Capitol Fax

Rich Miller's commentary on State Government

I was interviewed the other day by National Public Radio about the "campaign" to fill president-elect Barack Obama's US Senate seat. Most of what I said was left on the cutting-room floor, but my message to the NPR reporter was crystal clear: Ignore all the punditry and prognostication.

Admittedly, it's been enormous fun to watch all the hopefuls scramble for Gov. Rod Blagojevich's favor. The governor, by law, fills the vacancy, which was created when Obama resigned on Sunday. Blagojevich hasn't been this popular with this many politicians since he first took office and was handing out plum jobs and contracts. Times have changed, and pretty much everybody has treated him like a radioactive monster for the past couple of years, so I'm sure he's enjoying all the recent attention.

Congressman Jesse Jackson, Jr. has gone so far as to line up newspaper endorsements, and at one point convinced several Washington, DC reporters that he was the frontrunner to replace Obama. He even commissioned a statewide poll which he claims shows he'd be the best candidate of the bunch.

The Politico's Roger Simon recently pointed to President-elect Obama's choice of Illinois Veterans Affairs Director Tammy Duckworth to accompany him to a Veterans' Day wreath-laying ceremony as a significant clue. Duckworth is on just about everyone's short list. But some Chicago media outlets have reported that US Sen. Dick Durbin's advocacy of Duckworth's appointment might be hurting her. Durbin and Blagojevich don't have the best relationship, goes the logic. Then again, almost everybody has a lousy relationship with this governor.

The potential appointment list is almost endless. Congressmen like Luis Gutierrez and Jan Schakowsky have their hands out. Former statewide officials like Roland Burris have said they're ready, willing and able to serve.

Pretty much every story published about the vacancy has also mentioned retiring Illinois Senate President Emil Jones, partly because Jones is allied so closely with Gov. Blagojevich.

Jones' downsides are many. He specializes in crony politics. His family has benefitted mightily from state jobs and contracts. He has almost no respect in the media. And his antics have lost him most of the respect he once had in political circles.

Logic would seem to dictate that the governor would use this appointment to finally start turning around his absolutely awful reputation with voters. I mean, you'd think a guy with a 13 percent approval rating would want to nudge that upwards a little.

But when has reason or or logic ever entered into Blagojevich's playbook? Was the Statehouse war he waged over the last two years reasonable or logical? It tanked his poll numbers, but he kept on fighting. We're talking about a Democratic governor of one of the most Democratic states in the union who has lower job approval ratings than lame duck Republican President George W. Bush. Reason and logic? Please.

The point is that while the scramble for Obama's seat may be fun to watch, particularly Congressman Jackson's over the top circus, none of the "clues" pointed to in the media probably mean anything. Reporters, pundits and the professional prognosticators are all looking at this in a logical, traditional way. As mentioned above, this is not usually how Governor Blagojevich tends to operate.

The entire spectacle finally became so bizarre that I started to push my own replacement candidate last week. I decided that a longtime commenter on my blog who goes by the name of "Bill" and defends Gov. Blagojevich through thick and thin deserved the Senate seat as much as everyone else. Within 24 hours of starting a FaceBook group for "Bill," over 160 people had signed up for the cause. That's almost as many "followers" as two sitting congresspersons attracted to their own FaceBook groups which were designed to bolster their Senate dreams.

Bill's "candidacy" now has its own blog and three YouTube "campaign" videos, all created by a volunteer.

It's almost a movement.

Yeah, OK, that's a little over the top. But I figure Bill has just as much of a shot as anyone, considering who's doing the appointment.

Rich Miller also publishes Capitol Fax, a daily political newsletter, and thecapitolfaxblog.com.

Organ Donors Beware!

If you're an organ donor, you may want to reconsider your decision after reading about five people who are alive today because someone accidentally noticed at the last moment that they were not really dead. These are all 2008 cases: Raleane Kuperschmidt, 65, of Minnesota, Zack Dunlap, 21, of Oklahoma, Val Thomas, 59, of West Virginia, a 45 year-old Parisian whose name was not published by French media, and Kevin Mark. 25, of Wyoming. All were just seconds away from having their organs removed while they were still alive. All have recovered and are grateful some family member did what their doctors should have done: made absolutely certain they were dead.

Zack, for instance, was saved by a cousin, Dan, who was also a nurse. Not convinced that Zack was really dead, he ran a pocketknife over his foot and was startled when his "dead" cousin jerked his foot back. He also dug his fingernail under one of Zack's nails and behold, the "corpse" pulled his arm away!

The doctors who were about to extract his heart could, of course, have performed these same simple "operations" to make sure he was dead. Instead, they were apparently more concerned about following approved protocols, watching the readings on their sophisticated equipment and the second hand on the clock to make sure they waited the recommended time, instead of watching the patient who had entrusted his life to them. After all, you wouldn't expect a protocol full of medical mumbo-jumbo to include the suggestion of running a knife down a patient's foot. How unprofessional that would be!

A recent article in The New England Journal of Medicine explains why such cases are not rare. Drs. Robert Troug and Franklin Miller, after examining three cases of heart transplantation from infants who were pronounced dead on the basis of cardiac criteria, admitted that "The uncomfortable conclusion to be drawnis that, although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead."

Let's rephrase that last line better. They're saying that what doctors are doing today in hospitals all over the world MAY be ethical, not because the patients are actually dead but rather because they meet newer definitions of death agreed upon by various medical groups.

Before the development of modern critical care, people were considered dead when they were cold, blue, and stiff. Unfortunately, organs from such traditional cadavers cannot be used for transplantation. But now that new definitions of circulatory (cardiac) death and brain death (permanent cessation of functioning of the organism as a whole) have been accepted by the medical profession, organ transplantation has become mainstream, not to mention lucrative.

As Dr. Bernat of Dartmouth Medical School says, "researchers have begun to design 'innovative' protocols that aim to improve the function of transplants and expand the donor pool. These protocols test the conceptual limits of donation after circulatory death by permitting invasive intervention in living organ donors or by altering the tests required to determine death."

Get it? The aim of these new protocols is not to prevent people like Dunlap from being killed before they are dead. Just the opposite! Their aim is to increase the supply of Dunlaps to meet the growing demand for more organs.

Here are two types of invasive intervention being used: One, the administration of intravenous heparin or vasodilators, not to benefit the donor patient but only to improve the function of transplantable organs. Two, instituting extracorporeal membrane oxygenation (ECMO) in the donor after the declaration of death. As Dr. Bernat observed coolly, "This permits much more invasive intervention, including the insertion of arterial catheters before death."

The dead donor rule states that a donor must be dead before vital organs are procured. Death statutes require the irreversible cessation of circulation and respiration or the irreversible cessation of brain functions. However, John Shea M.D., a Canadian physician, points out that patients diagnosed as "brain dead" often continue to exhibit brain functions. In "Organ Donation: The Inconvenient Truth" he points out that the criteria for brain death "test only for the absence of some specific brain reflexes. Functions of the brain that are not considered are temperature control, blood pressure, cardiac rate and salt and water balance. When a patient is declared brain dead, these functions are not only still present, but also frequently active."

Shea also notes that the very definition of "brain death" is vague and inconsistent: "There is no consensus on diagnostic criteria for brain death. They are the subject of intense international debate. Various sets of neurological criteria for the diagnosis of brain death are used. A diagnosis of death by neurological criteria is theory, not scientific fact. Also, irreversibility of neurological function is a prognosis, not a medically observable fact."

Commenting on the five cases mentioned above, Dr. Paul Byrne, neonatologist and Clinical Professor of Pediatrics, observed that, "While these stories are reported as something miraculous, what occurred is not supernatural at allZack was always living - his heart was always beating, there was always blood pressure, he was always very much alive."

Over the years Dr. Byrne has collected information about numerous cases where patients labeled brain dead have "returned from the dead." The reason being, he says, "That brain death is never really death."

That being the case, we're talking about euthanasia first, then organ transplanting. Those three Denver infants, only hours old, were euthanised at the request of their parents so their organs could be donated.

Zack's story should be taken as a warning about the insufficiency of the brain death criteria. How many other organ donors are there who were not so lucky? "Brain death was concocted," says Byrne. "It was made up in order to get organs. It was never based on science."

Look at the back of your driver's license. You'll notice that it's now assumed that everyone wants to be a donor. The state just wants to know which organs and tissue. Not if, but which. There's no box to check if you don't want any part of the program. You're warned that it's a legal document, so you had better write NONE in that space if you don't want your organs harvested before you're dead. And make sure a witness signs, too.

A new law passed by the Illinois General Assembly went into effect on January 1, 2007. It reads, in part, "When there is a suitable candidate for organ donation and a donation or consent to donate has not yet been given, procedures to preserve the decedent's body for possible organ and tissue donation may be implemented under the authorization of the applicable organ procurement agency, at its own expense, prior to making a donation request pursuant to Section 5-25."

While thinking about all this, keep in mind what J. A. Barondess of the New York Academy of Medicine wrote in his book, Medicine against Society: Lessons from the Third Reich: "The engagement of German biomedicine in the design and execution of Nazi programs of racial cleansing was extensive and was organized by physicians and other professional leaders. In its active involvement and acquiescence, the German medical profession, one of the most sophisticated and respected medical enterprises in the world, dishonored itself and raised profound and persisting questions about the nature, strength, and relevance of the medical ethos and the relationship between medicine and the policies and programs of the state."

Is history repeating itself here in America in a more subtle (and therefore more dangerous) way?

Sincerely,

Richard O'Connor

Pearl City, IL

What Happens Now?

So, the election is over. What happens now? Can we find our way out of the economic mess? I really don't pretend to know. What I hope is that we can bring our government away from the system of government that promoted lies, spied upon Americans, restricted our movements, suppressed our right to petition the government, used torture in our civil society, undermined our Constitution, twisted the judicial system, and threatened the foundations of our government. I hope we can reestablish the system of checks and balances that has kept each branch of our national government somewhat in check. Can we bring back a presidential system that holds the President within the confines of the laws of our land? No president should be allowed to be above the law. Will the Congress get enough courage to hold even the President accountable? The fact that we did not bring charges against the President and Vice President for knowingly breaking the law is a huge problem that now remains. Future presidents now have precedents for doing things that only a dictator or king has been able to do in the past. Can we return to a government run by the people and for the people? Can we get out of the theocratic movement that has threatened America's future? Can we become a government based upon discourse rather than one based upon fear, division, and hate? An awful lot is riding on the new president. It will take strong shoulders to take us back toward the dream of an American society based upon the good characteristics of mankind and away from the more base behavior of the past eight years.

Gregory T. Krysiak

Lanark, Illinois

Honoring Home Health Care Professionals

November is Home Care and Hospice Month in Illinois, a time to honor and thank home health nurses, aides, therapists, social workers and other home care staff who are always there for us whenever we or our loved ones need home care and hospice. These services are delivered to recovering, disabled, chronically or terminally ill persons in need of treatment and/or support and assistance with the essential activities of daily living.

To help families and caregivers find home care and hospice when they need it, the Illinois HomeCare Council has recently launched a new website, www.HomeCareHeadquarters.com.

Not only does this free resource answer basic questions about these services, it allows consumers to search for home care and hospice by service, provider, county or city, and by payment options such as Medicare and Medicaid.

On behalf of the Illinois HomeCare Council, I encourage you to visit this important new website and to recognize those individuals in your community who are providing care and comfort to homebound individuals of all ages.

Sincerely,

Jan Costello

Executive Director

Illinois HomeCare Council

Capitol Report

By Jim Sacia, State Representative, 89th District

"I wish I would have called your office first." - It's a comment we often hear after constituents have been trying for days or weeks to resolve an issue with a state agency.

In my six years as your State Representative, my staff and I have helped get driveways on state highways moved, get Department of Corrections' prisoners moved from one facility to another and resolve licensing issues with the Secretary of State's Office or the Department of Professional Regulation. We have also been involved in helping untold numbers of constituents resolve tax and fee assessment issues with the Department of Revenue. I could go on, but you get the drift. The point is that the title "Representative" means just that. We are here to represent you and to intervene on your behalf.

People have been very gracious in thanking me for helping with an issue. The reality is that I have a phenomenal staff. Sally and Barb in Freeport and Susan in Springfield have exceptional liaison with all state agencies. We can't resolve every issue, but our chances of success are better than most residents trying to go it alone. All too often you dial an "800 number" that is busy, or connects you to an automated menu that's difficult to navigate. If you do get through to an actual person, they can't help with your problem. Agencies are receptive to State Representatives and their staffs and will usually help us resolve our constituents' problems.

Yes, I'm soliciting. My staff and I want you to call us. It's why we're here. I'm very proud of our constituent services record and my wonderful staff is prepared to help you.

My favorite story of a constituent we helped involves my own wife, who, rather than ask me, decided to try to resolve an issue with a state agency herself. After the numerous busy signals and long waits on hold she finally got in touch with a live body who, after listening to Jenny's issue simply told her "you'll need to speak to your State Representative about that." Jenny replied "Well, I'm sleeping with him, so I'll let him know." I wish I could have seen the look on the face of the gentleman on the other end of the line.

As we prepare to start our fourth term in the General Assembly, let me again emphasize that we are here to serve you!

As always, you can reach me, Sally or Barb at or e-mail us at . You can also visit my website at www.jimsacia.com. It's always a pleasure to hear from you.