Same sex marriage rights reaffirmed by the Senate

After a Supreme Court ruling in 2015, it seemed secure that the right to same sex marriage was the law of the land. However the recent Supreme Court decision overturning Roe v. Wade sent the question of abortion rights back to the states, and explicitly raised the question of whether other rights, such as marriage rights, might also be overturned. Justice Thomas, in his concurring opinion in the case (Dobbs) also mentioned that the rights to contraception and to same-sex sexual relations could be reconsidered, in his view.  

It appears that there will now be Federal legislation (and not just Court rulings) defending marriage rights. 

The NYT has the story:

Same-Sex Marriage Bill Passes Senate After Bipartisan Breakthrough. The 61-to-36 vote sends the legislation back to the House, which is expected to approve it and send it to President Biden.  By Annie Karni

"There was little question that the bill’s embrace in the Senate, where proponents had a breakthrough this month in drawing a dozen Republican supporters and overcoming a filibuster, gave it the momentum required to become law.

"The bill would repeal the Defense of Marriage Act, which denied federal benefits to same-sex couples. It prohibits states from denying the validity of an out-of-state marriage based on sex, race or ethnicity. 

...

"Its path represents a significant shift in American politics and culture in which same-sex marriage, once considered a divisive political issue, has become so widely accepted by members of both parties that a measure to protect has managed to attract decisive, bipartisan majorities in both the Senate and the House.

...

"Still, more than seven out of 10 Republican senators voted against the bill, underscoring how the party has continued to cater to religious conservatives who oppose same-sex marriage long after large majorities of the American public have come to support it.

...

"In the end, 12 Republicans voted for the measure

...

"The push to pass the legislation began over the summer, after Justice Clarence Thomas suggested in his opinion in the ruling that overturned Roe v. Wade, which had established a constitutional right to abortion, that the court also “should reconsider” precedents enshrining marriage equality and access to contraception.

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Earlier posts:

Friday, June 26, 2015

An ancient repugnance crumbles: Same sex marriage is a right, in all 50 of the United States

Opioids and pain management: revised CDC guidelines

 Concerned over the opioid addiction epidemic in the U.S., and the increasing number of overdose related deaths, the CDC issued the 2016 CDC Opioid Prescribing Guideline, which led to reduced opioid prescriptions by doctors. Sometimes this led to the undertreatment of pain, which in turn may have led to patients accessing opioids on the black market, where they are less safe. It may also have led to suicides of patients with unbearable pain.

The CDC has now issued some updated guidelines that appear aimed at balancing concerns with over-prescription against concerns with under-treatment.

Here are the updated guidelines:

CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022

"This guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years. It updates the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 (MMWR Recomm Rep 2016;65[No. RR-1]:1–49) and includes recommendations for managing acute (duration of <1 month), subacute (duration of 1–3 months), and chronic (duration of >3 months) pain.

...

"CDC recommends that persons with pain receive appropriate pain treatment, with careful consideration of the benefits and risks of all treatment options in the context of the patient’s circumstances. Recommendations should not be applied as inflexible standards of care across patient populations. This clinical practice guideline is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death.

A central tenet of this clinical practice guideline is that acute, subacute, and chronic pain needs to be appropriately and effectively treated regardless of whether opioids are part of a treatment regimen. 

...

"To avoid unintended consequences for patients, this clinical practice guideline should not be misapplied, or policies derived from it, beyond its intended use (67). Examples of misapplication or inappropriate policies include being inflexible on opioid dosage and duration, discontinuing or dismissing patients from a practice, rapidly and noncollaboratively tapering patients who might be stable on a higher dosage, and applying recommendations to populations that are not a focus of the clinical practice guideline (e.g., patients with cancer-related pain, patients with sickle cell disease, or patients during end-of-life care)

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Earlier post:

Tuesday, March 15, 2022

Opioid prescription reductions and suicides

Motorcycles as donorcycles

 Here's an article from JAMA Internal Medicine, noting that motorcycle rallies produce an increase in organ transplants.

Organ Donation and Transplants During Major US Motorcycle Rallies  by David C. Cron, MD, MS; Christopher M. Worsham, MD; Joel T. Adler, MD, MPH; Charles F. Bray, BS; Anupam B. Jena, MD, PhD,  JAMA Intern Med. Published online November 28, 2022. doi:10.1001/jamainternmed.2022.5431

"Key Points

Question  Is the incidence of organ donation and transplants higher during major US motorcycle rallies?

Findings  In this cross-sectional study of 10 798 organ donors and 35 329 recipients of these organs from a national transplant registry from 2005 to 2021, there were 21% more organ donors and 26% more transplant recipients per day during motorcycle rallies in regions near those rallies compared with the 4 weeks before and after the rallies.

Meaning  While safety measures to minimize morbidity and mortality during motorcycle rallies should be prioritized, this study showed the downstream association of these events with organ donation and transplants."

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Helmet laws by State (only the States in orange require all motorcycle riders to wear a helmet):

I wonder what would happen if some State passed a helmet law saying that adults are free to ride without a helmet, but doing so automatically registers the rider as a willing deceased donor. (Such a law might decrease deceased donation by convincing more riders to wear helmets.)

HT: Alex Chan

The market for large dinosaur fossils

Should fossils be regarded as national treasures, or as natural resources, or perhaps works of art? 

The NY Times has the story:

As Dinosaur Fossils Fetch Millions, There’s Many a Bone to Pick. Fossils are a multimillion-dollar business, bringing legal disputes, nondisclosure agreements and trademarks to the world of paleontology.  By Julia Jacobs and Zachary Small

"Fossil hunting has become a multimillion-dollar business, much to the chagrin of academic paleontologists who worry that specimens of scientific interest are being sold off to the highest bidders.

...

"Things were simpler at the beginning of his career, Larson said, when universities, museums and a smaller group of private collectors were the only ones who cared about buying pieces of natural history.

"It was not until 1997, with the sale of Sue, that dinosaurs started to be viewed as potential centerpieces of auctions.

...

"Many scientists are aghast at the growing commercial market, and increasingly anxious that scientifically important specimens will disappear into private mansions. Paleontologists are also concerned that the market could encourage illegal digging, and that American landowners — who, by law, generally own the fossils found on their land — would favor commercial fossil hunters over academic researchers.

“Ranchers who used to let you go and collect specimens are now wondering why they should let you have it for free,” said Jingmai O’Connor, a Field Museum paleontologist, “when a commercial collector would dig up the bones and split the profit.”

"Fossil diggers and dealers in the commercial sphere counter that if not for them, these specimens on private land would be left to erode further, never to be found.

"The United States is an outlier legally. Other dinosaur-rich nations, including Mongolia and Canada, have laws making fossils the property of the government. Thomas Carr, a paleontologist at Carthage College in Wisconsin, said he believed that the lack of protections for “natural heritage” puts scientists in the United States at a disadvantage."

Kreps II: Microeconomic Foundations II: Imperfect Competition, Information, and Strategic Interaction (coming soon)

 Princeton University Press announces:

Microeconomic Foundations II: Imperfect Competition, Information, and Strategic Interaction by David M. Kreps

"A cutting-edge introduction to key topics in modern economic theory for first-year graduate students in economics and related fields

"Volume II of Microeconomic Foundations introduces models and methods at the center of modern microeconomic theory. In this textbook, David Kreps, a leading economic theorist, emphasizes foundational material, concentrating on seminal work that provides perspective on how and why the theory developed. Because noncooperative game theory is the chief tool of modeling and analyzing microeconomic phenomena, the book stresses the applications of game theory to economics. And throughout, it underscores why theory is most useful when it supports rather than supplants economic intuition.

• Introduces first-year graduate students to the models and methods at the core of microeconomic theory today
• Covers an extensive range of topics, including the agency theory, market signaling, relational contracting, bilateral bargaining, auctions, matching markets, and mechanism design
• Stresses the use—and misuse—of theory in studying economic phenomena and shows why theory should support, not replace, economic intuition
• Includes extensive appendices reviewing the essential concepts of noncooperative game theory, with guidance about how it should and shouldn’t be used
• Features free online supplements, including chapter outlines and overviews, solutions to all the problems in the book, and more

By email, Kreps writes: "An e-book version will be released on January 3, 2023.  Physical books will only be released in late May (I gather, a bit later in England)"

Pay Transparency in New York City as the new law begins to take effect

 Here's a report from Glassdoor Economic Research:

A First Glimpse into the Impact of Pay Transparency in New York City by Daniel Zhao

"On November 1, New York City’s pay transparency law went into effect, requiring job listings to include salary ranges. While the move represents an opportunity for job seekers to get greater pay transparency, high-profile errors as the new law went into effect have raised concerns about the efficacy of the law. With similar laws going into effect on January 1, 2023 in California and Washington State, we examined Glassdoor data to give an early view into how employers are grappling with pay transparency in New York City.

"Key Findings

"Pay ranges are being published on the majority of active job listings. 60 percent of job listings in New York City have employer-provided salaries as of November 12, and there are hints of a spillover effect to neighboring states.

"Ranges have widened significantly, but remain relatively narrow. The median width of salary ranges has widened from $10,000 in October to as wide as $20,000 so far in November. Less than 3 percent of daily active job listings in November have a salary range wider than $100,000.

"Professional services like Financial Services, Information Technology and Pharmaceutical & Biotechnology are the slowest to add pay ranges to their pay ranges. This may mean enforcing pay transparency will matter more in these higher-salary industries than in lower-wage industries."

Turkey production

 This seemed like a post that I should delay until after Thanksgiving, from the extension division of Penn State:

Modern Turkey Industry. The modern turkey industry has developed a hybrid white turkey that is larger and faster growing than purebred or wild turkeys.