An Anything But Normal Election

In the press release for today’s Marquette University Law School Poll, you’ll find the following sentence: “Given the uncertainty created by historically high levels of absentee voting and the unknown levels of election day turnout, these results should be viewed with more than the usual caution.”

Poll Director Charles Franklin is referring specifically to the polling numbers in the Democratic presidential primary. But his note of caution seems wise as we careen toward next Tuesday’s election.

Put another way, we don’t know what we don’t know about this spring election.

After reporting, writing, and talking about Wisconsin politics for 40 years, I thought I had seen it all. I was wrong.

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Cigarette Packaging and Smokers’ Rights

I had the delightful opportunity at the beginning of the summer to deliver a conference paper in Portugal.  Lisbon’s cobblestone alleyways and bustling riverfront were exciting, but odd as it might seem, Portuguese cigarette packaging also caught my eye.

All cigarette packs in Portugal have graphic images related to the dangers of smoking cigarettes: rotted teeth, amputated toes, diseased lungs, stitched-up chests, and naked corpses sprawled out on coroners’ metal tables.  The images and the accompanying verbal warnings take up the fronts and backs of the packs, and brand names such as “Marlboro” appear only on the narrow bottoms of the packs.

None of the Portuguese smokers to whom I spoke – and there were plenty – seemed particularly offended by the packaging.  So-called “scare messages,” after all, are genuinely intended to get smokers to stop.  They are consistent with the World Health Organization’ s directives regarding cigarette packaging, and graphic images appear on cigarette packs in most European countries.

What about graphic images in the United States?  It briefly seemed that they would begin appearing after the passage of the Family Smoking Prevention and Tobacco Control Act in 2009.  The Act in fact mandated them, and the Food and Drug Administration (FDA) formally approved nine graphic images that it considered especially likely to make people afraid of smoking.

However, the tobacco industry and assorted neo-liberal pundits immediately rose up in arms.  The former, of course, worried about its profits, and the latter championed the “right to smoke.”  The graphic warnings, the pundits argued, interfered with freedom of choice.  They were the efforts of the nefarious “nanny state.”

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Informed Consent

White hospital bedsSeveral years ago, the Wisconsin veterinary state convention focused on the legal standard of informed consent in the profession. Lawyers explained that this meant that veterinarians needed to provide all options to owners and that owners make the decision as to what options to pursue. Although this seemed simple enough, and certainly some veterinarians already practiced some degree of informed consent, some veterinarians were understandably concerned about discussing a “no treatment” option and some veterinarians practice in situations where discussions with owners may be difficult (e.g., production medicine) or the time involved would defeat the purpose of their services (e.g., high-volume spay/neuter clinics). But the take-home message was that veterinarians are not the responsible parties for making the decisions for clients and that veterinarians need to provide all of the options, and all of the information that clients need to make decisions. Informed consent protects both parties to the transaction.

Informed consent provides transparency. In the veterinary profession, owners are held directly responsible for the decisions and charges incurred. When an owner is informed about diagnostic or treatment options, this includes the cost involved with the options. Informed consent means discussing what the diagnostics or treatments entail, the prognosis or outcome expected, and the costs involved. In fact, most veterinarians provide written estimates for procedures or hospitalization and may require a deposit. Although this may seem insensitive in some way—to require a deposit to provide care—the estimate can be the reality check an owner may need and, again, the owner client is the responsible party.

Informed consent is also the standard in the human medical profession, but the human medical profession does not provide estimates and doesn’t seem to even know, or admit to knowing, what price tag attaches to options. Much is said about the failures of human medicine. Some of this can be attributed to allowing the profession to not be transparent—to not providing information.

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