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Texas Abortion Drug Bill Could Mean More Side Effects and Higher Costs

12:51 pm in Uncategorized by RH Reality Check

Written by Mary Tuma for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

CORRECTED December 20, 2012, 12:41PM ET: This story originally said the mifepristone drug label was last revised in 2005. In fact, minor revisions were made to the label in 2009, but the FDA’s protocol for using the medication wasn’t changed.

Published in partnership with The American Independent.

A GOP lawmaker is looking to make Texas the latest state to restrict the use of abortion medications in a way that some experts warn could increase the drugs’ side effects while making them more expensive.

Anti-choice activists and legislators can’t enact an outright ban on abortion-inducing drugs like mifepristone (formerly known as RU-486). Instead, they have sought to force doctors to strictly adhere to U.S Food and Drug Administration guidelines that appear to be significantly out of step with the current scientific understanding of how the medications should be used.

Lawmakers have passed abortion drug restrictions in Arizona and Ohio, overcoming legal challenges. The Oklahoma Supreme Court recently ruled that similar legislation in that state was unconstitutional. A North Dakota bill is currently tied up in litigation.

In Texas, state Sen. Dan Patrick’s bill, which mirrors model legislation drafted by anti-choice group Americans United for Life, would require doctors who prescribe an abortion drug to follow the protocol outlined in the official drug label approved by the FDA. He introduced similar legislation in 2011 — with the AUL’s support — but it didn’t pass. Patrick also authored the state’s controversial pre-abortion sonogram law.

In most state’s, doctors aren’t required to abide by the FDA guidelines. And since the FDA only regulates the drug market and not the practice of medicine, “off-label” treatment isn’t against federal law either. In fact, the FDA itself notes that physicians may prescribe a medication off-label as long as they are well informed about the product and “base its use on firm scientific rationale and on sound medical evidence.”

AUL insists that off-label use of mifepristone “can be deadly.” While Patrick did not respond to interview requests from The American Independent, he “said the intent of [the bill] is to improve the doctor-patient relationship” in an email to the Texas Tribune. But the legislation’s strict adherence to the FDA guidelines worries reproductive health care advocates and medical experts. They say a substantial body of recent research shows that the mifepristone drug label is outdated, potentially creating unnecessary burdens, financial costs, and health risks for women.

During a medical abortion, mifepristone is given to the woman at the clinic. The second round of medicine, misoprostol, is taken a day or two later to help end the pregnancy.

The FDA guidelines say that women should take 600 milligrams of mifepristone. But 2012 World Health Organization guidelines recommend a lower dose of mifepristone. Citing several studies, the report states that “200 mg of mifepristone is the dosage of choice, since it is as effective as 600 mg, and reduces costs” when it is followed by a dose of misoprostol.

Some of the language in Patrick’s bill is ambiguous, but it appears that it would also require women to receive their second dose of abortion pills — the misoprostol — in the presence of her doctor rather than at home, where it is typically taken. A number of reproductive health advocates find that rule troubling.

According to the National Abortion Federation, the majority of women who take mifepristone will abort within four hours of using misoprostol. Because of this, most women choose to take the misoprostol dose in the comfort of their own home due to painful side effects such as cramping and excessive bleeding that can also occur within the first few hours. Nausea, vomiting, and fever are among the other side effects women may experience, according to NAF.

“Women want to plan for the expelling of this fluid and blood tissue at their own time and they want to be in a comfortable place,” said Elizabeth Nash, state issues manager with the reproductive health and policy-based Guttmacher Institute. “So you can understand why a woman would want to take the medicine at home, especially if she has a fair distance to travel, which could happen in a place like Texas.”

The FDA guidelines and, apparently, Patrick’s bill do not give women the option of taking the second drug at home.

But the medical consensus has evolved in recent years. Unlike the old FDA guidelines, the 2012 WHO guidelines say that “[h]ome use of misoprostol is a safe option for women.”

Similarly, abortion drug guidelines set forth in 2005 by the American Congress of Obstetricians and Gynecologists say that the lower 200-milligram dose of mifepristone is as effective as the higher, FDA-approved dosage and that “multiple large studies in the United States have demonstrated that a patient can safely and effectively self-administer the misoprostol … in her home.” The ACOG guidelines note that the alternate drug regimens were developed in an effort to “reduce side effects” and “make medical abortion less expensive, safer, and more rapid.”

Dr. Mitchell Creinin, who worked on the ACOG guidelines and currently chairs the Department of Obstetrics and Gynecology at the UC-Davis, says the FDA-approved regimen is “outdated” and that the “vast majority” of providers follow the updated protocol.

The FDA guidelines don’t just stipulate when and where the woman can take the abortion drugs, but how. Misoprostol is only approved by the FDA for oral use, says Creinin, whereas research has shown that ingesting a higher dose of the medicine buccally (placing the pill in between your teeth and cheek) or vaginally can, in some instances, decrease side effects and work faster and more effectively — especially as the pregnancy advances.

According to ACOG, the new protocol is effective for women who have been pregnant for up to 63 days; by contrast, the FDA guidelines limit the use of mifepristone to the first 49 days of pregnancy.

The proposed law could also place significant financial and logistical burdens on women. At roughly $100 for each 200-milligram pill, the FDA’s higher mifepristone dosage is expensive. Moreover, Texas already mandates an ultrasound at least 24 hours before an abortion, so the legislation would actually require four separate trips to the doctor (for the ultrasound, the mifepristone, the misoprostol, and a follow-up visit.)

Texas OB-GYN and abortion provider Dr. Bernard Rosenfeld says the FDA guideline requiring women to take the misoprostol in a clinic was meant to standardize a variable in the trial and that several subsequent studies have shown women can safely take it at home.

Rosenfeld, who has practiced medicine for more than three decades, says the rule goes against “good medical practice” and advises all his patients to take the pills at home.

“There is zero medical basis or benefit to take the pills in the clinic,” he said. “To make a woman come back to the doctor’s office and then find a way to get back home after taking the drug is really just mean and cruel and puts them at medical risk.”

“It’s really just meant to give women a hard time,” he added.

The bill also compels doctors to create a contract with another physician who promises to treat the woman should an emergency arise from the drug. The doctor must have “active admitting, gynecological and surgical privileges at the hospital designated to treat the emergency.” But because some women, especially those in rural areas, may have to travel far to receive an abortion, the hospital in which the admitting doctor works may not be the closest to the woman in the event of a medical emergency.

“Living in a small, rural town can be really problematic for a woman seeking an abortion under these rules,” said Nash. “This part is not well thought out. It does not think through what actual steps will be best for the patient.”

The legislation seeks to penalize doctors who do not follow the requirements. According to the bill, the Texas Medical Board may take disciplinary action, such as revoking a medical license, or assess an administrative penalty, which can mean a fine of up to $5,000 if a doctor fails to comply.

‘More dangerous and more expensive’

Anti-choice lawmakers promote the use of outdated FDA rules when it comes to abortion-inducing drugs as a way to stigmatize doctors, says Nash.

“Whenever you invoke the FDA guidelines you are essentially making it wrong to do something that doesn’t abide by them. But in reality, what we are talking about is off-label protocol that is less expensive and has fewer side effects,” she said.

Anti-choice advocates disagree. Dr. Donna Harrison, a pro-life doctor and director of research and public policy at the American Association of Pro-Life Obstetricians and Gynecologists, says the rigorous FDA process should be followed.

“The FDA guidelines are the only real safeguard for the American people,” she said.  ”So when you go off-label with the drug, you are experimenting on women.”

But doctors in many medical fields routinely prescribe off-label drugs. A 2006 study found that an estimated one-in-five drug prescriptions were off-label.

A 2007 study found that 79 percent of pediatric patients discharged from the hospital received off-label drugs. Off-label drugs are also commonly used in cancer treatments. According to a 1997 survey of 200 cancer doctors conducted by the American Cancer Society and the American Enterprise Institute, 60 percent of them prescribed off-label drugs to patients.

“Off-label use is pretty much the mainstay of how we use medicine in the U.S.,” says Creinin, pointing to everything from birth control regimens to anxiety medication. “Just because a drug is approved by the FDA doesn’t mean there aren’t better ways to use it after approval. Research continues on the drug and finding new uses and assigning different dosages is normal.”

“The bill is really about trying to make providers look as though they are not following the rules when in fact, [the more recent protocol] is just as safe and effective and actually has additional benefits,” said Nash.

Creinin is skeptical of legislators’ intentions.

“The question here is: why would lawmakers, who say they are looking out for the health and welfare of their constituents, want to legislate that women must follow the label when sufficient medical literature shows the old guidelines are more dangerous and more expensive?” he said. “What they’re really trying to say is that they know more than the doctor – but they really need to be getting out of this business.”

‘No medical benefit whatsoever’

Dr. Lisa Perriera, a fellow with Physicians for Reproductive Choice and Health in Ohio, is familiar with the legislation. She says that after her state passed its own law in 2004 restricting use of mifepristone, she began to see unfortunate consequences. For example, patients have reported back that after receiving their misoprostol dose in the clinic, they begin to experience uncomfortable side effects while driving home from the clinic.

“We have patients that have to travel as far as five hours in a car while the abortion process starts – that’s just not fair,” said Perriera.

Based on her experience, Perriera says the legislation has not deterred her patients from having abortions; it has simply affected how they have them. As a result of the seven-week gestational limit, more of them have switched to surgical abortions.

“Some women want to have abortions naturally, without medical instruments, but this bill would eliminate that option for them,” she said. “Legislating the way women have to take their medicine is taking choices away from them.”

In the end, the rules have made it “more inconvenient for patients and more costly,” said the Ohio physician.

“It is also forces women to undergo more visits for no medical benefit whatsoever,” said Perriera. “So this is really not about their health and safety.”

What Romney Said: A Timeline of Mitt Romney’s Anti-Choice Positions and the Questions the Media Isn’t Asking

6:22 am in Uncategorized by RH Reality Check

Written by Editor-in-Chief Jodi Jacobson for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Caricature of Mitt Romney

Image: Donkey Hotey / Flickr

In 2007, Mitt Romney stated that in regard to a “human life” amendment to the constitution, “I do support the Republican Platform and I support that being part of the Republican Platform.”

At no point during this conversation or any other in which he declared support for a human life amendment did he suggest support for exceptions for rape, incest, and life of the mother.

Over the past week, and in the wake of statements by Missouri representative Todd Akin which threw into stark relief the positions in the GOP Platform on women’s rights, presumptive Republican presidential nominee, Governor Mitt Romney has changed his position on a total abortion ban by insisting he would allow “exceptions” for victims of rape and incest.

Rather than asking probing questions about an issue that is of profound consequence for women’s lives and health, the media–ranging from George Stephanopoulos of This Week to Bob Schieffer of Face the Nation and others–have largely taken Romney at his word on this shift and failed to ask any questions. At the very least, the media ought to be asking Romney how his post-Akin position squares with his own statements of the past several years.

In recent months, for example, Governor Romney has insisted he is the “same man” as we was in the last presidential election; that Mitt Romney had quite a different position than the post-Akin Romney.

But what position does he really have? If he is, as he has claimed, “the same man” as he was in the last election cycle, then he supports a total abortion ban. And if he supports “exceptions,” why has he never stated this when asked about total abortion bans?

In 2011 and 2012, Romney has several times said he “had the same positions today” as “when I ran for president last time, so what you see is what you get.”

In a March, 2012 interview on the Tommy Tucker Show out of New Orleans, for example, Romney stated that he had the same positions as “last time.” In the same interview, he also confused the issue by declaring that he had the same positions in the last presidential contest as he did as governor of Massachusetts, when he claimed to be pro-choice. Which Romney are we listening to now?

Read the rest of this entry →

Wisconsin Republican Senator Proposes Bill To Label Single-Parenthood As Child Abuse

11:50 am in Uncategorized by RH Reality Check

(image: ee382, photobucket)

(image: ee382, photobucket)

Written by Michael Hayne for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Not a day goes by in this topsy-turvy, mad-max eschatology that Republicans have created where a Republican politician isn’t uttering some certifiably insane, hateful malarkey that would make Charles Manson blush. Whether you’re gay, black, female, or a spore with feelings, Republicans do not like you unless you aspire to be a white christian b/millionaire.

Indiana Senator Glenn Grothman (R-West Bend), a Republican in Wisconsin’s state senate, thinks that children from single parents are probably victims of child abuse. In his world, a deadbeat dad (Joe Walsh, anyone?) is an American hero whereas the single mom is a disordered, unstable Harlot and should probably be raped by a state doctor. But seriously, Grothman recently authored a controversial bill that directly targets single parents, which the State Senator plans on presenting to the Senate Committee on Public Health, Human Services and Revenue.

A portion of the bill reads as follows:

“In promoting those campaigns and materials, the [Child Abuse and Neglect Prevention Board] shall emphasize nonmarital parenthood as a contributing factor to child abuse and neglect.”

No word yet on whether single parents are covert Muslims/socialists/Maoists.

Despite the fact that single parents make up 32 percent of all parents in Wisconsin, they are inherently evil, and if the state cannot imprison them at Guantanamo Bay indefinitely, they will at least make sure that they’re regarded with severe suspicion.

The remainder of the bill reads as follows: Read the rest of this entry →

Making Sense of Herman Cain and Abortion

8:48 am in Uncategorized by RH Reality Check

Written by Amanda Marcotte for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

On this week’s episode of Reality Cast, I have a segment about the situation with Herman Cain’s incoherent and inconsistent approach to abortion rights. Cain has been on at least two TV shows where he said in the same breath both that he doesn’t think abortion should be legal and that the government shouldn’t make that decision for you, without acknowledging in the slightest that these two positions inherently contradict each other. There’s been multiple attempts to understand why Cain is so daft about this. Some folks believe he’s trying to have it both ways, but hasn’t figured out any political trickery to allow himself to speak out of both sides of his mouth without getting caught. I theorized at XX Factor that Cain’s incoherent position reflects the incoherent position of roughly half the people who claim to be “pro-life”, but also want abortion to be legal in some or all cases.

But now we have a little bit more of a clarification from Cain on his position.

“I do not think abortion should be legal in this country,” Cain said on Fox today. “Abortion should not be legal. That is clear. But if a family made the decision to break the law, that’s that family’s decision.”

Of course, this contradicts his previous statements about how the government should stay out of it. Now he thinks the government should ban abortion, and he seems to have not considered in the slightest that breaking the law isn’t just a matter of “choice”, but that it can have very real consequences if you’re caught. Read the rest of this entry →

Why is the U.S. Waging War on Women Raped in War?

12:44 pm in Uncategorized by RH Reality Check

Written by Kristina Kallas for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Mandatory sonograms, forced lectures by doctors, humiliating permission slips from abusive husbands, paternalistic opinions from Supreme Court Justice Kennedy, uneducated and patently stupid soundbites from Tea Partiers. That’s not the worst. In this newest wave of the war on women, let’s not forget the U.S. government’s abortion policies toward women in war.

Rape is systematically being used as a weapon of war in conflicts worldwide. During the Rwandan genocide it is estimated that between 250,000 and 500,000 women were raped in 100 days and that approximately 20,000 children were born as a result of rape. Recent reports from Burma indicate that Burmese soldiers have orders to rape women. 387 civilians were raped in Walikale, North Kivu in the Democratic Republic of Congo (DRC) in a 4 day period last year. In 2008 alone, the U.N. Population Fund recorded 16,000 cases of rape in DRC, two-thirds of them adolescent girls and other children, in an area where rape is vastly underreported. Imagine what the real numbers are.

The stigma associated with rape ostracizes girls and women, particularly those who become pregnant, because they are often seen as carrying the enemy’s child. They are frequently abandoned by their communities, struggling for ways of living with children born out of rape. That is, if they survive childbirth. The maternal mortality ratio in eastern DRC is estimated at 3,000 deaths per 100,000 live births (compare that with 24 deaths per 100,000 live births in the U.S. and 5 deaths per 100,000 live births in Denmark).

How does the U.S. address this emergency? Under the 1973 Helms Amendment to the Foreign Assistance Act, and subsequent policy by the Bush Administration, the U.S. prohibits any federal foreign assistance from being used to even mention abortion as an option to women raped in armed conflict. The current incarnation of these restrictions go beyond statutory requirements because the statute is limited to restricting the provision of abortion “as a method of family planning.” Rape is never family planning. The repeal of the Global Gag Rule did not affect these restrictions.

This U.S. policy stands in stark contrast to the development policies of other prominent donors and even its own domestic policy. As much as some Tea Partiers wish it wasn’t so, the domestic equivalent of these restrictions (the Hyde Amendment) does contain a rape exception. The United Kingdom, with a ruling conservative party, recognizes the need to provide abortions in conflicts in which rape and forced pregnancy are used as weapons of war. Norway formally recommended that the U.S. remove its restriction on funding to these victims during the Universal Periodic Review of the United States by the Human Rights Council.

The best an organization accepting U.S. funding can provide even to a twelve year old impregnated rape survivor hiding in the bushes of eastern Congo is a plastic sheet and a clean knife for labor. Or, if she suffers complications from having an unsafe abortion (because she doesn’t have access to safe abortion services, often because of U.S. abortion restrictions), they can provide her with “post-abortion care.” Giving these women “birthing kits,” or lecturing them about preventative family planning, when the family they would be planning for is with a contingent of combatants armed with guns, Viagra and orders to rape, is appalling. Beyond that, it violates international law.

August 12th marked the 62nd anniversary of the Geneva Conventions, which require that all persons considered “wounded and sick” in armed conflict receive comprehensive and non-discriminatory medical care dictated solely by their medical condition. Despite these protections, girls and women who are raped in armed conflict are routinely denied the option of abortion in the medical care provided to them in humanitarian medical settings. This is discriminatory and violates their rights under the Geneva Conventions. The U.S., by attaching these restrictions on humanitarian aid for rape victims in conflict, is violating the rights of these women. The urgency of this violation cannot be understated: the U.S. is the largest donor of humanitarian aid in the world, and is instrumental in preventing essential medical care to a desperately vulnerable population.

In order to bring the U.S. into compliance with the Geneva Conventions, and restore dignity to our foreign policy, President Obama must act now to ensure the rights of female rape victims in conflict. Over fifty organizations, legal academics and professionals have sent letters to President Obama as part of the Global Justice Center’s August 12 campaign to remove the abortion ban for girls and women raped in armed conflict. Sign the GJC’s petition urging President Obama to issue an executive order lifting these life-threatening restrictions here.

The GOP Debate in Iowa Reveals the Candidates Have No Grasp on Reproductive Health

10:42 am in Uncategorized by RH Reality Check

"The Iowa Debate Spin Room"

"The Iowa Debate Spin Room" by TalkRadioNews on flickr || The press gathered in the spin room on Iowa State at the Republican Debate

Written by Dr. Jen Gunter for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

The debate in Iowa was an opportunity for the GOP hopefuls to showcase their stand against abortion, because there’s nothing better than a pissing match about reproductive health to rally the fundraisers and fill the war chest. Here are some quotes from the evening:

Rick Santorum on why abortion should be illegal, even in the event of rape of incest:

“To be victimized twice would be a horrible thing. We should surround these women and help them.”

Tim Pawlenty reflected on his legislative record which he felt led to “abortion at historic lows,” bragging that based on:

“These results, not rhetoric, I may be the most pro-life candidate in this race.”

The candidates clearly do not understand any facts related to abortion (I suspect they don’t care, they’re just after sound bites and money). But seriously, if you are going to discuss a topic then learn about it beforehand. First of all, abortion does not victimize women. The rate of serious complications is less than 0.3 percent and study after study shows no effect on mental health. If I were the moderator I would have asked for clarification from Mr. Santorum for his definition of victimization and to provide medical evidence to prove it. Read the rest of this entry →

House Committee Votes to Reinstate Global Gag Rule (Again) and Other Misogynistic Amendments

8:23 am in Uncategorized by RH Reality Check

Written by Editor-in-Chief Jodi Jacobson for RHRealityCheck.org. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

A central motto of today’s GOP and Tea Parties appears to be: Never let evidence get in the way of efforts to pass a law undermining women’s access to healthcare.

An addendum to this motto appears to be: Never let an opportunity pass to deny funding to or politicize services providing care to the poorest and least-enfranchised women in the world, most particularly those who suffer high rates of maternal death due to lack of access to family planning services and high rates of complications of pregnancy and unsafe abortion.

In keeping with this, just weeks after publication of a major report underscoring the benefits of robust U.S. investment in family planning worldwide, the GOP-controlled House Foreign Affairs Committee voted in the early hours of the morning today to reinstate the Global Gag Rule (GGR) as part of the draft Fiscal Year 2012 State Department Authorizations Act, except this time with broader and more damaging implications than ever before.

Continue reading…

As They Seek to Ban Abortion, GOP Also Moves to Eliminate Title X Family Planning Program

8:53 am in Uncategorized by RH Reality Check

Written by Jodi Jacobson for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

As members of the anti-choice Republican and Tea Party House majority debated allowing women to die to salve the “consciences” of the United States Conference of Catholic Bishops, and using the tax code to virtually eliminate insurance coverage for abortion in the United States, the GOP/Tea Party majority took another brazen step.

It moved to dismantle Title X, the nation’s family planning program.

The House Appropriations Committee announced in a press release today a $327 million cut to family planning.  For FY 2010, $317 million was appropriated for the Title X program, but the President’s FY11 budget request was for $327 million.

“Today, the House Leadership launched its latest outrageous attack on women’s health,” said Cecile Richards, president of Planned Parenthood Federation of America. “The House Leadership’s FY 2011 Continuing Resolution proposes to completely eliminate the Title X family planning program, which has connected millions of  American women with health care since Richard Nixon signed it into law in 1970.”

Put another way, the House Appropriations Committee wants to ensure that more low-income women experience unintended and untenable pregnancies, and that they are then forced to bring those to term.  And along the way, by cutting Title X, Congress will also ensure that more women die of breast and cervical cancer and more people suffer from sexually transmitted infections.  This is dictatorship over women’s lives. Read more

Anti-choice Politicians Beware: Large Majority Strongly Opposes Republican Leadership’s “Plans” for Women

7:13 am in Uncategorized by RH Reality Check

Written by Jodi Jacobson for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

One thing you’ve heard over and over from politicians on the right in this month after the election is how focused they plan to be on jobs and the economy.

One thing you might not have heard so much about: While the new Republican House leadership has failed to articulate an economic strategy beyond “cut, cut, cut” and “make the rich richer,” they have a long list of bills they want to pass to restrict women’s health and rights.

Voters say: Not so fast.

A survey funded by Planned Parenthood Federation of America and conducted by Hart Research shows that large majorities of voters–including those who voted Republican or Tea Party in the last election–are strongly against proposed attacks on women’s health and rights.

The survey was conducted among 802 registered voters between November 5th and 8th, 2010. It measured support for and opposition to the GOP leadership’s policy proposals on women’s health, which come in part from the GOP’s “Pledge to America.”   Specifically, the GOP “Pledge to America” calls for “a government-wide prohibition on taxpayer funding of abortion and subsidies for insurance coverage that includes abortion.”

Read more

Death, the GOP, and the Politics of Health Care Reform

9:27 am in Uncategorized by RH Reality Check

Written by Scott Swenson for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

Fear is what the far right is. Fear is what they do. The same people who bring you fear and misinformation about sexuality education, contraception, family planning and abortion are once again stirring up fear about death.

We have nothing to fear, but fear itself.

There is no better way to stir up fear than to talk about death — unless you combine talk about government and death. Most people don’t want to think about death. The far right tried this in 1998 and 1999 in Congress when the party that touts "states’ rights" tried to overturn the popular will of voters who twice passed Oregon’s Death with Dignity law. The far right tried it twice in the federal courts, ultimately losing a 2006 Supreme Court case in a 6-3 decision allowing Oregon’s now 12-year-old Death with Dignity law to stand. Last year Washington voters made their Death with Dignity law the top vote getter in the state, at 59%, besting even President Barack Obama.

The last time the far right stirred up public fear about death they used extraordinary means to prevent a husband from carrying out his wife’s wishes not to be left in a persistent vegetative state, intervening in a family’s personal and private life decision. Remember Terri Schiavo? The GOP lost their House majority after voters saw how they exploited that situation, so for Sarah Palin and others to be scaring people now about a "death panel" in health care reform legislation demonstrates they care less about dying people than they do about cheap political manipulations.

Voters are consistently rejecting far right efforts to stir up fear about death, and at Read the rest of this entry →