How Police Officers Should NOT Treat an Autistic Person

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Dallas Police Department (Texas)

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At  http://dfw.cbslocal.com/2011/10/03/autistic-mans-acting-odd-lands-him-in-jail/ is a story that reveals the way police officers should not treat an autistic person. Police officers have a tough job, and they deal with the worst people in American society. It is not surprising, then, that they are cynical. Sometimes such cynicism is necessary and can save their lives. However, sometimes officers can become so cynical that they do not believe what anyone says, even an autistic person who informs the officers of his condition. If Mr. Blake did tell the officers that he had Autism (and Mr. Blake was wearing a medical alert bracelet), then they should have realized that they were not dealing with the usual troublesome drunk. If an officer did call Mr. Blake a liar, and this would not surprise me, then this was unprofessional conduct and is worthy of disciplinary action. One would think that after the Ryan Moats incident that Dallas police would have more common sense, but apparently these officers did not learn from their fired fellow officer’s mistakes. Do Dallas police get training in dealing with special classes of people, those who have Autism or Tourette’s Syndrome or other medical conditions that can cause behavioral problems? If so, the officers dealing with Mr. Blake apparently ignored their training, and they certainly lacked the virtue of prudence, the ability to adjust to particular circumstances in order to make the correct moral decision. Mr. Blake now sits holed up in his room, afraid a police officer will come after him.

Paul Craig Roberts has claimed that American police are frustrated with not being able to catch the real criminals, so they turn to intimidation and violence against law abiding citizens or those weaker and vulnerable. I do not believe that this is generally the case; officers do catch a significant number  of criminals who end up being convicted and sentenced to prison. There may be some officers who fall into the class to which Mr. Roberts refers. Part of the problem may be lowered police recruiting standards due to a dearth of qualified applicants. It becomes more difficult to weed out the smart-alack, power hungry,  searching for an adrenaline rush officers who cause many of the problems departments face. Funding difficulties may prevent courses on special needs individuals from being taught to officers, even at large police departments. I am sorry if police who may be reading this think I am being overly harsh; since I have Asperger’s Syndrome, I have particularly strong feelings about such incidents. There are times I will talk to myself in public, usually when I am reasoning out some problem to myself. Suppose someone complained about my behavior. Would I be dragged out of a place of business and arrested? I suppose incidents such as this one are understandable; Americans are overly rule-oriented and do not focus sufficiently on the ancient virtue or prudence, or practical reasoning (Aristotle’s phronesis). But a failure to recognize the unique nature of unique circumstances is a moral failure, not merely a technical failure, and that is what, in my judgment, occurred in the treatment of Mr. Blake.

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For Profit Medicine: An Oxymoron

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Universal health care

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As a traditional conservative I oppose for profit medicine. The classical liberal who calls himself a “conservative,” would probably label the previous sentence as an oxymoron. However, conservatives are not all of one stripe. The ethics of medicine must stem from the nature of medicine itself as an inherently moral enterprise. A patient, sick or injured, in need of help, comes to a health care practitioner. The practitioner, whether he be a physician, a D.O., a physician assistant, or a nurse practitioner, has the moral responsibility to use his skills and knowledge for the good of the patient. The profit motive should not enter into the patient-practitioner relationship–if it does, it becomes inherently corrupting.

For-profit hospitals are a monstrosity. When part of the responsibility of the physician is to the shareholders, business decisions often end up trumping medical decisions. This can lead to suboptimal patient care in order to bring more profit to the corporation, especially in a capitation system in which the practice keeps money left over that is not spent on patient care. . Even in “non profit hospitals,” business decisions affect medical care, and business people “run the show.” Hospital administrators are paid enormous salaries (500,000+ per annum in some cases) along with expensive benefits. I know of a case in which a CEO received a huge bonus even though the hospital had been in the red the previous year. Does this sound familiar? Remember the Wall Street bankers.

The American system of medicine, then, is run as a business rather than as a practice. It is no longer a true profession. Physicians are distrusted. Lawsuits are common and sometimes result in big judgments against a physician.

In reading UK newspaper articles about accidents or shootings, I have found (informally) that paramedics and physicians in the UK are more aggressive in starting trauma codes than their American counterparts. This is, of course, anecdotal–it would be interesting if a large-scale study could be done to compare the numbers in both systems. American physicians used to work up to two hours on a patient in a medical code (that did happen with my mother, who lived with no neurological sequelae). Now, three shocks interrupted by CPR, and often that’s it. Twenty minutes, perhaps thirty, and in rare cases, over an hour–but shorter periods are becoming more and more the norm. Doctors will say this is due to the low success rate–still, twenty minutes even in witnessed arrest in which the patient has no DNR is a short time to say, “He’s dead Jim,” given the utter finality of death. Money may play a bigger role in these decisions than medicine. The UK lacks the profit motive in medicine outside the private health facilities there, so the incentive is to keep trying in a code rather than stop in order to save money (I am indebted to my friend Megan for this insight).

Is it possible for a traditional conservative to endorse a non-for profit single payer system of health care for the United States? It has already happened: Paul Craig Roberts, whose conservative credentials are stronger than most self-styled “conservatives,” has endorsed that system. Affordability in the age of massive deficits is the problem, but if the system is run correctly more money might be saved in the long run due to decreasing health care costs–and if tort law is revised so as to protect physicians from frivolous suits, this could help even more. I am not quite ready to endorse such a system, but the more greed I encounter in the present privatized system the more I am tempted to endorse a nationalized system of health care.  It would at least take out the profit motive that is corrupting current medicine and taking it away from its proper ends.