“I Understand The Assignment”: The Case of Justice Tom Parker.

Posted on | July 22, 2024 | 4 Comments

Mike Magee

Without hyperbole, Project 2025 feels similar to Germany in the early 1930’s.

Their website introduction reads:

“It is not enough for conservatives to win elections. If we are going to rescue the country from the grip of the radical Left, we need both a governing agenda and the right people in place, ready to carry this agenda out on Day One of the next conservative Administration.”

Alabama’s 73-year old Justice Tom Parker is clearly one of those “right people.” He did not flinch in his February 16, 2024 decision in “LePage v. Center for Reproductive Medicine.” Citing an 1872 Alabama state law that allows for individuals to sue over the “wrongful death of a minor,”  he confidently declared that 8-cell embryos cryopreserved in fertility clinics were people.  He then added insult to injury. He tied  the decision to declaring that individuals  responsible for the mistaken loss of the cells liable for damages to the the state’s (Dobbs decision enabled) 2019 law banning abortion. A messy backlash against and for IVF soon followed. 

Not content to be both lawyer and doctor, Parker added theologian to his credentials stating in his decision:  “In summary, the theologically based view of the sanctity of life adopted by the People of Alabama encompasses the following: (1) God made every person in His image; (2) each person therefore has a value that far exceeds the ability of human beings to calculate; and (3) human life cannot be wrongfully destroyed without incurring the wrath of a holy God, who views the destruction of His image as an affront to Himself.”

Determined radicalized leaders, fueled with a religious fervor, long ago rejected the Founding Fathers commitment to separation of Church and State.

Consider the words of James Madison, in a speech to the House of Representatives in 1789: “The civil rights of none, shall be abridged on account of religious belief or worship, nor shall any national religion be established, nor shall the full and equal rights of conscience be in any manner, or on any pretext infringed.”

As we now turn the corner on our way to a November election, it is important to acknowledge that the threat we face is larger than Trump alone. To not acknowledge the leaders of Project 2025 and beyond at this moment in our history would be equivalent to believing that WWII was only about Hitler, Mussolini, and Hirohito, when in fact the challenge was far greater than that.

Stated simply, the human species in the Axis societies had gone off the rails, and channeled themselves into a death spiral. “Breaking the spell” required unprecedented force and ultimately the use of atomic bombs, followed by multi-decade investments through the Marshall Plan to reestablish civilized human societies.

It is for this reason that “limping to the finish line” is no longer an option for our nation.  Project 2025, the Supreme Court’s recent Chevron decision, and the multi-pronged assault on women’s reproductive freedom all suggest that an overwhelming defeat of Republicans down ballot will be required to lay the ground for recovery of a healthy two-party Democracy.

Anything less will embolden an already captive Supreme Court and MAGA insurrectionists. A two party system of Democracy has delivered reliable and peaceful transition of power for over two centuries until 2020. One of those parties has been usurped, placing our treasured Democracy at risk. The quickest way to reset a viable two-party system is to decisively defeat Trump and all MAGA down-ballot allies across the United States in November.

U.S. Presidents and Vice-Presidents Are Never Immune From Danger – Political Or Otherwise.

Posted on | July 14, 2024 | 4 Comments

Mike Magee

This has been a disorienting period of mixed messages when it comes to the highest offices of the land. Just two weeks ago on July 1, 2024, a majority of the  Supreme Court decided to expand Presidential immunity for criminal malfeasance to former President Trump who had so severely tarnished the post on January 6, 2021. Twelve days later, Trump declared he knew nothing about Project 2025, a frontal assault on our Democracy that he has been encouraging for years.

The Supreme Court’s meddling occurred just three days after President Biden was forced to acknowledge that he had badly flubbed the First Presidential debate, which led to a series of recovery moves (the ABC Stephanopoulos interview on July 6; the live Press Conference in D.C. on July 11; and the full-energy “Don’t You Quit” rally in Detroit, Michigan on July 12) aimed at trying to prove he wasn’t too old or infirm to do the job.

In the meantime, Vice President Kamala Harris remained loyal and capable in the wings, while Trump went silent, cagily delaying his decision on his own running mate until he had greater clarity on who exactly he was running against. 

And then one day later, a 20-year old registered Republican, came within inches of successfully assassinating the former President with an automatic sniper rifle of the variety vigorously defended as just fine for civilian circulation by Republicans.

All of this might lead you to believe, when it comes to the top two positions in our Executive Branch of government, that we have entered unusual times. But, as history well illustrates, nothing could be farther from the truth.

In our brief history as a functioning Democracy, eight of our Presidents have died in office and one has resigned. Four sitting Presidents were killed by gunshot (Lincoln, Garfield, McKinley, JFK) and three have survived attempts on their lives (Reagan, Teddy Roosevelt, and now Donald Trump). As for their #2’s, seven VP’s have died in office and two have resigned in office. And that doesn’t even begin to cover the many cases where these top elected officials have managed to maintain their positions by hiding and covering-up a range of debilitating physical and mental illnesses while in office.

The Founding Fathers had little interest in insulating their top leaders from legal oversight. But after we declared our independence in 1776, it took another decade or so before the Constitutional Convention settled on a system of top leadership and succession. They had already established that the office of the Vice President would be created, and that the President and the Vice President would be elected by the Electoral College.  But ultimate power lay with the Congress. If they saw fit for any reason to remove both the President and the Vice President, and put somebody in his place until the next election, they had the power to do so.

It took 5 more years for the body to decide on a plan who would lead the country if both president and vice president were to become disabled or removed at the same time. They decided that the next top two people in the Federal Government who had actually been elected by the people would be the President pro tempore of the Senate and the Speaker of the House of Representatives. That was the line of succession as of 1792.

This was the established law for another half century, until 1841, when William Henry Harrison died of typhoid.  He had only served for 31 days and, as it was laid out in the Constitution, the Vice President assumed his office, but the extent of his powers and the titling associated with his assumption of power were unclear. Was the Vice President just a substitute until the next election or was he actually now president? John Tyler pretty much resolved that question with a truly Trumpian move.  He contacted the first local judge he could find, and had himself sworn in as President, not as “Acting President.” This created a huge stir. John Quincy Adams went crazy over this issue, but a precedent had been set. From then on, if a President died, the Vice President became President.

Now, as we’ve seen, presidential and vice-presidential turnover is not uncommon. So this focus on succession is not a theoretical exercise. It’s a real issue for our representative democracy. And it is quite surprising in many ways that it’s been left as loose as it has been left in our Constitution. Crises like the one that involved John Tyler are how this issue has been queued up. Legislative solutions have largely been reactive. 

For example, in 1886, there was the assassination of James Garfield.  He was shot on July 2nd, 1881, but he lived for another 80 days, unable to function as President during that period of time. It is notable that over all of those 80 days, he never had a discussion with Chester Arthur, the vice president, about assuming the presidency or what would be the priorities. In fact, Chester Arthur was totally isolated, both by Garfield and by the people who serve Garfield.

Arthur did establish a committee to examine issues of succession, but they did little to correct the core problem of amassing so much power in a few individuals without adequate checks and balances. Now, it took only a few years more to expose that a President in power, supported by political allies and family, was powerful enough to skirt or ignore all the rules and boundaries Congress felt they had established. Case in point: Woodrow Wilson. But that is another story you can explore in greater depth HERE if it interests you.

So what have we learned in the past two weeks?

1. In our short American history, traumatic injury and loss of life have been a constant threat to our President and Vice-President in office.
2. Once in office, Presidents tend to minimize their mental and physical disabilities, and are aided in their conspiracies by family members and political loyalists and allies.
3. Peaceful transfer of power in the Executive branch has been recognized as “the weakest link” by the Founding Fathers who spent several decades attempting to manage this potential democracy-threatening liability.
4. The active debate within the Democratic party on their “final” 2024 ticket is consistent with other incumbent candidates who have struggled and managed to hold onto power with varying results.
5. Extending further protections from liability to the now wounded and newly heroic former President Trump, a convicted felony who openly declares his intent to extend the power of the Executive well beyond the fears of the original Founding Fathers, would suggest that this Supreme Court has, deliberately or mistakenly, wandered into new and uncharted territory.

“Off the Record, Mike, What’s Pelosi Doing in a Few Bullet Points?”

Posted on | July 10, 2024 | 4 Comments

An imagined conversation drawn from a compilation of real discussions with multiple individuals that occurred over the prior 48 hours. Mike Magee

______________________________________________________________________

OK. But not to be attributed to me.

1. Speaker Emerita Pelosi this morning (on MSNBC) signaled the timing (after the NATO summit) and outcome (Biden pulls out of the campaign) for the good of America and the Democratic Party.
2. Pelosi’s imagined private discussion with the President:  Joe, by next week it will come out that you have known you have Parkinson’s for over a year.  Trump has put a hold on ads under the banner ‘Cover-Up by Deep State’.
3. Pelosi’s Next Step:  Joe, this is time for your ‘George Washington move.’ You need to control and exercise your own exit as patriotic and on behalf of our nation (in contrast to Trump’s recklessness). As you exit, you can emphasize your full confidence in the Democrats’ deep bench – most especially women leaders in this post-Roe period.
4. Pelosi on Legacy:  In return for your sacrifice, Joe, your legacy will be secure, and you will be recorded in history for all time as the savior of our Democracy.
5. Pelosi response to, “Yes, but I’m the best for the job.”  Joe, the reason that Trump and the RNC have gone quiet is that they want to run against you. You’re the greatest politician I know. Why do you think they would do that? Don’t play into their hands. Take control of your future, our future, and the future of American Democracy.

OK, Nancy, but here’s what I want in return. . . (Pelosi response: No problem, Joe. You’ve earned it!)

Limping To The Finish Line Will Not Cure This Problem. Crushing the “Trump Reich.”

Posted on | July 8, 2024 | 4 Comments

Mike Magee

I have always felt a kinship with EJ Dionne. We are both Boomers, though I am 4 years his senior. We share similar politics, religious origins, early Catholic school educations, fathers in health care and mothers who were teachers, deep New England roots, addiction to the written word, blessings with long marriages and children (they 3, we 4), and deep revulsion with Trump and his enablers and everything they represent.

Viewing him as measured and wise, I took special care in reading his Washington Post column  today, “The words about Joe Biden I never wanted to write.” 

For twelve days since that first debate, I have worked to remain officially neutral on “what next to do,” and stayed focused on how to ensure a decisive (message sending) defeat not only of Trump but Republicans up and down the ticket, so that there is no confusion that the whole cabal – Project 2025, Leonard Leo et al, the  Supreme Court’s “Doomed Crusade”, Bannon-led MAGA insurrectionists – is sufficiently devastated that it can not remerge from the cinders.

There is no doubt that Biden’s physical and mental decline was on full view for over 50 million Americans two weeks ago. And you don’t have to be a medical historian or a prize winning journalist to recognize that the degenerative processes that are responsible for his decline are progressive (albeit possibly slowly progressive). That is to say, his decline will continue, as predictably as did Ronald Reagan’s.

But as E.J. makes clear in his opinion piece this week, “Biden’s capacity to do a ‘good job’ is not ‘what this is about.’ Donald Trump’s threat to democracy is the overriding question before the country…”

While Dionne is right that this is not “about Biden,” he understates the problem when he suggests instead that it is about Trump alone. That is no more true than to suggest that WWII was only about Hitler, Mussolini, and Hirohito, when in fact the challenge was far greater than that. 

Stated simply, the human species in the Axis societies had gone off the rails, and channeled themselves into a death spiral. “Breaking the spell” required unprecedented force and ultimately the use of atomic bombs, followed by multi-decade investments through the Marshall Plan to reestablish civilized human societies.

President Biden limping to the finish line, and repeating slight margin victories in seven swing states will not solve America’s current problem. We are too far along. As with Hitler’s Germany in the 30’s, the enemy’s course trajectory is by now visible for all to see, and it will achieve its’ Project 2025 goals and objectives if allowed. These determined radicalized leaders are more than half way there, fueled with a religious fervor that can not be modified by honest debate or calm logic. 

Success breeds success as well for evil as for good. So far, with Biden still in power, political arsonists have achieved an immune Executive branch; a biased Judiciary with no Code of Ethics; a House of Representatives directed from Mar-a-Lago; and 14 state houses with absolute control over their citizens reproductive rights.

Clearly the problem is bigger than Trump. Project 2025’s declaration leaves little room for confusion. It states: “It is not enough for conservatives to win elections. If we are going to rescue the country from the grip of the radical Left, we need both a governing agenda and the right people in place, ready to carry this agenda out on Day One of the next conservative Administration.”

There will be no Pearl Harbor to wake us from our sleep, or galvanize our clear majorities that know in their hearts that something has gone very, very wrong. That Presidential debate was our final warning.  Time’s up. As Sen. Chris Murphy (D-Conn.) said this weekend “This is a really critical week. I do think the clock is ticking.”

What then is the formula for an overwhelming defeat of the Trump Reich? Three pillars: Energy, Enthusiasm, Women-Led.

Boomer Boomerang.

Posted on | July 1, 2024 | 2 Comments

Mike Magee

Last year the New York Times Editorial Board asked the rhetorical question, “Can America Age Gracefully?” After last week’s Presidential Debate, the answer to the query seems pretty clear. “Apparently not?”

This is not simply a function of the graying of America (and her two Presidential candidates), but also a result of our unique form of Democracy that over rewards full-throated capitalism. It is simple math really. Wealth comes with power, and power delivers wealth. And given these realities, why would you cede control unless forced to by adversaries or the ravages of health or misfortune?

Joe Biden and Donald Trump are not alone. They are emotionally and physically tied to the Boomer Generation (born between 1946 and 1964) that reach age 65 between  2011 and 2029. Boomers currently constitute approximately 60 million Americans or roughly 17% of our population, but by 2034 will reinforce their dominance demographically. This is a function of declining birthrates colliding with projected rises in aging survival. The combination leads demographers to confidently predict that by 2034, the numbers of Americans over 65 will exceed numbers of American children ages 1 to 18.

There are many reasons why older Americans resist leaving positions of responsibility even as their physical and mental capabilities decline. Many cite financial concerns, fear of boredom, fear that isolation will accelerate their decline, or the belief (mistaken or otherwise) that their experience and skill is invaluable to their organizations. 

In corporate and non-profit organizations, mandatory retirement and succession plans are designed to counter balance these disincentives, and leave room for younger members to rise to positions of greater responsibility. But over the years, a legion of politicians, donors, political consultants and jurists have risen in lockstep, reinforcing extreme longevity in Washington and state houses across the land, even in the face of mental illness and obvious aging decline.

The New York Times Editorial Board weighed in again on aging, or more specifically on aging leadership, the morning following the debate. Accused by many of jumping the gun and under-stating the scale of the criminal threat of Donald Trump, they positioned their effort as a principled attempt “to protect the soul of the nation — the cause that drew Mr. Biden to run for the presidency in 2019 — from the malign warping of Mr. Trump.”

Speaker Mike Johnson, using a well-worn strategy (“No I’m not – you are”) was quick to suggest a late morning solution – apply the 25th Amendment to remove President Biden who is “not seen to be fit for the office, to not be up to the challenge.” Even a novice politician could have seen that argument would boomerang back to May 16, 2017.

That is when New York Times conservative columnist, Russ Douthat, penned “The 25th Amendment Solution for Removing Trump.”  In that article, Douthat wrote “One does not need to be a Marvel superhero or a Nietzschean Ubermensch to rise to this responsibility. But one needs some basic attributes:  a reasonable level of intellectual curiosity, a certain seriousness of purpose, a basic level of managerial competence, a decent attention span, a functional moral compass, and a measure of restraint and self‑control. And if a president is deficient in one or more of them, you can be sure it will be exposed. Trump is seemingly deficient in them all.”

The following day, there were response editorials. Here’s one in support of Douthat by Columbia Law Professor Jamal Green  He writes, “A President whose words are meaningless, cannot confidently conduct foreign policy. He cannot negotiate treaties, keep confidences or establish substantive relationships with foreign leaders.  He cannot be trusted to use the awesome and deadly powers of the military for legal and moral ends…in short, a compulsively lying president would be unable to discharge the powers and duties of the office.”

Other columnists that same day reacted in the negative to Douthat’s words, mainly because they did not believe that the 25th Amendment was designed for the purpose of removing somebody like President Trump. For example, Jonathan Bernstein in Bloomberg wrote, “It would be a grave mistake to use the mechanism of the 25th amendment to get rid of him…Sorry, Congress. If you believe Trump needs to go, you’re going to have to do it yourselves.” And, in fact, they made an attempt to do just that through impeachment several years later, an effort that failed to yield a Senate conviction.

Ian Tuttle that same day in the National Review wrote, “My colleague, Charles C.W. Cook wonders “just how much of a psychic shock such a move would inflict upon this country – especially on those voters who backed and liked Donald Trump… How would that look to the people who would believe that Trump had been removed by the very elites he had set out to vanquish?” 

And finally in Slate, Dahlia Lithwick wrote what many of us were thinking by then, “Donald Trump is the disease that plagues modern America, he’s a symptom. Let’s stop calling it a disability and call it what it is: WHAT WE ARE NOW.”

In a university lecture in the Spring of 2020, I reviewed the history of Presidential impairment and the various remedies when our body politic is confronted with a President like Trump who is “unwell.” The entire address in available online here.

In that speech, I laid out our options to deal with Trump: “Under severe circumstances, we basically have three choices. One is obviously to vote that person out at the next election cycle. And we’ve used that over the years. Second would be to impeach a president, and then convict him in the Senate.  That has been attempted recently. And the third approach is the 25th amendment that was enacted in the late 1970s. We’ll discuss the history behind that and what one is able to do with the 25th amendment and what one is not able to do.”

The rest is history. The body politic voted Trump out, but he steadfastly has denied the result, and boldly seized control of the Republican party and is their nominee once again for the Presidency. Along the way he has added “convicted felon” to his resume, though in last week’s debate once again insisted that “I didn’t have sex with a porn star.”

Whatever is one’s view on President Biden, the only question that remains for those who believe (as I do) that Trump is mentally ill and a threat to the future of our democracy, is this: What course of action best assures a resounding defeat of Trump and all his enablers in November? Let the deliberate and timely answer to that question guide all our actions over the very near future.

The “final, final, final” Final Battle of Donald Trump.

Posted on | June 24, 2024 | 3 Comments

Mike Magee

We now are two days away from the “final, final, final” Final Battle of Donald Trump.

One year ago, the former President, now convicted felon, promised his supporters in Columbus, Georgia that his recently announced bid for the presidency was “the final battle” against “corrupt forces” and the “Deep State” which was being orchestrated by “globalists”, “warmongers” and “the sick political class that hates our country.”

In the same speech, when the name Hillary Clinton came up, portions of the crowd reflexly responded “Lock her up!” Nowadays that response no longer resonates with the same echo. But that same day, in nearby Greensboro, NC, his “In the end, they’re coming after me, they’re coming after you, and I’m standing in the way,” still feels fresh.

The day after his New York felony conviction, in a “rambling 33-minute news conference inside Trump Tower,” while still under a gag order and clearly non-repentant, he focused on the “devil” judge (as he stated) who “was very unfair.”  And still, he managed to bravely inform his invitation only audience in the lobby of Trump Tower that “It’s my honor to be doing this, but it’s a really unpleasant thing, to be honest.”

By now, even his ardent supporters are privately admitting that “honesty” and the “rule of law” are not Trump’s strong suits. And that might soon become problematic for a “purple state” like North Carolina with its 16 electoral votes. Trump’s current messaging is a bit discordant with North Carolina’s K-12 lesson plan, titled   “The Rule of Law.”

It begins with the Teddy Roosevelt quote, “No man is above the law, and no man is below it” from his 1903 State of the Union address. A bit further on, students are informed that:

“The rule of law is basically an agreement that everyone will play by the rules. This allows us to enjoy a more peaceful and safe existence. The rule of law also ensures the protection of certain rights for each of us. Ideally, the rule of law applies equally to everyone, meaning you are treated fairly and equally, under the same set of rules, regardless of who you are.”

The lesson plan concludes with a homework assignment. Students are provided with a copy of chapter 28 in former Supreme Court Justice Sandra Day O’Connor’s “The Majesty of the Law,” to read.

In follow-up, the teacher is instructed to ask students: “When Justice O’Connor writes, ‘A nation’s success or failure in achieving democracy is judged in part by how well it responds to those at the bottom and the margins of the social order,’ what message was she conveying and how does it relate to the rule of law?”

In the post-Dobbs era, women and their doctors find themselves increasingly marginalized “in the social order.”  Not surprisingly, reproductive rights have increasingly appeared on statewide ballots. Referendums have carried the day in states like Ohio, Kentucky and Kansas. 6% of voters now say women’s autonomy and reproductive rights is their #1 issue in the upcoming national election. 

It has fast evolved as a multi-generational family issue.  For example, one 55 year old North Carolina swing voter said this week, “I have a daughter, and I have been through that experience myself and am very much an advocate for women. And I think that once they take that away, they’re coming for a whole other set of rights for women next.”

And yet, the former president remains comfortable leaning into the issue as he did this weekend when he addressed the evangelical “Faith&Freedom Forum” in Washington, DC, presenting himself as “a martyr to the Christian Right.”  Headlines read “The former president portrayed himself as having ‘wounds all over’ while suggesting that he was being targeted for his support of religious freedoms.”

Not surprisingly, he offered a full-throated defense of legislative actions in Louisiana this past week to enforce posting of “The Ten Commandments” in all public buildings.  This raised eyebrows even his most ardent supporters. Specifically Commandments #7, #8, and #9 – prohibitions on adultery, lying, and stealing – seemed to demand a careful reread by the beleaguered candidate.

Increasingly, Trump’s “Persecution Complex” is sounding disingenuous and even a bit “whinny.” As Vanity Fair wrote last week, “The king of projection accuses others of ‘unhinged’ behavior and threatening democracy. Democrats need to hold a mirror up to the GOP’s choice.”

His arch nemesis, Liz Cheney, was more direct, saying what her fellow Republican leaders refuse to acknowledge. “It is a real threat to his political success if people recognize that he himself is trying to unravel democracy.” Fellow Republican “Trump critic,” Adam Kinzinger was more edgy. “He reminds me of a child who is angry,” adding, “His mind is a scary place.” And he thinks even less of Trump’s unrepentant followers who he sees as the devil’s handmaids. He insists he sees “scales on their eyes.”

Healthy Women Mean a Healthy Democracy.

Posted on | June 17, 2024 | 2 Comments

Mike Magee

When he assumed the role on June 13, 2023, Jesse M. Ehrenfeld, MD, MPH focused on inequities in health care as a top priority for his year in office. In a memorable opening that day in Chicago, the Wisconsin anesthesiologist shared a personal mission with 700 AMA delegates centered on his then 4 year old son. Ethan was born 10 weeks premature at 2 lbs 7 oz.

“Watching my son cling to life, I was struck by the painful reality that, even though I was a physician and now, a father, neither I, nor my husband, could donate blood simply because we are gay. Discriminatory policies—policies rooted in stigma, not science—barred us from doing the most humane of acts, donating our blood.”

As the AMA’s 178th president, Dr. Ehrenfeld used that story as a jumping off point to share his priorities as their new President. He pledged that day to seek justice and equity, highlighting:

“Black women are at least three times as likely as white women to die as a result of their pregnancy.

“Black men are 50% more likely to die following elective surgery.

“LGBTQ+ teens and young adults suffer higher rates of mental health challenges that often go undiagnosed.”

He also warned, in the shadow of the Dobbs decision on June 24, 2022, of  “… discouraging trends related to health outcomes—maternal mortality rates in the U.S. are more than double those of other well-resourced nations, for instance—and are becoming more prevalent.”

But when it came to the politics of reproductive health access, he chose his words carefully and took a quieter tone with the audience of politically savvy doctors from red and blue states.

“Certain aspects of the country’s political climate have become dangerously polarized. Politicians and judges are making decisions about health care formerly reserved for patients and physicians and patients…” he said.

This statement, coming one year after Dobbs, clearly did not mirror, in intensity, the words of his predecessor, Jack Resneck Jr.,MD, who wrote on the day of the decision, “The American Medical Association is deeply disturbed by the U.S. Supreme Court’s decision to overturn nearly a half century of precedent protecting patients’ right to critical reproductive health care…In alignment with our long-held position that the early termination of a pregnancy is a medical matter between the patient and physician, subject only to the physician’s clinical judgment and the patient’s informed consent, the AMA condemns the high court’s interpretation in this case.”

That sentiment was reinforced by the nation’s 25,000 OBGYNs, 60% of whom are women. Their association (ACOG) wrote, “Today’s decision is a direct blow to bodily autonomy, reproductive health, patient safety, and health equity in the United States. Reversing the constitutional protection for safe, legal abortion established by the Supreme Court nearly 50 years ago exposes pregnant people to arbitrary state-based restrictions, regulations, and bans that will leave many people unable to access needed medical care.” 

Statements on behalf of the American Nurses Association, and the organizational arms for both physicians associates (PAs) and nurse practitioners (NPs) were equally forthright.

There are 4.2 million nurses, over 1 million doctors, and over 1/2 million PAs and NPs in the US. And as the latest US Census Report headlined, “Your health care is in women’s hands. Women hold 76% of all health care jobs.” This includes 90% of all nursing positions, 66% of PAs, and 55% of all current Medical School slots.

Not surprisingly, as women numbers have risen, traditional oaths for the caring professions have reflected changing priorities. For example, the women majority 2022 entering class of Penn State’s College of Medicine for the first time gave top billing in their professional oath to patients, not to the gods: “By all that I hold highest, I promise my patients competence, integrity, candor, personal commitment to their best interest, compassion, and absolute discretion, and confidentiality within the law.”

Seven years earlier, the American Nurses Association (ANA), created a formal Code of Ethics, which largely supplanted the 1893 Nightingale Pledge, with a four pillared Code which celebrated Autonomy (patient self-determination), Beneficence (kindness and charity), Justice,(fairness) and Nonmaleficence (do no harm), as anchors to Nursing’s 9 Provisions (or Pledges) that commit to: compassion and respect, patient-focus, advocacy, active decision making, self-health, ethical environment, scholarly pursuit, collaborative teamwork, professional integrity and social justice.

During Dr. Ehrenfeld’s one-year tenure following the Dobbs decision women’s access to health care deteriorated in red state after red state, a point reflected in clear losses for Republications on statewide initiatives supporting abortion access from Kansas to Kentucky, and Vermont to Michigan. But as the Kaiser Family Foundation reported this year, “As of April 2024, 14 states have implemented abortion bans, 11 states have placed gestational limits on abortion between 6 and 22 weeks…” Add to this that 1 in 5 current OB residents say they have decided to steer away from restrictive red states when they pursue practice opportunities on graduation.

And still, red states embracing MAGA’s marriage to White Nationalists seem to have doubled down on everything from restricting access to medication abortion and contraception, to book banning, to limiting  LBGTQ+ rights and promoting prayer in public schools in the hopes of achieving a Christian Nationalist society.

Which brings us to the fast approaching 2024 Presidential debate. Women’s reproductive autonomy will be well represented. It is arguably the premier equity and justice issue before us, central to both America’s patients and their caring health professionals. But let’s not forget it is also central to the health of our democracy.

John J. Patrick PhD, in his book Understanding Democracy, lists the ideals of democracy to include “civility, honesty, charity, compassion, courage, loyalty, patriotism, and self restraint.” 

What other form of government is there that so closely aligns with the aspirational pledges and oaths of our doctors, nurses, and body politic?

keep looking »

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