Letters to the Editor - Sept. 24, 2007

The government should claim organs for donation by eminent domain

Regarding "Campaign targets TV's skewed view of organ donation" (AMNews, Sept. 3): The gap between organ transplantation need and donations has grown, your table shows.

The corpse is a chattel (movable personal property). Chattel is subject to eminent domain.

Kelo v. New London, a recent Supreme Court case, allows condemnation of property for private use. Taking a corpse in eminent domain has great benefit, and serves a noble public purpose by 1) drastically lowering the cost of care of the recipient after transplantation; and 2) transforming a moribund patient into a taxpayer, back at work. The value to the recipient and family is infinite, and has no measurement.

Government deference to superstitious, religious objection by the family of the donor violates the Establishment Clause.

The estate should be compensated with the market value of the corpse, with funeral costs as a sign of good will by the government.

--David Behar, MD, Bethlehem, Pa.

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Rodeo injuries seem a waste of already strained medical resources

Regarding "International registry aims to round up rodeo injuries" (AMNews, Aug. 20): I would encourage the registry's organizers to also track the total cost of treating such injuries, and the insurance status of the injured individuals.

I doubt most rodeo participants are willing, or even expected, to pay out-of-pocket for injuries they sustain while pursuing this voluntary activity. In fact, I wonder if, given the high rate of injury, most participants would even qualify for a privately underwritten insurance policy.

It seems unfair that my uninsured and Medicaid-insured teen patients who engage in voluntary "extreme sports" can go to the head of the line to see an orthopedic surgeon or neurosurgeon, while my other patients wait for access to these specialists. Preventable injuries (especially preventable injuries that are courted) seem like a foolish waste of increasingly limited health care resources.

--Suzanne Berman, MD, Crossville, Tenn.

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Encryption not a burden when communicating with patients

Regarding "Privacy a problem for patient e-mails" (AMNews, Aug. 27): I disagree with the notion that encrypting e-mails deters patients from communicating with their doctor online. In 2005, I launched a Web site that lets my patients register, schedule appointments, request refills and exchange messages with me on routine matters like the results of their latest lab tests.

As a prominent HIPAA law firm directed, the site is housed on a secure server, and patients must log in with a user name and password to access its features. At this writing they've done so more than 12,000 times.

Far from discouraging them, my patients appreciate the security that encryption provides. When I leave them a message (or respond to one they've left for me), patients receive a system-generated message that says, "You have an important online message from Dr. Stark. Please log in here to read it."

I have formed a company to build encrypted sites for other physicians.

If your patients can log in to a Web site to pay telephone bills or pick the movies they want from Netflix, they can just as easily do so to get the results of their cholesterol tests. Mine have done it for nearly two years without confusion or complaint.

--Howard A. Stark, MD, Washington, D.C.

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