Mid-week updates

Here are some mid-week updates on developing Lawpsyc stories:

A U.S. State Department spokesperson sounded like she had read my recent piece on Gaddafi’s sanity when she called the embattled Libyan dictator “delusional” and “unfit to lead” earlier this week.

There are new developments in the Jaycee Dugard case.  I’ve analyzed this case numerous times, on the CBS Early Show, The O’Reilly Factor, AC 360, and other shows — defendants Phillip and Nancy Garrido allegedly kidnapped Jaycee as a child and held her hostage for decades while Phillip frequently raped Dugard, fathering her two children.  Well, the Garridos now reportedly are trying to make a plea deal, whereby they’d confess to all charges against them, seeking at least a reduced sentence for Nancy.  Phillip currently faces up to 400 years, while Nancy currently faces up to 241 years.  While there’s something to be said for zealously representing one’s client, Nancy’s lawyer sank to a new low, even in my experience as an attorney and expert witness, when he said that Nancy deserves leniency because she was a “mother” figure to Dugard and to Dugard’s children during their captivity.  Excuse me while I throw up!  Both Garridos deserve every minute of the maximum sentences that they face, and if I were the prosecutor, I wouldn’t agree to any reduction whatsoever.

And remember the “sweat lodge” case?  In case you don’t, a self-appointed “self-improvement” expert organized a paid “retreat” involving a Native-American-inspired “sweat-lodge” self-purification ritual in which participants remained in an intensely-hot room…until three of them died.  The  “expert” was charged with manslaughter, and his trial got underway this week.

While I’m on the subject of legal proceedings underway this week, hearings are being held here in Kansas to determine whether former Attorney General Phill Kline violated the ethics of the legal profession when he investigated crimes suspected to have been committed by the late abortion doctor George Tiller and by staff at a Planned Parenthood clinic in suburban Kansas City.  If you’ve heard about this guy and/or this case, chances are you’ve heard something utterly inaccurate and/or convoluted beyond comprehension.  As someone who has 1) served as an expert witness before a committee of the Kansas Legislature looking into these cases (advising them on how to close legal “loopholes” used to justify otherwise-criminal behavior), 2) represented a key figure in both cases as an attorney, and 3) explained developments in the cases both on Fox’s O’Reilly Factor (multiple times) and HLN’s In Session, I can tell you the following:

First, the chance that you heard about these criminal cases (against Tiller and Planned Parenthood) and/or the ethics case against Mr. Kline from a source that knows more about those topics than I do is very low.  Second, given everything I know about the criminal cases, I have zero doubt that crimes occurred, both in Tiller’s office and at the Planned Parenthood clinic.  Third, given everything I know about how these cases were investigated and prosecuted, some of the ethics charges against Mr. Kline look completely unsubstantiated to me, and the remainder look like infractions that have rarely, if ever, resulted in disciplinary action to a similar degree, raising the specter of political vengeance on the part of state officials philosophically aligned with the criminal defendants.  Finally, and most importantly, the Legislature here in Kansas has yet to take my advice and make crystal clear what’s required of a physician who intends to perform an abortion on, for example, a 12-year-old girl, or a woman eight months pregnant who wants the abortion because she’s allegedly “depressed” about the pregnancy.  As I told the legislators, whether you’re pro-life or pro-choice, we should all be “pro-law,” and when the law is clearly being ignored, whether it’s the law requiring doctors to report indications of child abuse or the law prohibiting late-term abortions except for grave health reasons, that should be unacceptable to all of us.

Now, this next one is a new case, but it updates a topic that I’ve covered in the past — giving test-taking “accommodations” (more accurately in many cases:  “advantages”) to students who claim to have various learning “disabilities.”  The Americans with Disabilities Act (ADA) requires that, if a person with a documented disability can nevertheless perform an academic or employment task with a “reasonable accommodation,” then that person’s educational institution or employer must make such “reasonable accommodation.”  The ADA wouldn’t require a flight school to admit a blind student, but it would require a liberal-arts college to present test questions to that person in a spoken or Braille format.  In cases involving less-clearly-defined disabilities, a “reasonable accommodation” becomes less-clearly-defined as well.  American educational institutions, on the whole, have defined and granted “reasonable accommodations” increasingly broadly in recent years, and I think it’s affecting both the fairness and the value of our educational system, all the way up to and including our professional schools.  For example, there are untold numbers of students across this country presenting notes from their pediatricians, even at the college level, and demanding accommodations for such “disabilities” as Attention Deficit Hyperactivity Disorder (ADHD).

In this just-settled federal case, the National Board of Medical Examiners (NCME) has been forced by the U.S. Department of Justice (DOJ) to provide a dyslexic medical student double the standard time and a private, distraction-free, room in which to complete the national licensure examination for physicians.  The problems created/perpetuated by precedents like this are twofold.  The first is accurate verification of the existence of a disability.  The intent of the ADA was that a “reasonable accommodation” would offset the ill effects of the disability without imposing an undue burden on the educational institution, employer, or society.  As a licensed mental-health professional, however, I can tell you that it’s quite easy for students and employees to get documentation of diagnoses like ADHD, whether they deserve it or not.  In fact, I’m confident that the majority of students with ADHD diagnoses in this country do not meet the American Psychiatric Association’s (APA’s) stringent diagnostic criteria.  But that hasn’t stopped pediatricians, largely untrained to apply the APA diagnostic criteria yet eager to please student patients and their parents, from freely passing out “tickets” to “accommodations” that, in the absence of true disabilities, become “advantages.”  It was never the intent of the ADA to give anyone an advantage.  As a college faculty member, however, I can report to you, for example, that there are college students with such “tickets” from their physicians who are “accommodated” with “note-takers” (fellow students who attend their classes and provide the ostensibly-disabled student with detailed notes), at which point the ostensibly-disabled student sleeps through class or skips it entirely.  Of course not every “accommodated” student abuses his/her “accommodations,” but when it happens, which is all too often, I think it’s blatantly unfair to the majority of students, and it devalues diplomas for all students (because employers can’t know whether a particular job applicant’s degree was earned under artificially-favorable conditions).  I think we need to be more rigorous in verifying non-obvious disabilities like ADHD, but this recent NCME settlement and its resulting new DOJ guidelines actually make verification requirements less rigorous.

Assuming the complainant in this NCME case truly is dyslexic, the second problem here is the creation of a double standard (i.e. one standard for people with disabilities and another standard for people without).  No one wants to see a dyslexic individual prevented from achieving his/her goals in life, but sometimes — like, I would argue, when we’re licensing physicians — we need some uniform standards.  I question whether it’s really “reasonable” to make it possible for someone to pass a licensure exam that he/she couldn’t otherwise pass, thus enabling that person to be licensed as a physician, if it takes that person twice as long as other physicians to solve the same problems, perform the same procedures, etc., and if that person can only do so in a distraction-free environment without making errors.  Consider this:  “qd” in prescription notation means “every day,” while “qid” means “four times per day.”  Getting those reversed, perhaps under time pressure, or perhaps with distractions in the environment, could kill somebody.  So, we have to consider whether it’s “reasonable” to have two time standards and two environmental standards for physicians trying to demonstrate their fitness to practice, and we have to consider that not from the perspective of the future physician, but from the perspective of a future patient.  Sure, if the complainant in the NCME case becomes a pathologist and looks at cultures under microscopes all day long, it might be fine, but generally, a license to practice medicine is issued without such limitations, just like diplomas are issued without notices to future employers saying, “This diploma was earned with the following ‘accommodations’:”

And finally, I remember one time when I was a kid and one of my brothers had worn one of my shirts.  I was looking all over our house for the shirt and finally saw it in his room.  When I went in his room to get it, he yelled at me to get out.  Our mother heard the commotion and said to us, “You [my brother] don’t take other people’s things, and you [me] don’t go in other people’s rooms uninvited.”  Now, this obviously wasn’t a big deal, but it illustrates something that I think goes on too often in our society, when things are big deals, like the budget battle underway in Wisconsin and elsewhere.  People don’t do the work to figure out which side is right and then back that side completely and consistently.  For example, someone says, “We don’t have any more money, so we have to cut spending.”   People then get behind that for a few days until someone else cries, “But if you cut spending, I’ll be hurt, and I’m a nice person who does important work.”  Then, as if the latter made the former somehow less true, people end up saying, “Ok, we’ll stop spending some money that we don’t have, but we’ll also keep spending other money that we don’t have.”  It’s the old, “If there’s a conflict, both parties must’ve done something wrong,” line from my childhood.  In my mom’s case, it was just that she had four kids and didn’t have time to investigate every conflict fully.  But we can’t afford to do that in matters as serious as our national and state budgets.  Sure, it’s easier and it feels better to many people to say, “You’re both right.”  But that’s not true.  And in our increasing cultural reluctance to figure out who’s right and who’s wrong and to then get, and stay, behind the one who’s right, we’re hurting ourselves badly by perpetuating problems that need to be solved now.  In Wisconsin, the state doesn’t have any money.  That’s the truth.  And someone’s finally trying to do something serious about it, just like someone’s going to have to do in every other state and in Washington.   And people seemed to be behind it for the first few days, until people on the wrong side of the issue — people who think it’s fine to keep spending nonexistent money as long as it’s spent on them — started crying loudly enough and making a big enough scene.  Now, I’m starting to see wishy-washiness about it, there in Wisconsin and all across the country.  Emotion-driven wishy-washiness is exactly what we don’t need right now.  Logic-driven resolve is.

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