On today, the day of Terri Schiavo’s death, it’s fitting that I came across “Live Everlasting,” a fantastic essay by Garret Keizer in Harpers. It’s one of the best statements I’ve read about the interplay of medical and social norms about the prolongation of life at all costs, and highlights a lot of the contradictions made by those who wish to take decisions of life from individuals and invest them in some higher authority. There are precious few pullquotes that do the length and depth of the essay justice, but perhaps this is enough to tempt you to dive in:

From that exalted vantage point, consider Dr. Thompson’s cavalier disregard for human life. He may have hastened his patient’s death by as much as five minutes. Let’s be as reckless as he was and say five hours. But should you perchance check a mortality table, you will discover that life expectancy at birth is roughly five years shorter for an African-American baby than for a white baby. This is true for both genders. In the interests of brevity we will not go into the life expectancies of Creoles born downstream from Louisiana power plants or Pacific Islanders born on former nuclear test sites or country kids born in the back hollows of Dr. Thompson’s practice.

I’m sorry, but this is one outright lie I can’t resist correcting. Anyone who’s prone to believe Dave Winer’s claim (here’s a screen grab of the post) that FeedBurner doesn’t have a service agreement or a privacy policy should know that both documents exist and are clearly linked at the bottom of the FeedBurner home page. (The terms of service are here, and the privacy policy is here.) Talk about being too lazy to do a little research of his own…

After playing with Scuttle a little bit and liking what I saw, I lost a bit of my sanity and joined the development project at SourceForge. It’s been a blast, mostly because it’s my first time on a SourceForge project, and I’m pretty impressed with the services that they offer. (It’s also been annoying, in that within a few hours of being added to the team, I made a complete rookie move and checked a private password into the public code repository. Dumbass.)

Like any new project, I spent a little time learning the layout of the code and database, making little optimizations here and there. And immediately thereafter, in another example of my progressive loss of sanity, I decided to add complete support for the del.icio.us API to Scuttle. However, it wasn’t that hard — in fact, the API is so simple and elegant that it took all of about three hours to implement the entire thing. And now, I can use any of the tools that exist to interface with del.icio.us to play with Scuttle, and that’s just cool.

Apparently, DreamHost has extended the deal I wrote about this weekend through April 24th, so again, if you’re in the market for webhosting, it’s worth a look.

A quick morning note on how absurd the Schiavo case has become: Terri Schiavo’s parents filed an amended complaint in Federal court today, demanding a jury trial in part because her husband and the Florida state courts violated her Eighth Amendment rights banning cruel and unusual punishment. Seriously.

Not even dealing with the notion that the Eighth Amendment applies to something other than penalties imposed on a person who has violated the law, I again return to the fact that withdrawing life-supporting measures is only cruel, harmful, or whatever other pejorative term people invent if it violates the wishes of the person involved. Just because her parents feel that it’s cruel doesn’t make it so. And talk about a slippery slope — what would prevent Schiavo’s parents from making this exact same claim in the case that an actual living will was present?

Holy shit — am I the only one who didn’t know that the Honorable Bill Frist, cardiothoracic surgeon and Majority Leader of the United States Senate, fraudulently “adopted” kittens from Boston animal shelters, brought them home, and killed them while practicing his surgical techniques? (Oddly, when you search his website for the word “kitten,” you find that he’s declined to include this little tidbit.)

Reading the dissent in today’s Eleventh Circuit Court of Appeals ruling on the Schiavo case, I think I found the words to explain what’s so offensive to me about the actions of Congress and Schiavo’s parents to date. The following quote, from the dissenting judge’s reasoning on why a preliminary injunction forcing the resumption of feeds would be approriate, is what gave me focus (emphasis mine):

In fact, I fail to see any harm in reinstating the feeding tube. On the other hand, a denial of the request for injunction will result in the death of Theresa Schiavo.

The Florida courts went through an excruciatingly detailed process to determine what Terri Schiavo herself would have felt was harmful, and ruled that there is clear and convincing evidence that she would feel it harmful to be artificallly supported in any manner. And as a result, replacing her feeding tube would be the very definition of harmful, for the very reason that it would prolong her life. I guess what I wonder is if the presence of a living will specifically forbidding the continuation of artificial sustenance would have changed the dissenting judge’s opinion on the harm of replacing the tube. Put another way: can the judge truly ignore what has been determined to be Schiavo’s ideas of benefit and harm and then substitute his own in order to decide how to proceed?

Extended more broadly, that’s exactly what all the supporters of the Congressional bill did — used their own views (or, says the skeptical side of me, the views of the various groups that support them) about good and bad, benefit and harm, moral and immoral, and then imposed those views on Terri Schiavo and the country. In the end, that idea that the views of someone other than me matter at all when I’m hooked up to life-sustaining equipment is what’s so frightening.

NGPOD FeedBurner counter
A few weeks ago, I wrote about my addiction to National Geographic’s Photo of the Day, and soon thereafter, I realized that I’d be a lot happier if I could get the photo in my syndication feeds. After a little unsuccessful hunting for a feed on the NG website, I emailed the webmaster asking if there was an unpublicized feed, or if the organization had any interest in a feed that I’d help them build. I never heard back, so after another attempted email, I just built an app that sets the feed up for me. (Ugh, I’m not a fan of screen scraping!) Over the past week, I’ve ironed out enough of the bugs that I think the feed is robust enough for a little broader use, so here it is: the National Geographic Photo of the Day, syndication-style. The feed is hosted at FeedBurner, a service I’ve never used but hear great things about.

Let me know if there are any problems; I’m anticipating one or two, since I’ve already run into a few HTML errors on the NG site that then find their way into the feed when the scraper grabs the various bits of data about each photo.

I’m not sure why I even try to write about national legal issues like the Schiavo case when I know that Dahlia Lithwick will just come along and kick my amateur ass to the gutter.

You can put aside the doctrine of federalism for Terri Schiavo, and the principles of separation of powers, and comity, and of deference to finality and the rule of law. But you’d want to be certain, on the day you do so, that what you’re sacrificing them for [is] some concrete legal value that matters a whole lot more. Subordinating a centuries-old culture of law to an amorphous, legally meaningless “culture of life,” is not a decision to be taken over a weekend.

Go read it — she’s still the best in the game at elevating the level of conversation by cutting through the bullshit and laying bare the whole picture.

Oh, awesome — Marcus Campbell has released the first early version of code to manage a local replacement for the del.icio.us bookmark manager! He calls it Scuttle, and it’s all official-like with a SourceForge project and everything. While I don’t have anything against del.icio.us — I love the app, and use the crap out of it — it’d be nice to get all those bookmarks out of a system that I don’t control. I guess it’s time to start playing with Scuttle!

Two quick morning observations about the continuing Terri Schiavo abomination:

First, it’s at least a little heartening to me to see that this afternoon’s Federal court hearing is before James D. Whittemore, a Clinton appointee and someone who’s expressed an understanding of the difference between state and federal powers. We’ll see how it plays out, but at least I feel that much more secure that by putting the issue into the hands of the Federal judiciary, Congress actually has taken a lot of the politics out of the debacle.

Second, how has it not come up in the popular press that the same President who flew back to Washington to sign the Schiavo bill also put his signature on the Texas Futile Care Law while governor of that state in 1999, a law that allows hospitals to discontinue life-sustaining measures over the objections of parents? (It’s the law that led to Texas Children’s ending life support on a baby last month, after a protracted legal battle that wasn’t able to tug at the heartstrings of our elected Federal representatives.) It’s hard to reconcile the two acts on Bush’s part, other than to observe that both laws had strong support from the religious right.

Update: thanks go out to Rafe for the pointer to this great (but long) post at Obsidian Wings, which says it all much better than I could deign to.

Hey, cool — the rumors were true, Yahoo has acquired Flickr. That’s awesome; it’s a fabulous web application, constructed by people who clearly get the web and have the programming skills to build an extremely usable interface, so it’ll be exciting to see how Yahoo integrates Flickr into its offerings. It’s nice to see that it will remain separate from Yahoo’s own photo service for the time being, since what makes Flickr so unique is that it’s not a generic store-and-print-your-photos service, but rather seems to be centered on using images to create communities and interconnections. It’s also nice to see that Yahoo will be throwing its resources at expanding capacity and lowering costs, which is always a bonus.

Congrats to Stewart, Caterina, and all the other people at Flickr!

For those who didn’t know, today’s the last day that DreamHost is tripling the specs on most of their webhosting plans, meaning that you can get a ton for a lot less than you’d think. (For example, the third level of hosting includes over 7.5 gigabytes of disk space and nearly 200 gigabytes a month of bandwidth, as well as 3,000 email accounts accessible by POP or IMAP, unlimited MySQL databases, custom domain name service, access to all your log files in raw and processed forms, and even a free domain name registration, all for $19.95 a month.) On the plus side, DreamHost gets reasonably good reviews from some of the users at MetaFilter (and by a few other people out there); on the minus side, I’ve heard that the company holds some sort of grudge against Movable Type, to the point of sending emails to users talking trash about it. (How odd!)

DreamHost has also been running a promotion for new users since last October, where if you sign up for a level 1 account (think all the above specifications cut down to anywhere from 1/3 to 2/3), prepay an entire year on a credit card, and use the promotion code “777”, the whole thing will cost you $9.24 for the first year. If you combine the two — the sale ending today and the 777 promotion — you’ll end up with about 2.5 gigs of disk space, 120 gigs a month of bandwidth, a free domain registration, and more email addresses than you’ll know what to do with. Seems worth it in almost any event!

I’m posting this because I think it’s a really good deal, not because I have any prior experience with DreamHost. That being said, because of a confluence of needing a hosting provider for a project I’m helping develop and the good prices, I did sign up for an account this week, and I’ll surely be posting my experiences as I start delving in to their offerings. And since I have an account, you can feel free (or not!) to use my referral name, hombrequeso, when you sign up (which earns me a small, small percentage). Also, feel free to post your own experiences with the hosting company — every signup comes with a 97-day money back guarantee, so in the next 94 days, I’d love to hear how other people feel!

Wow — I just found the text of the Terri Schiavo bills being considered by the House and Senate, and honestly can’t believe what I’m reading. To quote from the Senate Bill, S. 686 (emphasis mine):

Any parent of Theresa Marie Schiavo shall have standing to bring a suit under this Act…. In such a suit, the District Court shall determine de novo any claim of a violation of any right of Theresa Marie Schiavo within the scope of this Act, notwithstanding any prior State court determination and regardless of whether such a claim has previously been raised, considered, or decided in State court proceedings. The District Court shall entertain and determine the suit without any delay or abstention in favor of State court proceedings, and regardless of whether remedies available in the State courts have been exhausted.

So, to paraphrase, the Senate is demanding the following:

  1. that Schiavo’s parents can start another lawsuit;
  2. that the Federal District Court will then have to start anew in considering the new suit, without reliance on any prior state court hearings;
  3. and that the Federal District Court cannot decline or defer to the prior decisions of state courts.

Now, to quote from the House bill, H.R. 1332 (emphasis again mine):

In hearing and determining a claim or cause of action removed under this section, the court shall only consider whether authorizing or directing the withholding or withdrawal of food or fluids or medical treatment necessary to sustain the incapacitated person’s life constitutes a deprivation of any right, privilege, or immunity secured by the Constitution or laws of the United States. The United States district court shall determine de novo any claim or cause of action considered under subsection (c), and no bar or limitation based on abstention, res judicata, collateral estoppel, procedural default, or any other doctrine of issue or claim preclusion shall apply.

To paraphrase the House:

  1. the Federal courts must consider whether withholding life support deprives Schiavo of some right;
  2. the Federal courts must not consider whether continuing life support deprives her of her right to determine her own fate;
  3. the Federal courts again cannot rely on prior state hearings or decisions.

This is so much worse than I originally thought. Is there any doubt that this is a horrible violation of both separation of powers and states’ rights?

For those who are interested in a reasonable attempt to look at the reality of the Terri Schiavo case, Matt Conigliaro has an amazingly detailed information page, including a list of questions and answers that demonstrates how reductionist the media coverage (and Congressional “inquiry”) has become. Conigliaro is an appellate lawyer and has run a website for over two years focused on Florida law, and his coverage of the case over that time period has led to (relatively ridiculous) accusations of bias from both sides of the ostensible debate. Reading his numerous posts, it’s hard to see that bias; instead, he seems to be a good legal analyst, and very empathetic to both positions in what is fundamentally an emotionally wrenching debate however you look at it.

After reading Conigliaro’s chronology and Q&A section, I’m left with the understanding that every single court that has held a hearing has concluded that Schiavo is in a persistent vegetative state and that there is clear and convincing evidence — the strongest burden of proof available in civil cases — that she would have wished removal of life support measures. This determination was based on more than just evidence from reports of conversations with her husband, as well, something that’s not mentioned too much in media reports of the conflict. I’m also left with the realization that every attempt to subvert the ultimate court rulings have come from the realm of politics — initially, Terri’s Law, and now, a farcical consensus bill from the U.S. Congress, something that manages to be both unsurprising and terrifying at the same time.

What I’ve been confused about — and while slightly less so, remain confused about — is what the law being rushed through Congress right now aims to do. It seems from reports that it’s a case-specific law, allowing Federal judicial review of the state court rulings in Schiavo’s case; what I don’t understand is how there’s some idea that this will lead to a different outcome. As I understand it, the Eleventh Circuit Court of Appeals has denied every appeal and dismissed every case brought by those who have tried to overturn the rulings of the Florida courts, and the U.S. Supreme Court has twice declined to intervene, once in January and once yesterday. So we now seem to have have what might be well less than a majority of our Congressmen (since it only takes a majority of present legislators, not of all legislators, to pass a law) furiously posturing, and the President himself returning to Washington, D.C. early, all in the name of likely having no effect on the ultimate outcome whatsoever.

In the end, it seems that most everyone agrees on the right for people to create formal living wills that spell out how we wish to be treated in the case of tragedies like this. In Schiavo’s case, there isn’t a written living will, but every level of court available for recourse has determined her wishes in a manner that is as legally binding as a living will would have been. In spite of this, we now have the highest elected body of legislators in the country acting to force an entirely different set of wishes. What gives them the right? What would prevent Congress — or any elected body — from acting similarly even if a formal living will existed? Therein lies the real horror of the Schiavo case; apparently, it’s one more way that some seem willing to let the lawmakers of this country intrude on the private debates and decisions of its citizens.

I’m not quite sure how I’ve never known that Moleskine has a top-flipping reporter notebook (maybe it’s new, since it’s not yet listed in Moleskine’s own catalog), but I think I need to have one. I use Moleskines to write information about pretty much every consult I do in the hospital, and it feels like a notebook that flips open at the top would be perfect for writing while standing up and talking to patients.

There are a lot of things going on within and outside our borders that affect the wellbeing of the people of the United States — we have soldiers fighting and dying in Iraq, a currency that’s plummeting in value against those of our economic rivals, two nations openly threatening (and god knows how many quietly working) to arm themselves with nuclear weapons, a health insurance “system” that openly ignores over 45 million Americans, a retirement system that might not be able to remain solvent, worsening childhood and adult obesity, and a litany of other issues that affect millions and millions of people on a daily basis.

That’s why I’m particularly glad to see that our esteemed elected members of Congress are rising to the challenges before us, and starting to hold hearings to try to come up with real solutions to the problems of America. First up: an investigation of steroid use in professional baseball, and a sham hearing to try to sidestep the Terri Schiavo rulings of every single level of court in the country.

In all seriousness, there are days when I think our country needs a do-over.

In news that makes me pretty happy, TiVo and Comcast announced a deal today to bring TiVo’s technology to Comcast’s cable set-top box offerings. That’s great news for TiVo, which has been under a deathwatch for a little while now; Comcast has over 21 million customers, and could bring a lot of business TiVo’s way.

This is so awesome — the same weather that created mudslides in the west and dumped massive amounts of snow to the Southwest has brought three times the normal rainfall to the deserts of southern California, and as a result, Death Valley is blooming. The New York Times travel section has a good story about it; if you’re interested, you should probably read it soon, since the link will almost assuredly take you to the pay-per-view archives in the not-too-distant future.

Sorry about the silent week — it was a tough one at work. On Monday, I learned that two of my patients had relapsed, and that another patient’s tumor had begun growing in leaps and bounds. I spent most of the week scheduling tests, getting recommendations from more senior oncologists, and breaking bad news to the families, and every night I just collapsed from exhaustion. It’s a week I hope to never, ever repeat.

Egyptian camels

One of my recent guilty pleasures has been the National Geographic Photo of the Day, a site that’s been up since 2001 but that I just discovered about a month ago. The images have been uniformly amazing, from a suspicious African chameleon to a decomposing leaf in the Hoh River Valley to vanishing footprints on an island of sand. From the captions, the photos appear to come from the group that didn’t make it into the magazine’s articles, but it’s clear that says nothing about the quality or composition.

James Bennett published a nice op-ed piece over at Kuro5hin on Friday that tries to get to the bottom of the Google Toolbar shitstorm, and concludes that the large push against it has nothing to do with copyrights, derivative works, or content publishers’ rights, and instead is all about fear and loathing of Google. It’s worth the read, as is the resultant comment thread.

It’s so much fun watching someone like Cory Doctorow completely dissassemble the Google Toolbar nonsense. In a post on Saturday, he outlined the reasons why services that let users decide how to display content are the very reason for the innovation that’s driven the web since the day it appeared; yesterday, he followed that up with a glimpse of other projects out there that provide similar services for users using Google’s own data. And then this morning brought the latest salvo, a two-fer that included a good real-world analogy and a smackdown to a pathetic attempt to raise Cory’s ire.

Every time that the total hacks of the weblog world start to annoy me by simultaneously attempting to rule the terms of debate and ignoring the incredibly nuanced debate that’s occurring all around them (including in their very own comment threads!), it’s refresing to see that people like Cory step into the breach and provide a voice of reason.