Police get medical records without a warrant
arstechnica.com
arstechnica.com
That's an incredibly low bar. And if pharmacies respond to subpoena without even having a lawyer review them first, there really isn't anything to stop requests that fall below this low standard.
There may be some special authority subpoenas where things are different, but generally, no, immediately filing a motion to quash instead of complying with a subpoena will not make you subject to any sanctions for not complying up front.
https://www.healthcareitnews.com/news/irs-face-lawsuit-over-...
https://pharmacy.wsu.edu/2023/04/24/real-talk-on-the-future-...
> Applying to pharmacy school I was told the field was saturated, but now there are corporations offering pharmacists signing bonuses and most pharmacies are understaffed. What changed?
COVID. The pharmacists that were close to retiring just retired. There were less applications to pharmacy schools nationwide and therefore less people entering the field. Previously it was a requirement to have some kind of first post-graduate year (PGY1) and/or second post-graduate year (PGY2) residency to work in the hospital setting, but now I have seen job openings that have no residency requirement, and they are willing to do specialty training on the job because they need more people to fill roles and a larger applicant pool.
Judging by how long the lines at the pharmacy are, I have lots of company.
In fact, every medical insurance provider I've had for years has tried to push me onto their in-house pharmaceutical delivery service. Traditional pharmacies have been getting squeezed for a long time.
I don't even walk down the home aisle of mine anymore when I'm there because they will NOT have my detergent or dog food in stock and haven't had it the last 4-10+ trips I've made. Just an empty shelf where it should be sitting. It's an extra kick in the teeth because living where I live the CLOSEST "grocery" store is this Walgreens. I basically live off of Amazon deliveries and hate it but oh well.
Sometimes I'll drive the 20-25 minutes (3 miles) and get there and they're so understaffed that there's either a "We're at lunch, back in 1 hour" or "Everyone is sick, Pharmacy is closed."
Our pharmacy options are pathetic. And living in a food/pharmacy desert is a nightmare for people who don't have reliable transportation.
All this bs just to get my ADHD meds every month for the last 30 years of my life.
THIS. Expecting indifferently-paid and often-overworked pharmacist assistants, clerks, etc. to stand up to law enforcement - who can easily be armed, uniformed, belligerent, and right in their faces - is cruel and delusional.
They spend a vast sum of time, money and energy to gain a PharmD, then some asshat company puts them in situations where their licenses could be at risk?
Of course they do.
The state licensing boards are aware of the problem, and "neglect" to punish pharmacists who are caught in such situations with law enforcement.
Were I on the board of these companies, I'd be aghast and demand this clear operational issue, which threatens our capacity to provide pharmacy services long term, be remediated.
They sure af aren't going to toss me a lifetime check, when it happens.
“Here’s the phone number to corporate who is, by this policy, the only ones equipped and permitted to satisfy your request.” This also makes it so you don’t even send a car out anymore, but can handle the request electronically from the station.
2023 United States baby. Land of the free.
The parent post specifically says that it wold be company policy, so that wouldn't apply.
>> It seems like a well-drafted company policy posted and pointed to by the local store staff would be the right way to back up their customers and staff.
Instead of the Mayor, the Sheriff will go to some State Rep or congressperson and the same results happen.
I've seen similar moves play out in the past in real life
If every local sheriff can intimidate and bully a local pharmacist to get the information it's very different than if you need a congress person to call in a favor with supposedly one of the few people who have access to the information.
Not new…I’ve been disheartened about this for 35 years at least.
At that point, the company itself is under scrutiny in the public eye. They can't blame their front-line staff.
I expect everyone with access to personal data do the same.
Respecting privacy should be a tenant of law enforcement, since that’s like one of our rights or something, but cops and police unions have been operating outside of the law for their entire history in the US.
Obligatory ACAB
Police can rob you, rape you, or murder you in the street and even if it's caught on camera they can still face zero meaningful consequences for that. We've certainly seen it happen. They can also arrest you for something like "obstruction" or "contempt of cop" and that's something you'd have to spend time and money on fighting later in the courts. Ongoing retaliation is something else to be concerned about.
In any case, the can certainly do a lot besides "trying to frighten you"
https://en.m.wikipedia.org/wiki/Video_Privacy_Protection_Act....
And for that matter, I doubt the video store law applies to bookstores.
(A judge confirmation process ran in trouble because of video rental records - so a law was written ... which addresses only video rental. For maximum inefficiency or something.)
This seems trivial to solve. Subpoenas get forwarded to corporate legal and they handle releasing of records.
It seems peculiar this isn't SOP now. Perhaps it's because pharmacists/managers cost less (in $ and accountability) than lawyers.
With this policy across chains, judges would be skeptical of a cop who tried to bully a local records release. Even a rogue cop could understand this reality.
Imagine how much more difficult it would be to resist this when you're a clerk in a retail store working in public.
[0]: https://apnews.com/article/321440980fd54809a5bf8e404cfe4367
(Edited to add context)
Jeff Payne, the Utah cop who was fired after his violent arrest of that nurse went viral, later got hired by the Weber County Sheriff’s Office to work in the medical unit of the county jail.
Bullies are always going to bully. Roll-over-and-take-it is a terrible corporate strategy!
To give you an idea, in a nearby Walgreens, we have pharmacists snapping at customers saying "We got your prescription only two days ago. It's not going to be ready that quickly!"
A tale as old as the first police union: when the city tried to reign them in, the Portland Police politely threatened to walk off the job and the chief (iirc) casually showed up to negotiations with a dossier on one of the city councilors just laid out on the table next to his gun.
Why do "indifferently-paid and often-overworked pharmacist assistants, clerks, etc." even have access to this? In the US any random pharmacy clerk has access to list of all drugs that customers have ever bought from them and also "medical records" (according to the article)? WTF?
Doing away with this safety net to.. avoid addressing police overreach directly is a bad idea.
Are there any stats for how many potentially lethal errors they actually catch in practice?
I'm struggling to understand the logic in wanting pharmacists to be more ignorant. Even if cops couldn't interrogate pharmacists because they were all blind and dumb, they'd go to local doctors instead. The police are the problem that needs to be addressed.
You made a statement, it is up to you to back it up.
> I know from personal experience that pharmacists do catch errors, but I have no clue if anybody is keeping statistics on it.
Thanks for sharing your experience.
> I'm struggling to understand the logic in wanting pharmacists to be more ignorant.
This is IT security 101 - the less randos have access to a sensitive data the better.
> Even if cops couldn't interrogate pharmacists because they were all blind and dumb, they'd go to local doctors instead.
In context of US situation I guess the benefit if when out-of-state telehealth doctor prescribes and local pharmacy clerks don't have access to those records. The best theoretical end game would be to either have such records on encrypted device owned by patient or none at all.
> The police are the problem that needs to be addressed.
Last decade or so the tendency has been to solve this by technical means, where possible. Like e2e encrypted messages, encrypted iCloud/Google backups, recent announcement of local Google maps timeline, etc.
Chances are, if any of them know about the medications you’re on that they didn’t prescribe, it’s because you self-disclosed on your intake form or told the nurse during intake verbally. This is not necessarily a great way to know for sure, because patients forget things and people write or type or select the wrong thing.
In this system, it’s much more reliable to have all the prescriptions flow down to one endpoint and have someone trained who can see the exact medications and dosages, and that person can then give the patient the relevant information they need at the time of service.
the argument is that pharmacists are a "last line of defense" against the fractured system or mistakes from doctors (or clerical errors etc) but their authority is absolutely not limited to correcting errors or double-checking with the doctor's office. In practice the pharmacists here are incredibly full of themselves, they'll refuse to dispense birth control, etc, and there is no duty for the pharmacy to ensure someone else will service you, they can just say "no" and that's it.
My wife is an ER charge nurse, and she often complains about the behavior of cops in the emergency room. They have someone on the edge of death and the cops often are in the room yelling at the nurses to get them to do a blood draw and drug screening.
Cops need a warrant to get that, and even if they had a warrant in hand, performing the blood draw wouldn't even be considered until the patient is stabilized. But they never have a warrant, and the pressure the cops apply is withering. Most people -- even doctors and nurses -- would eventually cave.
Fortunately, as the charge nurse, she's the one who has to approve such a thing, so the cops have to deal with her. And she's hard as a rock. They aren't going to make her wilt.
The behavior you describe is that of a spoiled child, used to getting what it wants immediately by throwing an abusive tantrum, consequences to others and rules be damned. Same reason they execute PIT maneuvers on busy roads, lead high speed chases through the middle of towns, and empty full magazines into densely populated areas, all things that police in other countries are trained not to do, trained to be patient and follow instead. They want it now, and anyone hurt along the way is just a casualty of war, not their problem or responsibility.
This is exactly how she describes them. "Spoiled brats with guns".
Why can’t licensed pharmacy techs?
If so, Apples != Oranges
> The revelation raises grave medical privacy concerns, particularly in a post-Dobbs era in which many states are working to criminalize reproductive health care. Even if people in states with restrictive laws cross state lines for care, pharmacists in massive chains, such as CVS, can access records across borders.
I was “pro-life” from as long as I can remember thinking about the issue (I still recall the Bush v. Gore debates) until I voted last month in favor of making free access to abortion a constitutional right in Ohio. It initially took some coaxing from my wife, who helped me try to understand the issue from a woman’s perspective, and for a while I had doubts about whether I had done the right thing, but reading about far-right shenanigans (or potential shenanigans) makes me 100% confident I’m now on the correct side on abortion.
Wherever power __can__ be abused, it __will__ be abused. I wish abortion was less common, and we should work on making it less common, but the last thing we need is ideologues and extremist politicians second-guessing healthcare professionals and harassing women in what is one of the most desperate times in their lives.
————————————————————————
Edit: reading some of the strident and confrontational comments from some of those with whom I actually agree on the issue, it’s clear that “the cause”, if you will, doesn’t always have effective advocates.
I have a fairly thick skin, some I’m avoiding engaging in a similarly mean-spirited way, but extremists (on both sides) are their own worst enemy. In the same way that I was pushed away from being “pro-life”, in part by far-right extremists, I imagine the extremists on the far-left are also losing friends and alienating people.
If you believe life begins at conception and that ending a life is murder, then naturally you're going to believe that abortion is murder and is therefore immoral.
If you do NOT believe life begins at conception than naturally you're not going to believe it's murder and therefor not going to believe it's immoral.
It's possible to disagree with someone's stance on abortion without thinking of it as correct or incorrect.
---
edit: why is it people insist on arguing even when the entire point is that arguing about it isn't all that meaningful? The overarching point is to stop acting as if people are definitely right or wrong. stop arguing over semantics of words.
And let’s assume, for the sake of argument, that life does begin at conception. Isn’t the life and/or welfare of the mother also important? And who would you want making such a specific determination, a healthcare professional or Ron DeSantis?
What should matter is when humanity begins, or, sapience. There's no world in which it makes scientific sense to afford a small cluster of cells without anything even resembling a cow's brain (remember cows? the things we legally slaughter by the hundreds of thousands every day?), let alone a human brain, more rights than the woman the organs of whom are supporting it.
Not only that, but we don't allow the harvesting of organs post mortem without explicit, written consent, even if someone could use them to live. If we're not allowed to use other people's organs to ensure survival, even if the other person is dead, that should apply just as much to fetuses.
There's very obviously a correct side if you want to apply any semblance of logic, reasoning, and thought to the issue. There isn't one if you want to apply religion to it, and follow your gut to conclude that your all-powerful, all-benevolent god is putting souls in fetuses he knows will be aborted, taking them up to heaven for eternal happiness, and getting mad at us for it.
As OP I agree that government has no business getting involved in these debates. But don’t you think insulting and ridiculing religious people, including those who agree with you on the general issue, is a bit much? You’re not really helping your cause by alienating those folks.
I didn't invent the concept of god being all-powerful, all-knowing, and all-benevolent. That's my genuine, good-faith understanding of what people believe.
I'm also not mocking it. I disagree with it, but I'm taking it seriously, arguing with the assumption that people believe what they tell me they believe.
It's wild that religious people can say "You condone murder, and will be tortured for eternity for your beliefs" and that's just business as usual, but if I say "That's a bit silly, I would expect the god you tell me you believe in to be more forgiving and understanding" all of a sudden I'm being too mean.
It feels like there's no way to say "I simply don't believe that, and the evidence points to you being incorrect" that's polite enough for religious people, but they can say whatever they want to non-believers and it's ok because it's just what they believe.
People are arguing about your words because the ones you pick to make your argument DO matter. You've chosen the dichotomy generally pushed by the Right, rather than a discussion of health care or women's safety. Consider the difference in feel if you posted this as your two conditionals:
If you believe that doctors should be given leeway to treat their patients as they best see fit even if sometimes you disagree with their rationale, you're going to believe abortion should be available.
If you believe that moral rules should be followed and your moral rules are paramount regardless of any doctor's opinion on the ground, you're going to believe abortion should not be available.
This gives a very different feel and perspective to the conversation. The words you pick matter.
the art to disagreeing with someone without vilifying them is to recognize their beliefs come from their values.
Even what you're trying to argue about healthcare.
someone who believes in the word of God is going to argue an individual is less important than God's commandments, someone who does not will argue the individual is more important.
And I don't want to hear any whiffle about a dichotomy here, consider it a spectrum between 0 and 1 if it makes you feel better.
------------
The point is that framing this as correct/incorrect is a very poor way to frame it, it leaves no room for understanding.
Whether or not you believe that abortion is right or wrong isn't really relevant, except in so far as it informs your opinion about government coercion.
> should the government be able to force you at gunpoint/threat of imprisonment to carry a fetus for 9 months?
and: When should the government be able to force you at gunpoint/threat of imprisonment to carry a fetus for 9 months?
You can take my version and reduce it to yours with "always" and "never" responses, but the world is not digital, it is analog. My question allows for a lot more answers, a lot more debate, and compassion for one another.
A binary response leads only to argumentation because we can't find the edges that we agree on, only the boundary we fight over.
If you get to the point where you're asking "when", you're already saying the government should be able to force you to carry a fetus. I'm not sure how else to interpret it.
If it helps I guess you can twist my formulation to be "the government should be able to force you to carry a fetus under some circumstances that are evaluated by people on a case-by-case basis". All that "under" and beyond stuff is redundant, however.
As soon as we say that a case requires evaluation we apply force. We coerce the person by threatening them with imprisonment if they don't stop seeking an abortion. Further, we open the door to imprisoning people in a system that is already slow and burdensome; we then give people in government power to wait 9 months for the question to become moot.
> A binary response leads only to argumentation because we can't find the edges that we agree on, only the boundary we fight over.
The debate is not nor has it ever been over circumstances or conditions -- that is a distraction from the pro-life crowd.
For example, some propose exceptions for cases of rape. But can rape be proven in less than 9 months, including appeals? Obviously not. If an allegation or mere statement that a rape occurred is enough then we might as well not issue the threat.
Others propose exceptions if the pregnancy threatens the pregnant person, which just means that some cases will be decided by the government, ultimately.
The boundary is well-defined and fixed. You may just be uncomfortable with it, and that's your choice.
citation needed. I've heard of fines, I've heard of public shaming, I have not heard of imprisonment for attempting to get an abortion.
Most of the force you're discussing is against doctors rather than women.
FWIW, this is where we're at today, in the UK:
https://www.cnn.com/2023/06/12/uk/woman-jailed-abortion-pill...
> A British woman who used medication to induce an abortion after the United Kingdom’s legally allowed limit has been sentenced to prison for 28 months, the PA Media news agency reported.
And in the US:
https://www.washingtonpost.com/nation/2023/10/17/alabama-pre...
> Like Caswell, many of the women at the Etowah County Detention Center are detained under chemical endangerment of a child charges for alleged drug use during pregnancy, according to the lawsuit. Alabama passed the statute in 2006 to target people who put children at risk by converting their homes into methamphetamine labs, The Post previously reported. But the law has been increasingly applied to cases of fetal endangerment — a byproduct of Alabama’s 2018 personhood constitutional amendment that ensures “the protection of the rights of the unborn child.”
and https://www.reuters.com/legal/government/alabama-case-over-m...
> [O]fficials in Shelby County, Alabama, more than seven years ago brought and later dismissed chemical endangerment charges against a woman who [...] wasn't pregnant, AL.com reported in June 2015. And, in 2019, an Alabama grand jury indicted a woman who lost her unborn baby when she was shot, after declining to charge the shooter because it found she had fired in self-defense.
We're close, if not already there. It's a really bad time to be pregnant in some states.
"someone had a stiffer sentence for doing drugs while pregnant ... that's like imprisonment for abortion maaaaaaan!".
How do we break the cycle of increasing polarization? I honestly don’t know. It seems to be happening not just for abortion but for everything. All policy and culture, even innocuous stuff, seems to be getting polarized and tribalized in service of the politicians. Rejecting the extremist and villainizing framings of the opponent, on both sides, might help. Listening to and accepting the other side’s reasoning often does wonders for having civil conversation. I like to think of political debates as simply prioritizing what we want, and I wish our political debates would stop name-calling and just evaluate and rank the priorities rationally. This is hard to do though, it takes a lot of work, and there are conflicting priorities. Yelling and polarizing is way easier, takes less work, and is helping some politicians get what they want without having to be polite to their opponents or spend time evaluating their arguments. Maybe it would do some good if we can just help everybody we know see that our debates are mostly making us all tools of the politicians?
Life does not begin at conception because it never stopped. The sperm and the egg were both alive at the time of conception, and were life that split off of the collections of cells that we call the parents. Those parents were in turn conceived of live cells (again: a live sperm and a live egg) that came from their parents.
The whole point is that life is one big unbroken chain going back to some first cell (and at that point what is "life" gets complicated).
Rather the whole thing is about a "human life", as in when do we decide that this ball of cells is a separate individual deserving of the protection we give "people". And that is almost completely arbitrary, and science can offer no input on this at all.
Why is a fertilized egg a person? Why are the skin cells that have scraped off on your keyboard not a person deserving protection? If you start chopping bits of a person off (I am not recommending this), is the severed limb not a person? If you could chop off the head and keep both that and the body alive, would those be two people? Or would only the head count as a person?
Up until about 2020 men and women had more or less similar views on abortion.
https://news.gallup.com/poll/245618/abortion-trends-gender.a...
Even still, women's reproductive rights in general are ironically one of the least gendered opinions.
Being a hacker and/or entrepreneur, even loosely defined, doesn’t imply you’re a conformist. In fact, I think what makes HN one of the most desirable places to engage with on the internet is that it’s less of an echo chamber than most.
I also don’t think of myself as a hero by any means.
For what it’s worth, I don’t think changing a political stance should be considered “flip-flopping” unless it’s done for a self-serving purpose. Reevaluating should be considered an attempt to learn and grow. That’s why wisdom is often (but not always) associated with age and/or experience.
Retroactive shaming of anyone who was ever against your political position seems like some folks are devolving toward something even worse than cancel culture. The rudeness, as you put it, is not going to change my mind about the issue itself, but it does make me want to avoid the impossible-to-reason-with zealots.
To be honest, I think if we could strip all existing talking points on both sides, and get people to truly derive their own personal conclusions from scratch, I would expect the vast majority of people to be both in favor of women having absolute autonomy over their health care and body choices, and also in favor of trying to avoid abortion as a contraceptive if we can, avoiding late abortions, and hopefully using it only or mostly as a tool to treat bad situations. In other words, I would expect a lot of people to have the exact stance you’re arriving at - that we need to allow people to do what they need to, and we still hope that abortion isn’t happening excessively or willy-nilly or late without medical necessity. The core idea behind the two camps, the ‘pro-‘ position of each side, is not necessarily in opposition at all, so it’s funny it’s gotten so extreme and presented as completely opposites.
And I’ll do you one better:
US Supreme Court Justice Antonin Scalia, for all his faults (which are numerous), supported the 5-4 majority in a landmark case regarding flag burning.
https://en.m.wikipedia.org/wiki/Texas_v._Johnson
Imagine if Justice William Brennan, who wrote the majority opinion, said to Scalia rudely and dismissively “you don’t really believe in civil liberties, you’re only an absolutist on free speech”. It could have led to it being illegal today to burn the flag (which I don’t approve of on a personal level) - and presumably many other ways of expressing disapproval with how the US government conducts itself.
https://store.samhsa.gov/sites/default/files/d7/priv/sma16-4...
California's implementation is called CURES: https://oag.ca.gov/cures
They literally control our health and well being. Their cartel decides when they want to cut off drugs and services. If we use the last 120 years of data, the medical cartels has won at every cross roads, and seemingly 5% raises every year(with 2% CPI...).
Your entire healtcare records got leaked and now your SSN is on the internet(Beaumont)? OOPSIE but we can't use this data for science because HIPAA. Must keep healthcare data within the cartel for cartel uses only. Imagine if AI had all this data, it could just diagnose for free with offline local models. If anyone disagrees pour on some 'Medical isnt just Science, its ART! You can't just use Science!'
I say this with my monocle because I am a capitalist and I own a healthcare company. The standard billing practices are awful, the demand exceeds my employee supply, and everyone is so impressed that we own a healthcare clinic.
The medical cartels don't have to play by the rules, they are the power. They decide when red tape is cut, what are you going to due? Sue them? Ha look at those odds. Good luck finding a lawyer.
I'm not saying none of them could be pretty good, but it's tough.
Jurisdiction please.
> "The third-party doctrine is a United States legal doctrine that holds that people who voluntarily give information to third parties—such as banks, phone companies, internet service providers (ISPs), and e-mail servers—have "no reasonable expectation of privacy" in that information. A lack of privacy protection allows the United States government to obtain information from third parties without a legal warrant and without otherwise complying with the Fourth Amendment prohibition against search and seizure without probable cause and a judicial search warrant."
Ref: https://en.wikipedia.org/wiki/Third-party_doctrine
edit:
If you want to learn the legal reasoning for this, check out "Habeas Data: Privacy vs. the Rise of Surveillance Tech" by Cyrus Farivar. It's a great and horrifying book.
That logic applies similarly with your computing devices.
You'll need to a) call Congress to change the law and/or b) fight that out in court against a TON of precedents.
Once law enforcement has your data, they are not covered by HIPAA.
Ref: https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/un...
* I'm not a lawyer. That's why I'm citing sources.
And you’re sure as heck not getting any antibiotic stronger than a first aid cream without a prescription in Germany.
I also have a prescription for this ointment to treat eczema. Last time I ran out I tried to call my dermatologist for a refill, but apparently he's retired now. So just to get this stupid skin cream I had to make an appointment with another doctor, wait a month, and pay money when I already knew exactly the medication I needed from the pharmacy.
It's cartel based regulations by the AMA. Everything about being a doctor is gate kept. Prescriptions, test results, even becoming a doctor is artificially made harder than it needs to be to keep prices high.
One doctor on HN told me why patients could only get test results through another appointment with the doctor. I thought it was because the docs wanted more money. He told me it was because patients can misinterpret results and go suicide. Yeah makes total sense treating patients like simpletons to keep the money funneling in. Suicide?. Give me a break.
It's criminal behavior disguised as concern.
Everyone can get it. Not everyone can get it prescribed. But I have previously-prescribed medication which I now just order in bulk overseas. Not because it’s cheaper (it is). But because the hassle of getting prescriptions filled every month is tedious.
In a conference few years ago, we had couple LEO speakers and DEA agent , as an example, simply stated that cough medicine being gated in US is the price we need to pay for the way things are now.
I am admittedly on the fence. As a younger person, my response was 'everything for everyone; no restrictions'. These days I hesitate more.
OTC cough medication is literally everywhere in the US... are you talking about something more specific?
edit: The net effect of those being that anything that actually works requires prescription.
[1] https://www.reuters.com/world/us/us-fda-seek-public-opinion-... [2] https://www.webmd.com/parenting/teens-cough-medicine-abuse
It basically serves as a way to sell people OTC decongestants, since the one that actually works (pseudoephedrine) is BTC.
How do people keep buying it and using it if it genuinely doesn't do anything for them?
2. people believe the box and/or ads
3. it comes in combination drugs and people don't actually know what each drug does. many people simply "buy cold medicine" when they have a cold, with no thought to the mechanism of the components.
If you're in a place where it is legal you haven't tried it before, next time you have a stuffy nose, give it a try. It doesn't do anything at all, and studies prove it!
The reason I asked is that I've tried the OTC decongestant sprays (which I believe have phenylephrine in them?) some years ago, and they've worked damn well. I don't really believe that the sprays don't work, if that's the claim. But I don't know enough to tell whether the phenylephrine in particular has any effect, and I didn't memorize the ingredient lists of the ones I've bought and tried.
They're likely multi-medication sprays. Even if they were purely phenylephrine as an active (lol) ingredient, saline nasal spray (water!) helps with some stuffy noses, especially allergy-driven ones.
"A spray with phenylephrine in it worked" and "the phenyleprhine worked" are very different things.
It is a legitimate vasoconstrictor, but not when taken orally. https://www.cnn.com/2023/09/12/health/phenylephrine-tablets-...
> The agency approved phenylephrine for over-the-counter use in the 1970s, but it became even more common after 2005, when legislation restricted access to OTC drugs that use a similar decongestant ingredient called pseudoephedrine.
> Phenylephrine works by temporarily reducing the swelling of blood vessels in the nasal passages. A respiratory infection or allergies prompt the body to send white blood cells to the nose, throat and sinuses, leading to swelling in the nasal membranes and the creation of mucus. Decongestants constrict the blood vessels in the sinuses and nose, reducing the swelling and helping fluids drain.
> In pill form, some scientists say, phenylephrine gets absorbed by the gut and is metabolized so well that only a tiny bit makes it to the bloodstream, where it is needed to reach the nose, according to the citizen petition that asks the FDA to pull the drug from store shelves. A citizen petition is a way for industry, consumer groups or individuals to petition the FDA to change regulations or take other administrative action.
That is nasal not oral. The mechanism of delivery matters, and those aren't directly comparable to the oral medicines which are currently under scrutiny.
> the agency said that its order would only be related to the oral drugs and not the spray form.
"They wouldn't sell it if it didn't work!"
People buy homeopathy for the same reasons. "It cured my cold! I took it for a couple of days and the cold went away!" Forgetting, of course, that colds resolve on their own in that same timeframe.
Functionally, no, it won't. The ingredient doesn't do anything; it's a scam.
But overuse of them will cause antiviral resistance.
Same problem we've had with antibiotics.
I suspect the much more impactful driver of antibiotic resistance would be the antibiotics feed to live stock in mass.
Paragraph 2.1 of the main PDF on that page, on page 8:
> Increasing scientific evidence suggests that the clinical issues with antimicrobial resistance that we face in human medicine are primarily the result of antibiotic use in people, rather than the use of antibiotics in animals.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7651446/
> In France, antimicrobial consumption (AC) has been high for many decades in both hospitals and the community. Consumption within the community is 30% higher than the mean European rate and 2–3 times higher than the rates in countries with very low consumption and resistance levels, such as Scandinavian countries.
Given the similar mechanisms, they're likely to have the same issues with antivirals as they do with antibiotics.
Dishonesty is not cool.
What evidence would you accept? Is there evidence you'd like to highlight in the other direction?
>> Is there any evidence of this being a problem? Is antiviral resistance more prevalent in France...?
> Evidence, yes.
Either present evidence that France has increased rates of antiviral resistance, or stop gaslighting.
Dishonesty is not acceptable behavior, and is not excused by your mere desire to answer a different question about antibiotic resistance.
Drop this crap and just debate like an adult. You may have a point. But it’s difficult to see if you’re flipping out in the corner.
When people are evasive, or pretend to answer one question by talking about a different one, that is not debating like an adult. It is toxic and prevents genuine discussion.
Flippantly calling something dishonest when it may be miscommunication signals a tolerance for dishonesty. I would be upset if someone said I were dishonest, because I’m not. Someone who is commonly accused of dishonesty may be more ready to level that argument unsupported.
See what I did there? Do you see why that is not only counterproductive, but also immature?
If you really think someone is simply lying, downvote and move on. Self-congratulatory behaviour adds nothing to the discussion.
As far as the innuendo that I'm projecting or something, you are entitled to believe whatever you like. As for me and my interactions both in real life and online, I absolutely will not tolerate people who lie. Whether you do or not is up to you, I suppose.
Not all drugs are intended to treat conditions that laypeople are equipped to self-medicate for. Consider extreme examples to illustrate some of the reasons why: it would be completely crazy for people to attempt to use things like powerful chemotherapy or anesthesia drugs to self medicate. And between these and ibuprofen, there's a bunch of other drugs which could easily be harmful to the user (or the purchaser's dependents) if used under a layperson's unguided judgement.
I think this can be even more important in the US where people have a strong incentive to self-medicate without consulting a doctor.
Acetaminophen is a serious liver toxin that most of us know as Tylenol or paracetamol.
One problem the US has is that prescription stuff is held to a higher standard, but in most other countries the standards for medical stuff and how patients get those things are unrelated. So you could OTC something without lowering the legal standards for quality or testing. The US needs to fix that, keep the standards, but OTC by default unless it can be argued why not.
(Learned this one tinkering on the Airbreak CPAP project.)
https://airbreak.dev/disassembly/
Standard disclaimers apply, I'm not responsible for people bricking their CPAPs or other life support equipment with this information, you live your own life the way you choose. Please don't screw around with a "live" machine hooked to a patient cough.
I was trying to see what the differences were between the lowest-end "start" CPAP and the highest end - while the firmware would flash over, the menu controls wouldn't work due to the changes made on the low end model - but the therapy start/stop did work (and it was delivering the correct therapy I programmed in via SD card with the clinician software).
I was in Spain a few months back and basically any drugs are only sold in pharmacies. And, at least one drug (Aleve brand name) which is broadly available OTC in the US generally requires a prescription in Spain and maybe France at least.
I think the framing is silly, but in the spirit of argument, let’s accept it. What is the solution? (To me, it implies disbanding the police, which is not something most people want for obvious reasons.)
Today police, DAs, and judges are all incentivized to close as many big cases as possible. We need these people to be motivated to actually protect the public and help those in need. Police funding, promotions, and recognition could be realigned to much better promote a policing system that focus on actually serving the public rather than catching and punishing as many people as possible.
When officers start losing their badge or their pension for cutting corners, they'll stop cutting corners.
[1]: https://journals.sagepub.com/doi/full/10.1177/23780231198797...
https://www.sltrib.com/news/2019/10/12/ex-salt-lake-city-off...
https://www.sltrib.com/news/politics/2019/08/28/police-offic...
https://www.npr.org/sections/thetwo-way/2017/11/01/561337106...
Detective Jeff Payne was fired by SLC PD, remained unapologetic. Went to the next county north and hired at the County Jail. He then sued SLC and the PD for wrongful termination, arguing that his bodycam footage was misleading and that he was following direction of a supervisor.
We could start by enforcing the 4th amendment.
Then we could actually hold officers accountable for their actions.
Qualified immunity should be scaled back drastically and any LEO which violates the law should have a multiplier applied to the sentencing guidelines for any convictions against them.
I think if it's not in the form of a constitutional amendment, then we will be constantly at risk of having it repealed or lessened or made irrelevant by superseding laws.
I understand that we can not go around amending the constitution on a whim, but these topics are so young that we cannot foresee all the possible ramifications of any law that we try to pass but at the same time they are too important to not take action.
A simple, easy-to-understand constitutional mandate such as "no law shall be passed that infringes on a citizens right to digital privacy" would be the ideal solution.
After that, courts can be used to iron out the details and set precedence.
How could congress even begin to keep pace with that rate of change?
They certainly have not been keeping pace, and arguably going backwards in a number of areas (see FISA).
The courts could take every issue, one-by-one, and clarify the reasons for any decisions. These decisions would happen in the light of day with an appeals process ready to handle disagreements about the letter and intent of the laws in question.
> should be addressed by the national legislature in specific and clear text
Congress has not shown an interest in keeping pace with technology, and would therefore be hard-pressed to write such "specific and clear" legislation.
It would, therefore, fall to the lobbyists who have draft legislation ready to go with carve-outs custom made for the companies that sponsor them and which are not in the best interest of the average US citizen.
There is a solution for the problem you're highlighting: Congress passes a law which delegates authority to a regulatory agency. For instance, Congress doesn't need to be an expert on the latest airplanes in order to regulate them. They have assigned the FAA to do this.
Agreed, but I was trying to comment about digital privacy which is a fairly new issue.
> constitutional amendment would allow for a general principle. US laws really do not.
That's pretty much my point. We already have a similar amendment (the fourth amendment) already officially ratified, so this is not unprecedented.
The problem with the fourth amendment is that it was written in a time when the government would need to physically go somewhere and take something, so there is no general principle allotted for digital privacy.
At the same time, there _are_ laws governing ownership of data which made sense when it was the credit reporting agencies trading information for legitimate business purposes, but now we are in a very different landscape of what information can be stored, traded, transmitted, sold at a scale never before seen. These laws would need to be revised and would need the heft of a constitutional amendment to drive that process.
A problem with laws is that there are so many to choose from and they are so narrow. See for example the video rental records law. An extremely narrow law that ignores the broader issue entirely (and which penalty is not even scaled for inflation). Same for credit reporting. Or for HIPAA.
General principle is needed and we are not likely to get that from laws. And in the US that's not what laws are for. Generally. So the 4th amendment could be touched up to correct the fact that it was written when "online", "data", computers did not exist - and metadata was thin enough to not matter too much, and "privacy" was or was not the point and was unclear of a concept. Fixing the 4th would establish the principle that yes, now digital matters and privacy matters and must be included in the 4th. Otherwise we remain in the situation where it's easy to argue that it's not part of the 4th.
Silly specific example in this case, as a healthcare provider, I can't tell a cop you have high blood pressure, because HIPAA. A pharmacy can tell a cop you take lisinopril/HCTZ, which is only prescribed for high blood pressure, because ... shrug.
https://www.hhs.gov/hipaa/for-professionals/faq/505/what-doe...
> To comply with a court order or court-ordered warrant, a subpoena or summons issued by a judicial officer, or a grand jury subpoena.
Emphasis mine.
From the article:
> Instead, all the pharmacies hand over such information with nothing more than a subpoena, which can be issued by government agencies and does not require review or approval by a judge.
Emphasis also mine.
Police officers are not considered judicial officers, though they are officers of the court.
"Judicial officers are typically categorized as judges, magistrates, puisne judicial officers such as justices of the peace or officers of courts of limited jurisdiction; and notaries public and commissioners of oaths. The powers of judicial officers vary and are usually limited to a certain jurisdiction."
It seems to me that there's an extrapolation here that is not covered by HIPAA. HIPAA only refers to subpoenas issued by or reviewed by judicial officers, not a blanket allowance.
The provision that pharmacies are using is, I believe, this one:
> To respond to an administrative request, including an administrative subpoena or summons, a civil or an authorized investigative demand, or similar process authorized under law, provided that: the information sought is relevant and material to a legitimate law enforcement inquiry; the request is specific and limited in scope to the extent reasonably practicable in light of the purpose for which the information is sought, and de-identified information could not reasonably be used (45 CFR 164.512(f)(1)(ii)(C)).
> the information sought is relevant and material to a legitimate law enforcement inquiry
Your average PharmTech at CVS isn't assessing the legitimacy of the inquiry or its relevancy, but is instead blindly acquiescing (or being told to do so).
The other part that is a problem is the use of "and":
> and de-identified information
There's no de-identified information in "Show me all the prescriptions you filled for Mr XYZ."
But what there is is enough plausible deniability for the corporations to say they were following their interpretation of the law.
Something like "I'm a police officer with ABC department, and I need to know which drugs Mr. XYZ has purchased between [x] and [y] in regards to a criminal drug trafficking investigation I am investigating" seems to satisfy all of the requirements.
* "administrative request": the officer is asking
* "the information sought is relevant and material to a legitimate law enforcement inquiry": they are real police, and they are investigating a crime regarding this person and these drugs.
* "the request is specific and limited in scope to the extent reasonably practicable in light of the purpose for which the information is sought": It is about Mr XYZ, and it is about drugs he purchased, the crime being investigated is about the same.
* "and de-identified information could not reasonably be used": because it is specifically about Mr XYZ
Same for "constitution applies only to govt" - where now so many corporations or other groups wield comparable power. There is space for more improvements on the constitution - and then also perhaps now is not a great, constructive time to do that.
The reason other things aren’t in it isn’t because they aren’t or weren’t issues. It’s because they were out of scope for the purpose of that document.
A national law would work best but even state laws would be effective.
I consistently and strongly disagree with this. The police are a manifestation of our society. When they do bad things they do so in our name - whether or not you want them to do it. We have created a law enforcement structure that empowers these abuses to happen. Transferring the cost to them for acting the way society wants them to act is not the answer. We bear that responsibility and should bear that cost.
This _maybe_ works in some abstract way, but each police officer is autonomous and has the leeway to act any way they want.
I have autonomy as well, so I could commit a crime.
Let's say that I grew up poor, and the only opportunity in my neighborhood to make any substantial amount of money was to sell drugs. If I choose to sell drugs and get caught I go to jail.
Now at this point, we can say that we have created a societal structure that limits my opportunities (no economic development in certain areas) and empowered these drug sales (by making the drugs illegal thus increasing their value) to happen, but that does not somehow shift the blame from me to society.
I would do my prison sentence and try to move on with my life.
This apologetic stance for the abuses of the police is harmful.
Police officers are people and should have at least as many responsibilities and liabilities in the view of the law as any ordinary citizen.
In fact, as they are charged with upholding our laws, they should be held to a higher standard than an ordinary citizen. If a police officer commits a crime, then they have committed that crime _and_ they have abused the trust placed in them by the state, county, etc that they work for.
The FBI presumably has the responsibility and authority to police sheriffs departments and police departments that aren’t behaving appropriately, and the FBI is part of the Executive Branch. It would be relatively straightforward for the President to task resources to focus on this specific problem and ask the DoJ to focus on prosecuting civil rights cases.
Elsewhere someone suggest a privacy amendment to the Constitution, we already have that and it’s the 4th amendment. We don’t need more legal protections, we need to actually hold police officers and departments accountable. We need to enforce the laws we already have, most importantly the Constitution, against officers and end effectively limitless immunity.
We also need to raise hiring standards. The minimum standard to be a police officer in most civilized countries is similar to our requirements for FBI agents. Most police officers on duty in the US are uneducated, ignorant, and stupid so it is not a surprise that belligerent behavior is the norm. Only in the US did we actually have police departments placing a cap on the IQ of incoming officers. Only in the US do we have no national requirement for someone to serve as an officer. Some cities require a certification or attendance to a police academy, but there’s no national standard. Only in the US is the average cop your high school bully given a gun and a badge.
There’s a lot more that could be done here. Hell, it doesn’t even have to be blue-tinted government action, it could be red-tinted government inaction by getting prosecutors to defect from the gang and uphold the right of self defense, correctly aligned to the actual law, in matters involving the police. It is legal under the letter and color of law to use lethal force to defend yourself against unlawful conduct by the police, most especially if they are attempting to use unlawful force or make an unlawful arrest, however as a practical matter prosecutors are in the gang and will “back the blue” no matter what. We could easily make even the idiots we hire as cops think twice before busting down a door without a warrant, announcing their purpose, or just plain knocking first.
What I am very clearly not saying is any such stupidity as “disband the police”. In a well functioning society, the police serve a valuable purpose. We are not currently a well functioning society, and part of why is because the police operate like thugs.
India is at least a democracy, but it’s very much still developing and has corruption at nearly every level and facet of society, including police abuses. It’s nearly the opposite of well functioning.
I'm sorry I didn't enumerate every bad thing the police have ever done in every single country on Earth. I don't really know what you're expecting from the reply you made to me?
Is this true? On sufficiently long time scales, do you really think that most people continue to imagine / desire law enforcement and public safety being mashed into the same entity(ies), and for those entities to be state agencies?
My sense is that most people recognize that this is a temporary phenomenon.
For advocates of slavery (including the current plantation-masquerading-as-corrections regime), police are of course necessary, because slavery is only economically feasible in the presence of this subsidy (which is how the current framework of police began in the USA in the first place).
But if we imagine something only slightly more utopian, like restorative and rehabilitative justice that isn't designed as a profit generator, empowered by a sufficiently democratic and highly sensitive internet, then it becomes easy to imagine relieving the police of their duties and moving to more mature and stable systems of public safety.
For people following in a different land, US kids are raised worshipping winning and (american) football and baseball players. And mostly in that world, winning is what matters - for individuals and for the team. Fair play is a british kind of nonsense, so is the spirit of the rules. And cheating is a means to an end (getting caught is a problem: you have let your team down). When that becomes a problem the rules are touched up so that "everyone is a winner" - but winning is still the point and anyway the kids know this is BS and that they have lost. I caricature a little but only a little.
American cops are THAT. They are there to win and everything else is for the losers. They are still playing their game - and their team.