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Minneapolis Police: Uses dangerous drug to sedate criminals

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Minneapolis has some creative people. Too creative for their own good. Somebody probably saw that the guys who take down large animals with tranquilizer darts use darts filled with ketamine. “Hey, if it will take down those animals, why don’t we use it on the animals our police are fighting?” And an immensely stupid program began. It was also illegal, but if we’re controlling bad guys, who cares?

Time for disclosure. I am a doctor. I do not play one on TV. Not only that, I’m an anesthesiologist and used ketamine in my practice. For certain things, it has no equal. But its proper uses are quite limited.

Ketamine comes from a class of drugs called phencyclidines. The street version is known as Angel Dust, and abusers are Dusters. Because ketamine causes profound analgesia (pain relief), Dusters are known for feats of superhuman strength. Broken handcuffs are just one relatively well-known example. At the same time, Dusters may break their own bones. The analgesic effect of ketamine keeps them from realizing the damage they are doing to themselves.

By now, it should be pretty clear that ketamine is no panacea for the problem of sedating troublesome persons being arrested. At the wrong dose in the wrong person, police can put themselves in worse difficulties than when they started. How do you control someone who feels no pain and wants to cause you harm? Flashback to the villain Renard in The World is Not Enough. He is almost impossible to defeat in a fight because he feels no pain. But I guess the Minneapolis wise guys don’t watch James Bond films.

I have to wonder if the police bothered to look at any references. Even Wikipedia would have been helpful. If they had, they’d discover that there are a lot of other problems with ketamine. The first one should have given them a real headache. The primary reason we don’t use ketamine a lot in anesthesia is that it has a high incidence of emergence delirium. In language even an inattentive civil servant can understand, that means that if you give someone ketamine, they can hallucinate. This happens often enough that we try to avoid ketamine except in those odd cases where its other effects make it the best drug available. Just to make a bad problem worse, there are a lot of times when there isn’t anything you can do to stop the delirium. Welcome to hell.

We’ve only scratched the surface. Since Minneapolis police officers obviously consulted Dr. Conrad Murray, we should expect that they got the same level of advice Michael Jackson got. That means that they missed the fact that ketamine can lead to airway obstruction and death. It releases adrenaline, so it can cause hypertension and tachycardia leading to death. Did I mention that it can kill you? And, unlike opioids, you can give all the naloxone you want and it won’t do a bit of good.

But the Minneapolis police officers are really interested in saving lives, so we can let them use this drug they simply don’t understand on patients who aren’t consenting and may suffer badly from its administration. No problem.

The track record is as bad as I suggested up front. Ketamine administration has led to multiple episodes of cardiac and breathing problems, with many patients requiring emergency intubation. Now for a skilled health care provider, intubation is generally no big deal. But you never deliberately put yourself in a position where you create an uncontrolled need for intubation. The moment you do that, you’ll find yourself looking at the impossible situation. With somewhere around fifty thousand intubations under my belt, the next one can still be the one where I have to call a partner in to give it a try. My practice had over eighty anesthesiologists and two hundred nurse anesthetists, so there was usually another set of hands available. But who is the paramedic in the field going to call? Ghostbusters has an unlisted number.

Let’s get one thing clear. Minneapolis police officers did not have a hand on the syringe. They asked the Hennepin County paramedics to administer ketamine. And if a cop asks, how is a paramedic supposed to refuse? But the paramedics are supposed to operate according to a strict protocol, and only give ketamine when a patient is “profoundly agitated, unable to be restrained, or a danger to themselves or others.” It’s clear that this guideline was violated on multiple occasions.

And this brings us to the nub of the matter. Ketamine is properly used only in the sort of situation described in the protocol. In anesthesia, we will also use it in autistic or severely mentally retarded patients who cannot be managed by breathing them to sleep with gases. In short, we mostly use it in the controlled medical equivalent of the field situation.

It’s likely that Dr. Jeffrey Ho (the director of Hennepin County EMS who happened to graduate from the same medical school I did!) is actually well aware of the proper use of ketamine. He’s a recognized expert in pre-hospital emergency care. And if ketamine is used in the very restricted fashion the policy describes, it’s probably better than most alternatives. But when police decide that they want a set of chemical handcuffs rather than doing their job, we have a problem.

Police work can be difficult and dangerous. But police are not allowed to place people in danger just to make their own life easier. Doing so exceeds the bounds of our social contract with police, and also violates a host of laws. For a paramedic to go along with such an improper request places that paramedic in violation of state laws on the practice of medicine. Their drivers’ license isn’t enough. You follow the protocol or get permission from the supervising ER doc by calling it in.

Hennepin County and the city of Minneapolis have a problem on their hands. Their best bet will be to quietly approach persons who were harmed by this cavalier misuse of ketamine and buy out their legal liability. Then the EMS and police persons involved should be invited to leave. Promptly. Do not pass Go. Do not collect $200.

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Conservatism

Why Tomi Lahren’s abortion view harms American conservatism

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Why Tomi Lahrens abortion view harms American conservatism

Democrats are unambiguous and united in their view of abortion. It wasn’t always this way. As recently as a decade ago, there were a good number of pro-life Democrats winning elections and expressing their views as pundits.

Today, they don’t exist.

Republicans aren’t so repulsed by the pro-abortion people in their midst. It’s understandable that as a party that’s less focused on individual issues, one can be a Republican without checking off all the various boxes. This is fine. What’s not fine is for breaks in the ranks of conservatives. There are certain things that must remain universal among those who claim to embrace conservatism, especially among those who speak for conservatives.

Fox Nation’s Tomi Lahren is one of them. She claims to be a conservative, but she’s pro-choice. That fact, by itself, is understandable because the issue is a polarizing one in which people can be swayed to one side based on personal experience. It’s not like taxes which warrant universal scorn from conservatives. There are gun-toting, tax-hating, pro-choice conservatives.

But there’s a bigger problem with Lahren’s perspective. She’s not just attacking the Alabama abortion bill and pro-life perspectives in general. She’s doing so with an argument that flies in the face of reality.

Do we think government is the answer? No. In fact, one of the most appealing parts about the Alabama abortion bill is that it represents the first true opportunity for the Supreme Court to overturn Roe v. Wade. When it reaches the Supreme Court (and it almost certainly will) it gives us the first glimpse of how the current makeup of the court will react. In fact, the makeup of the court could actually be better if one of the left-leaning Justices retires soon.

Once Roe v. Wade is out of the way, we can finally express the truly conservative aspect of federalism that should have never been taken away – the states’ rights to determine their own healthcare laws.

If Tomi Lahren doesn’t like the abortion ban, that’s fine. Her choice. But to defend her choice by insinuating a challenge to Roe v. Wade is somehow an attack on limited-government tenets is false and harms conservatism.

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Culture and Religion

President Trump affirms abortion exceptions for rape, incest, and life of the mother

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President Trump affirms abortion exceptions for rape incest and life of the mother

Following last week’s fury over the Alabama abortion bill that essentially bans abortion in all cases other than a threat to the life of mother, President Trump has weighed in. While not addressing the bill directly, he still declared his stance on abortion and called for voters to stand with him to protect life.

Opinion

Our EIC noted a couple of days ago that belief that life begins at conception means being an abortion absolutist that backs the Alabama law. I tend to agree, which is why I believe we have to classify the President’s remarks as a secular belief in the sanctity of life. When we insert our human morality into the equation, it becomes a moral issue to want exceptions.

That’s fine. There may be bickering over who may actually be pro-choice based on their perspectives, but from a political perspective we need to make sure we keep our eyes on the big picture. We want Roe v. Wade to be overturned. Then, the states can decide how they want to handle the “healthcare” issue of abortion.

The rest is part of the cultural battle against abortions. This is why I’ve said many times in the past that we have to view this as a multi-front battle. We have the political front, and that’s going to be ever-changing. But we also have the cultural front in which we have to make decisions about how we view the life within the mother, whether from a religious or moral perspective. The third front is the scientific arena which has been quickly shifting away from the pro-abortion world to vindicating past claims pro-lifers have been making for decades.

The President’s stance, while not perfectly aligned with mine, is still exponentially better than anything the entirety of the Democratic Party is putting forth. What’s worse is that their candidates are pushing radical abortion ideas.

Quote

“If we believe the miracle of life begins when a human is conceived, then we must defend that life as a fellow creation of God regardless of the circumstances. Then, we must do everything in our power to aid the mother through the challenges she and her child will face.” – JD Rucker

Final Thoughts

We can bicker over the extent that pro-life laws should block abortions, but the general direction of overturning Roe v. Wade should allow conservatives to walk along the same path. We can discuss details afterwards.

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Culture and Religion

Ethical dilemmas

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Q&A

Q: Is it ever ethical to take a human life?

A: Yes.

WHY?

Killing is not always murder.

SELF DEFENSE

In most societies and most jurisdictions, preventing another person from taking one’s own life is justifiable even if deadly force is required.

LAW ENFORCEMENT

If a law enforcement officer fears for his or her life or to protect the life of another, the Use of Force Continuum must be applied. There are various models but this is the basic one that has been taught to federal officers.

Continuum

WARFARE

Taking the life an enemy soldier with a rifle pointed at you may not cause ethical anguish when considered abstractly. It must not cause a moment’s hesitation on the battlefield.

Today, sometimes the person who “pulls the trigger”, or launches the drone in the Middle East or Southwest Asia could be sitting in an air-conditioned room in the Nevada desert. He or she is in no immediate danger. But it is warfare none the less.

But when an Al-Qaeda or ISIS operative is taken out in Pakistan or Afghanistan, for instance, his family including possibly small children are going to be in the wrong place at the wrong time.

I would submit that the toughest decision ever made by a U.S. President and Commander-in-Chief fell upon the gentleman from Independence, Missouri. The war of attrition continued in the Pacific after Germany had already been defeated in Europe. The Empire of Japan would never have surrendered had not the atomic bombs been dropped on Hiroshima and Nagasaki in August 1945 under orders from Harry S. Truman.

I personally served in the United States Air Force for 5 1/2 years between December 1968 and June 1974 during the Vietnam era with assignments for nearly three years in the Philippines and on Okinawa. But I never faced combat.

Friends and family who did fight in Vietnam understandably did not like talking about it. War is hell. No doubt. That particular war should never have happened. But the blame is upon political leaders not the soldiers who just did their duty. They just did what they had to do to protect themselves and their fellow soldiers.

CAPITAL PUNISHMENT

I live in Hawaii which does not and surely never will execute criminals for any crime whatsoever. Byran Uyesugi committed the worst mass murder in Hawaii history on November 2, 1999 murdering 7 people at Xerox on Nimitz Highway in Honolulu. I haven’t seen an article or heard word mentioned about him in years. No need to Google it again now.

But of course I hear about executions in many states on the U.S. mainland, many of them in Texas. I can’t say whether Byran Uyesugi would be a threat to public safety if he ever was released or escaped. Life imprisonment may well serve the cause.

Executing a prisoner as punishment or retribution is something that I would not personally want to happen. But if a person is liable to harm others, and if the people of a state support capital punishment, that is a decision they and their elected officials must make and bear responsibility for.

TERRORISM

This is a separate category from warfare per se. Some may call it asymmetrical warfare. But here we are not dealing with nation-states and formal military combatants.

I have no problem whatsoever with KSM having been waterboarded. If he expired during that, and it resulted in information that saved innocent lives, it would have been justifiable in my book. He’s still in Gitmo and they may as well throw away the key.

ABORTION

It was an abortion issue that led me down the path of this ethical dilemma. But first I wanted to address other scenarios where we as human beings, even the most moral among us, usually agree that there are limited circumstances where one may and must take another human life.

IS ABORTION EVER NECESSARY?

That is the key to dealing with the ethical dilemma.

In the strictest sense, the answer is no. The possible exception to that would be the life of the mother. If a medical doctor determines that either she or her baby can survive but not both of them, both lives have equal value.

There are mothers who will sacrifice their own life to bring new life into this world. If she is not medically capable of making her own decision, then that is the most heart-wrenching choice her husband could ever have to make.

Life begins at conception. A sperm or an ovum by itself is not yet a life, but when the DNA of both mother and father form a zygote, it is a new distinct life which is not a clone of either parent. Therefore, I would not even support the morning after pill.

EXCEPTIONS?

The part that we as Christians and as conservatives may legitimately differ over is the matter of rape and incest. Either way, an abortion kills a living child. There’s no getting around that.

Therefore I believe that in both cases, the pro-life position is that exceptions should not be made. This is not as simple a conclusion to reach as it might at first seem.

RAPE

A woman’s life is already tragically impacted when she is raped. Adding to that, killing her offspring in her womb due to the circumstances of the conception and the unknown hereditary traits that might be passed along from the rapist will further traumatize any woman with a conscience.

While I would hope that a loving Christian mother would want her child no matter what, I would not condemn her for whatever she decides. If she does not choose to raise the boy or girl herself, adoption is a far better option than abortion.

Testimonies of people who were conceived by rape confirm that their lives do matter. The ethical dilemma comes in whether we criminalize abortions in cases when the baby was conceived via rape.

I want the children to live. But do we really want to tell a doctor he cannot abide by the decision of the woman who suffered the rape?

I pose the question but I’m not going to try to provide a conclusive answer. You will have to decide for yourself on this.

INCEST

This is a harder issue to deal with than rape. The reason is that hereditary and genetic anomalies may occur as a result of inbreeding. An entire extended family will be disrupted by any case of incest.

Incest is one of the most unpleasant subjects to even have to consider. It totally disgusts decent people. Unfortunately, in this world it happens all too frequently.

That’s why I believe that a baby in the womb conceived by incest must lead to respect of a professional medical evaluation of the situation.

I will not go into how the birth of such a child complicates any family structure. You can visualize that easily enough for yourself.

Yes, every human life has value from the moment of conception. That is why it is one of the most difficult choices a pregnant woman will ever have to make on behalf of her entire family.

Again, as with rape cases, do we really want to bring felony charges against a medical doctor who is caring for a mother who has an incest-conceived child in her womb?

WHO MAKES THE LIFE OR DEATH CHOICE?

In the case of a civilian facing a deadly threat to himself or herself, or of a police officer or a soldier in the line of duty, he or she must make a split-second decision whether to use lethal force. It is an irrevocable decision, the consequences of which are the alternative to possibly dying on the spot.

With capital punishment, it is a decision which each sovereign state must make. There is a federal death penalty but it is used rarely for people such as Timothy McVeigh.

Concerning terrorism, this will continue to be a thorny issue as long as our leaders refuse to properly focus upon the underpinning ideology of Jihad. Suffice it to say here, this is an existential issue that is just going to have to be dealt with realistically.

BUT IS ABORTION A CHOICE?

That is tearing our society apart at the moment. Both the Bible and the Constitution were written before modern technology existed. We can never fully comprehend the eternal and infinite wisdom of Almighty God as long as we are still here on this mortal sphere. We must also apply the U.S. Constitution to technology which did not exist in the 18th century or in the minds of our Founders.

For Christians, this is very much a spiritual and religious issue. But how do I present an argument to U.S. Senator from Hawaii Mazie Hirono who is a Buddhist? She does not accept or acknowledge the Judeo-Christian tradition. I have no idea if Buddha ever had any concept regarding abortion nor does that line of reasoning hold any promise in this present context.

Therefore, I hope she can realize that defining the object of abortion as a human life is not just a modern conservative invention. When she talks about decades of precedent set by Roe v Wade, that pales in comparison with millennia of respect for life in the womb.

Of course I realize that neither I nor any other of the people she was elected to serve here in Hawaii will ever convince Mazie that abortion is not just a woman’s healthcare choice.

It’s hard to imagine that anyone can seriously look at an ultrasound in this day and age and declare that abortion-on-demand up to the moment of delivery is a constitutional right.

If they cannot see that it is a human baby in the womb, then they suffer from cognitive dissonance. No further discussion or debate will change their mind.

If they say it is already a child but they don’t care, likewise they have made their choice and it is a choice of death.

OUR ORIGINAL QUESTION

Is it ever ethical to take a human life?

Yes, but abortion on demand is not one of those circumstances. Children conceived in rape or incest have a right to life.

The question with which I will leave you is:

Will you prosecute medical professionals who perform an abortion at the behest of the mother in cases of rape and incest? That’s what state laws that will inevitably be decided by SCOTUS will determine.

EPILOGUE

In Hawaii, we must elect conservatives to Congress because none of the incumbents will ever change course and support pro-life legislation. If your U.S. Senators and Representatives in your state are more reasonable, please contact them with your views. The same goes with state legislators.

This could go either way when it reaches the U.S. Supreme Court. It’s possible that Roberts and Kavanaugh could go the wrong way and let Roe v Wade stand. I’d rather see this reach that ultimate arbiter after President Trump has the opportunity to nominate someone to succeed RBG.

YOUR ANSWER

The ethical dilemma does not extend to the wanton slaughter of pre-born babies. But, you must answer for yourself what should be done in cases of rape or incest. Do you believe abortions under such circumstances should be criminalized and doctors prosecuted? Don’t tell me; contact your legislators.

Psalm 139 13

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