing so beautiful and legitimate as to play the man well and properly, no knowledge so hard to acquire as the knowledge of how to live this life well and naturally; and the most barbarous of our maladies is to despise our existence." These words could serve as the manifesto of modern secular humanism: Do not despise life in the name of a political ideology, religious doctrine, or "higher" calling of any kind.

Stone disease rarely causes death now. Renal colic is no longer a conjunction of life and death in that sense (even if at moments it makes the sufferer feel as if death were preferable). But the stone is still an emblem of death, a memento mori. Before it passes, it lies dormant and quiet within the soft tissues, a hard, lifeless thing. Even before it forms, it exists as a possibility that flesh could regress to. One of the oldest problems of living things is to keep in solution the dust from which we evolved. With the phase change from solute to crystal, something in the living tissue returns to where it began: death in life, life in death. Montaigne shows us what it means to humanize suffering and death rather than demonize them. In some ways, he anticipates another great humanist, Viktor Frankl, the psychiatrist who found self-realization even in the Nazi death camps; Frankl taught that suffering, like love and work, is one of the ways by which human beings make meaning (9).

Montaigne was eminently a practical man, and were he alive today, I believe that he would take the advice of scientifically minded physicians who had some good to offer him. Yet I can imagine his humanist attitudes persisting in the teeth of scientific medicine. I cannot see him submitting to a restrictive diet without a fight. I cannot see him, for that matter, submitting to "domineering" physicians. He would take some or all of his care into his own hands. I can even see him welcoming stone passage, at least occasionally, to test himself in the school of virtue, to enhance pleasure with the contrast of pain, to meditate on his death.

He would grant the practical power of science. I think he would even admire its humility, as embodied in the saying of Claude Bernard: "We can do more than we can know" (10). But I see Montaigne harboring a deep reservation about scientific medicine. Whether in the delusory theorizing of his own day or in the molecular mechanisms of ours, science transcends the everyday world of ordinary human experience. Our science is pure, simple, abstract, and beautiful; it is not like our lives. Effective medical science has no place for the transformative power of suffering, and it has difficulty coming to terms with death. I suspect that Montaigne might regard scientific medicine, for all its power, as not so different from the medicine of his own day: a high calling or specialized knowledge in whose name we "despise our existence," that is, disengage from lived human experience. Montaigne "played with the stone" and lived it, too—a means to virtue and wisdom and an occasion for good humor and even pleasure. So, he might admonish us: Do what you can to get rid of illness and suffering, but accept and even welcome them as well.

Could physicians dedicated to the relief of suffering also welcome it? Montaigne shows us how. We could use suffering to test ourselves in our contemporary school of virtue, to stretch our capacity for empathy. We could enhance the pleasure of successful treatment by feeling, as deeply as possible, the patient's pain and then relief. We could welcome suffering as an opportunity to demonstrate perseverance, heroism, or skill. We could regard suffering as a reason for faith or a reason for doubt. What we may not do is disengage from or transcend suffering in the name of conquering illness and death, or feel that impersonality and disengagement are the price of rational intervention. We must prize what F. Scott Fitzgerald said characterized a first-rate intelligence: the ability to hold 2 opposing ideas in the mind at the same time and still function.



PUBS and restaurants should be forced to carry posters warning drinkers how much alcohol they are consuming, doctors demanded yesterday.

But the move by the British Medical Association has sparked new fears that the Nanny State is now out of control.

Doctors claim that the details of alcoholic units in beer, wine and other favourites listed on bar pumps and menus are not enough to alert customers to what they are drinking.

Under the latest example of information overload, every pub, club and bar in Britain would have to put up public information posters spelling out alcohol levels.

Tory MP Philip Davies last night joined drinks industry leaders in condemning the new health offensive. “This is completely barmy,” he said. “Do they really think that people don’t realise that drinking a lot of alcohol every night is not good for their health? It is blindingly obvious.
Giving in to a demand like this would be attempting to appease health zealots, who will never be satisfied. Every measure that is introduced will always lead to calls to go one step further. It is the Nanny State gone mad.” Pub groups are equally angry and say that such as scheme would be unworkable.

Tony Payne, chief executive of the Federation of Licensed Victuallers Associations who represent the trade, said: “When we think about all the alcoholic drinks we sell, there would not be enough space on a poster to cover the units in every one.

“Why can’t they just put it in price lists. That should accommodate people who are interested.”
The posters-in-pubs demand by leading doctors is yet another example of the Nanny State ap­pearing to be all-powerful and beyond question.

Last week ministers announced plans to create a method for calculating the carbon content of goods and services which must be shown. The details would help the public to grasp the carbon footprint of anything from a flight to New Zealand to a box of matches.

The smoking ban next month, which will involve all enclosed public places, has been welcomed by health experts but is seen by some as too draconian.

The BMA said most customers had no idea how many units were in the average drink and it was up to the state to get this information across.

Dr Vivienne Nathanson, head of science and ethics at the BMA, said a glass of wine may be 175ml in one pub, 250ml in another and more than that elsewhere. One glass could contain anything from one unit to three or more.

“People are getting into accidents and going over the limit because they have no idea what the drink is,” she said. “Labelling enables people to comply with the law and comply with medical advice.

“We have got to get it right. It is not about the Nanny State – it is about the information state. And it’s the state’s job to give people information so they can make informed choices.”

Dr Nathanson said a poster would be the best way to get the information across. A poster would not have to list every brand of beer or wine, as drinks could be summarised in categories.

“When you are in a pub, you do not ask to look at the label on a wine bottle,” she said.

“If you don’t know how much alcohol there is in a glass in front of you, it is hard to work out how much alcohol you have had that day or week.” she said.

Last night the British Beer and Pub Association said alcohol content was displayed on 85 per cent of packaging. But they were in talks with the Government over raising public awareness.

“We’d want to make sure anything we did informed customers in a way they found helpful. We would be willing to discuss it with ministers but we would have to see the detail,” said a spokesman.

The Government announced last week that alcoholic drinks will get new information labels. In a voluntary agreement between ministers and the industry, all drinks will be expected to carry details of units and recommended safe levels on labels by the end of 2008.

At present, bottles and cans carry percentage details of alcohol and most carry unit information. But the Government also wants safety advice for pregnant women put on there as well as the recommendations for sensible drinking.

In recent years, the number of Britons drinking to excess has spiralled as the relative cost of alcohol has fallen. At the same time, pubs use larger wine glasses with more than three units of alcohol.

Some pubs routinely give customers a “double” if they order a spirit with mixer. This has made it harder for drinkers to keep count of the alcoholic units they are consuming during an evening.

But Blair Gibbs, spokesman for the TaxPayers’ Alliance said: “The Nanny State can never find enough reasons to spend more of our money telling us how to live our lives.

“Any health campaign can always be justified by someone but why is it always taxpayers who have to pay?”

Joseph L. Wertz, 80

HAMILTON TWP. ­ Joseph L. Wertz, 80, of Hamilton Square passed away on Friday in Compassionate Care Hospice at St. Francis Medical Center in Trenton.
Born in Trenton, Mr. Wertz was a resident of Hamilton Square for many years.
Mr. Wertz was a U.S. Army veteran of World War II.
He was a member of Grace-St. Paul Episcopal Church and was a volunteer with the church.
Mr. Wertz retired from The Trentonian in 1992 after 41 years of service. After retiring he worked at Triangle Blueprint.
He enjoyed volunteering at St. Francis Medical Center. Mr. Wertz also enjoyed camping, playing the harmonica, and biking, and he was an avid coin collector.
Joseph was the son of the late Daniel and Sarah Wertz, husband of the late Hazel E. (Cowan) Wertz, and brother of the late Dorothy, Lillian, Frank, Edward and John (Doc).
He is survived by a daughter, Mary M. Wertz, with whom he resided; a son and daughter-in-law, Joseph L. and Cathy Wertz; three grandchildren, Samantha, Joseph and Jesse; several nieces and nephews; several sisters-in-law and the Henry family; the Sisters of St. Francis; and many special friends and Nettie.
Funeral services will be held at 9:30 a.m. Thursday from the Saul Colonial Home, 3795 Nottingham Way, Hamilton Square. Burial Office and Requiem Eucharist will be celebrated at 10:30 a.m. at Grace-St. Paul Episcopal Church, 3715 East State St. Extension, Mercerville, with the Rev. Jack V. Zamboni, pastor, officiating.
Interment will follow in Greenwood Cemetery, Hamilton.
Family and friends may call from 6-9 p.m. Wednesday (June 6) at the Saul Colonial Home.
Memorial contributions may be made to Compassionate Care Hospice at St. Francis, 601 Hamilton Ave., Trenton, NJ 08629.


Law firm helps explain employment laws

Law firm Deters, Benzinger and LaVelle recently hosted an employment law seminar to help local employers navigate through the laws with the Department of Labor, EEOC, and many other regulators.

The event included a judicial perspective of employment cases presented by Kentucky Court of Appeals Judge Michelle Keller and the role of an occupational health physician for FMLA cases presented by Evan Davies, medical director of the St. Elizabeth Business Health Services, a co-sponsor of the event. Tim Tepe of Schiff, Kreidler-Shell, another co-sponsor of the event, and Deborah Denney of Chubb Insurance discussed the necessities of employment practices liability coverage.

DBL partners Mark D. Guilfoyle, Kelly Schoening and Bob Hoffer provided legal perspectives on current issues in hiring/firing employees, the ADA and reasonable accommodations, FLSA white-collar exemptions and electronic discovery.


Bill would rename medical district

Published Monday, June 04, 2007

Springfield’s medical district would be renamed the Mid-Illinois Medical District under legislation the Illinois House approved on Friday.
The House voted 109-0 for the revised version of Senate Bill 1568, which still needs to pass in the Senate and be signed by the governor before becoming law.

The bill’s sponsor, Rep. Raymond Poe, R-Springfield, said the name change would reflect the fact that the medical district is meant to serve a regional area, not just Springfield.

“We have always been regional in terms of where we expect the economic and health-care benefits to accrue,” said Mike Boer, president of the medical district commission. “But that hasn’t been understood.”

SB1568 spells out that the medical district’s program area would include Cass, Christian, Logan, Macoupin, Mason, Menard, Montgomery, Morgan, Sangamon and Scott counties. The boundaries of the medical district itself would remain the same: the section of Springfield bounded by North Grand Avenue and 11th, Walnut and Madison streets.

At present, the district’s official name is the Illinois Medical District at Springfield, but it often gets called the Springfield medical district.

The new moniker could improve the district’s chances of attracting state funding because a larger number of legislators would represent the medical district territory, Poe said.

He previously introduced legislation that would have set aside $300,000 a year for the district in each of the next 10 years. That proposal didn’t advance. The money was to be used to hire employees and run an office to promote and further develop the medical district.

The funds are not included in the budget plan that House Democrats approved earlier this week, Poe said.

The money could be added, however, depending on what happens with budget negotiations during the legislative overtime that started on Friday.

“If we, as House Republicans, become players and the budget is changed any way at all, that’s one thing that (I) will be working on, to try to make sure that we get that in the budget,” Poe said.


Law Seeks Clues In Dead Man's ID

Harnett County sheriff's investigators are still trying to determine the identity of a man found dead near a storage shack in Kipling last Wednesday.

Investigators have determined that the man died of natural causes, but they don't know who he is. They have put together a composite drawing, hoping for clues.

Harnett Sheriff's Maj. Gary McNeill said they are making progress in the investigation.

"We have a name who we think it might be but we haven't been able to confirm it yet," he said.

Deputies responded to the area near an abandoned building at 8:30 a.m. Wednesday when a worker with the Embarq telephone company discovered the body.

Found Near Kipling

The worker found the man's body lying next to the wood line near the shack on U.S. 401. Sheriff Rollins estimated the body had been there at least 48 hours.

The medical examiner said the man died of natural causes. He was carrying no form of identification.

Officials say the man, a white male in his late 40s, is approximately 6 foot, 4 inches tall, weighing 150 pounds. He has no scars or tattoos, but has a large mole on the right forearm.

Anyone with information should contact the Harnett County Sheriff's Office at 893-9111.

- Tom Woerner

Anti-discrimination law applies to transgendered


It comes too late to help Carol Barlow, but she certainly could have used it.

Could have invoked it when she got fired.

Could have pointed to it when the job interviewer laughed in her face
Could have sued after, she says, her boss said, "When you become Carol or whatever the hell you're doing, you're out of there."

Because Carol Barlow used to be Bruce Barlow. And first Bruce, and then Carol, suffered harassment, indignities and discrimination at one job and then another, and still more on innumerable job interviews.

Well, that won't cut it anymore.

Starting June 17, it will be illegal under state law for businesses to discriminate against Carol Barlow and any other transgender person. New Jersey's anti-discrimination law, already one of the most far-reaching in the country, will add "gender identity and expression" to its list of protected categories for employment, housing, public accommodation, credit and business contracts.

The legislation, passed in December, makes New Jersey the ninth state with a transgender law.

Vermont, Oregon, Iowa and Colorado passed similar laws this year, but they won't take effect until mid summer.

This latest amendment to the New Jersey Law Against Discrimination means it will be illegal for employers to not hire, not promote, not give a raise to, or to harass or fire an employee because she or he is transgender.

"It's not going to affect me but for the people who come after me it will mean a lot," says Barlow , who lives in Clifton. "I hope this law gets rid of some of the fear that our people have."

Barlow , who once did computer support work for the Herald News, is 61 now and nearing retirement. But she worked on the amendment anyway, agreeing to be featured in a 2005 television commercial that urged lawmakers to pass the bill.

The transgender category in the law covers transsexuals -- people born one sex who live as a member of the opposite sex and may have had sex reassignment surgery; cross dressers -- people who dress as the opposite sex sometimes; and androgynous people -- those whose gender is ambiguous.

The new law "is a big deal and it isn't a big deal," says Leslie Farber, a lawyer in Montclair who specializes in job discrimination cases.

Not a big deal because it codifies a decision made in 2001 by the state's Appellate Division. In that case, the court ruled that an employer's refusal to renew a medical director's contract as he was changing from a man to a woman violated the law against sex discrimination.

"We applauded that (2001) decision but we soon found out it really wasn't good enough because no one knew about it," says Barbra Casbar, president of the Gender Rights Advocacy Association of New Jersey, which worked to pass the amendment.

And that's why Farber thinks this is a big deal. Because starting June 17, transgender people will be included in that sign posted in every workplace explaining to employees that it is illegal for their employer to discriminate because of race, creed, age, nationality, marital status, domestic partnership, sexual orientation and now gender identity or expression.

"A statute has much more authority than an interpretation," says Steven Goldstein, chairman of Garden State Equality, another group that helped to pass the amendment. "Transgender people can say, 'Look, there's a law on the books.' They don't have to say, 'There was a court case that interpreted...' blah, blah, blah."

The Law Against Discrimination was enacted in 1945, and was the first state civil rights statute in the country, according to Frank Vespa-Papaleo, director of the state's Division on Civil Rights. It included race, creed, color, origin and national ancestry under its umbrella. Since then the law has been amended "probably hundreds of times," Vespa-Papaleo says, including in 1972 when it was expanded to include people with disabilities, a full 18 years before the federal government passed the Americans with Disabilities Act.

Lawyers don't see the new amendment that includes transgender people as posing a problem for employers.

But one area that may be murky is the legal interpretation of "discrimination," says Julie Greenberg, a law professor at Thomas Jefferson School of Law in San Diego, Calif., and an expert in legal issues surrounding sexual identity and orientation.

Could businesses be violating the rights of transgender employees by telling them they must use the bathroom or locker room of their sex at birth?

"Part of the problem of bathroom use is other's objecting," Greenberg says. Workers feeling like their privacy has been breached and complaining to their bosses.

A case like that arose in Minnesota, which has a similar statute. In 2001 the state Supreme Court found that an employer was not violating the anti-discrimination law by making a policy in which employees must use the bathrooms of their birth sex. The suit had been brought by a transgender worker who identified as female and had a state court declare him legally female. Female coworkers complained when their colleague used the women's bathroom, and in response the company made the policy.

There is a movement among transgender people to install unisex bathrooms in workplaces and public buildings to avoid just such a problem.

"The one thing I think we all strive for is respect," Casbar says.


Certified Elder Law Attorneys Are a Rare Breed

It’s safe to call elder law a small niche in the legal scene. Only 39 lawyers in New Jersey have been certified as elder law attorneys by the National Elder Law Foundation (NELF) of Tucson, Ariz., which is authorized by the American Bar Association to grant the certification. The foundation has certified fewer than 400 elder law attorneys nationwide.
These lawyers focus on age discrimination, elder abuse, estate planning and probate, long-term care and health care decisions.

“We take a holistic approach to clients,” says Deirdre Wheatley-Liss, a certified elder law attorney in Parsippany. “What happens when you are getting a little slower? What happens if you need care? Just because a person gets older doesn’t mean you don’t have any rights. How do you have dignity as you age? And what will happen to you and your property?”

Any lawyer can handle cases confronting senior citizens, but certified elder law attorneys commit to the niche by meeting requirements set by the NELF that include a written test and ongoing courses on elder law issues.

Wheatley-Liss says the field is about 20 years old and rapidly growing. “Estate-planning attorneys handle estate issues and what happens when you die,” she says. “But elder law attorneys look at what happens if you live.”

A critical issue for people nearing retirement is preparing for the eventual need for medical assistance. “People are living longer and they don’t know enough about issues like health insurance, prescription drugs and whether they will be able to afford to live in the communities they spent their lives in,” says Wheatley-Liss.

“Some give away their money to children and assume the children will take care of them. People need to be educated about this in advance of the crisis situation.”

Donald M. McHugh, a certified elder law attorney in East Hanover, says the first wave of baby boomers is keeping elder law attorneys busy. Many boomers, he says, don’t realize that Medicare won’t cover all their future health care costs. “They should be looking at long-term care insurance or other planning techniques,” says McHugh. “Once they are sick, they are uninsurable.”

Individuals also tend to disregard the prospect of moving into an assisted-living facility or nursing home. “They should be thinking about setting aside funds in trusts and shelters to preserve the assets that can be designated for long-term healthcare,” says McHugh. “By setting aside certain funds, you don’t have to spend your entire estate on hospitals.

“If you’re a senior on a public benefit plan who wants a little bit better quality care,” he adds, “you better have something socked away so you can supplement whatever your insurance carrier covers.”


Dr. Jack Kevorkian Released From Jail, But Continues His Death Mission

On Friday, Dr. Jack Kevorkian was released from prison after serving eight years of a 10 to 25 year sentence for murder by injection of terminally ill patient Thomas Youk. While promising to respect the strict terms of his two year parole that forbid his assistance of other suicides, Dr. Kevorkian has vowed to continue his crusade to legalize the laws that landed him in jail.

“I'm going to work with activist groups trying to get it legalized. And putting my voice in with theirs to legalize it whenever I can. Either through legislators or through courts if possible.”

But national advocates of assisted suicide, who are now focused on a bill on the docket of California's legislature, fear the timing of his release and the doctor's penchant for brash remarks may turn out to be a net loss for their cause. In an interview on Sunday, for example, just two days after his release, he called the government a “tyrant,” the American public “sheep,” and his strongest critics “religious fanatics or nuts.”

While many opponents of assisted suicide have reacted with outrage over his early release and fear that his high profile will catapult legal assisted suicide beyond its current borders, others disagree. They say his bellicose style may undercut the more diplomatic approach taken by advocates of the landmark 1997 “Death with Dignity Act” in Oregon. That successful campaign focused on extreme cases of illness and relied on euphemistic terms like “the right to die,” “compassion,” and “death with dignity,” to tug at the heartstrings of voters.

“Dr. Death” (a nickname Dr. Kevorkian does not reject), on the other hand, wants to show the world what he is doing and why he is doing it. He has allowed himself to be photographed with his “killing machine,” and he video-taped the deaths of more than one of his patients (some of whom were not even physically sick and whom he knew for less than 24 hours), and advertised a “first come, first serve” deal for the kidney of one of the patients whom he helped to commit suicide.

Apparently, he didn't have a change of heart in jail. In an interview that aired on 60 Minutes on Sunday evening, Mike Wallace asked Dr. Kevorkian if he regretted “helping Tom Youk.”

“No, why would I regret that? That's like asking a veterinarian, 'Do you regret helping that person's animal?'”

Mike Wallace rightly followed up the doctor's provocative answer:

“Well, wait a minute. Tom Youk was a man. And it was a compassionate murder, but you murdered him.” (Notice Mr. Wallace's assumption that the murder was true compassion.)

Dr. Kevorkian responded:

“But it was a man whose life didn't measure up anymore. You know, David Hume said it, 'No man ever threw away a life while it was worth keeping.'”

As brash as his words may sound, they are not off-the-cuff. He has had plenty of time to think about his approach. Maybe he feels there is not much to lose. After all, during his long prison stay, no law was passed in any state to advance the assisted suicide agenda. Not even convincing influential members of the media that murdering a suffering patient is an act of compassion has produced the desired effect of national acceptance of assisted suicide.

That's why Dr. Kevorkian wants to take the campaign to another level. The Oregon Law has always been too restrictive for his likes, and as of yet, it hasn't served as a catalyst for advocacy in other states. So why would it be worth defending? It requires a doctor's certification that a patient has a terminal illness that will lead to death within six months. Some of the 130 men and women whom Dr. Kevorkian says he helped to die in the 1990s were not terminally ill; some were disabled and others were just depressed.

His actions, in fact, are coherent with his philosophy. Like David Hume, Dr. Kevorkian believes some lives are not worth keeping. When a life doesn't “measure up” to a person's hopes, or when a subject wants to throw it away for whatever reason, a doctor (just like a veterinarian) should not be restricted by the presence of imminent, natural death or even terminal illness if he decides, with (or in some cases even without) the patient's direct consent, death by injection is in his patient's best interest.

Take this extract from a 1986 edition of Medicine and Law, where Dr. Kevorkian wrote in support of medical experimentation on living human subjects as an example of his view on the value of human life in certain circumstances:

“The so-called Nuremberg Code and all its derivatives completely ignore the extraordinary opportunities for terminal experimentation on humans facing imminent and inevitable death … [including] the extraction of medical benefit from the process of judicial execution from those dying of irremediable illness or trauma [...] Other potential subjects include comatose, brain dead, or totally incapacitated individuals as well as live fetuses in or out of the womb.”

In the same article, Dr. Kevorkian proposed assisted suicide “by proxy,” meaning, in his own words, “the killing by the decision and action of another, of fetuses, infants, minor children, and every human being incapable of giving direct and informed consent.”

Dr. Kevorkian's proposals may seem over the top to many (and it is precisely this impression of extremism that assisted suicide advocates fear), but he is only drawing logical conclusions from a philosophy that all assisted advocates share: the poor “quality” of one's life can obliterate the value of life itself, and sometimes killing a patient is an act of compassion.

I disagree with that premise. As I see it, all human life is invaluable. Society only accepts the veterinarian practice of “mercy killing” because it believes animals are essentially different than human beings. Animals don't give and experience love and affection in the same way as humans. They cannot find meaning and peace in the acceptance of tragedy. They cannot look beyond their present state of suffering with hope for a better future. Simply put, animals are never made better by suffering, while human beings can turn their own suffering or the suffering of others into life-changing moments of personal and spiritual growth.

Nobody should be required to use extraordinary and artificial means to keep a dying person alive. The body tells us when it's time to go. But as we watch the legislative battle in California, it is important to know exactly what the euphemistic terms of “death with dignity,” “the right to die,” and “compassion” really mean. They assume the value of human life depends on its “quality” and that doctors should be involved in deciding when life should end.

It looks like Dr. Kevorkian's straight talk may help us see through the fog.


WRIT Acquires $49M Medical Portfolio

ROCKVILLE, MD-Washington Real Estate Investment Trust continues to add to its medical office holdings. The REIT has just acquired Woodholme Medical Office Building and Woodholme Center for $49 million. Baltimore-based Greenebaum & Rose Associates was the seller.
The two buildings total 198,000 net rentable sf and include 844 parking spaces. Located off the Baltimore Beltway in the Pikesville/Owings Mill submarket, the properties are part of the Woodholme Center, a 22-acre, mixed-use development that also has retail, restaurants, and a rehabilitation center.

The five-story Woodholme Medical Office building has a 97% occupancy rate and features 125,000 net rentable sf and 567 parking spaces. Woodholme Center, a four-story class A office building, has 73,000 net rentable sf and 277 parking spaces. It is 95% leased primarily to law and professional service firms.

The portfolio is expected to achieve a first-year, unleveraged yield of 7% on a cash basis and 7.2% on a GAAP basis, according to WRIT. As part of the transaction, the company will assume a $21.2 million loan with an interest rate of 5.3%. The remaining balance will be funded through its line of credit.
Stewart Greenebaum, founding partner of Greenebaum & Rose, tells GlobeSt.com that the buildings have performed very well. “They are first class, suburban buildings.” The company decided to sell for a myriad of reasons, according to Greenebaum. “Properties of this nature are management intense and we are a relatively small company. Also, we prefer development deals where we build. With cap rates being where they are now this was an ideal time to go in this direction.”

This acquisition is the latest of a series of medical office trades WRIT has made. Last month, it acquired the Ashburn Farm Office Park, a medical office portfolio for $23 million. It is a 100% leased portfolio totaling 75,400 net rentable sf. WRIT expects the portfolio to achieve a first-year, unleveraged yield of 6.6% on a cash basis and 7% on a GAAP basis.

In March WRIT acquired a medical office building in the heart of the District’s West End. The building, 2440 M St., traded for $50 million.


La Quinta to consider medical marijuana ban tomorrow

Marcel Honore
The Desert Sun
June 4, 2007

La Quinta could become the latest valley city to prohibit medical marijuana dispensaries, if its city council approves a ban during its regular meeting tomorrow.

Presently there are no dispensaries in La Quinta, so the ban would be a preemptive move to "head it off at the pass," as Councilman Tom Kirk put it.

Kirk and Councilwoman Terry Henderson both felt California cities are put in a tough position to decide the controversial issue, since state and federal law differ on medical marijuana.

Mayor Don Adolph first brought the issue to City Manager Tom Genovese when nearby Palm Desert began grappling with the fate of an existing dispensary there. The meeting starts 4 p.m. at City Hall, 78-495 Calle Tampico.

Firms offer free legal help for injured troops

By Rick Maze - Staff writer
Posted : Monday Jun 4, 2007 17:37:54 EDT

Three national law firms have agreed to provide free legal representation for combat-injured service members at Walter Reed Army Medical Center in Washington and National Naval Medical Center in Bethesda, Md., as they try to navigate the complicated military disability rating process.

A formal announcement is expected Wednesday about a partnership between the law firms and Disabled American Veterans to provide the legal help.

“Investigative reports have revealed a significant number of cases where the U.S. military appears to have assigned low disability ratings to service members with serious injuries and thus avoided paying them full military disabled retirement benefits,” the DAV said in a prepared statement. “This partnership has been created to help protect the rights of those injured soldiers who have given so much of themselves to protect us.”

The three law firms have all done substantial pro bono work on other issues, but have joined DAV after complaints about problems with the military’s disability system, which determines such things as whether a service member receiving a one-time separation benefit or monthly payments for life if they must leave the military because of disabilities.

The firms are Foley & Lardner LLP; LeBoeuf, Lamb, Greene & MacRae LLP; and King & Spalding LLP. Each of the firms has offices around the world.

While the free legal aid applies only to those in the Washington area, DAV officials said they consider this a test of what could become a larger, nationwide program.

The House of Representatives has approved legislation that would require the government to provide legal help for injured service members facing the disability evaluation and ratings process, once as a separate bill and later as part of the 2008 defense authorization bill. The Senate has not taken up similar legislation, although Sen. Carl Levin, D-Mich., the Senate Armed Services Committee chairman, said he expects a bill to improve benefits for service members injured in combat will be prepared later this year, separate from the annual defense policy bill.

The House-passed plan, called the Wounded Warrior Assistance Act of 2007, requires assignment of an independent advocate to any service member facing the disability evaluation process. The advocate would not be a lawyer, but rather a medical professional.


Law aims to make mental health calls safer


A safety law taking effect this week lets community mental health workers bring a second worker with them on calls to consider detaining seriously disturbed patients.
The "Marty Smith law" grew out of the death of a case worker in Bremerton in November 2005. Smith was killed when visiting a client to evaluate him for involuntary commitment, which is the kind of situation the new law is aimed at.

The Service Employees International Union 1199NW and private nonprofit providers like Behavioral Health Resources in Olympia and Shelton were among the bill's backers.

The new requirements take effect this week, a month after Gov. Chris Gregoire signed House Bill 1456 into law, said Rep. Tami Green, the Lakewood Democrat who sponsored the bill. In a related move, lawmakers authorized $3.7 million in new funding after July 1 that will help agencies with training and making other changes to the system.

"I think it needs to happen,'' said counselor Micki Dextre, who works for Behavioral Health Resources in Olympia and lobbied for the legislation. "When you are driving around with a psychotic person in your car, it can get a little scary … because they can go off.

"We are seeing it more and more where clients become psychotic. We are the front-line people and we go out to their homes, and we step into the situation,'' Dextre added.

"Just last week I was dealing with a client who is schizophrenic and doesn't open the door to anyone.''

BHR is a nonprofit group that provides state-paid mental-health care to the public through state-funded contracts, and it has about 300 workers with face-to-face dealings with clients. The organization already has trained its workers, partly because the agency saw incidents that were worrisome.

Incidents in recent years included a client pulling a knife on an employee.

"A lot of it has to do with being prepared … in case someone does get violent to have an escape route,'' BHR chief executive John Masterson said.

Who it covers

The new law does not affect workers directly employed by the state, but some state employees in the mental-health arena are carefully watching the state's progress in putting the new statute into effect.

"Anything to do with mental health we're watching," said Tim Welch, spokesman for the Washington Federation of State Employees, which has members at the Western and Eastern state hospitals in Steilacoom and Cheney. Welch said recent reports of increasing numbers of assaults at Western State have drawn particular interest, and the union is interested in other legislation from Green that failed but would have set minimum staffing levels at state hospitals.

"A lot was done to fund safety at the mental-health hospitals this year but more needs to be done,'' Welch said. "We clearly believe we need extra staffing. The administration at Western State Hospital believes otherwise and wanted to use training before asking for more staffing.''

The Service Employees International Union Local 1199NW, which represents some nurses at Western State and community mental-health counselors at organizations such as BHR, also is watching closely. Assaults on staff have increased by 19 percent since 1999 and several assaults have increased by 80 percent, according to state Department of Labor and Industries data cited in recent news accounts by the Tacoma News Tribune.

Out in the field, mental-health workers such as Dextre say they will have more protections.

"It took a lot of these incidents that occurred" to spur action, she said. "We had three or four incidents in one year. That's when people got concerned and the training got in place."

Dextre, a member of SEIU 1199NW, said she hasn't yet seen employees go out in pairs on involuntary detention calls. But Masterson said it has been an approved procedure at BHR and he doesn't expect any problems putting the Marty Smith protections in place.

"I support it," Masterson said of the changes. "The main provisions include making sure there is appropriate training for staff so they can protect themselves, ensuring they have access to a cell phone, and making sure they have access to enough medical records so they can assess the risk.''

"I think the question is statewide. Part of the problem is there is not always good information about how frequently that policy is followed. … It's different in an urban setting than a rural setting - if you have to travel 50 miles on back roads to get to someone,'' Masterson said.

Worker safety report

The Department of Social and Health Services released a report on mental-health outreach workers' safety late last month that details the incidence of assaults and also is based on a safety summit convened last fall. The agency now is developing a plan for outreach and education to help prepare mental-health workers to deal with dangerous clients.

Details on that effort still are in the works, according to David Kludt, a program administrator with DSHS's mental-health division.

The legislation makes Washington No. 1 in the country for this particular aspect of mental-health worker safety, Green said. But she added, "the Marty Smith bill is sort of bittersweet. It is frustrating that it can take someone to die before you can do something with worker safety.''

Because Smith had to travel from Bremerton to Poulsbo within the half-hour required by his employer in an emergency, he did not have time to adequately review medical files on the violent client. Even then, Green said, the files were inadequate.

In 2006, Green had sought legislation to require at least two employees to respond in such difficult situations, but she compromised this year and believes the law as written gives more control of situations to employees; the legislation also requires training.

"Most of the mental-health centers have already started moving that way. The handwriting was on the wall," Green said, adding that most of her concern is for smaller mental-health clinics located outside urban centers.

Green also is looking at the related safety of state employees in state mental hospitals and has a second bill that would set mandatory staffing levels, increasing the number of employees who have direct care contact with patients. That bill and its Senate companion both died without hearings in the 2007 Legislature, but Green is optimistic.

"Any time we make improvements in worker safety it buoys the spirit of all mental-health workers. It gives you some hope that you can fix the mental-health system,'' Green said. "I think the Marty Smith bill is kind of the first step for how we can make more improvements. I'm going to keep working on it.''

Medical marijuana bill in Rell's hand

HARTFORD - For the last five years, state Rep. Penny Bacchiochi, R-Somers, and legislative allies from both parties have fought to legalize marijuana use for medicinal purposes.
Though they have had more success this year than any prior, the controversial bill's fate now rests solely with Gov. M. Jodi Rell, who admits she struggles with mixed feelings about the measure.
The bill, which cleared the House 89-58 on May 23, was approved 23-13 in the Senate late Friday night.
"The difference between now and then is public awareness," Bacchiochi said, referring to the 2003 House debate when she first revealed she had risked arrest to purchase marijuana to help a loved one. "As the public becomes more familiar with this, so does the legislature. And as they become more familiar, they become more comfortable with it."

Over the past five years, Bacchiochi has become the leader for both Republicans and Democrats who want to see the drug legalized for palliative purposes.

The Somers lawmaker has recounted many times, both in one-on-one conversations and on the House floor, how she purchased marijuana illegally in the late 1980s to help her former husband, who had developed terminal bone cancer.

Facing chemotherapy, radiation treatments, and surgery to remove a spinal tumor, he suffered intense pain and debilitating nausea until he died, according to Bacchiochi, who said smoking marijuana offered him at least a respite from that pain.

The House rejected a medicinal marijuana bill in 2003. Similar measures died from inaction on the House calendar in 2004 and 2005 - the latter after first receiving approval in the Senate. No bill was introduced last year as advocates regrouped and built support among lawmakers in preparation for 2007.

Bacchiochi added that advocates also were helped because the marijuana debate never devolved into a partisan struggle. Each side of the question attracted Democrats and Republicans. "I appreciate the leadership allowing the whole chamber to make a decision" without pressure to form a consensus within the party, she said.

The legislation on Rell's desk would allow a doctor to certify that an adult patient has a debilitating condition that could benefit from using marijuana.

Patients and their caregivers then would have to register with the Department of Consumer Protection. Afterward, they could cultivate up to four plants, none of which could exceed 4 feet in height.

Connecticut actually enacted its first law to allow medical marijuana use in 1981, authorizing doctors to prescribe its use to relieve nausea associated with chemotherapy and eye pressure from glaucoma.

But the state law is unworkable because, under federal statute, physicians who prescribe marijuana can be sent to prison.

Rell told Capitol reporters two weeks ago that she is torn.
On one hand, she said, when a loved one is suffering, "you would do anything in your power to alleviate that pain."

But the governor also said she understands those who fear legalization would send a dangerous message - especially to youth - that drug use, in general, isn't dangerous. The bill would have been better, Rell said, had it been limited only to terminally ill patients.

"The governor still has mixed feelings about this," Rell spokesman Christopher Cooper said over the weekend. "She'll be reviewing the final language very closely."