thegreekdog wrote: Symmetry wrote: thegreekdog wrote: Symmetry wrote: thegreekdog wrote:
Symmetry wrote:Surely the state has made a decision to defer to the doctors it employs as to what is or isn't necessary. If an illness of any kind is politically unsavoury to the politicos in charge, should it go untreated when diagnosed and treatment is recommended?
The state already has an obligation to pay for medical treatment of those that it imprisons. The deciders of what or what isn't proper medical treatment shouldn't depend on politicians, but on medical diagnosis by medical professionals.
Do you object to the state paying for the medical expenses of its prisoners? The alternative is a gulag.
Or do you object to medical professionals deciding what is or isn't medically necessary?
The issue is not whether the prisoner gets treatment. The issue is whether the state pays for the treatment. I think the government is fully able to and should be fully able to determine whether it must pay for the treatment, whether the doctor says it's necessary or not.
That seems like a rather disturbing principle. Essentially you're saying that medical diagnoses should be left to popular consensus rather than medical expertise with regards to implementation.
The issue, of course, is whether the prisoner gets treatment.
I wish you would stop framing the issue as one about who gets to make the diagnosis when I've already indicated multiple times that this is not the issue. The doctor absolutely should make the diagnosis. I'm certainly not suggesting that anyone other than the doctor should make the diagnosis. The issue is not whether the prisoner gets treatment. The prisoner could be diagnosed with a brain tumor by a doctor; the prisoner should have it operated on. The question then becomes who should pay for it. Does the patient pay for it? Does the doctor pay for it? Does the state pay for it? States make determinations as to who gets what money on a daily basis. I'm fairly sure you're familiar with how that works, so I'm struggling as to why this is so difficult for you to grasp right now.
Except, in today's world, you cannot really seperate those two.
The law is that prisoners, being held by the state and essentially "in our care" should get what is considered humane treatment, which has also been ruled to include what doctors consider mandatory. This was not one rule, it was a series of rulings.. I am summarizing. I think you have better access than I to the original briefs should you wish to review them.
Anyway, all that was established already. The sole issue the judge had to rule upon was whether this particular procedure met those criteria. The judge felt It did. The doctor ruled it a necessity, and other rulings dictated that the state has to pay necessary care for prisoners. (Jimbo -- Whether the judge liked the rule, the judge's personal opinion on transgender treatment or even payment of advanced prisoner medical treatments was irrelevant. The prior rulings directed his current assessment of what the law dictated.)
That is why I interjected my assertion way back.. that the law itself needs to be changed. I disagreed with Symmetry in that I think we not only can, but must
set reasonable limits, because we plain cannot afford to just pay for everything, even those deemed medically necessary -- we cannot do so for free, working and tax paying citizens, never mind convicted murderers.
Off hand, I think we need independent boards to go over standards of care for prisoners.. for all areas of society, to be honest. It should include doctors involved with the populations (in this case prisoner's doctors, though perhaps retired or folks in other states), as well as ethicists, "budget" types, and yes... legal experts. However, seems like the last time such was mentioned, it was condemned as "death panels". Folks get hyped up and hysterical about limiting care, (unless its the "A" bit of course.. ironic, that.. but that is for other threads).
However, one thing we DON'T need is to have judges have to cater to every last whim of special interests. Judges should rule on the law. Whether that rule is popular or not is irrelevant.