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Annie Le had time to fight back

ABC News reports:

Sources also said investigators are finding evidence that the pint-size scientist who weighed only 90 pounds put up a fierce struggle against her attacker.

Blood spatter was found on a laundry cart, and a bead from her necklace was found on the floor of the basement lab where she was killed and stuffed into a wall panel.

More here

Hat tip to Hecate's Crossroad

Being legally disarmed she would had little chance against a larger stronger attacker like the man accused of the crime.  In light of this new evidence anyone who claim a weapon would have her no good are full of crap or just refusing to live in the real world. Even a small knife would have helped her get away.

Or maybe they just have a secret hankering to commit murder and want to know their victims will be helpless:

Never forget, even for an instant, that the one and only reason anybody has for taking your gun away is to make you weaker than he is, so he can do something to you that you wouldn't allow him to do if you were equipped to prevent it. This goes for burglars, muggers, and rapists, and even more so for policemen, bureaucrats, and politicians.

-Alexander Hope, from the novel "Hope" by L. Neil Smith and Aaron Zelman

I have a daughter not much older than Annie Le.  The thought that she might end up dead because some bureaucrat wants to make it easy for the criminals to ply their trade makes me so mad I can't see straight.

Free Speech is now Obstruction of Justice -- Followup

Jacob Sullman at ReasonOnline has a followup on this story

Drug Control Becomes Speech Control

When the government accuses a doctor of running a "pill mill," prosecutors portray every aspect of his practice in a sinister light. Prescribing painkillers becomes drug trafficking, applying for insurance reimbursement becomes fraud, making bank deposits becomes money laundering, and working with people at the office becomes conspiracy.

When Siobhan Reynolds thinks a doctor has been unfairly targeted for such a prosecution, she tries to counter the official narrative by highlighting the patients he has helped and dramatizing the conflict between drug control and pain control. But now the government has turned its reinterpretive powers on Reynolds, portraying the pain treatment activist's advocacy as obstruction of justice and thereby threatening the freedom of anyone who dares to suggest there is more than one side to a criminal case.

more

Hat tip to Radley Balko

The Wages of Socialism are Death

The Telegraph (UK) reports

Sentenced to death on the NHS
Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors warn today.

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By Kate Devlin, Medical Correspondent
Published: 10:00PM BST 02 Sep 2009

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In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.

As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.

“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients."

The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.

The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.

Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions.

It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Government’s health scrutiny body, in 2004.

It has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system.

Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.

They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication.

However, doctors warn that these signs can point to other medical problems.

Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance.

When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.

If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.

Dr Hargreaves said that this depended, however, on constant assessment of a patient’s condition.

He added that some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.

He said: “I have been practising palliative medicine for more than 20 years and I am getting more concerned about this “death pathway” that is coming in.

“It is supposed to let people die with dignity but it can become a self-fulfilling prophecy.

“Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.”

He added: “What they are trying to do is stop people being overtreated as they are dying.

“It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”

He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.

Prof Millard said that it was “worrying” that patients were being “terminally” sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.

In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.

“If they are sedated it is much harder to see that a patient is getting better,” Prof Millard said.

Katherine Murphy, director of the Patients Association, said: “Even the tiniest things that happen towards the end of a patient’s life can have a huge and lasting affect on patients and their families feelings about their care.

“Guidelines like the LCP can be very helpful but healthcare professionals always need to keep in mind the individual needs of patients.

“There is no one size fits all approach.”

A spokesman for Marie Curie said: “The letter highlights some complex issues related to care of the dying.

“The Liverpool Care Pathway for the Dying Patient was developed in response to a societal need to transfer best practice of care of the dying from the hospice to other care settings.

“The LCP is not the answer to all the complex elements of this area of health care but we believe it is a step in the right direction.”

The pathway also includes advice on the spiritual care of the patient and their family both before and after the death.

It has also been used in 800 instances outside care homes, hospices and hospitals, including for people who have died in their own homes.

The letter has also been signed by Dr Anthony Cole, the chairman of the Medical Ethics Alliance, Dr David Hill, an anaesthetist, Dowager Lady Salisbury, chairman of the Choose Life campaign and Dr Elizabeth Negus a lecturer in English at Barking University.

A spokesman for the Department of Health said: “People coming to the end of their lives should have a right to high quality, compassionate and dignified care.

"The Liverpool Care Pathway (LCP) is an established and recommended tool that provides clinicians with an evidence-based framework to help delivery of high quality care for people at the end of their lives.

"Many people receive excellent care at the end of their lives. We are investing £286 million over the two years to 2011 to support implementation of the End of Life Care Strategy to help improve end of life care for all adults, regardless of where they live.”

Note the weasel wording, "Many people receive excellent care at the end of their lives." Not most or a majority but an indeterminate many. Sorry "spokesman for the Department of Health" but many doesn't really mean much in this context. One thousand would still be "many" even if selected from 100 thousand patients.

Next "spokesman for the Department of Health" tells the reader just how much money is being spent -- £286 million -- "...to help improve end of life care for all adults." More political damage control. When you can't dazzle them with success (ie brag about your accomplishments) baffle them with bullshit (ie brag about how much money you are spending not accomplishing).

Free Speech is now Obstruction of Justice

Apparently the Department of Justice thinks so.

Wichita Witch Hunt

No good deed goes unpunished when a private citizen is up against the federal drug warriors--those members of the Department of Justice who have been seeking, with increasing success in recent decades, to effectively control the practice of pain relief medicine. But a current drama being played out in federal court in Kansas portends an even darker turn in the DOJ's war--a private citizen is being threatened with prosecution for seeking to raise public and news media consciousness of the Feds' war against doctors and patients.

The current contretemps in Wichita has its roots in 2002 when Sean Greenwood, who for more than a decade suffered from a rare but debilitating connective tissue disorder, finally found a remedy. William Hurwitz, a Virginia doctor, prescribed the high doses of pain relief medicine necessary for Greenwood to be able to function day-to-day.

Yet when federal agents raided Hurwitz's clinic in 2003 and charged the pain management specialist with illegal drug trafficking, Greenwood's short-lived return to normalcy ended. He couldn't find another doctor willing to treat his pain--the chances were too good that the "narcs" and the federal prosecutors who work with them would assert impossibly vague federal criminal drug laws. Three years later, Greenwood died from a brain hemorrhage, likely brought on by the blood pressure build-up from years of untreated pain.

Greenwood's wife, Siobhan Reynolds, decided to fight back. In 2003 she founded the Pain Relief Network (PRN), a group of activists, doctors and patients who oppose the federal government's tyranny over pain relief specialists.

Now, the PRN's campaign to raise public awareness of pain-doctor prosecutions has made Reynolds herself the target of drug warriors. Prosecutors in Wichita have asked a federal grand jury to decide whether Reynolds engaged in "obstruction of justice" for her role in seeking to create public awareness, and to otherwise assist the defense, in an ongoing prosecution of Kansas pain relief providers. The feds' message is clear: In the pursuit of pain doctors, private citizen-activists--not just physicians--will be targeted.

For Reynolds, the script of the Kansas prosecution has become all too familiar: The feds announced a 34-count indictment at a December 2007 press conference. Local media dutifully reported the charges with minimal scrutiny and the accused--Dr. Stephen Schneider and his wife, Linda, a nurse--were convicted in the court of public opinion before their trial even began.

In such an atmosphere, it is very difficult to make the point that physicians engaged in the good faith practice of medicine are being second-guessed--not by fellow physicians, but by the federal government--and punished under the criminal law for administering what the Drug Enforcement Agency (DEA) of the Department of Justice considers more narcotics than is necessary to alleviate a patient's pain.

When pain doctors administer too much of a controlled substance, or do so knowing that they will be diverted to narcotic addicts, they are deemed no longer engaged in the legitimate practice of medicine. But the dividing line is far from clear and not subject to universal agreement even within the profession. Any patient in need of relief can, over time, develop a chemical dependence on a lawful drug--much like a diabetic becomes dependent on insulin. And, once a treatment regimen begins, many patients' tolerance to the drug increases. Thus, to produce the same analgesic effect, doctors sometimes need to increase the prescribed amount, and that amount varies from person to person.

It is notoriously difficult even for trained physicians to distinguish an addict's abuse from a patient's dependence. Nonetheless, federal narcotics officers have increasingly terrorized physicians, wielding the criminal law and harsh prison terms to punish perceived violators. Since 2003, over 400 doctors have been criminally prosecuted by the federal government, according to the DEA. One result is that chronic pain patients in this country are routinely under-medicated.

The litany of abusive prosecutorial tactics could fill a volume. A "win-at-all-costs" mentality dominates federal prosecutors and drug agents involved in these cases. After a Miami Beach doctor was acquitted of 141 counts of illegally prescribing pain medication in March 2009, federal district court Judge Alan Gold rebuked the prosecution for introducing government informants--former patients of the doctor who were cooperating to avoid their own prosecution--as impartial witnesses at trial.

Improprieties galore marked the prosecution of Dr. Hurwitz. Before his trial in federal court in Virginia in 2004, the DEA published a "Frequently Asked Questions" (FAQ) pamphlet for prescription pain medications. In a remarkable admission, the DEA wrote that confusion over dependence and addiction "can lead to inappropriate targeting of practitioners and patients for investigation and prosecution." Yet on the eve trial, the DEA, realizing that Hurwitz could rely on this government-published pamphlet to defend his treatment methods, withdrew the FAQ from its Web site. Winning the case proved more important than facilitating sound medical practice. Hurwitz was convicted.

In Kansas, it appears that zealous prosecutors are targeting not only the doctors, but also their public advocates. When Reynolds wrote op-eds in local newspapers and granted interviews to other media outlets, Assistant U.S. Attorney Tanya Treadway attempted to impose a gag order on her public advocacy. The district judge correctly denied this extraordinary request.

Undeterred, Treadway filed on March 27 a subpoena demanding a broad range of documents and records, obviously hoping to deter the peripatetic pain relief advocate, or even target her for a criminal trial of her own. Just what was Reynolds' suspected criminal activity?

"Obstruction of justice" is the subpoena's listed offense being investigated, but some of the requested records could, in no possible way, prove such a crime. The prosecutor has demanded copies of an ominous-sounding "movie," which, in reality, is a PRN-produced documentary showing the plight of pain physicians. Also requested were records relating to a billboard Reynolds paid to have erected over a busy Wichita highway. It read: "Dr. Schneider never killed anyone." Suddenly, a rather ordinary exercise in free speech and political activism became evidence of an obstruction of justice.

On Sept. 3, a federal judge will decide whether to enforce this subpoena, which Reynolds' lawyers have sought to invalidate on free speech and other grounds. The citizen's liberty to loudly and publicly oppose the drug warriors' long-running reign of terror on the medical profession and its patients should not be in question. Rather, the question should be how the federal government has managed to accumulate the power to punish doctors who, in good faith, are attempting to alleviate excruciating pain in their patients.

My guess is Siobhan Reynolds' campaign was starting to yield results and the cockroaches are trying to turn off the lights. I really do not understand the thinking of someone who will sentence even one person to unnecessary pain in the pursuit of a paycheck. That kind of evil needs some end-of-rope counseling.

Hat tip to The Advice Goddess Blog