[HN Gopher] Hospitals are reporting new mothers for neglect from...
___________________________________________________________________
Hospitals are reporting new mothers for neglect from poppyseed
false positives
Author : fortran77
Score : 162 points
Date : 2023-03-25 17:45 UTC (5 hours ago)
(HTM) web link (reason.com)
(TXT) w3m dump (reason.com)
| chris_wot wrote:
| I once went to the hospital with my fiance. The doctor insisted
| on a pregnancy test before an xray, despite my fiance insisting
| she was celibate.
|
| I'll never forget the look of horror on the nurses face when she
| found out what he was requiring.
| irrational wrote:
| My wife has already passed through menopause, but they still
| insisted on a pregnancy test before back surgery recently.
| anonymouskimmer wrote:
| Being post-menopause is almost 100%, not quite 100%.
|
| https://healthnews.com/womens-health/menopause/can-you-
| get-p...
|
| > Generally speaking, postmenopausal pregnancy is unlikely,
| although not entirely impossible. HRT will not trigger the
| ovaries to produce new eggs. If a woman has remaining eggs
| after menopause, HRT might trigger the release of an egg.
| There are few reports of postmenopausal women conceiving
| naturally, but this is very rare.
| psychphysic wrote:
| That's totally different situation ethically.
|
| He was open and made a recommended investigation contingent or
| knowledge of the risks.
|
| And she could decide the invasiveness of peeing on a stick is
| not worth the benefit of being able to have an x-ray.
|
| On the other hand no offer was made. A test was illegally
| applied (even if you can force someone to have a test they must
| know about it), incorrectly interpreted with unjustly severe
| outcome.
|
| Also, you can be a celibate lesbian nun and in some countries
| you can't get prescribed valproate without having a coil or
| implant. Seems much more problematic.
| nullc wrote:
| I'd love to see a study that tried to estimate to that extent
| absurd, invasive, and overly protective nannie policies cause
| people to choose to not have children at all, contributing to
| declining birth rates?
|
| How many kids never get to exist at all because the government
| and other institutions have made it ever more obnoxious, even
| personally dangerous, to have one?
| BoxFour wrote:
| probably close to zero?
|
| There's considerable debate over whether even China's "One
| Child" policy had any direct effect or it just happened to
| coincide with a natural decline in birth rates that would've
| happened in China regardless.
|
| If it's not even clear that an incredibly blunt government
| policy had that much of a direct effect, I'm not sure what
| research could possibly turn up for other nations.
| nullc wrote:
| > whether even China's "One Child" policy had any direct
| effect or it just happened to coincide with a natural decline
| in birth rates
|
| Surely you jest: https://www.chinadaily.com.cn/china/images/a
| ttachement/jpg/s...
|
| How does natural decline in birth rates explain the massive
| shift towards male children not experienced in other
| developing nations?
| BoxFour wrote:
| Birth rates are not the same thing as gender disparity,
| obviously.
| AngryData wrote:
| On the other hand, ive also heard a decent amount about
| native undocumented Chinese women from the same policies. A
| large number of undocumented native Chinese women popped
| into existence from those policies when they started
| reaching college age, and others into corporate business
| which we do know about. But how many more merely work local
| service jobs under the table, or got married and became a
| homemaker. Living in a more rural area with a more
| traditional lifestyle would already have incentivized women
| into those rolls, and then more would just want to stay
| hidden for fear of government appraisal, and there is no
| clear or obvious record of those people.
| MiguelX413 wrote:
| Any examples of such policies?
| nullc wrote:
| Here is an article that discusses policy/fertility
| interactions in Canada https://thehub.ca/2023-03-14/counting-
| up-canadas-missing-kid...
|
| But the examples I had in mind were parents getting
| prosecuted for letting their children outside unsupervised
| (several stories on HN in the last year or two), or examples
| in this thread like overzealous mandatory reporting in the
| original article or someones pediatric doctor becoming a
| problem after asking if they have guns in their home.
|
| Anecdotally I know people for whom concerns about invasive
| bureaucracies caused them to choose to delay or not have
| children, as well as people who relocated to places which
| they thought had better practices before doing so. Anecdotes
| don't count for much but I think it's not controversial that
| have many policies that are ineffective. Any policy that
| doesn't actually protect children but imposes a risk or cost
| on parents is probably a net reduction on the production of
| new adults, but maybe only a very small one.
| petermcneeley wrote:
| "She had no idea that her urine would be tested for drugs, which
| resulted in a terrifying, monthslong investigation aimed at
| determining if she was a fit mother." I dont think she should be
| surprised; you give up rights when you become incarcerated.
| chrisbolt wrote:
| Where did it say they were incarcerated?
| perakojotgenije wrote:
| The image in the text shows a bagel with some poppy seed
| sprinkled on it. If I compare that to poppy seed strudel[0] the
| amount of seed on that picture is laughable. I wonder what would
| the test show after a few slices of said strudel. Are those
| strudels available in USA?
|
| [0]https://www.google.com/search?q=poppy+seed+strudel&hl=hr&sxs..
| .
| dghlsakjg wrote:
| Definitely available in the states.
|
| I had to do a USA federally mandated drug test for a license
| once and one of the questions they ask before administering is
| if you have had poppy seeds recently.
| phil21 wrote:
| These exist, although pretty rare these days to come across
| them in my experience.
|
| You can still get the filling by the can in most grocery
| stores. Nothing like a warm poppy seed kolache...
| SketchySeaBeast wrote:
| Didn't we all learn of the dangers of poppy seeds in that very
| special episode of Seinfeld?
|
| How could the hospital possibly not know about the false
| positives?
| [deleted]
| sublinear wrote:
| How is this still a problem with drug tests? This has been
| happening for decades now.
| Angostura wrote:
| I presume because the seeds do contain trace amounts.
|
| ISTR New Scientist doing a fun article many decades ago about
| all the psychoactive items in a traditional British afternoon
| tea. Quite a lot of laudanum in some varieties of lettuce
| sigstoat wrote:
| it's mostly a problem with screens, simple, inexpensive tests
| that should only be used a precursor to running an expensive
| test involving mass spectrometers.
|
| usually the manufacturer of the screening test mentions this in
| the documentation, that nobody feels like reading. certainly
| not the administrators implementing/enforcing the policies.
| freeone3000 wrote:
| Heroin is made from poppy seeds. We decided that eating small
| amounts of the seeds is delicious, and injecting small amounts
| of the paste is multi-year prison sentence. The test can only
| test for (a protein found in) the seeds.
| efnx wrote:
| Heroin isn't made from poppy seeds, it's made from the latex
| secreted by the seed pod. but yeah, other than that detail,
| agreed.
| bongoman37 wrote:
| [dead]
| thfuran wrote:
| Because it isn't really a problem with the tests but rather the
| interpretation of the test. They're not actually false
| positives -- poppy seeds do contain opiates. The problem is
| assuming that detecting opiates at a very low level implies a
| drug habit and not a deli habit
| [deleted]
| swayvil wrote:
| Airport security and this are strongly parallel. Both a kind of
| theater. Nobody believes it but we're all forced to play along.
| animitronix wrote:
| These hospitals need to be sued out of existence.
| reaperducer wrote:
| Chances are the hospitals are following the law. A hospital
| isn't going to risk losing its license because someone ate the
| wrong muffin at the wrong time.
|
| They don't "need to be sued out of existence" any more than
| their thousands of patients need to have their healthcare
| provider yanked out from under them.
|
| The law should be changed to give them some discretion.
| dahdum wrote:
| > To guard against false positives, the Mandatory Guidelines
| for Federal Workplace Drug Testing Programs, published in
| 2017, require a codeine cutoff of 2,000 nanograms per
| milliliter of urine. But the Hackensack University Medical
| Center's lab, according to Kate's complaint, used a cutoff of
| 300 ng/ml, less than one-sixth the federal standard. Virtua
| Voorhees Hospital's lab, according to Kaitlin's complaint,
| used a cutoff of just 10 ng/ml, 99.5 percent lower than the
| recommended level.
|
| This makes them look pretty negligent.
| gbear605 wrote:
| According to the article, they're acting much more strictly
| than the law requires (or recommends).
| Brian_K_White wrote:
| They are not following the law.
|
| The law declares a specific threshold concentration level,
| and they are using a level 1/200th of that. They absolutely
| should suffer severe recompense and punative damages for
| doing that.
|
| Laws should not allow discretion. That is how you get abuse
| and discrimination through selective enforcement. If a law
| would be intolerable and inhumane with 100% enforcement, then
| that is how you know it shouldn't exist in the first place,
| and is in fact still intolerable and inhumane even with
| discretion and selective enforcement.
|
| In this case, the law doesn't in fact exist, and no selective
| enforcement is needed. The law already does not say that
| eating poppy seeds is illegal, because that doesn't approach
| the level to trigger the law.
| thriftwy wrote:
| Greeks had this procedure where you had to wear a noose have
| you planned to propose a new law. That one would be
| appropriate here.
| whyenot wrote:
| No. If the goal is to stop this practice, then the doctors and
| administrators responsible should lose their licenses and be
| criminally prosecuted. Money and civil cases do not solve all
| problems. The responsible parties must be accountable for their
| criminal actions.
| logicalmonster wrote:
| Suing the hospitals sounds like a fine idea, but nothing that
| strikes at the root of the problem.
|
| So long as the War on Drugs exists, you're going to have dumb
| as shit people interpreting dumb as shit rules in dumb as shit
| ways.
|
| You have to choose between having a War On Drugs, or accept
| that there will always be nasty, unintended consequences to it.
| pjdemers wrote:
| They don't watch Mythbusters?
| https://www.youtube.com/watch?v=MIN7cq8Mc-4 Or Seinfield?
| https://www.youtube.com/watch?v=mYzuQr7YVYg
| dcchambers wrote:
| Forget the fact that these hospitals should be aware of the fact
| poppyseeds can cause false positives, they _never_ should have
| administered an unauthorized drug test in the first place. That
| 's more horrifying IMO.
| ipnon wrote:
| It does make some sense to drug test patients, and a doctor
| does have the wide authority to order tests with some manner of
| invasiveness. Patients don't want to disclose illegal drug use,
| even though these drugs do interact with administered
| therapies.
| indymike wrote:
| > a doctor does have the wide authority to order tests with
| some manner of invasivene
|
| False. A doctor has zero ability to order tests without
| patient consent (or consent of a guardian) in the US.
|
| > Patients don't want to disclose illegal drug use,
|
| This is why medical care should NEVER be directly connected
| to law enforcement or make conclusions. For a care provider
| to thing that a patient waking up, handcuffed will make that
| patient EVER come back for care again is insanity. Medicine
| should not be about punishment, ever.
| nullc wrote:
| > False. A doctor has zero ability to order tests without
| patient consent (or consent of a guardian) in the US.
|
| Ability isn't the right word, because they absolutely do
| it. It's unethical and perhaps illegal in some places, but
| they are _able_.
|
| I've personally been administered a test non-consensually:
| I showed up at a hospital with severe pancreatitis, the
| doctors seemed convinced it was due to alcoholism but I
| (and my partner who they questioned privately) both
| reported that I don't drink at all. After several days they
| suddenly started aggressively treating me, performing
| tests, etc. I wondered what changed and got hold of my
| chart-- without my knowledge or consent they took a hair
| test to assay long term alcohol use and suddenly wanted to
| treat me when it came back negative.
|
| I get that they needed to exclude an obvious potential
| cause and couldn't trust the patient to give an honest
| answer... but the non-consensual test really destroyed my
| trust. Of course, if they'd asked I would have readily
| agreed and it isn't as if their skepticism wasn't already
| apparent.
| indymike wrote:
| > It's unethical and perhaps illegal in some places, but
| they are able.
|
| Able does not always refer to physical ability. It can
| refer to legal ability.
| SilasX wrote:
| To the chagrin of "may I"/"can I" pedants everywhere...
| lostlogin wrote:
| In the US system, do you get to pay for the pleasure of
| having a test you don't want?
| mindslight wrote:
| > _I get that they needed to exclude an obvious potential
| cause and couldn 't trust the patient to give an honest
| answer_
|
| I disagree with this resigned acceptance to medical
| paternalism. The basic situation is that you are the
| patient, and all care should be per your direction. The
| doctors' responsibility is to treat you based on what
| you've told them. If you're actually lying, the
| responsibility for misdiagnosis rests entirely on you.
|
| Doctors hedging against a patient lying should only ever
| be considered within this larger backdrop. For example
| independent of the nonconsensual sample and testing, it
| was severely unethical for them to have delayed your care
| by several days while indulging their own curiosity.
| dragonwriter wrote:
| > False. A doctor has zero ability to order tests without
| patient consent (or consent of a guardian) in the US.
|
| Hospitals generally require a very broad consent at
| admission.
| [deleted]
| Hizonner wrote:
| Advance consent isn't legally _or_ ethically valid unless
| it 's informed and the procedure is actually medically
| necessary and appropriate. Being tested actively contrary
| to your own interests would never, ever qualify.
| Scoundreller wrote:
| > A doctor has zero ability to order tests without patient
| consent (or consent of a guardian) in the US.
|
| Huh? So if they pickup my comatose body in an alley, the
| doctor (or medic!) can't take test my blood sugar?
| dghlsakjg wrote:
| That falls under implied consent. In the case where youre
| unable to give consent, medical providers are given
| license to provide care that would be considered
| reasonable and necessary given your condition. Once you
| are conscious you can withdraw consent for treatment at
| any time.
|
| A secret drug test on a conscious person who is not
| showing symptoms of intoxication is pretty far outside of
| the limits of implied consent.
| Scoundreller wrote:
| People can be dependent on all kinds of drugs without
| symptoms of intoxication.
|
| Irrelevant to know for say, a job (if you can do the
| work; who cares?) but could be quite relevant if you're
| hospitalized, or your new child needs to be treated for
| withdrawal from it.
| dghlsakjg wrote:
| That's irrelevant to legality, which is what I was
| talking about.
|
| Medical consent is more complicated than just this, and
| what you're talking about crosses into doctor patient
| confidentiality as well.
|
| Suffice it to say that testing patients without informed
| consent and sharing that data with law enforcement is not
| something that most ethical review boards would condone.
|
| From a practical and moral point of view this kind of
| incident is what keeps people from telling their doctor
| all of the relevant information for best care. If you
| have a drug problem and think a medical provider will
| work to have your child taken away if you are honest
| about it, will you ever seek treatment or be honest?
|
| If you don't have a drug problem, but still think that
| what you say to your doctor or kids doctor will get used
| against you, will you hesitate to get care in the future?
|
| Do you think these mothers will ever interact with
| another pediatrician with full trust again?
| deberon wrote:
| What's the withdrawal like coming off lemon poppy seed
| muffins? Poor kids.
| Scoundreller wrote:
| Probably nothing with the cutoffs they're using here, but
| neonatal opioid abstinence syndrome is absolutely a
| thing. And not all necessarily by "drug addict" mothers,
| but lots of legitimate long-term opiate use. But one
| would hope they would be up-front about the latter at
| least.
| indymike wrote:
| In this case the guardian is either the person who
| brought you in or the hospital itself.
| Scoundreller wrote:
| No, some rando that comes across your comatose body in an
| alley isn't your guardian.
| StanislavPetrov wrote:
| >doctor does have the wide authority to order tests with some
| manner of invasiveness.
|
| That they have the authority doesn't mean they _should_ have
| the authority. There is nothing more sacrosanct that bodily
| autonomy. It doesn 't matter if the doctor "knows better" or
| the medical testing you don't opt in for could potentially
| lead to worse medical outcomes for you. If you are an adult,
| it should be your right to decide what testing and procedures
| are performed on you - full stop.
| aaomidi wrote:
| Informed consent is still important.
|
| testing for drugs, and then reporting them is a gross fucking
| violation of patient privacy rights.
| candiodari wrote:
| How much do you want to bet that social services has an
| exception to this? Such an exception would enable them to
| make extra money and "think of the children" ...
| weaksauce wrote:
| yeah that's really insane... this has to violate some kind of
| ethics standards that is actionable.
| psychphysic wrote:
| In the Beauchamp and Childress biomedical ethics model it's
| autonomy.
|
| Typically this would require a court order.
| MagicMoonlight wrote:
| How do we know they are false positives?
|
| Of course someone being reported for neglect is going to lie.
| What proof do they have that it was poppy seeds? Do they have
| hair tests etc showing zero opiate use?
| Xorakios wrote:
| In the cases mentioned in the Reason article, all 3 mothers had
| hair tests showing zero opiate use.
| thriftwy wrote:
| There's much worse problem that when the poppy seed false
| positives get enough exposure, real criminals are going to use
| poppy seed doubt, and get away with it it their lawyers are
| good enough.
|
| You are not winning with this.
| swayvil wrote:
| Actually, that's a damn good idea. Have a urine test hanging
| over your head? Eat some poppy bagels.
|
| So if you get flagged then you have plausible deniability.
| anonymouskimmer wrote:
| That's works until the prosecution is asking the jury to
| consider why you refused a subsequent opiate hair test.
| swayvil wrote:
| Full-body-depilatory is part of my gender-identity.
| Contradict me and face the twitter wrath.
| thriftwy wrote:
| So just shave it all in advance.
| JaimeThompson wrote:
| Much the same level of reasoning has been used as a
| justification to remove anonymity from the Internet.
| ergonaught wrote:
| So, that's your takeaway?
|
| You're not concerned about nonconsensual drug testing and
| reporting to state agencies.
|
| You just think maybe the women are liars?
| jklinger410 wrote:
| Focusing on the wrong part of the problem, lol
| veec_cas_tant wrote:
| It's in the article:
|
| >The day after Kate learned that she was suspected of using
| opioids--five days after she gave birth--the hospital "refused
| to discharge" her, the complaint says. That afternoon, DCPP
| caseworkers separately interrogated Kate and her husband,
| Jesse. Kate agreed to a second urine test, which came up
| negative. She was finally released that evening, but her baby
| did not come home until October 1, "ten days after her birth
| and five days after DCPP cleared Kate to bring her baby home."
|
| > Although the DCPP "cleared Kate and Jesse to take baby A.L.
| home," the hospital kept the baby for another five days, and
| the agency's investigation continued. It included a "Certified
| Alcohol and Drug Counseling evaluation" and yet another urine
| test, which was "negative for all substances." In November,
| Kate received a letter saying the DCPP had concluded that "the
| allegation of neglect was 'unfounded.'"
| Hizonner wrote:
| >The day after Kate learned that she was suspected of using
| opioids--five days after she gave birth--the hospital
| "refused to discharge" her, the complaint says.
|
| That was unlawful detention, by the way. By fraud, under
| false color of authority, and/or by force. They have no
| authority to hold anybody against their will (with very
| specific exceptions having to do with mental state and _not_
| applicable here).
|
| > She was finally released that evening, but her baby did not
| come home until October 1, "ten days after her birth and five
| days after DCPP cleared Kate to bring her baby home."
|
| That was kidnapping, by the way.
|
| We're talking about actual felonies here. Not that you can
| get prosecutors interested in that kind of crime, but it's
| still true.
| klyrs wrote:
| Presumption of guilt, demanding proof of innocence, is not
| justice.
| 10000truths wrote:
| Because the presumption of innocence is a cornerstone of our
| legal framework. It's been well known for a while now that
| poppy seeds can trigger false positive results in a drug test,
| and it's not a particularly uncommon component of foodstuffs,
| so it constitutes reasonable doubt.
| civilized wrote:
| Horrible, but, completely unrelated question. How much poppy seed
| would I need to eat to get high?
| anonymouskimmer wrote:
| I think you misspelled "poppy".
|
| It depends on what strain, and whether they've been cooked into
| a bagel or are uncooked:
| https://www.frontiersin.org/articles/10.3389/fchem.2020.0073...
|
| > In this work, it was found that in harvested poppy seeds, and
| thermally processed poppy seeds (with and without a food
| matrix), if used in normal levels would not exceed the
| recommended acute reference dose. It was also shown that the
| levels of all alkaloids reduce when thermally processed, in
| comparison with harvested, untreated seeds.
|
| But basically a lot. Which is why poppies are processed for
| heroin. Not eaten straight.
| CapstanRoller wrote:
| I won't answer the question directly, but I will say that it is
| possible and that you shouldn't try:
|
| many people have died while doing this, because the seeds carry
| an unknown and highly variable amount of poppy latex. One may
| use some amount and feel nothing, but later use the same amount
| with a different batch of seeds and rapidly OD (usually fatal
| for opioid naive people).
|
| This is especially a problem due to the potentially long delay
| of come-up, which is why many folks die after redosing
| (believing that the first dose did nothing or wasn't
| sufficient).
|
| Lastly, baked goods containing poppy seeds do not pose any
| danger, as high heat destroys basically all the alkaloids.
| srean wrote:
| You will probably die trying if you go that route. The 'high'
| chemicals are in the fleshy, sappy part of the fruit. Some
| traces may remain on the seed.
| Scoundreller wrote:
| Ehhhhh, not always:
|
| https://www.foodsafetynews.com/2022/11/poppy-seeds-not-
| meant...
| srean wrote:
| I am not sure whether you were agreeing with me or
| refuting, but the article you linked vindicates my stand --
| you may die trying and not get a hit.
| Scoundreller wrote:
| This time it was a high-thebaine batch, but no reason it
| couldn't have been a high-morphine batch.
|
| The thebaine is found in the pod the same way as morphine
| is, not the seed itself. But if the seeds aren't washed
| enough and the variety isn't a low alkaloid one...
|
| Not sure how much the manufacturers test. Obviously one
| wasn't testing for thebaine.
| CapstanRoller wrote:
| The chemicals are on the seeds as well, sometimes to a
| significant degree, unless they're processed before sale.
| You're right about the danger of trying it.
| coffeebeqn wrote:
| Making opium is extremely easy. Basically you grow legal poppy
| flowers and cut a small incision in the seed pod and collect
| the sap. Then you dry it and you're ready to start your own den
| mannschott wrote:
| I've had a lot of Mohnstrudel (Poppy Seed Strudel) in Austria
| [1]. You won't get high; you'll just get diabetes. ;-)
|
| https://kochen.kerpe.at/wp-content/uploads/2020/02/Mohnstrud...
| swayvil wrote:
| Opium users are the new agents of satan. Ripe for scapegoating
| and asset forfeiture.
|
| It's a symptom of social pressure. Like when the ratcage gets too
| crowded and they start eating each other.
| A4ET8a8uTh0 wrote:
| Eh. I kinda understand the origin of semi-nanny state US has been
| turning into. Medical facility is just one of the places that can
| ( and sometimes is legally obligated to ) report you for even
| suspected transgression. The rules are sometimes difficult to
| follow to the letter so the general approach is to 'report and
| let god sort them out' ( in the case of financial industry, if
| you are interested in Orwellian language, it was called
| 'defensive' filing ).
|
| This is where we are. We are not here by accident. Each time a
| 'feel good' proposal was made, 'for the children' argument
| countered any reasoned argument against it. I am a parent and I
| already had a taste of this intrusion into my life by our kid's
| doctor ( she asked me whether I have guns in my house -- and my
| wife answered before I could even say 'It is not your business'
| ).
|
| It is going to get worse until it sufficiently pisses off the
| population. We are not there yet.
| tristor wrote:
| There are at least 5 separate issues at play here, but the one
| most front-and-center in my mind is that under no circumstance
| should any medical procedure be done on any person in the US
| without informed consent of the person, their guardian, or their
| medical PoA.
|
| Even if a procedure is "medically necessary", that does not give
| doctors the permission to do that procedure without your informed
| consent. When a procedure is not "medically necessary", it's even
| worse. There are people who refuse "medically necessary"
| procedures every day in this country on numerous different
| grounds, including religious grounds, and this is deeply legally
| protected and well upheld in case law.
|
| There is no valid justification for the behavior of these
| hospitals.
| anonymouskimmer wrote:
| Collection of a sample could generously be considered a medical
| "procedure" done on a person. But if a sample has already been
| collected for other purposes, testing said sample for an
| additional purpose can't be even generously said to be a
| medical procedure done on a person.
|
| The lack of informed consent as to what will happen with a
| collected sample is the thing. It's also incredibly stupid, as
| without informed consent a person can't think to tell the
| collector that they've recently eaten a poppyseed bagel, and
| thus their results will be tainted.
| 015a wrote:
| Insurance companies would _absolutely_ classify each specific
| test done on a specimen as a medical procedure. Each one
| costs money.
| PragmaticPulp wrote:
| > To guard against false positives, the Mandatory Guidelines for
| Federal Workplace Drug Testing Programs, published in 2017,
| require a codeine cutoff of 2,000 nanograms per milliliter of
| urine. But the Hackensack University Medical Center's lab,
| according to Kate's complaint, used a cutoff of 300 ng/ml, less
| than one-sixth the federal standard. Virtua Voorhees Hospital's
| lab, according to Kaitlin's complaint, used a cutoff of just 10
| ng/ml, 99.5 percent lower than the recommended level.
|
| Using a cutoff that is 200 times more strict than standard drug
| testing practices without giving the patient any warning that
| they'll be tested (and guidance to avoid poppy seed foods) is
| asking for false positives.
|
| Given that the other cases resulted in six-figure settlements,
| it's surprising that this practice continues.
| LeoPanthera wrote:
| > Using a cutoff that is 200 times more strict than standard
| drug testing practices without giving the patient any warning
| that they'll be tested (and guidance to avoid poppy seed foods)
| is asking for false positives.
|
| Occam's razor must apply here. They know what they're doing,
| and doing it intentionally.
| bmmayer1 wrote:
| Shouldn't Hanlon's razor apply here instead? "Never attribute
| to malice that which is adequately explained by stupidity"
| victor9000 wrote:
| Stupidity is the perfect alibi of malice.
| [deleted]
| HarryHirsch wrote:
| von Hammerstein-Equord, commander of the _Reichswehr_ in
| the early 1930s was more focussed on outcomes: "One must
| beware of anyone who is both stupid and hardworking; he
| must not be entrusted with any responsibility because he
| will always only cause damage."
| px43 wrote:
| Both can be true. The hospitals are doing it intentionally
| because some misguided stupid people think they're saving
| the world.
| hattar wrote:
| Interestingly, both could apply here.
| watwut wrote:
| At some point, one must stop playing perpetually naive
| Pollyanna and start making realistic guesses.
| LeoPanthera wrote:
| The past few years have convinced me quite strongly that
| malice is sometimes, even often, the correct explanation.
| kzrdude wrote:
| I think we're too slow to call it malice sometimes,
| aren't we? If it doesn't look cartoonishly evil we
| ascribe it to other intentions, I mean. While it would be
| more bold to just call it evil, such as: evil by
| neglience, evil by greed, etc.
| gruez wrote:
| >While it would be more bold to just call it evil, such
| as: evil by neglience, evil by greed, etc.
|
| It might be more bold _right now_ , but the net effect of
| expanding words to mean stuff it didn't mean before is
| that words get even more watered down. If "evil" includes
| people acting negligently, what do you call people who
| were actually intentionally out to cause harm? Super-
| evil?
| kzrdude wrote:
| That's not what I wanted to say. It depends on the
| situation. Not all neglience is evil, of course not. Not
| all greed is evil, either.
| andrewflnr wrote:
| Yeah, but even then usually someone has to benefit. I
| don't see who benefits. Drug investigators? Picking an
| arbitrary cutoff looks like plausible stupidity to me...
| Which is not to say the hospital shouldn't be punished
| harshly, just that probably no one should go to jail
| either.
| morkalork wrote:
| No idea who really benefits but there's been scandals
| like this before:
| https://www.washingtonpost.com/news/morning-
| mix/wp/2018/02/2...
| https://projects.thestar.com/motherisk/
| hgsgm wrote:
| Sometimes stupid people are malicious, muddying attempts
| to distinguish.
| doctor_eval wrote:
| Sufficiently advanced stupidity is indistinguishable from
| malice... and vice versa.
| dahdum wrote:
| In the complaint we can see she tested at just _18_ nanograms.
| Utterly negligent.
|
| > No one explained the details of the test results to Kaitlin
| at the time, but Kaitlin later learned that the second test
| conducted on her urine sample reported a finding of 18
| nanograms of codeine per milliliter of the sample (18 ng/mL).
| The laboratory testing Kaitlin's sample employed a cutoff of 10
| ng/mL to determine whether a sample was positive for codeine, a
| testing cutoff level that is dramatically lower than
| recommended in Federal guidelines.
|
| https://www.aclu-nj.org/sites/default/files/field_documents/...
| StrangeATractor wrote:
| > Given that the other cases resulted in six-figure
| settlements, it's surprising that this practice continues.
|
| Honestly that sounds pretty low.
| encryptluks2 wrote:
| [dead]
| nullc wrote:
| > Given that the other cases resulted in six-figure
| settlements, it's surprising that this practice continues.
|
| a six figure settlement is a rounding error for these
| institutions. Given their inefficiency it could easily cost
| many times that just to change their practices and train
| doctors to not do the wrong thing.
|
| Funding incentives for child welfare agencies also encourage
| them to cast a wide net (and miseducated mandatory reporters).
| giantg2 wrote:
| Mandatory reporters might be reporting everything, not out of
| miseducation, but rather out of fear of overzealous
| prosecutors.
| dahdum wrote:
| > a six figure settlement is a rounding error for these
| institutions. Given their inefficiency it could easily cost
| many times that just to change their practices and train
| doctors to not do the wrong thing.
|
| They refused to discharge the mother for days and kept the
| baby in the NICU for an extra week. Average cost per day for
| the NICU is ~$3k/day. Six-figure settlements aren't enough if
| they get away with it frequently.
| MikeDelta wrote:
| I seriously hope they sue and get an 8 figure settlement, or
| even more. And legal consequences for those involved.
| giantg2 wrote:
| Sounds like the hospital is subjecting mothers to damages
| through their negligence.
| candiodari wrote:
| No, Youth Services is doing that. The hospital is just
| referring them, as they are legally obliged to do, and making
| extra money in the process ...
| giantg2 wrote:
| CPS is generally required to investigate any complaint and
| follow a protocol. The hospital doesn't have a failed drug
| test since it doesn't meet the guidelines. They're only
| required to report if they reasonably believe the mother is
| using drugs. Tests below the guideline level don't provide
| that basis. It's an unnecessary/false report.
|
| It's the same way that courts grant protection orders or
| red flag orders - they're supposed to use the basis of
| something being more likely than not. Yet they consistently
| "err on the side of caution" and simply grant the order
| even though it's not actually likely to occur in most
| cases. Thus we see some lawyers advising their clients to
| file orders without basis during divorce to gain leverage.
| I'd love to see the numbers, but I would guess the process
| is abused or misruled on more often than it's used
| correctly.
| candiodari wrote:
| I find this to be very typical of CPS. As they report
| themselves, they miss the large majority of actual child
| abuse (and one reason often cited, that children and
| parents agree actual child abuse is less of a problem ...
| than CPS. So everyone lies to CPS, and they're
| essentially only used as a means to hurt others, for
| example in divorce).
|
| You'd think the reaction to this problem would be to
| seriously downsize CPS, and raise the threshold for
| involvement. The opposite is happening.
| behringer wrote:
| Also sounds like a phi violation.
| coffeebeqn wrote:
| The hospital we had our last birth at have fentanyl through the
| epidural or some kind of opiate orally. I really wonder how
| they can even run these tests unless they don't use any opiates
| Centigonal wrote:
| Despite agonizing the same receptors, fentanyl is chemically
| very different from poppy alkaloids like codeine.
| messe wrote:
| Ok, but how do they rule out codeine usage while pregnant?
| I'm not sure about the US, but in Ireland, small doses of
| codeine + ibuprofen or paracetamol (acetaminophen) are
| readily available from pharmacies without a prescription,
| and as far as I'm aware they're not strictly recommended
| against during pregnancy.
| kevviiinn wrote:
| Tylenol 3 is not available in the US without a
| prescription, no formulation of codeine is. Besides poppy
| seed bagels, that is
| ChaseMeAway wrote:
| Interestingly a few states do offer a Codeine cough syrup
| without a prescription[0].
|
| From the article: "Codeine regulation varies widely
| across countries and states. In some states, including
| North Carolina, Florida, Oklahoma, and Iowa,1,2
| pharmacists can dispense a small quantity of cough syrup
| containing codeine OTC. Based on individual state law,
| this information may not be logged into the prescription
| drug monitoring program, which may contribute to
| providers being unaware of their patients' use of
| codeine."
|
| This is an exceedingly rare practice in the US however.
|
| [0]https://www.pharmacytimes.com/view/behind-the-counter-
| codein...
| kevviiinn wrote:
| Interesting, I wasn't aware of codeine being available
| OTC in the US. Thank you!
| messe wrote:
| Interesting. As far as I know only the combinations with
| a higher strength codeine are prescription only in
| Ireland. It's the same in the UK, as far as I know
| (presumably because it would be nigh impossible to
| prevent small amounts of cross-border smuggling with the
| North)z
|
| Most opiates on the other hand, would be rarely
| prescribed by doctors
| Gibbon1 wrote:
| My experience is women hoard Tylenol 3 to use for period
| pain.
| kevviiinn wrote:
| It would have had to been prescribed in the first place
| then, no?
| [deleted]
| Gibbon1 wrote:
| Women also trade them to each other. And they get
| prescribed surprising often.
| ksenzee wrote:
| Interesting, are you located outside the US? I've lived
| in Washington state, Utah, Maryland, and briefly in
| Missouri and Massachusetts, and I've never seen or heard
| of this happening. (And I am a woman of reproductive
| age.)
| lostlogin wrote:
| What a shambles. And if she was abusing the drug, treating it as
| a legal problem rather than a healthcare one is also tedious.
|
| No attitude like this exists with alcohol, yet that drug seems to
| cause the odd problem.
| bongoman37 wrote:
| [dead]
| grumple wrote:
| Is it not illegal to perform nonconsensual, nonemergency testing
| on people? The people that authorized this at the hospital should
| go to prison for that imo.
| lostlogin wrote:
| The young, old and unwell are not able to give consent. Dealing
| with that _should_ be a routine part of every day work in a
| hospital.
___________________________________________________________________
(page generated 2023-03-25 23:02 UTC)