GOP Could Steal the Election
Still 77 Cents
The Food Ordeal
Syria and Civil War
Edward S. Herman
A Post Arab Spring
Christian Right Star
DO NO HARM
Loretta Capeheart's Battle
YEAR OF THE CO-OP
Are You Feeling Cooperative?
John e. Peck
Role of the Executive
Rio Earth Summit
A Coup Over Land
NOTE: Z Magazine subscribers and sustainers have access to all Z Magazine articles here and in the archive. The latest Z Magazine articles available to everyone are listed in the Free Articles box at the top of the table of contents, and are starred in the list below. Questions? e-mail Z Magazine Online.
The Carnage Continues, Part 2
Medical errors include misdiag- nosis, hospital acquired infections, medication error—both inpatient and outpatient—excessive radiation, unnecessary surgeries, nursing home diarrhea, medical error, and blood clots. Medical errors have become the leading cause of death to Americans, exceeding heart disease and cancer with over 800,000 deaths attributed to error—or 2,191 deaths per day.
The New York Times (July 12, 2012) reported on the case of Rory Staunton, a 12-year-old boy who fell down, cut his arm, went to NYU Lagone Medical Center emergency room several times, his pediatrician several times, and was misdiagnosed at all levels. His blood tests were mislaid and he subsequently died of sepsis a couple of days after falling. This was a systemic death caused by a health care system.
The Times covered it as if it was an individual case of misconduct, instead of a national epidemic. Several days later the Times published an announcement by the hospital that they had developed a “checklist” to prevent such events in the future. Checklists are considered “low hanging fruit solutions,” as they cost almost nothing and allow institutions to march forward without making the systemic changes necessary to prevent such error-induced deaths. The systemic causes are:
for profit care
non-accountability to following
policies and procedures
legal issues that conflict with
- lack of root cause analysis
A recent op-ed piece in the Times (August 1, 2012) by Dr. Sanjay Gupta symbolizes in part how the mainstream media and members of the medical profession can distort the reality of medical error. In his piece, Gupta underestimates the number of deaths due to medical error by over 600,000, alluding to 200,000 deaths. He also never mentions the systemic causes and mostly attributes the blame to individual doctors or healthcare workers making mistakes.
Free Market Medicine
Free market medicine, or for-profit care, exacerbates adverse events. For-profit hospitals have 2 to 4 times the medical error rate as not-for-profit facilities. The healthcare system as it has evolved in the
In the end, the U.S. has created an epidemic of harm for both mortality (+800,000 deaths) and morbidity (millions of injured due to medical care) or one out of three who enter the healthcare system suffer an adverse event—according to the latest study by Health Affairs—and is considered 37th in the world for quality of care. According to a recent report by Health and Human Services, Dr. Lee Adler, a leading physician and researcher, writes hospitals see medical errors as “the normal risk of doing business.” Obamacare, for all its controversies, will not address the contradictions in our healthcare delivery system vis-a-vis medical error. It leaves intact the for-profits, the insurance companies, and other bureaucratic delivery systems that maintain rather than change the systemic causes.
There are two areas that need immediate attention if the numbers of patients harmed is to be reduced in the near term. One area is staffing ratios for clinical care personnel and the second area is ratios of auxilliary personnel who clean the hospitals. The good news is that if both of these categories were brought up to scientific standards, it would greatly impact the data on medical error and infections.
STAFFING. The linkage between low staffing ratios and patient harm has been in the scientific literature for decades. Linda Aiken pointed out in her articles published in Peer Review the connection between higher ratios and higher patient mortality in 2002. She wrote that each patient above a 1:4 ratio produced an increase of 7 percent mortalilty and a ratio of 1:8 increases patient mortality by 38 percent. Maintaining an RN ratio of 1:4 saves 72,000 lives annually according to Rothenberg in a journal article published in 2005. Despite this scientific proof that staffing ratios of 1:3 or 1:4 save lives, only one state in the U.S. has a ratio law, California, which mandates 1:2 in an ICU and 1:3 in a medical unit. Every year many states introduce regulatory language on ratios, only to see them die due to lobbying by State Hospital Associations, an employer association instituted to protect hospitals against unwarranted regulations. In a free market economy labor costs are considered expenditures. Increases in net profit are directly linked to labor costs and numbers of employees. However, healthcare is not a steel mill and the economic designs and paradigms have to be created using different metrics and cost benefit math. If healthcare, a scientific industry, is not reading or complying with its own scientific studies where data clearly shows the relationship between safety and ratios and that prevention is clearly cheaper than paying for the downstream error or infection, then even the language that healthcare is now applying about austerity makes no scientific sense.
CLEANING OR LACK THEREOF. The epidemic of hospital acquired infections (100,000 deaths annually) is also a direct result of the staffing levels of cleaners provided in each facility. New data presented in April at the annual meeting of the Society for Healthcare Epidemiology of America documented the lack of hygiene in hospitals.
A study of patient rooms in 20 hospitals in
A recent Johns Hopkins study said that 26 percent of supply cabinets were contaminated with a dangerous bacterium, MRSA, and 21 percent with Vancomycin Resistant Enterococcus (VRE). Stethoscopes, blood pressure cuffs, and EKG wires were used on patients without being cleaned.
Studies published as long ago as 1978 warn that blood pressure cuffs frequently carry live bacteria, including MRSA, and are a source of infection. In a newly released British report, one-third of blood pressure cuffs were found to be contaminated with Clostridium difficile, a germ that can cause lethal diarrhea if it enters via the mouth.
By cutting cleaning staffs, reducing time spent cleaning and testing surfaces, and then paying for infections, the system cheats itself, paying more money post infections than it would spend preventing infections. By nearly doubling cleaning staff hours on one ward, a hospital in
REPORTING ERROR. Hospitals have been and continue to be reluctant to gather reliable data and then release the numbers to the public domain. Of the 27 states that have reporting laws, Health and Human Services, in a newly released study, reports that there is little or no compliance and few consequences for non-reporting. Most of these state bills were underfunded and few accountability clauses for not reporting were built into the legislation. Chamberland in a 2012 study found that 50 to 96 percent of errors go unreported. Roehk in his study says hospitals only capture 14 percent of adverse events. Non-reporting can be considered a symbol of a system that prefers its own created image rather than a realistic look at medical error.
ADMINSTRATIVE EVIL. How can we explain the seemingly paradoxical circumstances where health care delivery poses a risk to those that require these services? One analytical tool is a perspective called Administrative Evil. The authors of a book called Unmasking Administrative Evil (2004) studied the role of evil in the field of public administration—historically and within our current structures. Evil in this context is a constructed reality. In other words, we have created structures within our society that permit evil acts to be done by our public administrators, often in the guise of efficiencies or improvements.
For example, an administrator might decide to reduce staff in a particular department to provide for more urgent care in another—leaving patients vulnerable in the understaffed area. A decision such as this, which, on closer examination, is really unethical, is being made by someone who is acting within his or her role as others would expect them to—from an organizational or policy perspective. Other more ethical options might not even have been considered.
In this state of “inverted morality,” what appears to be good is actually bad; what looks like it is right is wrong.
Health care is operating unsafely. It is injuring millions of healthcare workers (one in ten apply for worker compensation every year) and killing and injuring millions of patients. It is a badly designed system that does not even read, apply, or implement recommendations and findings of its own science. The cost of injuring millions of patients and healthcare workers is staggering. If even a certain percentage of these injuries were prevented each year, it would pay for the systemic changes that are at the very heart of the problem.
A redesign of the healthcare system is what is needed. In the short term, every state must pass a ratio law to provide the needed number of nurses and other clinicians and the ratio laws must include provision for the correct number of hospital cleaners to prevent infections. The regulatory process must be supported by labor and civilian groups such as the AARP (many of the victims of medical error are the elderly, especially for medication error), and other social groups. They must push past the lobbying efforts of the hospital associations that are in business to prevent any such change.
Accordingly, reporting laws must be re-written to assure accountability and a standardized method must be produced to compare apples to apples. Shiftwork regulations must change and actually follow the science, transparency must become the code word for an industry with habits of secrecy, hierarchical relationships that produce bullying and tension between classes of health care workers must be addressed and so on. It is not an easy task, but healthcare will never be safe unless we begin to address the systemic causes involved in 95 percent of all errors if a rigorous root cause analysis is done.
William Charney, an occupational health scientist, is editor of Epidemic of Medical Errors and Hospital-Acquired Infections.
Z Magazine Archive
AnnouncementsLABOR - May 1 is May Day. Workers of the world will celebrate the 124th anniversary of International Worker’s Day. Born out of a call for an 8-hour workday in the United States, this day is an opportunity for all workers to show their solidarity with one another, as well as to renew the call for labor rights.
FARM CONFERENCE - The Farm Conference on Community and Sustainability will be held May 24-26 in Summertown, TN, in partnership with the Fellowship of Intentional Communities. Tour green homes, see sustainable food production, learn about solar installations, alternative education, midwifery, and more.
Contact: Douglas@thefarmcommunity.com; http://www.thefarmcommunity.com/.
PALESTINE - The Conference of the Palestinian Shatat in North American will be held June 3-5 in Vancouver. The conference will examine the future of the Palestinian liberation movement.
Contact: firstname.lastname@example.org; http://www.palestinianconference.org/.
LABOR - The Pacific Northwest Labor History Association’s 45th annual conference will be held May 3-5, in Portland, OR. This year’s theme is Labor Under Attack: Learning from the Past and Preparing for the Future. A call for presentations, workshops and papers is currently underway.
Contact: PNLHA, 27920 68th Ave. East, Graham, WA 98338; 206-406-2604; PNLHA1@aol.com; http://www3.telus.net.
MARIJUANA - On the first Saturday of May marijuana legalization activists will hold informational and educational events, rallies and marches in over 300 cities around the world.
ECONOMICS - The Union For Radical Political Economics will hold its 39th annual conference May 9-11 in New York City.
RECLAIM THE DREAM - The 2013 Poor People’s Campaign & March from Baltimore to Washington D.C. will be May 11. Communities, schools and unions interested in participating are encouraged to contact the Baltimore People’s Assembly.
Contact: 410-500-2168; 410-218-4835; BaltimorePeoplesAssembly@gmail.com; Southern Christian Leadership Conference of Baltimore and the Baltimore Peoples Power Assembly, 2011 N. Charles St., Baltimore, MD 21218.
MOTHER’S DAY - The 17th Annual Mother’s Day Walk For Peace will be May 12th, in Dorchester, MA. The walk began in 1996 for families who had lost children to violence. The day has become a way for thousands of people to financially support the work of the Louis Brown Peace Institute.
Contact: http://www.ldbpeaceinstitute.org/; http://mothersdaywalk4peace.org/.
NATO 5 - An International Week of Solidarity with the NATO 5 has been called for May 16-21. Supports call on supporters to raise awareness of the NATO 5 and support funds for the defendants on the one-year anniversary of their preemptive arrests.
Contact: email@example.com; https://nato5support.wordpress.com.
MOUNTAINTOP - The 2013 Mountain Justice Summer Activist Training Camp will be held May 19-27 in Damascus, VA. It will be a week of workshops, field trips to view Mountain Top Removal coal mines, direct actions, and service project.
FEMINIST SCI-FI - The feminist science fiction convention WisCon 37 is scheduled for May 24-27 in Madison, WI.
Contact: WisCon, ? SF3, PO Box 1624, Madison, WI 53701; firstname.lastname@example.org; http://www.wiscon.info/.
ANARCHY FEST - A month-long Festival of Anarchy is scheduled for May in Montreal. The festival includes The Montreal Anarchist Bookfair (May 19-20).
Contact: http://www.anarchistbookfair.ca/; http://www.radicalmontreal.com/.
LABOR - The International Labor Rights Forum will present: Down the Supply Chain, Driving Corporate Accountability, on May 22 in Washington, DC. The Labor Rights Awards Ceremony and Reception will honor pioneers in supply chain worker organizing, working solidarity and international labor rights policy.
MULTICULTURE - The 26th annual National Conference on Race & Ethnicity in American Higher Education (NCORE) will take place May 28-June 1, in New Orleans.
Contact: SWCHRS, 3200 Marshall Avenue, Suite 290, Norman, OK 73072; 405-325-3694; email@example.com; www.ncore.ou.edu.
MEDIA - The 2013 Alliance for Community Media Annual Conference will be held May 29-31, in San Francisco, CA. Participants will include educators, community leaders, media professionals, journalists, nonprofit leaders, policymakers and students.
RADIO - The 38th Annual Community Radio Conference is schedule for May 29-June 1, in San Francisco, CA, with discussions and workshops.
Contact: 1101 Pennsylvania Ave. NW, Suite 600, Washington, DC 20004; 202-756-2268; firstname.lastname@example.org; http://www.nfcb.org/.
BRADLEY MANNING - On June 1, a rally will be held at Fort Meade in support of Bradley Manning.
BIKES - Bikes Not Bombs is holding its 24th annual Bike-A-Thon and Green Roots Festival in Boston, MA on June 3, with several bike rides scheduled, music, exhibitors and more.
Contact: Bikes Not Bombs, 284 Amory St., Jamaica Plain, MA 02130; 617-522-0222; email@example.com; www.bikesnotbombs.org.
LEFT FORUM - The 2013 Left Forum will be held June 7-9, at Pace University in New York City.
Contact: 365 Fifth Avenue, CUNY Graduated Center, ? Sociology Dept., New York, NY 10016; http://www.leftforum.org/.
VEGAN FEST - Mad City Vegan Fest will be held in Madison, WI, June 8. The annual event features food, speakers, and exhibitors.
Contact: 122 State Street, Suite 405 B, Madison, WI 53701; firstname.lastname@example.org; http://veganfest.org/.
ADC CONFERENCE - The American-Arab Anti-Discrimination Committee (ADC) holds its annual conference June 13-16, in Washington, DC, with panel discussions and workshops on civil rights, media and other topics.
Contact: 1990 M Street, Suite 610, Washington, DC, 20036; 202-244-2990; email@example.com http://convention.adc.org/.
CUBA/SOCIALISM - A Cuban-North American Dialog on Socialist Renewal and Global Capitalist Crisis will be held in Havana, Cuba, June 16-30. There will be a 5 day Seminar at University of Havana, plus visits to a cooperative, urban garden, community development project, social research centers, and educational & medical institutions.
Contact: firstname.lastname@example.org; http://www.globaljusticecenter.org/.
NETROOTS - The 8th Annual Netroots Nation conference will take place June 20-23 in San Jose, CA. The event features panels, trainings, networking, screenings, and keynotes.
Contact: 164 Robles Way, #276, Vallejo, CA 94591; email@example.com; http://www.netrootsnation.org/.
MEDIA - The 15th annual Allied Media Conference will be held June 20-23, in Detroit.
Contact: 4126 Third Street, Detroit, MI 48201; http://alliedmedia.org/.
GRASSROOTS - The United We Stand Festival will be hosted by Free & Equal, June 22 in Little Rock, Arkansas. The festival aims to reform the electoral process throughout the U.S.
SOCIALISM - The Socialism 2013 Conference is scheduled for June 27-30 in Chicago, featuring talks and panel discussions.
Contact: firstname.lastname@example.org; http://www.socialismconference.org.
LITERACY - The National Association for Media Literacy Education (NAMLE) will hold its conference July 12-13 in Los Angeles under the heading, Intersections: Teaching and Learning Across Media.
Contact: 10 Laurel Hill Drive, Cherry Hill, NJ 08003; http://namle.net/conference/.
IWW - The North American Work People’s College will take place July 12-16 at Mesaba Co-op Park in northern Minnesota. The event will bring together Wobblies from branches across the continent to learn new skills and build One Big Union.
PEACESTOCK - On July 13th, the 11th Annual Peacestock: A Gathering for Peace, will take place at Windbeam Farm in Hager City, WI. The event is a mixture of music, speakers and community for peace. Sponsored by Veterans for Peace.
Contact: Bill Habedank, 1913 Grandview Ave., Red Wing, MN 55066; 651-388-7733; email@example.com; http://www.peacestockvfp.org.
CHILDREN’S DEFENSE - July 15-19, join clergy, seminarians, Christian educators, young adult leaders and other faith-based advocates for children at CDF Haley Farm in Clinton, Tennessee, for five days of spiritual renewal, networking, movement building workshops, and continuing education about the urgent needs of children at the 19th annual Proctor Institute for Child Advocacy Ministry.
Contact: firstname.lastname@example.org; http://www.childrensdefense.org.
ACTIVIST CAMP - Youth Empowered Action (YEA) Camp will have sessions in July and August in Ben Lomond, CA; Portland, OR; Charlton, MA. YEA Camp is designed for activists 12-17 years old who want to make a difference in the world.
Contact: email@example.com; http://yeacamp.org/.
LA RAZA - The annual National Council of La Raza (NCLR) Conference is scheduled for July 18-19 in New Orleans, with workshops, presentations and panel discussions.
Contact: NCLR Headquarters Office, Raul Yzaguirre Building, 1126 16th Street, NW, Washington, DC 20036; 202-785-1670; www.nclr.org.
LABOR - The Eastern Conference For Workplace Democracy: Growing Our Cooperatives, Growing Our Communities, will be held at Drexel University in Philadelphia, PA, July 26-28.
Contact: firstname.lastname@example.org; http://east.usworker.coop/.
WOMEN/LYNNE STEWART- Radical Women is asking for support letters and cards to be sent to Lynne Stewart. Stewart is a civil rights attorney and political prisoner who is currently in jail. She has breast cancer and authorities have denied her request for transfer from her Texas prison to the New York City hospital where she received medical attention during a prior bout of breast cancer. Send messages and cards to: Lynne Stewart 53504-054, Federal Medical Center Carswell, P.O. Box 27137, Fort Worth, TX 76127.
Contact: 747 Polk Street, San Francisco, CA 94109; 415-864-1278; RadicalWomenUS@gmail.com; http://lynnestewart.org/; http://www.radicalwomen.org/.
HAITI/WOMEN - Haiti’s government is considering a legal reform measure that would prohibit and punish all sexual assault, including marital rape. MADRE and the International Campaign to Stop Rape & Gender Violence in Conflict are launching a petition to raise international support for this push to address violence against women in Haiti.
Contact: 121 West 27th Street, #301, New York, NY 10001; 212-627-0444; email@example.com; http://www.madre.org.
SYRIA/MIDDLE EAST - The Middle East Children’s Alliance (MECA) is currently seeking funds to assist more than 200,000 refugees fleeing violence in Syria.
FOLK FESTIVAL - The Falcon Ridge Folk Festival will be held August 2-4, in the Berkshires, NY.
Contact: http://www.falconridgefolk.com/; firstname.lastname@example.org.
WAR RESISTERS - The War Resisters League will hold its 90th anniversary conference, Revolutionary Nonviolence: Building Bridges Across Generations and Communities, August 1-4, at Georgetown University. The event will focus on the U.S.’ long history of antimilitarism.
Contact: 339 Lafayette Street, New York, NY 10012; 212-228-0450; email@example.com; http://www.warresisters.org.
POPULAR ECONOMICS - The Center for Popular Economics is holding its 2013 Summer Institute August 4-9 at Hampshire College in Amherst, MA. No background in economics is needed for this intensive training. This year’s theme is, The Care Economy: Building a Just Economy with a Heart.
Contact: Center for Popular Economics, PO Box 785 Amherst, MA 01004; 413-545-0743; firstname.lastname@example.org; www.populareconomics.org.
VETERANS - Veterans for Peace is holding the 28th annual convention August 6-11 in Madison, WI. This year’s theme is, Power To The Peaceful.
DEMOCRACY - The Democracy Convention will take place August 7-11 in Madison, WI. The convention brings together nine conferences including topics such as media, education, defense, race, environment and others.
MEN - The 38th National Conference on Men & Masculinity: Forging Justice: Creating Safe, Equal and Accountable Communities, presented in partnership with HAVEN, will be held in Detroit, MI, August 8-10.
Contact: email@example.com; http://www.nomas.org/.
OCCUPY - An Occupy National Gathering will be held in Kalamazoo, MI, August 21-25.
Contact: firstname.lastname@example.org; http://occupynationalgathering.net/.
COMMUNITIES - The Communities Conference is a networking and learning opportunity for co-operative or communal lifestyles, with workshops, events and entertainment; scheduled for August 30-September 2 at the Twin Oaks Community in Louisa, Virginia.
LABOR DAY - The 29th annual Bread and Roses Festival, a celebration of the ethnic diversity and labor history of Lawrence, MA, will be held September 2, in honor of the 1912 Bread and Roses Strike. There will be music, dance, poetry, drama, ethnic food, historical demonstrations, walking & trolley tours.
Contact: PO Box 1137, Lawrence, MA 01842; 978-794-1655; http://www.breadandrosesheritage.org/.
OCCUPY WALL STREET - September 17 is the two-year anniversary of the Occupy Wall Street movement. Events are planned in New York City and worldwide.
TEACHERS - The 13th Annual Conference, “Teaching for Social Justice: The Politics of Pedagogy,” will be held October 12 in San Francisco, CA. The free event features workshops, resources, and free childcare.
Contact: 415-676-7844; email@example.com; http://www.t4sj.org/.
HAITI - International Action, which brings clean water and chlorinators to Haiti, seeks office space capable of housing up to six people and their office equipment.
Contact: Zach Bremer, Zbrehmer@haitiwater.org; 202-488-0735; http://www.haitiwater.org/.
MEDIA - The Union for Democratic Communications and Project Censored are sponsoring a joint conference on media democracy, media activism and social justice to be held November 1-3 at the University of San Francisco. Proposals for presentations, workshops and panels from activists and critical scholars are invited.