Epidemic of errors is real health issue
The Sun's editorial "Malpractice muddle" (Dec. 22) raises the important question of what has caused the fluctuations in doctor's malpractice insurance and notes that we should focus on the facts, rather than the spin, about the causes.
So here are some facts:
A 1999 Institute of Medicine report found that there are 98,000 deaths every year caused by medical errors.
A 2005 "Healthgrades" report found that there were 195,000 deaths from medical error in each year for 2001, 2002 and 2003.
A 2006 follow-up study to the 1999 Institute of Medicine report found that medication errors occur to the average patient at least once per day of hospitalization, harming at least 1.5 million people a year.
A follow-up report by the National Academies of Science states that 400,000 preventable drug-related injuries occur each year in hospitals, 800,000 in long-term care settings and about 530,000 among Medicare recipients in outpatient clinics.
A 1999 CDC study concluded that at least 2 million Americans are infected by bacteria spread to them in hospitals -- and approximately 90,000 of them die as a result.
A 2001 investigation of hospital-spread infections conducted by the Chicago Tribune put the numbers of dead from hospital-spread disease each year at more than 100,000.
A 2006 study by the Harvard University School of Public Health found little merit to the "perception that 'jackpot' awards in frivolous suits are draining the system."
Maryland has had medical certification as a prerequisite for malpractice claims and caps on pain and suffering awards for 20 years.
In light of these facts, and dozens of similar studies and reports, one wonders why the focus should be on limiting malpractice lawsuits and limiting victims' rights and possible compensation.
The legislature should consider the facts and pass legislation that addresses the epidemic of malpractice and negligence which is causing untold suffering, loss of innocent life and draining the resources of the entire health care system.
Michael Bennett
Baltimore
The writer is president of the Coalition for Patients' Rights
Lawyers exploit liability system
Thank you for The Sun's well-reasoned editorial on medical liability ("Malpractice muddle," editorial, Dec. 22).
As a doctor who is unduly affected by the cost of liability insurance, I agree with one of The Sun's main points: Since the books of the insurers are not open it is hard to know which side to believe.
But I do know one thing -- the system works poorly for the injured (the patients) and for doctors and hospitals.
Studies show that less than one-quarter of the insurance payments made by doctors make their way to those who claim injury. The rest goes, for the most part, to the lawyers (on both sides) and the insurance companies.
And what bothers me is that our legislature, which is in a position to change the system, is heavy with the lawyers who benefit most from the existing system.
When I testified this year before a legislative committee studying this issue, one-third of the members of the committee were lawyers.
But none of them mentioned their obvious conflict of interest or, heaven forbid, recused themselves from dealing with this issue, as would have been be ethically appropriate.
Dr. Sam Akman
Baltimore
Meaning is the key to real recovery
I thank The Sun and our elected officials for finally addressing the addiction problem this city faces ("U.S. bill targets 'bupe' limit," Dec. 17).
However, while buprenorphine may be a viable alternative to methadone, which is highly addictive, it still does not address the recovery aspect of the problem.
Recovery from the disease of addiction cannot be implemented when one still consumes any mind-altering and mood-changing substances.
This process begins with an individual's desire to free himself from a self-defeating and self-destructive way of life.
Recovery involves a search for meaning and purpose -- and this cannot happen under the influence of any prescribed medication.
After 10 years of owning and operating a recovery program, I have found that the greatest tool or resource in addressing addiction is spirituality -- an ongoing, active relationship with a source that gives life meaning and purpose.
Israel Cason
Baltimore
The writer is founder and CEO of the I Can't We Can recovery program.
Keep the gospel off sports pages
There are few things more irritating to me than the annual exercises in narcissism and self-congratulation known as "Christmas newsletters."
But The Sun's article "Taking the gospel to the gridiron" (Dec. 24) is representative of a category that comes close -- i.e., articles in the Sports section about athletes and their religion.
Most people read the Sports section because they enjoy sports and want to read about the results of athletic contests and the performances of individual athletes.
Human interest-type stories about the lives of the performers are also welcome.
However, articles about athletes' religious preferences, use of prayer, personal relationships with God, and beliefs about God's involvement in their lives and influence on their decisions (athletic and otherwise) do not belong in the Sports section.
Matthew 6:6 relates Jesus' admonition about praying to God in secret and not in public "as the hypocrites" do.
Athletes who consider themselves religious should pay attention and apply that maxim to personal religious matters.
Keep them private. Don't wear your religion on your sleeve.
Religion is between you and your God. Fans don't want to read about it in the Sports pages.
Harris Factor
Columbia
Embrace the wind for cleaner power
I am glad to see the coverage wind energy has gotten in The Sun recently, whether for a project in Western Maryland, Pennsylvania or off the Atlantic coast ("Wind farm may rise off Delaware shore," Dec. 20).
But as both an avid birdwatcher and hiker (as well as a mechanical engineer), I find it very disappointing to see the amount of opposition that arises when large-scale wind energy projects are proposed.
Aside from solar power, wind is the only fuel-free, pollution-free and carbon-free source of electricity that exists. (While nuclear energy may be carbon-free, storing radioactive waste for thousands of years cannot possibly be considered pollution-free).
While there have been some valid concerns about bird kills and the aesthetics of wind energy, I challenge anyone who doubts the merits of wind energy to learn about the impact of electricity generated from coal and other polluting sources of energy.
To borrow from Al Gore's vocabulary, the inconvenient truth is that electricity generation has consequences, one of which is the degradation of the environment.
For instance, one need only go to the Web and Google the phrase "mountaintop removal" to learn more about the way that coal is mined.
The impact on wildlife habitat through this method of coal extraction, in which literally hundreds of feet of mountaintops are lopped off to get to the coal underneath, is far worse for birds and other animals than any impact caused by wind farms.
Coal mining accidents also caused more than 40 human deaths in the United States this year -- a fact many people, amazingly, seem to accept.
Left unchecked, global warming will kill off entire species of birds -- and is a far graver threat than even coal mining.
And coal is the biggest source of carbon dioxide from electricity generation, while wind energy does not contribute any greenhouse gases at all.
Regarding the aesthetic concerns about windmills, I was in Shenandoah National Park this October and read that visitors to the park in the 1930s could see the Washington Monument on a clear day, 70 miles away.
Well, thanks to the smog that is largely a result of coal-burning power plants, there are no longer any days when the air is clear enough to see the Washington Monument.
I wish the hikers who are concerned about seeing windmills would consider that their views have already been marred by the air pollution caused by electricity generation.
It is even more ironic to me that there is concern about being able to see windmills (perhaps a one-half a thumbnail high on the horizon) off the coast of the Atlantic Ocean at resort areas such as Rehoboth.
Aren't there already jet skis and speedboats zipping around in view of the beach?
And if current projections about sea levels are accurate, these seaside resort areas could be underwater by 2100.
Views from the beach will be a very low priority at that point.
Wind energy may not be a 100-percent perfect solution. But not only is it drastically better than alternatives such as coal or nuclear power, but wind and solar power are the only truly sustainable solutions we have for generating electricity.
Given our society's thirst for electricity, I don't think we have much of a choice but to embrace this technology and promote it wherever it is feasible.
Jeff Blankman
Owings Mills
Nigeria must master its own future fate
The series "The Real Cost of Oil" (Dec. 17-Dec. 18) paints a stark and all-too-familiar image of my country, Nigeria.
The disturbing portrait of life in the delta region reflects reality in most parts of Nigeria, where complacency in government affairs has become endemic and institutionalized.
The plight of the delta region reflects the predicament many indigenous people around the world, from Bolivia to the Congo, find themselves facing once they have the blessed misfortune of having mineral wealth underneath their ancestral land.
And in looking for solutions the focus should not be on the oil companies but on the national government.
It is the government's responsibility to ensure that its people and resources are protected and utilized efficiently.
There is a notion that governments in developing countries such as Nigeria are impotent to press these oil companies to do what they are supposed to do.
This is categorically false, unless these countries are not truly independent.
The problem in Nigeria and in most other developing countries is that the government is complicit with the foreign companies in a web of greed and disregards the basic needs of its citizenry.
The people of the Niger delta do not need to be taught how to fish or be provided with a well. I find that idea condescending and colonial.
The people of the delta have to be integrated into the companies as workers. This will help them gain expertise, education and increase their standard of living.
As one who studied Nigeria's history, I can't help but think that the people of the delta region must see their situation as d?j? vu all over again.
This is because in the 18th and 19th centuries the delta region was the site of huge plantations for the palm oil trade, which helped supply Britain's industrial revolution.
The cost of this trade for Nigeria was substantial but not devastating. The current situation will no doubt be worse for the people of the delta, as oil renders useless the very land from which those beautiful palm trees sprouted.
If Nigeria is truly independent, it has to take responsibility for its people, land and future.
Ebuka Umunna
Baltimore
Wrong way to limit the spread of AIDS
In the headline for The Sun's front-page article about the current push for circumcision in Africa to prevent HIV, the word "hope" should have been changed to "hype" ("2 studies in Africa offer hope on HIV," Dec. 14).
The studies the article mentioned don't look so good under close scrutiny. Each was concluded prematurely and without proper follow-up.
The lower rate of AIDS infection among the circumcised participants may well have resulted from decreased sexual activity during their recovery from the painful surgery. Despite this, some circumcised subjects still became infected.
The article also pointed out that that circumcision is common in the United States and rare in many other parts of the world.
But it failed to make a key point: The AIDS rate is much higher in the United States than in most other industrialized nations -- places where circumcision is uncommon.
If circumcision has a protective effect, how can that be?
The answer is that it doesn't.
In Western Europe, for instance, more sensible attitudes toward sex prevail and condom use is encouraged.
Condoms, not genital cutting, are the answer to AIDS prevention.
Nobody seriously proposes using circumcision as a substitute for condoms, nor is there any massive campaign to promote genital mutilation in Sweden or Finland. So why the push in Africa?
I believe adults should be permitted to undergo any surgical procedure they wish.
But since an infant cannot give consent, to circumcise him is a human rights violation.
And attempts to sell expensive surgery to poverty-stricken Africans, when condoms will do the job cheaply and easily, are ethically indefensible.
Jon Swift
Baltimore
Israeli occupation not cause of conflict
The writer of the letter "A 'Marshall Plan' for Mideast peace" (Dec. 23) poses a mostly one-sided and totally unrealistic plan for Middle East peace.
Under his plan, Israel would withdraw to its pre-1967 borders, compensate Arab refugees who lost property and help build a Palestinian state.
Almost in passing he mentions that peace-loving Arabs must then "marginalize" those Arabs who still want to destroy Israel, as if that would happen or even matter.
But so long as groups like Hezbollah and Hamas are dedicated to Israel's destruction, there is no potential for peace. Furthermore, Israel would be foolhardy to return to the 1948 armistice border that left Israel's center too narrow to defend.
First, the conflict did not begin in 1967 when Israel occupied the West Bank and Gaza.
Rather, it began in the 1800s when large numbers of Jews and Arabs began immigrating to sparsely-populated, Ottoman-controlled Palestine.
In 1947, Arab states rejected the United Nations' effort to establish of Jewish and International zones in Palestine.
In 1948, Arab states tried to destroy the state Jews established in their zone, i.e., Israel. From 1948 to 1967, Arab terrorists launched frequent attacks in Israel, and Syrian gunners on the Golan Heights regularly fired on Jewish farmers.
In 1967, Egypt massed troops on Israel's border and announced its intent to drive all Jews into the sea.
In the war that followed, Israel captured the West Bank, Gaza and the Golan Heights.
Israel would not have occupied those areas had that war not occurred.
Eldersburg
Hiring on the cheap won't enhance USM
The writer of the letter "Overpaid coaches, underpaid teachers" (Dec. 21) is quite right when he says that university instructors deserve the sort of consideration now reserved for athletic coaches.
And it is really appalling when instructors such as the lecturer from Morgan State University who wrote the letter "Low-paid lecturers carry heavy burden" (Dec. 21) must teach year after year without health benefits, a pension plan or even job security.
The problem is that this "faculty underclass" of full-time lecturers and instructors hired on repeated annual contracts, with none of the benefits or protections of regular employment, is exploited -- just like alllabor underclasses,
Until recently, the University System of Maryland would not allow such "temporary" contracts except in emergency situations.
All full-time faculty engaged were on tenure track and, after six or seven years of satisfactory work, could be considered for permanent tenure.
Then somehow the practice of annual hiring on the cheap was allowed and it has spread like a noxious weed.
With a new administration preparing to take office in Annapolis, this would be a good time for the Board of Regents and USM administrators to take a more sensible look at the long-range needs of Maryland higher education.
The universities brag about their growth -- new programs, more students, branch campuses -- but such growth means, or should mean, additional, qualified faculty members, who are suitably compensated.
And this will cost money, even if their salaries don't reach those of the football and basketball coaches.
Edwin Hirschmann
Baltimore
The writer is a professor emeritus at Towson University.
Elizabethan idiom carries real weight
Victoria Brownworth is quite correct that "one of the most compelling stories of early Colonial American history is... the establishment of the Jamestown Colony."
But her review of my book, The Weight of Smoke, does a disservice to readers by mischaracterizing the way I go about telling that story ("Next time lay offe ye olde idiom," Dec. 10).
Evidently, Ms. Brownworth wishes I had written a different novel. In particular, she takes issue with my re-imagining of Elizabethan (she wrongly calls it "Jacobean") speech and thought and says, "Prithee how to depict the vernacular of yore? Aye, matey, there's the rub."
Pardon me, but the example of my writing she then cites bears not a trace of such hackneyed, cartoon-like gibberish.
If sometimes I impart a different language to my characters than the one we speak today, it is because I believe those characters think, act, feel and believe rather differently than most of us do, and that our understanding of them requires something other than Hollywood platitudes or James Fenimore Cooper-style melodrama.
George Robert Minkoff
Alford, Mass.
Welcoming Muslims is threat to women
I don't think the issue is about swearing on the Koran -- the issue is multiculturalism and the conflicts it creates ("Not Goode enough," editorial, Dec. 26). And Islamic gender apartheid would not be good for my granddaughters.
We go around brandishing our tolerance like a holy spear, without regard for the effects it may have on our grandchildren.
But the more Islamic immigration to this country occurs, the more Islamic political power there will be. And thus the more our culture will bend to Islamic norms, which will not be good for women or for our granddaughters.
The old process of assimilation has been rendered impotent by multiculturalism.
We might feel good and self-congratulatory now about how open-minded we are. But our granddaughters will live under an oppressive, anti-feminist agenda if Islam gains any measure of political power.
Dana Ely
Fulton
City's murder rate is still out of control
I don't understand the desire to make the city's murder rate sound better than it is ("City passes '05 homicide total," Dec. 26).
The city had 353 murders in 1993, the highest 1990s murder count I could locate, when its population was about 731,000. The murder rate was 48.3 murders per 100,000 residents.
In 2000, the city had a population of about 651,000 and 261 murders for a rate of 40 murders per 100,000 residents.
In 2005, the city had 269 murders with a population of about 635,000, or about 42.3 murders per 100,000 residents.
But none of this justifies The Sun's statement that: "The homicide rate is still significantly lower than its peak in the mid-1990s, when more than 300 people were killed each year."
Indeed, according to data published by Morgan Quinto press, based on FBI crime reports, Baltimore ranked No. 1 in murder rate for large cities and No. 6 among cities of all sizes in the United States in 2005.
The Sun's article went on to note: "'It's hard to help people who don't want your help,' said police spokesman Matt Jablow, adding that more than 80 percent of city homicide victims have criminal records."
This police line of spin is difficult for me to understand. It's an abdication of responsibility both for the murders and the original crimes.
Do the police mean to suggest that killing another person who had been convicted of a crime is somehow an approved act?
Or is every murder victim supposed to know their time is up and ask for police protection?
It seems to me that in Baltimore we have a systemic problem that begins with failed families and involves failure to deliver drug treatment, failed juvenile services, failed social services, failed community policing and failed schools.
The city has maintained its inability to do anything much of anything about all of these issues for more than 30 years - and, as far as I can see, the grand failures occur only in the poorer neighborhoods.
I'd like to see a little less spin and a little more interagency planning, please.
Jill Marquiss
Baltimore
As a Baltimore resident I was not surprised that we passed last year's homicide total with a week to go in 2006.
But what I found most interesting were the elected officials' opinions about what we need to do to bring the murder rate down.
Soon-to-be mayor Sheila Dixon calls for "improved relations between the police department, the state's attorney's office and the court system."
Del. Jill P. Carter laments the illegal arrests and other unproductive practices of the police department.
Baltimore Circuit Court Clerk Frank M. Conaway says the answer is more foot patrol officers in the violent neighborhoods.
And City Councilman Kenneth N. Harris Sr. calls for more legislation to combat crime, and moving officers in specialized units to the district offices.
But none of the above will solve the problem, since the police, the state's attorney's office and the courts all step in after the murder.
And none of these officials mentioned the shooters, who are the only ones who can drive down the homicide numbers.
As far as I can see the shooters are not afraid of the criminal justice system.
Somehow we have to get to the shooters.
Otherwise, all we can do is wait until they kill each other off, then maybe the homicide numbers will come down.
R. A. Bacigalupa
Baltimore