Ok, here comes another one. I know this is becoming like all election all the time, but hey, it is just a few days away. A few more days of this and it will be over… maybe. Anyway, next is this one:

CONSTITUTIONAL AMENDMENT
ARTICLE X, SECTION 22

PATIENTS’ RIGHT TO KNOW ABOUT ADVERSE MEDICAL INCIDENTS

Current Florida law restricts information available to patients related to investigations of adverse medical incidents, such as medical malpractice. This amendment would give patients the right to review, upon request, records of health care facilities’ or providers’ adverse medical incidents, including those which could cause injury or death. Provides that patients’ identities should not be disclosed.

The direct financial impact this amendment will have on state and local government revenues and expenditures cannot be determined, but is expected to be minimal. State agencies will incur some additional costs to comply with public records requirements of the amendment, but these costs will be generally offset by fees charged to the persons requesting the information.

Once again though, we’ll need the real full text, not just the summary:

BE IT ENACTED BY THE PEOPLE OF FLORIDA THAT:

1) Statement and Purpose:
The Legislature has enacted provisions relating to a patients’ bill of rights and responsibilities, including provisions relating to information about practitioners’ qualifications, treatment and financial aspects of patient care. The Legislature has, however, restricted public access to information concerning a particular health care provider’s or facility’s investigations, incidents or history of acts, neglects, or defaults that have injured patients or had the potential to injure patients. This information may be important to a patient. The purpose of this amendment is to create a constitutional right for a patient or potential patient to know and have access to records of a health care facility’s or provider’s adverse medical incidents, including medical malpractice and other acts which have caused or have the potential to cause injury or death. This right to know is to be balanced against an individual patient’s rights to privacy and dignity, so that the information available relates to the practitioner or facility as opposed to individuals who may have been or are patients.

2) Amendment of Florida Constitution:
Art. X, Fla. Const., is amended by inserting the following new section at the end thereof, to read:
“Section 22. Patients’ Right to Know About Adverse Medical Incidents.
“(a) In addition to any other similar rights provided herein or by general law, patients have a right to have access to any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident.
“(b) In providing such access, the identity of patients involved in the incidents shall not be disclosed, and any privacy restrictions imposed by federal law shall be maintained.
“(c) For purposes of this section, the following terms have the following meanings:
“(1) The phrases “health care facility” and “health care provider” have the meaning given in general law related to a patient’s rights and responsibilities.
“(2) The term “patient” means an individual who has sought, is seeking, is undergoing, or has undergone care or treatment in a health care facility or by a health care provider.
“(3) The phrase “adverse medical incident” means medical negligence, intentional misconduct, and any other act, neglect, or default of a health care facility or health care provider that caused or could have caused injury to or death of a patient, including, but not limited to, those incidents that are required by state or federal law to be reported to any governmental agency or body, and incidents that are reported to or reviewed by any health care facility peer review, risk management, quality assurance, credentials, or similar committee, or any representative of any such committees.
“(4) The phrase “have access to any records” means, in addition to any other procedure for producing such records provided by general law, making the records available for inspection and copying upon formal or informal request by the patient or a representative of the patient, provided that current records which have been made publicly available by publication or on the Internet may be “provided” by reference to the location at which the records are publicly available.”

3) Effective Date and Severability: This amendment shall be effective on the date it is approved by the electorate. If any portion of this measure is held invalid for any reason, the remaining portion of this measure, to the fullest extent possible, shall be severed from the void portion and given the fullest possible force and application.

OK. So looking at this, this is exactly what I said I WOULD support when I was talking about Amendment 8. Rather than automatically forbidding doctors to practice with a certain number of black marks on their record, just make sure that the record is publically available and people choosing doctors (and hospitals hiring doctors for ERs and such) can make an informed decision.

So… if this was a proposed new law in the legislature, I might very well support it.

But the problem is that this is not a proposed normal law. This is a proposed amendment to the Florida Constitution. Now, the “Statement and Purpose” says this is to “create a constitutional right for a patient or potential patient to know”.

I said that having things like a “Bill of Rights” in a Constitution (or amendments thereto) is appropriate… but what is appropriate there is definitions of governmental restrictions… in other words places where government is prohibited to act because certain rights are reserved to individuals. In other words, what are called “negative rights”. Things that the government is prohibited from interfering in. “Positive rights”, which are actually not rights at all, but rather entitlements… things which

Now, personally I am very dubious about the idea of positive rights in any context. I’m not sure there actually is any such thing. The idea that an individual should be protected from many forms of abusive government action seems obvious to me. The notion that people somehow should be “entitled” to specific things bestowed upon them by the government does not.

Now, that does not mean that I believe that under no circumstances should government every bestow things on people. In some cases they should, and regulations in many areas while to be avoided if possible, is sometimes necessary or desireable. But those things should be matters of policy, and I do not think they elevate to the level of a “right”. And thus I think those sorts of things should be decided OUTSIDE of a constitution.

So, in this case I actually SUPPORT the policy goals of this amendment. I think it would be a good thing if something like this was enacted as a LAW. However I think it is inappropriate for something like this to be included in the state constitution. So…

My vote is: NO

I am so not doing enough of these fast enough. I’ll have to really work on the weekend. Anyway, it is lunch time, and I’m all woozy from prescription cough medicine (I’ve been sick for about a week now), so I figure I have a few minutes to do another one of these before trying to get my woozy head around finishing writing a couple of documents I have to write for work today… Anyway:

CONSTITUTIONAL AMENDMENT
ARTICLE X, SECTION 20
PUBLIC PROTECTION FROM REPEATED MEDICAL MALPRACTICE

Current law allows medical doctors who have committed repeated malpractice to be licensed to practice medicine in Florida. This amendment prohibits medical doctors who have been found to have committed three or more incidents of medical malpractice from being licensed to practice medicine in Florida.

The direct financial impact on state and local governments resulting from the proposed initiative would be minimal. There will likely be additional costs to the state of less than $1 million per year, but these costs will be offset by licensure fees.

OK, but like a couple of others, this is the abbrivated ballot text, and to really judge this one needs to look at the full text…

BE IT ENACTED BY THE PEOPLE OF FLORIDA THAT:

a) Statement and Purpose:
Under current law, a medical doctor who has repeatedly committed medical malpractice in Florida or while practicing in other states or countries may obtain or continue to hold a professional license to practice medicine in Florida. The purpose of this amendment is to prohibit such a doctor from obtaining or holding a license to practice medicine in Florida.

b) Amendment of Florida Constitution:
Art. X, Fla. Const., is amended by inserting the following new section at the end thereof, to read:
“Section 20. Prohibition of Medical License After Repeated Medical Malpractice.
“a) No person who has been found to have committed three or more incidents of medical malpractice shall be licensed or continue to be licensed by the State of Florida to provide health care services as a medical doctor.
“b) For purposes of this section, the following terms have the following meanings:
“i) The phrase “medical malpractice” means both the failure to practice medicine in Florida with that level of care, skill, and treatment recognized in general law related to health care providers’ licensure, and any similar wrongful act, neglect, or default in other states or countries which, if committed in Florida, would have been considered medical malpractice.
“ii) The phrase “found to have committed” means that the malpractice has been found in a final judgment of a court or law, final administrative agency decision, or decision of binding arbitration.”

c) Effective Date and Severability:
This amendment shall be effective on the date it is approved by the electorate. If any portion of this measure is held invalid for any reason, the remaining portion of this measure, to the fullest extent possible, shall be severed from the void portion and given the fullest possible force and application.

Some of my questions on the measure based on the abbreaviated text were answered by reading the full text. Anybody voting on these things should always read the full text and not rely on the summaries… Also, this is an ammendment to an existing document, so one needs to look at the current language too…

OK, WTF… According to the copy of the Florida Constitution on the official Florida Senate website, there is ALREADY an Article X Section 20 (Dealing with “Workplaces without tabacco smoke”), whereas this says Section 20 will be added onto the end of Article X… something is screwy here. Perhaps a couple of the old sections were repealed and the website hasn’t been updated yet? I don’t know, but I don’t like this!

OK, lets assume this is just some numbering snafu, and I just don’t have a current copy of the constitution, even if it is on the official government website… lets look at a couple other things about the ammendment…

But before I do that, I just have to say, Article X is “MISCELLANEOUS”. What kind of structure is that? This is a constitution! There shouldn’t be a section like that! And Article X Section 21 is “Limiting cruel and inhumane confinement of pigs during pregnancy.” Excuse me??? Now, I’m not saying that I advocate cruel and inhumane confinement of pregnant pigs, and this might very well make a great normal LAW. But it has absolutely no place in a CONSTITUTION.

Constitutions (national, state, whatever) are supposed to at a high level define the basic structures of government, how they interact with each other, how offices are filled… that sort of thing. And perhaps basic definitions of rights and responsibilities. (Such as the Bill of Rights in the US constitution.) Issues of specific governmental policies on specific narrowly drawn issues have no place in a constituation. Those types of issues should be resolved through the normal legislative process as implemented by the executive and interpreted by the courts. To put them in a constitutional document is to corrupt the value of the constitution and to improperly elevate policy issues into the basic structure of government. This is wrong. And will effect my vote on this issue as well… and perhaps most of the proposed ammendments…

OK, now back to this specific amendment. Basically it imposes a three strikes and you are out rule on doctors with regard to malpractice. I was worried when I just read the summary about just how one was determined to have committed malpractice, if there were mechanisms for appeal, etc. The full amendment defines that a bit more. A “final judgement” is needed, meaning that an appeals process is available before that point. However, there is still no mechanism here for evaluating the comparative seriousness of incidents. That is troubling. Not all cases of malpractice are equal, some are worse than others. Also the opponants arguments about this chasing away doctors does have some weight, but my main concern on this item from a pure policy point of view is simply that it is arbitrary, and takes choice away from the individual, and instead mandates a puinshment for the doctors. I’m not saying I’m for bad doctors continuing to practice and hurt people… I just don’t think this is the correct way to deal with it.

I’d be for a policy requiring full disclosure, so you could look up a Doctor’s history and see exactly what issues they had in the past, and then make an educated decision. But I don’t want the government making that call for me. So on a pure policy basis, I would be against this.

However, and I take this to be even more important, as I indicated above… this is a policy issue which can and should be decided by the legislature. This is NOT something that should be included in a State Constitution. (Although I understand the way the initiative process is structured… it can apperantly only ammend the constitution, not other laws, makes this very tempting.) Matters of governmental policy, rather than governmental structure and organization, have no place in the constitution. If laws need to be passed on this subject, the legislature should do this. This is not the right place or method. Therefore…

My vote is: NO

Lunch is over. More later.

Looking over the next few ballot questions though… the next 7 of them are all constitutional ammendments. And they ALL seem to relate to policy issue rather than structural issues. So I may already know my vote. But on each one I will make a seperate evaluation on the policy issue and state what my opinion there is. But, even if I am for the policy, I most likely will be AGAINST the ammendment… simply because policy issues should not be corrupting a state constitution. That is not what they are for. Or at least not what they SHOULD be for… even if that is how they are obviously being used. That is what the legislative branch is for. (And in some cases the executive and the courts.)

Proposed Amendment No 6 is slightly different, but I’ll talk about that one when I get to that one…

Also, I am strongly reconsidering my earlier stated position on Brevard County Referendum 2. I’d said my position was already weak. I may be about to flip. If I do, I will of course post an update. :-)

Hmmm… what I’ve been talking about here may also apply to the Brevard County Charter Amendment 3. I’ll have to think about that one a little too. If I change my mind on it, I’ll be sure to post about it. I’m sure you all will be waiting in great suspense.

Oh please, oh please, oh please! We couldn’t possibly get this much fun, could we???

Tie Goes to the…
(Matt Glassman, Tech Central Station)

Interested in becoming president this year? If so, hope for an electoral college tie. With an unlikely, but plausible, perfect tie — 269 electoral votes for both George W. Bush and John Kerry — anyone meeting the Constitutional qualifications for president could end up president. Here’s how.

(via Fark)

Read the whole thing, it goes through the whole scenerio. That would be awesome!!!