Saturday, March 26, 2005

Even as Doctors Say Enough, Families Fight to Prolong Life

The New York Times
March 27, 2005
Even as Doctors Say Enough, Families Fight to Prolong Life

BOSTON, March 26 - For years, when families and hospitals fought over how to treat critically ill patients, families often pressed to let their loved ones die, while hospitals tried to keep them alive.

But in the last decade or so, things have changed.

Now, doctors and ethicists say that when hospitals and families clash, conflicts often pit families who want to continue life support and aggressive medical care against doctors who believe it is time to stop.

"The most common case that comes before the ethics committees," said Dr. John J. Paris, a bioethicist at Boston College, "are families now insisting on treatment that the doctors believe is unwarranted."

Extraordinary medical advances have stoked the hopes of families. Also, more patients and families feel empowered to make medical decisions, and some are skeptical of doctors' interpretations or intentions.

When asked in polls about Terri Schiavo, the brain-damaged Florida woman, 60 percent to 70 percent of respondents said they would remove Ms. Schiavo's feeding tube and, in similar circumstances, would choose not to keep themselves or a spouse alive.

Many right-to-die requests would not cause conflict with a hospital these days because they are more likely to be in sync with doctors' assessments. When there is a conflict, it typically involves families who feel their loved one would not want to endure surgery or treatment that might not succeed.

But even families who say they believe in removing life support may find that position untenable when their own relatives are involved.

"About 15 years ago, at least 80 percent of the cases were right-to-die kinds of cases," said Dr. Lachlan Forrow, the director of ethics programs at Beth Israel Deaconess Medical Center in Boston, who handles 50 to 100 end-of-life conflicts a year. "Today, it's more like at least 80 percent of the cases are the other direction: family members who are pushing for continued or more aggressive life support and doctors and nurses who think that that's wrong."

Dr. Lisa Anderson-Shaw, co-chairwoman of the ethics committee at University of Illinois at Chicago hospital, said that in 1998 she consulted on 2 such cases, while last year, she fielded 11.

Chuck Ceronsky, a co-chairman of the ethics committee of Fairview University Medical Center in Minneapolis, said, "The right-to-die families find a more receptive audience in the hospital, as opposed to years ago when a doctor might say, My job is not to end life."

Mr. Ceronsky added, "We have a disproportionate number of cases where people come in with something they think ought to be tried, or that they've read on the Internet ought to be tried."

Ethics committees resolve most cases, often through repeated family discussions over weeks or months.

But at least three states, Texas, Virginia and California, have laws that let doctors refuse treatment against the wishes of a family, or even a patient's advanced directive in certain circumstances. In other states, like Wisconsin, doctors are seeking such laws.

"When they're asking for things that become absolutely nonsensical, then you don't have to do it anymore," said Dr. Kay Heggestad, who is the chairwoman of the ethics committee of the Wisconsin Medical Society and is helping draft a "futile care" bill in her state. "If someone marches into my office with normal kidney function and demands dialysis, I am not required to offer that."

Recently, several life-support requests have landed in court.

In October, when doctors at a hospital in Salt Lake City declared 6-year-old Jesse Koochin brain dead and planned to remove life support, Jesse's parents, Steve and Gayle Koochin, went to court. A judge ruled against the hospital and granted the Koochins the right to take Jesse home, where they kept him on a ventilator and said they were convinced that he could get better with alternative medical treatments. A month later, Jesse died.

In Boston, doctors considered it so inhumane to keep alive Barbara Howe, a 79-year-old woman with Lou Gehrig's disease, that the chairman of the ethics committee wrote in June 2003, "this is Massachusetts General Hospital, not Auschwitz."

When Ms. Howe's daughter, Carol Carvitt, said her mother would not want to disconnect life support, the hospital sued. A judge said it was Ms. Carvitt's decision, but urged her to think about her mother's best interests. This month, Ms. Carvitt agreed to terminate life support by June 30.

And last November in Orlando, Fla., Alice Pinette insisted that her husband, Hanford, stay on life support even though his living will said he would not want to. A judge sided with the hospital, which removed the ventilator, and Mr. Pinette, 73, died.

"Medical advances give people greater expectations, and they're not willing to accept that death is inevitable; somebody somewhere can save Mom," said Dr. Forrow, of Beth Israel in Boston. "They have way more belief that the decision about that is partly up to them: my business, my body, my mom's body. Fifteen years ago, it was the doctor's purview alone."

Some are wary that doctors may be truncating treatment because of soaring medical costs, and Dr. Dianne Bartels, associate director of the Center for Bioethics at the University of Minnesota, said: "Sometimes there's also mistrust of the medical system. A doctor might have said, 'Your husband's never going to make it,' and he's already survived two or three times, so why should they believe the doctor?"

Thomas W. Mayo, an associate professor at Southern Methodist University law school and an author of the Texas law, cited another reason.

"There are more specialists with less contact with the family," Mr. Mayo said. "As patient volumes have increased and reimbursement rates cut to the bone, there's less incentive for everyone in the system to provide that. When a stranger says, 'Well, there's nothing we can do other than turn things off,' you're hearing that from someone you have no reason to believe other than he's wearing a white coat."

The Texas law, signed in 1999 by Gov. George W. Bush, allows doctors to remove life-sustaining treatment over the objections of families, provided an ethics committee agrees and the hospital gives the family 10 days to see if another facility will accept the patient.

Dr. Robert L. Fine, an author of the law and the chairman of the clinical ethics committee at Baylor University Medical Center in Dallas, said that life support could be withdrawn even if a patient's living will specified otherwise, but that ethics committees would give great weight to such a document.

Virginia's law is similar; California's is much vaguer, saying physicians cannot be required to provide health care contrary to generally accepted health care standards.

Now, in most disputes in Texas, "families look for an alternative willing to provide care and if none is available they say, 'O.K., it's time to stop,' " Dr. Fine said.

There have been two recent exceptions. Last week, Sun Hudson, a 5-month-old, died after a judge gave Texas Children's Hospital in Houston permission to disconnect his ventilator over the objections of his mother.

And last Sunday, the case of Spiro Nikolouzos, 68, was resolved when his family, who fought a Houston hospital's plan to remove his ventilator, found a nursing home to accept him.

In the absence of laws like Texas's, hospitals often accede to a family's wishes because they fear being sued. They are reluctant to go to court because judges often rule that even if the hospital's assessment is correct, families' claims of what patients would have wanted take precedence. And doctors and ethicists in many states have not lobbied for a Texas-style law because of expected opposition from right-to-life advocates.

There is also discomfort with determining when health care is futile.

"It is controversial even within the bioethics community," Mr. Mayo said. "There are times when medicine has nothing more to offer and we're not obligated to offer it, but when you go to implement that, it gives people the heebie-jeebies."


U.S. Is Set to Sell Jets to Pakistan; India Is Critical

The New York Times
March 26, 2005

U.S. Is Set to Sell Jets to Pakistan; India Is Critical

WASHINGTON, March 25 - The United States will sell F-16 jet fighters to Pakistan in a deal that State Department officials said Friday would improve regional security. But the decision was immediately denounced by India as adding a fresh element of instability to relations between the nuclear neighbors.

The size of the arms sale has not been decided, State Department officials said, although Pakistan previously said it was seeking about two dozen of the planes, which can be used in ground or air attack roles and have a maximum range of more than 2,000 miles.

President Bush personally telephoned Prime Minister Manmohan Singh of India early Friday to inform him of the decision to sell F-16's to Pakistan, White House officials said.

In words apparently meant to soften the impact of a major weapons transfer to India's rival, Mr. Bush said the administration had also cleared the way for India to discuss a combat aircraft purchase with American arms manufacturers.

Mr. Bush, speaking from his Texas ranch, told the Indian prime minister that the United States was "responding" to New Delhi's request for information on "multirole combat aircraft," according to White House officials.

The possibility of the F-16 sale to Pakistan had been hinted at by people in the administration and was reported by The Wall Street Journal this month before Secretary of State Condoleezza Rice visited India and Pakistan.

Even so, Mr. Singh told Mr. Bush of his "great disappointment" over the pending arms sale and warned that it would undermine regional security, according to Sanjaya Baru, the prime minister's spokesman, as quoted by The Associated Press from India.

Relations between India and Pakistan remain tenuous and bitter. They have fought three wars, mostly over the Kashmir territory, and now both nations have nuclear arms. Still, they are committed to off-and-on peace talks. And in an important step, the Pakistani president, Gen. Pervez Musharraf, has promised to visit India for a cricket match between teams from the countries early next month.

The F-16 is valued for its ability to take on a variety of missions, including delivering precise airstrikes. In that role, it has been used extensively in Afghanistan and Iraq to attack suspected insurgent hiding places, and Pakistan has said it would use the plane to strike at terrorists.

The fighters to be sold to Pakistan may be newer models off the production line, and not the older variant purchased by Pakistan in the 1980's. In 1990, it ordered more, but delivery was blocked when Congress passed legislation to punish the Pakistanis for their ambitions to develop nuclear weapons.

State Department officials said the purchase price would be unknown until a formal agreement is reached on which model of the fighter will be sold, and how it will be equipped. The F-16C/D models purchased by the United States Air Force from the Lockheed Martin Corporation in 1998, for example, cost $18.8 million each, though exported versions of the plane typically cost more.

The arms sale is seen as reward for cooperation in the aftermath of the Sept. 11, 2001, attacks, when Pakistan opened its territory as a crucial portal into neighboring Afghanistan during the war to topple the Taliban government and oust fighters of Al Qaeda. Even so, some military analysts complain that Pakistan is not doing enough today to hunt down insurgents and terrorists still seeking refuge in the mountainous areas of Pakistan just across the Afghan border.

The Bush administration has also chosen to overlook or play down other irritants, including what some officials say has been a lack of cooperation in investigating the nuclear black-market network run by A. Q. Khan, a Pakistani scientist, and the slowness of General Musharraf to return his country to democracy.

State Department officials explained that the arms sale fit into the broader strategic relationship across South Asia. "We are looking to improve security and improve prosperity and improve development of the entire region as a whole through an integrated program of engagement," Adam Ereli, the State Department deputy spokesman, said at a news briefing Friday afternoon.

"And that engagement includes security, it includes energy, it includes economy, it includes diplomacy, politics," he said. "And part of that is a decision to begin negotiations with the Pakistani government and Congress to sell F-16's to Pakistan and to respond favorably to a request for information from India for the possible sale of multirole combat aircraft."

Mr. Ereli said that "relations between India and Pakistan have never been better," and that "to the extent that we can contribute to Pakistan's sense of security and India's sense of security, that will contribute to regional stability."

Pakistan has the older F-16's already in its arsenal, and has been lobbying to buy more for years. As one reward for its assistance after Sept. 11, the United States began selling Pakistan spare parts for those older planes.

India, on the other hand, has been buying its fighters elsewhere, but American companies are lobbying to get into the Indian arms market.

Like most newer-generation strike jets, the F-16 can carry nuclear weapons. But State Department officials denied that sales of advanced aircraft to the two countries would increase the ability of either to deliver nuclear weapons across their shared border, citing the fact that both countries have tested medium-range missiles capable of carrying warheads.

But Larry Pressler, a former Republican senator from South Dakota who gave his name to the amendment that halted the F-16 transfers to Pakistan in the 1990's, said Friday that the decision to go ahead with the jet-fighter deal "is a mistake."

"I know that we want to be friends with Pakistan because of the terrorism thing, but you don't fight terrorism with F-16's," he said in a telephone interview. "F-16's are capable of nuclear delivery. That's about the only reason Pakistan wants them. The only people they are in a fight with are in India. India now will have to get the same thing somehow. So it raises tensions and stakes without meeting any of our objectives."

The United States wants several things from Pakistan, and the sale of F-16's could more tightly bind the two nations. In particular, Washington wants more help in unraveling the Khan nuclear network, particularly its assistance to Iran and North Korea. But a State Department official said there was no quid pro quo with the arms deal.

A senior administration official also said the United States wanted more signs of democratization, including a decision by General Musharraf to surrender his military position as a sign of relinquishing some of his consolidated power.

In part to mollify India, Secretary Rice made a point of lauding India's leaders for its help with Southeast Asian tsunami relief, and she insisted during her visit to the region last week that the United States would join India in a larger strategic partnership. She also expressed hope to leaders of both countries that they would work with each other to peacefully resolve their dispute over Kashmir.

Senior officials said Friday that the United States was trying to balance the arms sale to Pakistan by animating "the strategic dialogue" with India that would emphasize that nation's role as "a world power."

"We are comfortable that we have a kind of concerted approach in which neither side feels that we are acting or taking steps to undermine the relations that we have and compromise their interests," a senior State Department official said.


Bush Breaks Silence on School Shooting

The New York Times
March 25, 2005
Bush Breaks Silence on School Shooting

CRAWFORD, Texas (Reuters) - President Bush offered federal help and personal prayers on Friday to the Red Lake Indian reservation in northern Minnesota after being criticized for remaining silent for days about the deadliest U.S. school shooting in six years.

Bush, on vacation at his Crawford, Texas, ranch, spoke for five minutes to Floyd Jourdain, chairman of the Red Lake Chippewa tribe, about Monday's rampage in which a 16-year-old killed nine people and himself.

White House spokeswoman Dana Perino said Bush sent his condolences to the ``entire Red Lake community,'' and ``pledged continued help from the federal government.''

``The president ended the call by saying he is praying for the victims and the families,'' Perino said, adding that Bush would discuss the shooting publicly in his weekly radio address on Saturday.

While White House spokesman Scott McClellan spoke briefly about the shooting on Tuesday, Bush steered clear of the incident in public remarks, focusing instead on the fate of brain-damaged Florida woman Terri Schiavo.

Bush's silence drew fire from some American Indians, including Clyde Bellecourt, a Chippewa Indian who is the founder and national director of the American Indian Movement in Red Lake.

``It's kind of late,'' Bellecourt said of Bush's call to Jourdain. ``He should have been the first one to reach out to the Red Lake Indian community.''

Bellecourt cited Bush's decision to rush back to the White House from his Texas ranch last weekend to sign unprecedented emergency legislation allowing Schiavo's case to be reviewed in federal courts.

``He does not have any problems flying in to restore the feeding tube to Terri Schiavo. I'm sure if this happened in some school in Texas and a bunch of white kids were shot down, he would have been there too,'' Bellecourt said.

Perino said the president had tried calling Jourdain on Thursday, but got voice mail instead.

The White House said the FBI has jurisdiction in the case and has responded by sending 10 victim specialists to Red Lake.

Perino said FBI specialists were now in Minnesota doing a ``needs assessment.'' The FBI could provide funds to help victims with grief counseling and funeral arrangements.

Monday's rampage by Jeff Weise was the worst U.S. school shooting since the Columbine massacre in 1999 killed 15.

Weise identified himself as an ``angel of death'' and a ``NativeNazi'' in online material.


Friday, March 25, 2005

Peggy Noonan's Schiavo mess

Peggy Noonan's Schiavo mess

The next time Peggy Noonan offers GOP leaders free advice, for the sake
of their party they might want to beg off. It was just one week ago
that the Wall Street Journal columnist sounded the alarm for
conservatives, urging Republicans -- for their own self-interest -- to
take every step possible in order to save Terri Schiavo. "You have to
pull out all the stops," Noonan implored.

A key element of Noonan’s strategy, besides the fact that it would
please the GOP’s pro-life base, was her insistence that the maneuver
was completely risk-free because there was "just about no one" on the
other side to oppose Republicans -- nobody who supported Michael
Schiavo, the “disaffected husband.” No one, that is, accept for "the
few bearded and depressed-looking academics he's drawn to his side."
According to Noonan, "Politically this is a struggle between many
serious people who really mean it and one, just one, strange-o." Better
yet: "Move to help Terri Schiavo, and no one will be mad at you." In
other words, a lay-up for Republicans.

What a difference a week makes. With Congress and President Bush
following Noonan’s advice almost to the letter -- issuing novel
subpoenas, crafting last-minute legislation and trying to set all sorts
of legal precedence -- polls indicate that the vast majority of
Americans are in fact "mad" at Congress and Bush for intervening.
They’ve sided with the "strange-o," the allegedly "disaffected
husband," and not with Noonan’s army of "serious people." How bad is it
for Republicans? According to Wednesday’s CBS poll, job approval
ratings for both the Republican Congress as well as Bush hit new lows
this week.

So, in this week’s column
does Noonan concede
her errors, acknowledge she misread the mood of the country and
apologize to Republican leaders for her monumentally wrong-headed
political strategy? No. First, she rearranges the facts of the Schiavo
legal battle to her liking. For instance, Noonan insists Terri’s
"husband, and only her husband," said she would not want to live on
life support. That’s simply not true. And either Noonan has not
bothered to read the court records, or she’s comfortable ignoring
adjudicated facts. Then Noonan launches into vicious personal attacks
against anyone who disagrees with her radical, pro-life minority
agenda. (Noonan may be stridently pro-life, but don’t bother looking
for binders full of her anti-death penalty columns. They do not exist.)
She belittles her opponents' "bizarre passion" for death and warns they
are paving "the low road that twists past Columbine and leads toward

The surreal part is that the targets of Noonan’s acid barbs (i.e. the
"unstable," "unhinged," "red-fanged and ravenous" tube-pullers) include
a majority of self-described "conservative Republicans" and "white
evangelicals." According to the CBS and ABC polls, strong majorities in
both of those groups agree that Congress and Bush were wrong to
intervene in the Schiavo case. On this issue, Noonan has swum so far
out of the mainstream that she can no longer see the Republican base.


Who is Randall Terry?

Who is Randall Terry?

Christian activist Randall Terry has reappeared in the news in recent days as the spokesman for the parents of Terri Schiavo. Terry, founder of the anti-abortion group Operation Rescue and the Society for Truth and Justice, appeared on Fox News at least four times in the past four days -- on the March 18 edition of Hannity & Colmes, and during live coverage of the Schiavo case on March 20 and March 21. But Terry has a controversial past that was not fully disclosed in any of his Fox News appearances or on the March 19 edition of National Public Radio's Weekend Edition, which aired a brief clip from Terry. In all but one of those instances, Terry was identified only as the Schindler family spokesman.

Only when Terry appeared on a March 21 "Fox News Alert" did another guest -- Fox News contributor and Democratic strategist Susan Estrich -- point out that Terry was "involved in the anti-abortion movement" and with Operation Rescue, which "operated outside the law."

On his own website, Terry noted that he "has been arrested over forty times for peaceful opposition to abortion," but he neglected to mention the details of his anti-abortion activities with Operation Rescue in the 1980s and 1990s. In an April 22, 2004, Washington Post article, staff writer Michael Powell summarized some of Terry's anti-abortion actions:

In 1988, Terry and his legions started standing in front of local abortion clinics, screaming and pleading with pregnant women to turn away. They tossed their bodies against car doors to keep abortion patients from getting out. They waved crucifixes and screamed "Mommy, Mommy" at the women. When Terry commanded, hundreds went jellyfish-limp and blockaded the "death clinics."

In 1989, a "Holy Week of Rescue" shut down a family planning clinic in Los Angeles. More than 40,000 people were arrested in these demonstrations over four years. Subtlety wasn't Terry's thing -- he described Planned Parenthood's founder, Margaret Sanger, as a "whore" and an "adulteress" and arranged to have a dead fetus presented to Bill Clinton at the 1992 Democratic National Convention.

Additional evidence suggests that actions by Terry and Operation Rescue may have provoked violence at abortion clinics. As the New York Times reported on July 20, 2001, "One of his [Terry's] most avid followers in Binghamton was James E. [sic: C.] Kopp, now charged in the 1998 murder of a doctor who performed abortions in Buffalo [New York]." Kopp was convicted of second-degree murder and sentenced to 25 years to life in prison. A November 6, 1998, Times report further detailed Terry's connection to Kopp:

In July 1988, when Randall Terry drove through the night from his home in Binghamton, N.Y., to Atlanta to start the series of anti-abortion protests that would finally put his new hard-line group, Operation Rescue, onto America's front pages, James Charles Kopp was in the van riding alongside him, said former leaders of Operation Rescue.

And when Mr. Terry was arrested on the first day of Operation Rescue's "Siege of Atlanta," Mr. Kopp followed him into jail, said the leaders, who spoke on the condition of anonymity. Along with more than 100 other Operation Rescue members, according to some people who were there, Mr. Kopp remained in jail for 40 days and adhered to Mr. Terry's orders not to give a real name to the police or courts.

After his release, Mr. Kopp returned to Operation Rescue's Binghamton headquarters, and was there working alongside Mr. Terry as the group's power and influence in the anti-abortion movement surged in late 1988 and 1989, according to the former leaders of Operation Rescue.

Further, the Miami Herald reported on March 20 that Operation Rescue's "sympathizers continue to make an impact, some serving for the Bush administration."

As CNN noted on March 4, 1998, Terry was named in a lawsuit -- seeking to "force anti-abortion leaders to pay for damages caused in clinic attacks" -- which was filed by the National Organization for Women (NOW) under the Racketeer Influenced and Corrupt Organizations (RICO) Act, and Terry settled with NOW out of court. The New York Times reported on November 8, 1998, that Terry "filed for bankruptcy last week in an effort to avoid paying massive debts owed to women's groups and abortion clinics that have sued him." As the Los Angeles Times reported on February 28, Terry's use of bankruptcy law to avoid paying for the judgments against him helped prompt Senator Charles E. Schumer (D-NY) to propose an amendment to the bankruptcy bill recently passed by Congress that "specifically would prevent abortion opponents from using the bankruptcy code to escape paying court fines," although it was not included in the final version of the bill. Versions of that amendment appeared in earlier versions of the bankruptcy bill, which stalled action on it in 2002 and 2003 when "a core of House Republicans balked" at the provision, the Los Angeles Times noted.

According to a June 14, 2003, report by the conservative World Magazine (no longer available online, but reprinted on the right-wing bulletin board Free Republic), Terry solicited donations by declaring on his website that "The purveyors of abortion on demand have stripped Randall Terry of everything he owned," but failed to disclose that the money would be used to pay for his new $432,000 house. The report noted Terry's defense: "Terry told World that he wanted a home where his family will be safe and where 'we could entertain people of stature, people of importance. I have a lot of important people that come through my home. And I will have more important people come through my home.' " World noted that the same month he paid the deposit on his new home, a court ruled that Terry, who divorced his first wife and has remarried, "was not paying a fair share of child support." In an article on his website, Terry denounced the World report as "journalistic trash, a 'hit piece' of malice and misinformation."

Terry's words and personal life have also stirred controversy. As the Fort Wayne (Indiana) News Sentinel reported on August 16, 1993, at an anti-abortion rally in Fort Wayne, Terry said "Our goal is a Christian nation. ... We have a biblical duty, we are called by God to conquer this country. We don't want equal time. We don't want pluralism. ... Theocracy means God rules. I've got a hot flash. God rules." In that same speech, Terry also stated that "If a Christian voted for [former President Bill] Clinton, he sinned against God. It's that simple." According to a March 18, 2004, press release, Terry declared on his radio program that "Islam dictates followers use killing and terror to convert Western infidels." As The Washington Post reported on February 12, 2000, in his 1995 book The Judgment of God Terry wrote that "homosexuals and lesbians are no longer content to secretly live in sin, but now want to glorify their perversions." In a May 25, 2004, interview about his gay son with The Advocate, Terry stated that homosexuality is a "sexual addiction" that shouldn't be rewarded with "special civil rights."

According to the February 12, 2000, Washington Post report, Terry was censured by his church, the Landmark Church of Binghamton, New York, for a "pattern of repeated and sinful relationships and conversations with both single and married women." Terry denies the accusation.

— A.S.


Dishonest Debate
Dishonest Debate

Friday, March 25, 2005; Page A18

ONE CAN DEBATE the merits of creating personal accounts in Social Security but not the case for fixing the program's solvency problems. Over the next 75 years, as the Social Security trustees reported on Wednesday, the program has a projected deficit of $4 trillion; the longer the nation waits to address this problem, the nastier the tax hikes or benefit reductions that will result. But that's not the impression conveyed by some Democratic leaders. The trustees' report, according to Senate Minority Leader Harry M. Reid (D-Nev.), "confirms that the so-called Social Security crisis exists in only one place: the minds of Republicans." The senator's desire to score political points is understandable. His willingness to do so by implying that Social Security is healthy is not.

Democrats defend this opportunism by saying the president is worse. President Bush, they complain, is talking up an alleged Social Security "crisis" in order to ram through an unrelated proposal to create personal accounts. But, in addressing Social Security, Mr. Bush is taking on an issue that the Clinton administration also regarded as important; he is not inventing a problem. He can be faulted for not specifying the benefit cuts or tax hikes he favors to restore solvency, but at least he acknowledges some will be needed. In that context, personal accounts are not irrelevant; they involve risks, but they are potentially a way of cushioning the necessary benefit cuts in the traditional Social Security system.

Democrats are right that the Bush tax cuts have created a much bigger crisis: Their impact on the deficit over the next 75 years, as estimated by the Congressional Budget Office, is about three times greater than the Social Security shortfall projected by the trustees. It is also true that Medicare poses more of a problem than Social Security. Mr. Bush dodges that larger problem, pretending that he put Medicare on the road to reform when, in fact, he and Congress mostly added to its fiscal problems by creating a new entitlement for drug reimbursements. But it's hard to take seriously the Democrats who say that Mr. Bush should switch focus from Social Security to the much bigger problem of Medicare: If they aren't willing to play a constructive role on the supposedly "minor" challenge of Social Security, why should anyone believe that they would behave constructively if the administration wanted to fix Medicare?

The nation faces a severe economic threat from the aging of its population combined with escalating health costs. The sooner it begins to grapple with this problem, the less painful the solution will be. For Mr. Bush, that would mean acknowledging the need for more revenue. For the Democrats, it would require for a smidgeon of honesty about Social Security's state.


Bush's Approval Takes a Tumble
Bush's Approval Takes a Tumble

By Dan Froomkin
Special to
Friday, March 25, 2005; 12:42 PM

Was President Bush's showy foray into the Terri Schiavo case a tremendous political miscalculation? Or could it be those skyrocketing gas prices?

One way or the other, Bush's approval ratings seem to have taken a sharp tumble in recent days.

As I noted in yesterday's column, the latest CBS and Newsweek polls showed a sudden drop-off.

Now comes Gallup, finding the public's satisfaction with the president at an all-time low.

Bill Nichols writes in USA Today: "President Bush's approval rating has fallen to 45%, the lowest point of his presidency, according to a new USA Today/CNN/Gallup Poll."

"The finding, in a poll of 1,001 adults Monday through Wednesday, is a dip from 52% in a poll taken last week. . . .

"The White House declined to comment. Republican National Committee spokeswoman Tracey Schmitt said that Bush is taking on 'tough issues, whether it's to reform Social Security, promoting the spread of democracy or making a renewed pitch to Congress to pass comprehensive energy reform.' "

Here's a fascinating fact: "The new poll found the largest drop for Bush came among men, self-described conservatives and churchgoers."

Now I should point out, to be fair, that Bush's approval ratings were as low or lower in other polls last spring, when the public was at the height of its unease with the situation in Iraq and the prison abuse scandal. See for more.

And Gallup itself explains: "This is the lowest such rating Bush has received since taking office, although it is not significantly different from the 46% approval rating he received in May 2004."

So what's up?

Gallup speculates that "[t]he timing of the seven-point drop suggests that the controversy over the Terri Schiavo case may be a major cause."

But the survey also "suggests that the public's increasingly dismal views about the economy, and about the way things are going in general, could also be factors in Bush's lower approval rating. . . .

"One factor contributing to the economic malaise is almost certainly the rising price of gas and oil. In an open-ended question, 17% of Americans cited fuel prices as the most important economic problem facing the country, up from just 5% who said that a month ago, and 3% who mentioned it in mid-January."

Here is the spread in approval rating polls since Bush took office, from DePaul University economics Professor Stuart Eugene Thiel's wonderful Professor Pollkatz's Pool of Polls Web site.

Thiel has another chart showing how Bush's approval tracks pretty closely to gas prices (inversely of course).

For a little historical context, I went back to look at's summary of President Clinton's second-term job approval ratings, and it looks like they never got anywhere near so low. In fact, even during impeachment proceedings they remained largely in the 60s.

The Gallup numbers come on the heels of a CBS poll that found Bush's job approval rating down six points in a month to 43 percent, with his disapproval rating up four points to 48; and a Newsweek poll that found Bush's approval rating down five points to 45 percent, with his disapproval rating up six points to 48 percent.

Meanwhile, the Pew Research Center for the People and the Press finds that support for Bush's proposed private accounts for Social Security dropped over the last month among its most likely supporters: younger Americans.

"In February, people age 18-29 favored the idea of private accounts by a 66%-19% margin. Today, just 49% favor private accounts, while 25% are opposed, and nearly as many (26%) say they don't know how they feel about the issue.

"Despite the White House effort to keep Social Security reform on the front burner, public awareness of the issue has not increased substantially over the past month."

Ironically, for the White House, that's a good thing.

"In general, opposition to the plan to allow private accounts is much higher among people who have heard a lot about it than among those who are less familiar with it. Overall, people who have heard a lot about the plan oppose it by 52%-41%, while those who have heard little or nothing favor it by a 47% to 30% margin."
Gas Watch

John Harwood writes in the Wall Street Journal's Washington Wire column that the White House won't intervene on gas prices.

"Bush is 'a believer in the free market,' says economic adviser Hubbard, noting price rises spur 'more supply.' He reiterates administration opposition to tapping Strategic Petroleum Reserve except in emergencies."
Progressive Indexation Watch

When it comes to Social Security, Bush and Vice President Cheney just can't stop talking about progressive indexation all of a sudden.

Progressive indexation would reduce Social Security's shortfall by cutting future benefits from those promised under current law. By twiddling a few key formulas, it would eventually mean big cuts for the wealthy, smaller cuts for the middle class, and no cuts for the poor.

The version of progressive indexation that Bush and Cheney are talking about also includes some private accounts.

But what's really fascinating about this is that although Bush's private-accounts proposal would potentially transform Social Security into a big 401(K) plan, progressive indexation would tend to turn it into more of a welfare program.

Isn't that going in precisely the opposite direction?

Well yes. But opponents point out that the two things have something in common: They both would fundamentally change Social Security.

Edmund L. Andrews writes in the New York Times: "Though he has been loath to propose specific measures to reduce future benefits, Mr. Bush and other officials are gingerly promoting the idea as a way to cut costs and still protect low-income retirees.

"Supporters of 'progressive indexation' say it could achieve several goals: it would eliminate a big part of Social Security's long-running financial gap; it would guarantee benefits at current levels and allow them to rise in real terms for people at the bottom of the income ladder."

Andrews quotes critic Jason Furman, an economist at the Center on Budget and Policy Priorities: " 'This raises the question of whether broad political support for Social Security can be sustained if workers pay very different amounts of payroll taxes but most workers receive the same level of benefits,' Mr. Furman wrote in a research note on Monday."
Cheney Weighs In

James O'Toole writes in the Pittsburgh Post-Gazette about Cheney's Social Security talk in western Pennsylvania yesterday:

"Enumerating some of the options for restructuring the retirement system, Cheney mentioned a proposal from Sen. Lindsey Graham, R-S.C., for lifting the $90,000 ceiling on the amount of income liable to the Social Security tax. President Bush has not ruled out that approach and Cheney mentioned it twice yesterday, although he noted that it would amount to 'a big hit,' on the self-employed and on small businesses.

"Cheney also pointed to a plan offered by Robert Pozen, a former member of Bush's advisory committee on Social Security, for indexing Social Security benefits on a sliding scale according to income." Pozen is the guru of progressive indexation.

O'Toole also notes: "By design, most of the audience, and most of the questions to Cheney, were friendly. Bob Glancey, chairman of the Allegheny County Republican Party, asked him why the proportion of contributions eligible for personal accounts wasn't even larger. . . .

"Cheney did face some skeptical questioning, however, as other members of the audience challenged him on the likely returns of the investment accounts, and on the fact, which Cheney acknowledged, that establishing personal accounts would not shore up Social Security's long-term financial outlook."

The Associated Press notes that Cheney got called out by an audience member after he lauded the Thrift Savings Plan, which lets federal government employees create private account over and above Social Security.

"One person in the audience, Kim Miller, 28, of Mount Lebanon, told the vice president she participated in that program during her three years as a congressional staffer, and did not do so well.

" 'Private accounts are putting a ton of risk on our shoulders,' she said."

Cheney also spoke in Battle Creek, Mich.

Blogger Holden doesn't like how the White House is being very slow about releasing the transcripts of the Cheney events, and he thinks it's on purpose.
WMD Commission Watch

Katherine Shrader writes for the Associated Press: "None of the 15 U.S. agencies that collected or assessed intelligence on weapons of mass destruction in Iraq is likely to be commended for doing an exemplary job, according to officials familiar with a report being prepared by a presidential commission.

"The nine-member panel led by Republican Laurence Silberman, a retired federal appeals court judge, and Democrat Charles Robb, a former Senator from Virginia, is expected to issue its report on weapons of mass destruction next week. It's unclear how much of the report, which may run into the hundreds of pages, will be available to the public."
The Politics of Travel

Peter Baker writes in The Washington Post: "President Bush expanded his planned May trip to Moscow by adding stops in two former Soviet republics that have resisted Russian influence, an itinerary seen as a pointed message to President Vladimir Putin. . . .

"The addition of Latvia and Georgia to the trip is likely to irritate the Russians, while demonstrating U.S. concern over Moscow's attempts to exercise sway over parts of its former empire, analysts said."

Here's the White House announcement.
Where's the Statement?

After tragedies of a certain order, it's standard operating procedure for the president to make a statement.

But Ceci Connolly writes in The Washington Post: "Native Americans across the country -- including tribal leaders, academics and rank-and-file tribe members -- voiced anger and frustration Thursday that President Bush has responded to the second-deadliest school shooting in U.S. history with silence. . . .

" 'From all over the world we are getting letters of condolence, the Red Cross has come, but the so-called Great White Father in Washington hasn't said or done a thing,' said Clyde Bellecourt, a Chippewa Indian who is the founder and national director of the American Indian Movement here. . . .

"The reaction to Bush's silence was particularly bitter given his high-profile, late-night intervention on behalf of Terri Schiavo, the brain-damaged Florida woman caught in a legal battle over whether her feeding tube should be reinserted."
Draft Cheney Watch

Turns out Jonathan Chait and I have been gathering string on the same phenomenon -- but he published first, in this morning's Los Angeles Times: 'The Draft Cheney movement is burbling just below the surface. Fred Barnes suggested it earlier this month in the Weekly Standard. Tod Lindberg of the Washington Times and Lawrence Kudlow of National Review Online echoed Barnes in columns this week."

Chait notes how "the columns hyping Cheney read like a thinly disguised plea for Bush's support. 'If the president let it be known he thinks Cheney would be the best person to succeed him,' writes Barnes, 'that would be enough to release Cheney from his promise not to run.' "
The Wead Tapes, an Epilogue

Robin Abcarian writes in the Los Angeles Times about what the last several weeks have been like for Doug Wead, the former Bush friend whose secret tapes of the president wound up on the front page of the New York Times in February.

"The secret taping came to light after the New York Times received an advance copy of his most recent book, 'The Raising of a President' and began pressing Wead to show that his assertions about Bush -- who, Wead wrote, was worried that questions about drug use would haunt a presidential campaign -- were based on fact or firsthand knowledge. Now Wead faces an uncertain future. Furious criticism has come from the right, left and center. And though the president joked at the recent Gridiron dinner about Wead, ('Anyone looking for a transcript of the program should call Doug Wead'), the Bushes are famous for remembering and punishing breaches of trust. All the apologies in the world are unlikely to reopen doors that have slammed in Wead's face."
Faith Based Watch

NBC's Campbell Brown got an interview with David Kuo, the former deputy director in the White House Office of Faith-Based and Community Initiatives.

She reports: "The president promised $8 billion a year in tax incentives. It would have amounted to a huge increase in funds for all charities. But in negotiating the president's tax cut plan, the White House dropped the $8 billion in favor of other tax cuts.

"Kuo believes the White House, having reaped political benefit, didn't fight hard enough for the money. . . .

"As for Kuo, he says he hopes speaking out will spur the White House to push harder to make the president's faith-based initiative more about getting help to those in need."
Begging to Differ

White House Press Secretary Scott McClellan writes in a letter to the editor in The Washington Post this morning: " 'U.S. Misled Allies About Nuclear Export,' the March 20 front-page story about nuclear material exported to Libya, was flat wrong. Our allies were not 'misled' by the United States about North Korea's proliferation activities. We provided an accurate account of the intelligence assessment of the most likely source of the nuclear material that was transferred to Libya through A.Q. Khan's network."
A Different Ballgame?

Judy Keen writes in USA Today: "President Bush has remodeled his team, his priorities and his style for his second term.

"He has centralized power in the White House and named a Cabinet of loyalists to ensure that they promote his agenda, not their own. He has defined a few goals -- overhauling Social Security and the tax code, spreading democracy in the Middle East -- and is changing the way he deals with Congress to try to achieve them."
Or More of the Same?

Julian Borger writes in the Guardian Weekly that when it comes to foreign policy: "Any embryonic thoughts that the world view from the White House had changed . . . have been dispelled by three stunning appointments over the past two weeks. . . .

"Taken together this string of nominations (all subject to confirmation) is reminiscent of the stereotypical American tourist abroad who, on meeting a foreigner who does not speak English, simply repeats himself more loudly. In this administration's eyes, the rest of the world has failed to grasp the virtue of its policies and needs to hear them again through a diplomatic megaphone."
The Bald Truth

I noted in Wednesday's column, in my final item, the preoccupation among several bloggers with Bush's well-documented predilection for touching bald people's pates.

What is that all about?

Well, a reader calls my attention to the fact that the mystery, such as it is, was actually solved in one of the other articles I linked to that day.

Alan Freeman of Toronto's Globe and Mail was writing about the highlights and lowlights of life in Crawford and asked some folks inside the Coffee Station, "the diner-cum-gas station on Crawford's Main Street that's the only eating place in town," what they thought of Bush.

"'He's very gracious and he's just happy,' said Dorothy Spanos, who operates the Coffee Station with her husband Nick.

"Mr. Bush comes by the restaurant occasionally, the last time was the Friday after U.S. Thanksgiving. The routine is always the same.

"'The Secret Service comes first. They secure the area. We turn the fuel pumps off and they bring in the dog. They're very discreet.

" 'Then they come in and he signs autographs and visits with the people,' she said, bringing a framed collection of 12 photos from the November visit.

" 'He loves rubbing bald heads. He says it brings him luck.' "


Tom DeLay's Cri de Coeur

The New York Times
March 25, 2005

Tom DeLay's Cri de Coeur

Here is some badly needed comic relief from Congress: The House ethics committee, now that it has been rendered impotent by the Republican leadership, is plumping for a 50 percent increase in financing to see to such vital needs as writing a new ethics manual to educate lawmakers. ("J is for Junket, so naughty and nice.")

The money would also pay for the hiring of an unusual new Capitol worker - specialists authorized to explain House rules to innocent representatives. Political grief counselors, let's call them. One of their first assignments should be succoring the majority leader, Tom DeLay, who issued a plaint before a gathering of power conservatives last week that lumped his own festering ethical troubles (attacks "against me") with all criticism of conservative causes, including the sorry attempt to exploit the troubles of Terri Schiavo ("a huge nationwide concerted effort to destroy everything we believe in").

Mr. DeLay's solipsistic wailing should be a further caution to the Republican majority who went along with the replacement of the ethics panel chairman and the neutering of its rules after the committee issued three cautions to Mr. DeLay. He was told to temper his autocratic behavior in dealing with members, lobbyists and federal agencies.

The panel purge, a favor by Speaker Dennis Hastert, was aimed at protecting Mr. DeLay from more investigation of complaints about such lapses as his reported junketeering on lobbyists' money. Beyond the House, Texas prosecutors have filed money-laundering charges against DeLay political operatives. Mr. DeLay denounces all these matters as vicious assaults. For a while, he even had House rules crimped last year to let him remain in power if he were indicted. That scandalous touch of homage was reversed after Republicans felt constituent heat that they were following the leader too far.

It is time for more such second thoughts. Any new money for the ethics panel will be wasted unless Republican members, wary of being yoked to Mr. DeLay, demand that the rules be stiffened to gain some ethical credibility in the House.


What Happens Once the Oil Runs Out?

The New York Times
March 25, 2005

What Happens Once the Oil Runs Out?

Princeton, N.J.

PRESIDENT BUSH'S hopes for the Arctic National Wildlife Refuge came one step closer to reality last week. While Congress must still pass a law to allow drilling in the refuge, the Senate voted to include oil revenues from such drilling in the budget, making eventual approval of the president's plan more likely.

Yet the debate over drilling in the Arctic refuge has been oddly beside the point. In fact, it may be distracting us from a far more important problem: a looming world oil shortage.

The environmental argument over drilling in the refuge has often been portrayed as "tree huggers" versus "dirty drillers" (although, as a matter of fact, the north coastal plain of Alaska happens to have no trees to hug). Even as we concede that this is an oversimplification, we should also ask how a successful drilling operation would affect American oil production.

The United States Geological Survey has estimated that the Arctic oil field is likely to be at least half the size of the Prudhoe Bay oil field, almost 100 miles to the west. Opening that oil field was like hitting a grand slam: Prudhoe Bay, which has already produced more than 13 billion barrels, is the biggest American oil field. (I was once at a party with a bunch of geologists from Mobil Oil when an argument broke out: who discovered Prudhoe Bay? Everybody in the room except me claimed to have done so.)

Unfortunately, you don't hit a grand slam in every at-bat. The geological survey estimates that the Arctic refuge could produce at least half as much oil as Prudhoe Bay. It is also possible, however, that the refuge could produce no oil at all - it often happens in the oil industry. At the other extreme, the upper range of the geological survey's estimate soars to 16 billion barrels. Although the geologists at the survey are widely respected, the upper ranges of their petroleum estimates for the refuge have drawn criticism, sometimes expressed as giggles, from other petroleum geologists.

Despite its size, Prudhoe Bay was not big enough to reverse the decline of American oil production. The greatest year of United States production was 1970. Prudhoe Bay started producing oil in 1977, but never enough to raise American production above the level of 1970. The Arctic refuge will probably have an even smaller effect. Every little bit helps, but even the most successful drilling project at the Arctic refuge would be only a little bit.

But if the question of whether to drill in the Arctic National Wildlife Refuge is the wrong one, what's the right one? In 1997 and 1998, a few petroleum geologists began examining world oil production using the methods that M. King Hubbert used in predicting in 1956 that United States oil production would peak during the early 1970's. These geologists indicated that world oil output would reach its apex in this decade - some 30 to 40 years after the peak in American oil production. Almost no one paid attention.

I used to work with Mr. Hubbert at Shell Oil, and my own independent research places the peak of world oil production late this year or early in 2006. Even a prompt and successful drilling operation in the Arctic refuge would not start pumping oil into the pipeline before 2008 or 2009.

A permanent drop in world oil production will have serious consequences. In addition to the economic blow, there will be the psychological effect of accepting that there are limits to an important energy resource. What can we do? More efficient diesel automobiles, and greater reliance on wind and nuclear power, are well-engineered solutions that are available right now. Conservation, although costly in most cases, will have the largest impact. The United States also has a 300-year supply of coal, and methods for using coal without adding carbon dioxide to the atmosphere are being developed.

After world oil production starts to decline, a small group of geologists could gather in my living room and all claim to have discovered the peak. "We told you so," we could say. But that isn't the point. The controversy over the Arctic National Wildlife Refuge is a side issue. The problem we need to face is the impending world oil shortage.

Kenneth S. Deffeyes, a professor emeritus of geology at Princeton, is the author of "Beyond Oil: The View from Hubbert's Peak."


When You're Late, Call Albany

The New York Times
March 25, 2005

When You're Late, Call Albany

The last two months have not been friendly to New York's subway riders. Stalls, detours - any wise commuter now knows not to go into a subway station without a good book. Looking for someone to blame? Well, the people with the power to do something about it are making critical decisions this moment in Albany.

Right now, New York's lawmakers are haggling about how much of the $106-billion-plus budget should go for transportation. The debate is between upstate legislators who want money for roads and bridges versus downstate lawmakers who want to help the Metropolitan Transportation Authority fix its subways. The real fight, of course, is who should pay.

The state's mission has to be saving the core services of the authority. This is not a narrow, parochial matter about New York City; this is basic to the health of New York State. If these commuters cannot get to work, the New York City economy suffers. And if you start pulling the plug on the city, the state economy starts heading down the drain.

An additional source of revenue must be found, and the choice should be based on what is fair, not who has the most high-powered lobbyist. Some of the more reasonable options are a tax on new cars, a motor vehicle registration tax or a surcharge on real estate transfer taxes for sales of properties over $1 million.

These revenues should first pay for the fundamentals before they finance any additions to the subways. The hundreds of thousands of riders who have been late to work in the last few months can tell the Legislature that you don't start adding rooms to a house that badly needs fixing.


Army Says 27 Detainees Killed From 2002 to 2004

The New York Times
March 25, 2005

Army Says 27 Detainees Killed From 2002 to 2004

Filed at 3:50 p.m. ET

WASHINGTON (AP) -- Twenty-seven detainees were killed in U.S. custody in Iraq and Afghanistan in suspected or confirmed homicide cases between August 2002 and November 2004, the Army said Friday in its first comprehensive accounting.

The Army Criminal Investigation Command said that in the 16 cases it has completed thus far, it found sufficient evidence to support a range of charges against 21 soldiers, including murder, negligent homicide and assault. It did not specify how many of the 21 had been charged.

Five of the 16 closed cases were referred to other agencies, including the case of an Iraqi who died at the Abu Ghraib prison outside of Baghdad on Nov. 4, 2003. The cause of death was determined to be ``blunt force trauma.'' No Army personnel were found to be involved; the Navy took the case and has court-martial charges against several Navy SEAL commandos and one sailor.

The CIA and Justice Department also are investigating that death.

There are 24 cases encompassing the 27 deaths. All but two of the 24 cases involved a single Iraqi or Afghan death. One case involved two deaths and another involved three.

Of the eight Army criminal investigations that remain open, pending further leads and action, five of the cases involved incidents that occurred during raids or firefights or in other circumstances outside of a U.S.-operated detention facility.

Chris Grey, spokesman for the Criminal Investigation Command, said detailed information about the eight open cases is not being released ``to protect the integrity of the investigations.''

In two of the open cases, however, legal actions have begun against accused soldiers. One involves the death of an Iraqi major general in November 2003. Four soldiers from the 3rd Armored Cavalry Regiment, based at Fort Carson, Colo., have been charged with murder and dereliction of duty.

Another of the open cases involves three separate killings in the Sadr City sector of Baghdad in August 2004, all involving soldiers from the 1st Cavalry Division who allegedly shot the Iraqis during search operations. Two soldiers in these cases have pleaded guilty at courts-martial and charges against two other soldiers are pending courts-martial, the Army said.

In one of the Sadr City cases, two 1st Cavalry soldiers have been convicted of murder.

One is Staff Sgt. Johnny M. Horne, of Winston-Salem, N.C., who pleaded guilty Dec. 10, 2004 to killing a critically wounded 16-year-old Iraqi on Aug. 18, 2004. Horne described it as a mercy killing. He was sentenced to three years in prison, a reduction in rank to private, total forfeiture of wages and a dishonorable discharge.

The other soldier convicted in the same killing was Staff Sgt. Cardenas J. Alban of Inglewood, Calif. He was convicted Jan. 14 and sentenced to one year in prison, a bad-conduct discharge from the Army and reduction in rank to private.

Another 1st Cavalry soldier faces charges of murder and obstruction of justice in the deaths of two other Iraqis who were killed while being detained during the same August 2004 operation in Sadr City. Still another soldier faces charges of murder and making a false statement in connection with one of those two deaths. The involvement of other soldiers is still under investigation.

Grey said 17 of the 24 total homicide cases happened in Iraq; the other seven were in Afghanistan.

``We take each and every death very seriously and are committed and sworn to investigating each case with the utmost professionalism and thoroughness,'' Grey said. He added that some cases are complicated by the fact that allegations have arisen long after the abuse occurred.

Once the Criminal Investigation Command finishes an investigation, it gives its findings to the relevant military command to determine whether charges will be filed. Sometimes an accused soldiers' commander will decide not to press criminal charges that investigators bring to him.

One such case involved the death of a detainee, a former Iraqi Army lieutenant colonel, on Jan. 9, 2004.

An autopsy indicated the cause of death was blunt force injuries and asphyxia, and it was ruled a homicide. Investigators determined there was sufficient evidence against two soldiers for the offense of negligent homicide and nine other soldiers for various offenses ranging from assault to making false official statements. The soldiers' commander, however, decided the Iraqi died as a result of the lawful use of force in response to misconduct by the Iraqi.

That case is closed.


The Era of Exploitation

The New York Times
March 25, 2005

The Era of Exploitation

Congress is in recess and the press has gone berserk over the Terri Schiavo case. So very little attention is being paid to pending budget proposals that are scandalously unfair, but that pretty accurately reflect the kind of country the U.S. has become.

President Bush believes in an "ownership" society, which means that except for the wealthy, you're on your own. The president's budget would cut funding for Medicaid, food stamps, education, transportation, health care for veterans, law enforcement, medical research and safety inspections for food and drugs. And, of course, it contains big new tax cuts for the wealthy.

These are the new American priorities. Republicans will tell you they were ratified in the last presidential election. We may be locked in a long and costly war, and federal deficits may be spiraling toward the moon, but the era of shared sacrifices is over. This is the era of entrenched exploitation. All sacrifices will be made by working people and the poor, and the vast bulk of the benefits will accrue to the rich.

F.D.R. would have stared slack-jawed at this madness. Even his grand Social Security edifice is under assault by the vandals of the G.O.P.

While the press and the public are distracted by one sensational news story after another - Terri Schiavo, Michael Jackson, steroids in baseball, etc. - the president and his party have continued their extraordinary campaign to undermine the programs that were designed to fend off destitution and provide a reasonable foundation of economic security for those not blessed with great wealth.

President Bush has proposed more than $200 billion worth of cuts in domestic discretionary programs over the next five years, and cuts of $26 billion in entitlement programs. The Center on Budget and Policy Priorities, which analyzed the president's proposal, said:

"Figures in the budget show that child-care assistance would be ended for 300,000 low-income children by 2009. The food stamp cut would terminate food stamp aid for approximately 300,000 low-income people, most of whom are low-income working families with children. Reduced Medicaid funding most certainly would cause many states to cut their Medicaid programs, increasing the ranks of the uninsured."

Education funding would be cut beginning next year, and the cuts would grow larger in succeeding years. Food assistance for pregnant women, infants and children would be cut. Funding for H.I.V. and AIDS treatment would be cut by more than half a billion dollars over five years. Support for environmental protection programs would be sharply curtailed. And so on.

Conservatives insist the cuts are necessary to get the roaring federal budget deficit under control. But they have trouble keeping a straight face when they tell that story. Laden with tax cuts, the president's proposal will result in an increase, not a decrease, in the deficit. Shared sacrifice is anathema to the big-money crowd.

The House has passed a budget that is similar to the president's, except it contains even deeper cuts in programs that affect the poor. In the Senate, a handful of Republicans balked at the cuts proposed for Medicaid. Casting their votes with the Democrats, they were able to eliminate the cuts from the Senate budget proposal. The Senate also added $5.4 billion in education funding for 2006.

All the budgets contain more than $100 billion in tax cuts over the next five years, which makes a mockery of the G.O.P.'s budget-balancing rhetoric. When Congress returns from its Easter recess, the Republican leadership will try to reconcile the differences in the various proposals. Whatever happens will be bad news for ordinary Americans. Big cuts are coming.

The advances in areas like education, antipoverty programs, health services, environmental protection and food safety were achieved after struggles that, in some cases, took many decades. To slide backward now (hurting millions of people in the process) because of a desire to siphon funds from those programs and hand them over as tax cuts to the wealthiest members of our society, is obscene.

This is not a huge national story. It's just the way things are. It was Herbert Hoover who said: "You know, the only trouble with capitalism is capitalists. They're too damn greedy."



US deserter denied Canada asylum


US deserter denied Canada asylum

A former US soldier who quit the army in protest against the Iraq war has been denied refugee status in Canada.

Jeremy Hinzman, 26, was the first to receive an answer from a number of US deserters seeking Canadian residency.

Mr Hinzman, who served in Afghanistan in a non-combat role, left the 82nd Airborne Regiment when he was deployed to Iraq.

Correspondents say the decision may affect eight other ex-servicemen, but improve Canadian-US relations.

In its judgement Canada's Immigration and Refugee Board said Mr Hinzman had not convinced its members that he would face persecution if he were sent back to the US.

Board member Brian Goodman wrote in the judgement: "The treatment does not amount to a violation of a fundamental human right, and the harm is not serious."

The ruling did not come as a surprise, the BBC's Lee Carter in Toronto says.

While Canada opposed the US-led invasion of Iraq, officials are aware that accusing Washington of persecuting its own citizens would cause an international diplomatic incident, our correspondent says.

Jail threat

Mr Hinzman's lawyer said he planned to appeal, and that they remained confident of success.

Given that I enlisted for a noble country, doing noble things, I thought, if called upon I would do it. After being trained, I realised I could not
Jeremy Hinzman

"He is disappointed. We don't believe that people should be imprisoned for doing what they believe is illegal," Jeffry House told Canadian TV.

Mr House also settled in Canada after dodging the US military draft during the Vietnam War.

If Mr Hinzman's appeal is not successful, his final option would be a direct plea to Canada's immigration minister for leave to remain on compassionate grounds.

He faces court martial proceedings and could be sentenced to up to five years in prison if he fails and is returned to the US.

Mr Hinzman fled his unit in January 2004, shortly before the 82nd Airborne was due in Iraq.

He had served three years in the army, but had asked to be classified as a conscientious objector ahead of deployment to Afghanistan in 2002.

Mr Hinzman now lives with his wife and young son in Toronto, where his case has been championed by Quakers and anti-war activist groups.


Thursday, March 24, 2005

Second Opinion
Second Opinion
by Howard Markel

Last Thursday, Bill Frist took to the Senate floor to offer a diagnosis of Terri Schiavo's condition. His conclusions were based not upon the time-honored technique of examining the patient in question but rather on watching "an hour or so" of video footage of Schiavo.

As a physician, I was astounded. Long-distance doctoring is problematic on many levels but especially for a doctor who has not practiced much medicine for more than a decade. Plus, there is the fact that even when Frist did see patients on a daily basis, he practiced as a heart transplant surgeon. Which means that most of his clinical work was done with anesthetized patients on an operating table. To be sure, no one has ever questioned his credentials as a transplant surgeon. But in the real world of medicine, his opinions on persistent vegetative state, especially those supported only by videotapes from Schiavo's parents, simply don't carry much clinical weight.

Given Frist's propensity to play doctor from the floor of the U.S. Senate, I thought it might be equally appropriate for me to play medical school professor--a role I play in real life--and evaluate his medical decision-making process, much as I do for medical students. Below are excerpts from Frist's statements to the Senate last Thursday, interspersed with my comments.

Mr. President, in closing tonight, I want to take a few final moments to speak on an issue that I opened with earlier this evening, and it has to do with the Terri Schiavo case in Florida. I'd like to close this evening speaking more as a physician than as a United States Senator and really speak to my involvement as a physician--and as a Senator and as leader in the United States Senate which has been a fascinating course of events for us over the last forty-eight hours.

It is vital for a physician to identify himself clearly and definitively. If you are the physician actually treating the patient or are involved in his or her treatment as a consultant, then say so. If not, identify that fact clearly and quickly to avoid misleading others who depend on your objectivity. This is especially important when you have not been involved in the patient's care or if you have some other agenda--in this case, political--at stake in the case.

I was interested in it in part because it is a very difficult diagnosis to make, and I've been in a situation such as this many, many times before as a transplant surgeon.

You may have encountered such situations "many, many times," but there's a big difference between encountering such situations and being an expert on them. And there's little reason to believe you are the latter. When, after all, would a transplant surgeon ever be called in to make a diagnosis of persistent vegetative state in a patient? Generally, other physicians--typically neurologists--make that decision long before the organ donor (either dead or clinically brain dead) is wheeled into your operating room. This is critical because these other physicians have no conflict of interest in the outcome; as the surgeon who has a relationship with the patient awaiting an organ, you do.

I have talked with her family and had the opportunity to meet her son, and her son told me that she is responsive. She has a severe disability; a lot of people with cerebral palsy and disabilities have severe disabilities.

Doctor, please be more precise in your medical terminology. Cerebral palsy is a neurological condition likely related to traumatic births that typically impairs one's ability to use muscles that affect walking, moving one's arms and hands, or even speaking. But cerebral palsy patients typically do not have cognitive deficits; Schiavo clearly does. No first-year medical student would link these very different neurological problems in the same sentence.

Persistent vegetative state, which is what the court has ruled--I question it. I question it based on a review of the video footage, which I have spent an hour or so looking at last night in my office.

Just a moment ago you correctly asserted that persistent vegetative state, or PVS, is a "very difficult diagnosis to make." But now, based on your brief review of a home video, you are willing to question the diagnosis of many other doctors who have actually examined Schiavo?

One of the classic textbooks that we use in medicine is called Harrison's Principles of Internal Medicine. In the sixteenth edition, which was published just this year in 2005, on page 1625, it reads, "the vegetative state signifies an awake but unresponsive state. These patients have emerged from coma after a period of days or weeks to an unresponsive state in which the eyelids are open, giving the appearance of wakefulness."

While I am certainly glad you can quote Harrison's, it is not exactly the text of choice for this argument. That's because the book is basically an encyclopedia of just about every malady known to humankind. Each topic is covered in a few pages, which serve as only a quick introduction to the more in-depth searches every physician needs to perform--especially when entertaining diagnoses they do not typically see in their daily practices. Tell me, Doctor, did you check more comprehensive books or treatises on neurology and, more specifically, the vast medical literature on PVS produced in the past ten years?

I would simply ask, maybe she is not in this vegetative state, and maybe she's in this minimally conscious state. In which case the diagnosis upon which this whole case has been based would be incorrect. Fifteen neurologists have signed affidavits that Terri should have additional testing by unbiased, independent neurologists.

You cite these 15 neurologists who filed affidavits on behalf of Schiavo's parents. What about the dozens of presumably unbiased and independent experts appointed by the court who examined Schiavo numerous times over the past 15 years? All these doctors concluded that she was suffering from PVS and that there have been no significant signs of improvement. In fact, it has only been the physicians hired by Schiavo's family who have disagreed. Why do you discount the court-ordered doctors as well as those hired by her husband--but not those hired by her parents?

Time and again, Doctor, you have waved your stethoscope in the political arena. But physicians are expected to treat illness and not to let ideology get in the way of their medical judgments, especially when it comes to controversial issues such as end-of-life decisions, reproductive choices, or the prevention of sexually transmitted diseases. Our patients deserve and rely upon us for such objectivity; our professional ethics demand it. Perhaps you need to be shown to the Senate Cloak Room. It contains plenty of hooks where you might hang up your white coat before entering the Senate chambers.

Howard Markel is professor of pediatrics and the history of medicine at the University of Michigan. He is the author of When Germs Travel, due out in paperback from Vintage/Random House in May.

Originally published 03.23.05


George W. to George W.

The New York Times
March 24, 2005

George W. to George W.

Of all the stories about the abuse of prisoners of war by American soldiers and C.I.A. agents, surely none was more troubling and important than the March 16 report by my Times colleagues Douglas Jehl and Eric Schmitt that at least 26 prisoners have died in U.S. custody in Iraq and Afghanistan since 2002 - in what Army and Navy investigators have concluded or suspect were acts of criminal homicide.

You have to stop and think about this: We killed 26 of our prisoners of war. In 18 cases, people have been recommended for prosecution or action by their supervising agencies, and eight other cases are still under investigation. That is simply appalling. Only one of the deaths occurred at the Abu Ghraib prison in Iraq, reported Jehl and Schmitt - "showing how broadly the most violent abuses extended beyond those prison walls and contradicting early impressions that the wrongdoing was confined to a handful of members of the military police on the prison's night shift."

Yes, I know war is hell and ugliness abounds in every corner. I also understand that in places like Iraq and Afghanistan, we are up against a vicious enemy, which, if it had the power, would do great harm to our country. You do not deal with such people with kid gloves. But killing prisoners of war, presumably in the act of torture, is an inexcusable outrage. The fact that Congress has just shrugged this off, and no senior official or officer has been fired, is a travesty. This administration is for "ownership" of everything except responsibility.

President Bush just appointed Karen Hughes, his former media adviser, to head up yet another U.S. campaign to improve America's image in the Arab world. I have a suggestion: Just find out who were the cabinet, C.I.A. and military officers on whose watch these 26 homicides occurred and fire them. That will do more to improve America's image in the Arab-Muslim world than any ad campaign, which will be useless if this sort of prisoner abuse is shrugged off. Republicans in Congress went into overdrive to protect the sanctity of Terri Schiavo's life. But they were mute when it came to the sanctity of life for prisoners in our custody. Such hypocrisy is not going to win any P.R. battles.

By coincidence, while following this prisoner abuse story, I've been reading "Washington's Crossing," the outstanding book by the Brandeis historian David Hackett Fischer about how George Washington and his troops rescued the American Revolution after British forces and German Hessian mercenaries had routed them in the early battles around New Jersey.

What is particularly moving is one of Mr. Fischer's concluding sections, "An American Way of War," in which he contrasts how Washington dealt with prisoners of war with how the British and Hessian forces did: "According to the 'the laws' of European war, quarter was the privilege of being allowed to surrender and to become a prisoner. By custom and tradition, soldiers in Europe believed that they had a right to extend quarter or deny it. ... In these 'laws of war,' no captive had an inalienable right to be taken prisoner, or even to life itself."

American attitudes were very different. "With some exceptions, American leaders believed that quarter should be extended to all combatants as a matter of right. ... Americans were outraged when quarter was denied to their soldiers." In one egregious incident, at the battle at Drake's Farm, British troops murdered all seven of Washington's soldiers who had surrendered, crushing their brains with muskets.

"The Americans recovered the mutilated corpses and were shocked," wrote Mr. Fischer. The British commander simply denied responsibility. "The words of the British commander, as much as the acts of his men," wrote Mr. Fischer, "reinforced the American resolve to run their own war in a different spirit. ... Washington ordered that Hessian captives would be treated as human beings with the same rights of humanity for which Americans were striving. The Hessians ... were amazed to be treated with decency and even kindness. At first they could not understand it." The same policy was extended to British prisoners.

In concluding his book, Mr. Fischer wrote lines that President Bush would do well to ponder: George Washington and the American soldiers and civilians fighting alongside him in the New Jersey campaign not only reversed the momentum of a bitter war, but they did so by choosing "a policy of humanity that aligned the conduct of the war with the values of the Revolution. They set a high example, and we have much to learn from them."


DeLay, Deny and Demagogue

The New York Times
March 24, 2005

DeLay, Deny and Demagogue

Oh my God, we really are in a theocracy.

Are the Republicans so obsessed with maintaining control over all branches of government, and are the Democrats so emasculated about not having any power, that they are willing to turn the nation into a wholly owned subsidiary of the church?

The more dogma-driven activists, self-perpetuating pols and ratings-crazed broadcast media prattle about "faith," the less we honor the credo that a person's relationship with God should remain a private matter.

As the Bush White House desperately maneuvers in Iraq to prevent the new government from being run according to the dictates of religious fundamentalists, it desperately maneuvers here to pander to religious fundamentalists who want to dictate how the government should be run.

Maybe President Bush should spend less time preaching about spreading democracy around the world and more time worrying about our deteriorating democracy.

Even some Republicans seemed appalled at this latest illustration of Nietzsche's observation that "morality is the best of all devices for leading mankind by the nose."

As Christopher Shays, one of five House Republicans who voted against the bill to allow the Terri Schiavo case to be snatched from Florida state jurisdiction and moved to federal court, put it: "This Republican Party of Lincoln has become a party of theocracy. There are going to be repercussions from this vote."

A CBS News poll yesterday found that 82 percent of the public was opposed to Congress and the president intervening in this case; 74 percent thought it was all about politics.

The president, who couldn't be dragged outdoors to talk about the more than a hundred thousand people who died in the horrific tsunami, was willing to be dragged out of bed to sign a bill about one woman his base had fixated on. But with the new polls, the White House seemed to shrink back a bit.

The scene on Capitol Hill this past week has been almost as absurdly macabre as the movie "Weekend at Bernie's," with Tom DeLay and Bill Frist propping up between them this poor woman in a vegetative state to indulge their own political agendas. Mr. DeLay, the poster child for ethical abuse, wanted to show that he is still a favorite of conservatives. Dr. Frist thinks he can ace out Jeb Bush to be 44, even though he has become a laughingstock by trying to rediagnose Ms. Schiavo's condition by video.

As one disgusted Times reader suggested in an e-mail: "Americans ought to send Bill Frist their requests: 'Dear Dr. Frist: Please watch the enclosed video and tell us if that mole on my mother's cheek is cancer. Does she need surgery?' "

Jeb, keeping up with the '08 competition, vainly tried to get Florida to declare Ms. Schiavo a ward of the state.

Republicans easily abandon their cherished principles of individual privacy and states' rights when their personal ambitions come into play. The first time they snatched a case out of a Florida state court to give to a federal court, it was Bush v. Gore. This time, it's Bush v. Constitution.

While Senate Democrats like Hillary Clinton, who are trying to curry favor with red staters, meekly allowed the shameful legislation to be enacted, at least some Floridian House members decided to put up a fight, though they knew they couldn't win.

The president and his ideological partners don't believe in separation of powers. They just believe in their own power. First they tried to circumvent the Florida courts; now they're trying to pack the federal bench with trustworthy conservatives and even blow up the filibuster rule. But they may yet learn a lesson on checks and balances, as the federal courts rebuffed them in the Schiavo case.

Mr. DeLay moved yesterday to file a friend of the court brief with the Supreme Court asking that Ms. Schiavo's feeding tube be restored while the federal court is deciding what to do. But as he exploits this one sad case, Mr. DeLay has voted to slash Medicaid by $15 billion, denying money to care for poor people in nursing homes, some on feeding tubes.

Mr. DeLay made his personal stake clear at a conference last Friday organized by the Family Research Council, a conservative Christian group. He said that God had brought Terri Schiavo's struggle to the forefront "to help elevate the visibility of what is going on in America." He defined that as "attacks against the conservative movement, against me and against many others."

So it's not about her crisis at all. It's about his crisis.



Spinning Schiavo

Spinning Schiavo

Back in the Clinton impeachment era, the more emotional and agitated conservatives got about the topic, the further they found themselves from mainstream public opinion. The same thing is happening now with the Terri Schiavo episode. Stunned at how few Americans side with them on the right-to-die case, and how Congress' intervention has turned into a legal, political and public relations setback, right-wing critics online have been lashing out -- and they’re leaving the facts and reason far behind. (Did we mention that this reminds us of the impeachment days?)

Yesterday, a desperate consensus began to emerge that the real problem wasn’t that an overwhelming, 63-28 percent majority of Americans side with Michael Schiavo in his decision to remove his wife's feeding tube; it's that ABC News was "shameless" and "incompetent" in wording what critics called a "push poll" that produced those results. Yet even after stumbling their way through polling analysis, partisan critics refused to address this salient point: ABC’s findings were completely in line with every other poll taken regarding the Schiavo case. Truth is, the only real debate about public opinion is over just how lopsided the margin is in favor of keeping the feeding tube out.

Yet Mickey Kaus insisted the offending ABC poll and its "overwhelming anti-tube sentiment" were "surprising." Really? Last week, a previous ABC poll found 87 percent of Americans would want to die if they were in Terri Schiavo’s condition. Why, just seven days later, would it be surprising that 63 percent think Schiavo’s feeding should remain disconnected? It’s only "surprising" if you’ve paid no attention to previous polling data on this issue -- or if you simply refuse to acknowledge it. For instance, in March 2003, Fox News polled on the Schiavo story (it was making headlines in Florida back then) and asked what people would do if they were Schiavo’s guardian. By a huge margin of 61-22 percent, respondents said they would remove the feeding tube. Asked to reverse the scenario, an even larger percentage, 74, said they would want their guardian to remove a feeding tube.

Those kinds of numbers don’t offer conservatives much solace, so they have set out to discredit them. Specifically, they have faulted the ABC poll question for describing Schiavo as being on "life support." Critics such as Michelle Malkin cried foul, insisting that Schiavo is "not on 'life support' and has never been on 'life support.'" She suggested it was only because ABC had misled people that so many of them sided against pro-life Republicans in Congress.

Three points for Malkin and her online band of would-be medical

1. The phrase "life support" came straight out of court documents from the appellate court decision in Florida, as in, "In this case, the undisputed facts show that the guardianship court authorized Michael to proceed with the discontinuance of Theresa's life support."

2. Dr. Jay Wolfson, the court-appointed doctor who examined Schiavo for months, recently noted during a Washington Post online chat: "In Florida and elsewhere, including according to the guidelines published by the American College of Cardinals, feeding tubes are defined as 'artificial life support.'"

3. The U.S. Supreme Court has found that, legally, tube feeding is no different from other forms of life support in that it too, represents "life-sustaining treatment."

Also, regarding the Fox News poll from 2003 which found 61 percent would remove Schiavo’s feeding tube, here’s how she was described in that poll question: "Terri Schiavo has been in a so-called 'persistent vegetative state' since 1990. Her eyes sometimes open, but doctors say she has no consciousness." Note that even with the more descriptive language and the absence of "life support," the poll produced almost exactly the same results as this week’s ABC survey.

But all the right-wing chatter about push polls became irrelevant late yesterday when CBS released its own poll which illustrated, yet again, that a huge majority side with Michael Schiavo, 66 to 27 percent. (Note the numbers are nearly identical to the ABC poll.) Additionally, in this age of bitter partisan divide, it seems one of the few things on which Americans agree -- besides the fact that Terri Schiavo should be able to die in peace -- is that the legislative and executive branches were wrong to get involved. According to the CBS survey, 82 percent think Congress and the president should not have intervened. That includes 68 percent of white evangelicals. Worse for the GOP, 74 percent think the action was done in order to "advance a political agenda."

The bottom line, according to the CBS poll: In the wake of the Schiavo controversy, approval ratings for Congress (34 percent) and President Bush (43 percent) have plummeted to new lows.

How are Malkin and friends going to spin that?


U.S. bars Italians from examining victim’s car
March 23, 2005

U.S. bars Italians from examining victim’s car

Associated Press

ROME — The U.S. military command in Iraq has blocked two Italian policemen from examining the car in which an Italian intelligence agent was shot to death in Baghdad, a newspaper said Wednesday.

Corriere della Sera said that the policemen were about to leave when the Italian Embassy in Baghdad received an order from the U.S. command on Monday to abort the mission for security concerns.

The embassy in Baghdad reportedly alerted Rome authorities, who called off the trip.

The car, a Toyota Corolla, is reportedly still in American hands, at Baghdad airport where it was originally rented.

The Foreign Ministry in Rome declined comment on the report, while officials at the Italian Embassy in Baghdad could not immediately be reached. The U.S. military in Baghdad had no immediate comment.

Italian authorities say that examining the vehicle is key to assessing what happened on March 4, when U.S. troops opened fire on the car carrying secret service agent Nicola Calipari, another intelligence officer and journalist Giuliana Sgrena, who had just been released after a month of captivity in Iraq.

Calipari died on the spot, while the other two were wounded.

Prosecutors investigating the shooting have received photographs of the car, but they want to analyze bullet holes and other elements, according to Corriere.

Calipari’s killing outraged Italians and prompted Premier Silvio Berlusconi to demand that Washington provide an explanation. Italy agrees that the shooting was an accident but disputes some key elements of the U.S. account.

The U.S. military said that the vehicle was speeding and refused to stop, and that a U.S. patrol tried to warn the driver with hand and arm signals, by flashing white lights and firing shots in front of the car and into the car’s engine block.

Berlusconi said the car was traveling slowly at night and stopped immediately when a light was flashed at it, shortly before U.S. troops fired on the car. Foreign Minister Gianfranco Fini said the fire appeared to have hit the right side of the car.

Vowing to shed light on the incident, Washington has ordered an investigation into the shooting, to be led by a U.S. brigadier general with the participation of Italian officials. The joint commission is expected to release its findings by mid-April.


Frist Urged Changing The Definition of Brain Dead to Include Babies Born With Condition Comparable to Schiavo's

Frist Urged Changing The Definition of Brain Dead to Include Babies Born With Condition Comparable to Schiavo's

Frist wrote a book in 1989 called Transplant where he advocated changing the definition of "brain dead" to include anencephalic babies. Anencephalic babies are in the same state as Terri Schiavo except that she suffered a physical trauma that put her into a vegetative state while the anencephalic babies are born that way.

This remarkable discovery buttresses the argument that Frist's advocacy for Schiavo is wholly political. How does he explain this remarkable inconsistency? Here is the relevant passage on Frist as quoted by the New Republic in 2003:

"And, although Frist writes frequently about the ethical issues surrounding transplants--for example, the question of when death begins--he approaches these issues in starkly scientific terms, with little patience for religious objections.

"Near the end of the book, for example, Frist suggests changing the legal definition of 'brain death' to include anencephalic babies, who are born with a fatal neurological disorder but show just the slightest hint of brain-stem activity. Such a change would make it possible to harvest their organs for transplant--something the Catholic Church and pro-life groups oppose. 'Three thousand anencephalic babies were born a year, enough to solve our demand many times over--but we never used them.'" [The New Republic, 1/27/03]

originally published March 23, 2005


Hiding Our War Dead. Italy Publicly Honors Its War Dead, America Hides Its Dead

Hiding Our War Dead. Italy Publicly Honors Its War Dead, America Hides Its Dead
Wednesday 23rd March 2005

Is That Respecting Our Soldiers?

by Gail Vida Hamburg

The state funeral in Rome last month for Nicola Calipari - the Italian intelligence officer who rescued a kidnapped journalist from Iraqi captors, only to be gunned down by jittery American soldiers at a checkpoint in Baghdad - was a national event that united all Italians, merging their raw sorrow with the singular grief of his widow and children. It was the second time Italy pulled out all the stops for its Iraq War dead. In November of 2003, it staged an elaborate state funeral for nineteen of its citizens, killed in a suicide truck bombing in Nasiriyah.

In both instances, Italy’s Prime Minister Silvio Berlusconi, his ministers, President Carlo Ciampi, and an honor guard in full-dress uniform stood with grieving families on the tarmac of Rome’s Ciampino military airport to receive their dead. There were national days of mourning and public visitation hours to the reposed, and at night, the Coliseum’s lights were dimmed in a mark of respect.

All Italy watched (on television) as officers from Italy’s civil services carried the flag-draped coffins past honor guards representing every branch of the military. The Carabinieri (paramilitary corps), in their regal uniforms and blue-and-red plume hats, stood guard while lone buglers played the Last Post and other laments. Stricken Italians lined the routes of the funeral cortege to pay their respects, before the bodies were entombed in Rome’s war memorial.

The participation in these last rites symbolized a shared sacrifice between those who prosecute wars, those who must fight them, and those who grieve and honor them-not just the dead and their families, but the entire nation. The pageantry on display was no more excessive than the heroism of the fallen, for surely there can be no greater excess than surrendering one’s life for the country.

America, on the other hand, with 1,516 U.S. fatalities in Iraq as of March 16, 2005, pays little public attention to its war dead. Indeed, aside from the printed obituaries in metro sections of dailies, there is little acknowledgment by the government or substantial reporting in the media of the soldiers who perish in Iraq and the families they leave behind. We do not see or hear them. They die alone on the hot sands of Iraq and their survivors grieve privately on American soil.

This administration, which asks for courage and resolve from the military, can find in itself neither courage nor resolve to embrace them in death. According to Pentagon rules, “There will be no arrival ceremonies for, or media coverage of, deceased military personnel returning to or departing from Ramstein [Germany] airbase or Dover [Del.] base, to include interim stops.” Last year, defense contractor Maytag Aircraft fired civilian workers, Tami Silicio and David Landry, for taking photographs of soldiers’ coffins at an airbase in Kuwait. The photographs surfaced at after a Freedom of Information Act request by First amendment advocate, Russ Kick.

Even acknowledging soldiers’ deaths through meaningful tributes upsets many in the war faction. When Nightline anchor, Ted Koppel, broadcast a tribute to the soldiers who had died in Iraq by reading their names off camera while the photographs of the dead men and women were projected on the screen, supporters of the war cried foul.

The President has also made it his policy not to attend military funerals. If he believes our military is fighting for noble ideals, if he admires, as he says, their valor and sacrifice, why must he absent himself from their funerals or prevent our witness of their final return? Why must our war dead come home like thieves in the night?

Many mothers and fathers and children of dead soldiers are wrestling with their gods and demons, trying to find meaning for the holes in their hearts. Recognition of their departed - not with lavish state funerals, but public acknowledgment and remembrance of their sacrifice - may not give the families the meaning they seek, but it could show them that America honors and values their irrevocable loss.

In July of 1965, at the height of the Vietnam War, President Lyndon Johnson spoke with a previously elusive candor. “I do not find it easy to send the flower of our youth, our finest young men, into battles. I have seen them filled with hope and life. I think that I know, too, how their mothers weep and how their families sorrow.”

But president Bush doesn’t know and neither do we. His war machine brings our fallen soldiers home from Iraq, dead as dead can be, and drops them down the well of forgetting. forgetting.

Do you hear the thud? Can you bear it?