Category Archives: Ethics

The Registered Nurse Shortage

Posted on March 20, 2023 by | 68 comments

by James C. Sherlock

I have reported often about the severe and increasing shortages of nurses both in Virginia and nationally.

At some point in nearly everyone’s life, we literally will not be able to live without the help of a nurse, whether for injury or illness or just declining overall health.

We need both the nurses and ourselves to be safe when that happens. We will have to fill the shortages, first by recruitment and retention. Perhaps simultaneously by increased legal immigration of qualified nurses from other countries.

This article will focus first on what RNs were paid in 2021, both in Virginia and nationwide. We will examine it in absolute and in relative terms. Virginia in 2021 was competitive on pay in relative terms. But wages may be insufficient in absolute terms to address the shortages.

Then we will discuss what else needs to be done to recruit, train and retain more nurses. I mentioned in an earlier article that RN instructors in training programs are one of the biggest needs.

The Census Bureau and Bureau of Labor Statistics have captured the large increases in registered nurse (RN) pay across the board and the doubling of the pay of travel nurses in 2021. Those pay surges were driven by COVID supply and demand and funded partially by federal emergency money.

You will see that, by what I consider a useful calculation, Virginia RN’s median wage compensation is 18th among the states when adjusted for each state’s cost of living index. Virginia is the top-paying state among adjacent states and the District of Columbia.

Regardless of the reason, it was past time that we paid them more. We need the pay raises to stick. It is the only way over the long run to begin increasing the supply.

I say begin because there are other factors driving nurses away. Safety is a huge factor. Continue reading →

68 Comments

Posted in Ethics, Government Oversight, Health Care, Immigration, Labor & workforce, Long Term Care and Nursing Homes

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Unconstitutional Viewpoint Discrimination in Virginia K-12 Teacher Evaluation Standards

Posted on February 25, 2023 by | 31 comments

Daniel Gecker Esq., President of the Virginia Board of Education. Appointed to the Board of Education by Governor Terry McAuliffe and reappointed to a four year term by Governor Ralph Northam. Date of expiration of appointment – June 30, 2023

by James C. Sherlock

Progressives, in the fullness of their dogma, oppose the entire Bill of Rights.

The Bill of Rights is specifically structured to limit the powers of government, which progressives find not only unsuitable, but unimaginable.

In the Golden Age of Progressivism in Virginia, 2020 and 2021, they controlled the governor’s mansion, the General Assembly, the Attorney General’s Office and all of the state agencies.

With total control, they took flight.

They have always known what seldom occurs to conservatives not prone to offend the Bill of Rights.

With total control of state government, progressives can enact and have enacted laws, regulations and policies that violate both the federal and state constitutions.

They know it will take a decade or more for courts to push back. Meanwhile they can call opponents “haters.”

After which the worst that can happen is that nobody is held accountable. Except the taxpayers.

I just exposed unconstitutional viewpoint discrimination in the University of Virginia’s hiring process. that was implemented starting in 2020.

The same fertile progressive imagination is also present in the Board of Education’s new (in 2021) Standard 6. “Culturally Responsive Teaching and Equitable Practices performance indicators” (starting on page xv) in “Guidelines for Uniform Performance Standards and Evaluation Criteria for Teachers“(Guidelines). Continue reading →

31 Comments

Posted in Civil Rights, Courts and law, Culture wars, Democracy and Western Civilization, Education (K-12), Ethics, Freedom, General Assembly, Governance, Government workers and pensions, Individual liberties, Parental Rights

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The Players and the Dispute in the High Level Cage Match at UVa – Can a Racism Charge be Far Behind?

Posted on February 21, 2023 by | 20 comments

By James C. Sherlock

Loren Lomasky,
Cory Professor of Political Philosophy, Policy & Law.       Courtesy UVa.

I read yesterday morning on BR “Tragedies in Charlottesville” by UVa professor Loren Lomasky, who wrote:

It is reasonable to judge that in either the longer or shorter version of the history of the university, no single individual has done it as grievous a harm as the man who now serves as its chief academic officer.

Among the few propositions on which Loren Lomasky and provost Ian Baucom agree is that the University of Virginia would be better off with exactly one of them gone.

Wow! Cage match!

I guess you could say that Dr. Lomasky has had enough.

He opposes, obviously strongly, Provost Baucom’s strange intervention into academics school-wide after the November shooting of three young men at the University.

We also suspect the fight might reflect the history between the two men. Baucom was Dean of the College and Graduate School of Arts & Sciences during most of Professor Lomasky’s tenure there.

Libertarians like Dr. Lomasky seek, in his case as a career, to minimize encroachments on and violations of individual liberties and to maximize personal autonomy and political freedom.

They are believers in personal agency and taking responsibility for ones actions. They insist on academic freedom.

Nice to see the professor, who advocates all of that, call out the University of Virginia leadership in the person of provost Ian Baucom, who emphatically does not advocate any of it.

Not a word about that story yet that I can find in the mainstream media that cover Virginia.  Fair enough.  Perhaps we will see it tomorrow.

Nothing in The Cavalier Daily yet, which does,however, offer a riveting story pressing for free menstrual products in the dorms.

But Professor Lomasky also called out the DEI bureaucracy at UVa in the strongest terms.

I have no doubt that they have opened a “case.” (Update.  I understand that Prof. Lomasky has been the subject of at least three investigations by the EOCR division of DEI).

Continue reading →

20 Comments

Posted in Culture wars, Education (higher ed), Ethics, Freedom, Individual liberties, Race and race relations

Government Actors Try to Deflect, Deny and “Move On” from Failures During COVID

Posted on February 19, 2023 by | 37 comments

Courtesy CBS rendering of two CDC spring of 2021 survey findings about American high school girls reported Monday, Feb 13, 2022

by James C. Sherlock

The Centers for Disease Control and Prevention (CDC) is in full self-defense mode.

CDC and the left backed, indeed insisted, upon social isolation during the pandemic.

Now they deflect and deny agency in the consequences. They continue to try to insulate themselves from the catastrophic educational and mental health effects on children and adolescents of that social isolation.

A weakened CDC Director is pledging to overhaul the agency and its culture, a backhanded admission of the unimaginably bad performance of CDC during COVID.

The entrenched bureaucracy that is that agency and its culture is admitting nothing. They are counting the days until she leaves.

So, if experience counts for anything, we pretty much know how the CDC “overhaul” will work out.

Virginia is due for the same sort of review of state actions during COVID.

The Northam administration stumbled badly at nearly every new turn after failing to either exercise or implement Virginia’s own pandemic emergency plan. Which was excellent and predicted nearly exactly the course of events.

Then they tried to cover up the existence of that plan itself.

I am not sure that such a review is forthcoming. If it is, it will be preemptively be declared political. It must be done anyway.

The federal government, under progressive management, is “moving on.”

Or trying to.

I hope Virginia government does not make the same mistake. Continue reading →

37 Comments

Posted in Change Management, Children and families, Culture wars, Disasters and disaster preparedness, Education (K-12), Ethics, Federal, Governance, Health Care, Mental illness and substance abuse, Planning, Politics

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Moral Injury Is Driving Doctor Burnout

Posted on February 14, 2023 by | 15 comments

by Dr. Scott Armistead

Physician burnout is a major issue in the U.S., receiving attention in medical education, medical specialties and at various government levels. Moral injury, in my professional and teaching experience, is a significant and growing challenge to physician wellness. Moral injury happens when one’s personal convictions are unwelcomed and one is pressured to think, be silent, speak, act or not act in a way that compromises one’s conscience.

I graduated from the VCU School of Medicine (formerly Medical College of Virginia) in 1991, trained in family medicine and served in a mission hospital in Asia for 16 years. In 2015, I transitioned to a Virginia university practice and became heavily involved in the lives of medical students.

In the time that had passed since I was a medical student, I found the environment of medicine and medical education had significantly changed. One area of change was the emergence of the “provider of services model.” “Provider,” a relatively new term at the time, is now commonplace. Continue reading →

15 Comments

Posted in Culture wars, Education (higher ed), Environment, Ethics, Health Care, Individual liberties, Public safety & health, Science & Technology, Uncategorized

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Miyares Reminds Republicans the Difference a Year Makes

Posted on January 16, 2023 by | 11 comments

by Shaun Kenney

If Virginia Republicans needed a sizzle reel, this was it.

With news that leftist Commonwealth Attorneys are openly refusing to enforce the law in some cases, the threat to the rule of law and the problem of selective enforcement is greater now than ever before.

Which is why a long list of actual accomplishments is enough to lift the spirits of anyone kicking the dirt about what Virginia Republicans might be in future:
Short list?

• Miyares actually reminds us of his constitutional oath (something his predecessor set aside rather quickly);
• Launching Operation Ceasefire;
• Keeping repeat offenders off Virginia’s streets;
• Listening to and working with local law enforcement across Virginia;
• Protecting consumers from bad corporate actors;
• $1 billion in settlements while tackling the opioid crisis, specifically targeting the cheap availability of fentanyl — which is more of a problem than most people realize;
• Protecting Virginia energy ratepayers;
• Touring Virginia public schools regarding school safety;
• Perhaps the marquee issue: investigating Loudoun County Public Schools for their horrific and heavy-handed treatment of concerned parents.

There are also these: (1) Virginia Republicans are moving forward with a focus on process rather than agenda; (2) Miyares knows Virginia like the back of his hand; and (3) Miyares intends to move in coalition. Continue reading →

11 Comments

Posted in Crime , corrections and law enforcement, Culture wars, Elections, Ethics, Governance, Law enforcement, Open Government, Uncategorized

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As TJHSST is Investigated, an Email from 2020 Reveals a ‘Pattern and Practice’ of Hiding Awards

Posted on January 7, 2023 by | 9 comments

by Asra Q. Nomani

This week, Virginia Attorney General Jason Miyares walked through the glass doors of the Korean Community Center off Little River Turnpike, the dome of Thomas Jefferson High School for Science and Technology visible through the window, and with him stood five parents of current and former students at TJ, as the school is known locally.

In a devastating announcement for Fairfax County Public Schools, Miyares announced twin civil rights investigations into, first, the withholding of National Merit Commended Student awards by TJ administrators and, second, a Fairfax County school admissions policy, put in place in December 2020, that a federal judge ruled discriminates illegally against Asian American students.

Miyares’ team will be seeking to identify a “pattern and practice” of discriminatory actions, a standard in civil rights cases. Currently, in defense of the school district, FCPS spokeswoman Julie Moult told reporters on Dec. 29, that withholding National Merit Commendation awards from students this year was a “one-time human error in the fall of 2022 only.”

“To suggest a deliberate intent to withhold this information would be inaccurate and contrary to the values of FCPS,” Moult continued. The district, she went on, values “hard work and dedication.”

“Fairfax County Public Schools also seems to value obfuscation and deception,” said Norma Margulies, the mother of a student at TJ, an immigrant from Peru, and one of the parents standing on stage with Miyares.

An email, obtained by Fairfax County Times, reveals that, indeed, in fall 2020, TJ staffers misled parents and students about the National Merit Commended Student award, presented to the top 3 percent of 1.5 million students who take the PSAT exam.

In the email, dated Nov. 24, 2020, at 11:53:25 a.m., a TJ staffer copied and pasted information about the Commended Student award into an email to a parent, who was asking about the award, incorrectly stating, “There is no letter and no formal announcement for Commended scholars and the list of Commended scholars is not made public.”

In fact, more than two entire months earlier, on Sept. 10, 2020, according to a National Merit Scholarship Corporation spokeswoman, the Illinois-based nonprofit sent a letter to TJ Principal Ann Bonitatibus notifying her the school had 230 National Merit Commended Students. Most of them were Asian- American. The school district typically releases the names of National Merit Semifinalists, who advance to compete to be National Merit Finalists.

The National Merit letter included a note with the explicit expectation that schools will inform students and parents, “Please present the letters of commendation as soon as possible since it is the students’ only notification.” Continue reading →

9 Comments

Posted in Education (K-12), Ethics, Parental Rights, Race and race relations, Uncategorized

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Richmond’s Metzger Bar and Butchery Denies Service to Christian Non-Profit

Posted on December 7, 2022 by | 78 comments

by The Republican Standard Staff

On Wednesday evening, an hour and a half before a reserved Family Foundation gathering in a private room, Metzger Bar and Butchery denied entry and service to the pro-family group, solely based on their political opinions and religious beliefs.

“It is alarming and disgraceful that this restaurant has a political litmus test to get in the front door,” said Victoria Cobb, President of the Family Foundation. “All Virginians should be concerned about this extreme bigotry and intolerance of people of faith, irrespective of their own political or religious beliefs. Everyone should be concerned that Virginians are being denied access in the marketplace, solely based on their beliefs.”

Cobb continued, “We live in a free market and people have many choices of where to dine, so we took our business elsewhere. Metzger’s has now isolated a wide base of customers who would rather go elsewhere than patron a bigoted restaurant. Most Virginians are charitable and would not only serve people with differing political or religious viewpoints but would share a meal with them and enjoy the exchange of different viewpoints.” Continue reading →

78 Comments

Posted in Children and families, Civil Rights, Culture wars, Ethics, Feminism and women's rights, Individual liberties, LGBQT

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Great Investigative Reporting of a Heartbreaking Story

Posted on December 6, 2022 by | 4 comments

Courtesy Asra Investigates

by James C. Sherlock

For a story that will simultaneously make you angry and break your heart, read “Fathering While Black,” by Asra Nomani and Debra Tisler.

It is the story of a guardian ad litem (GAL), Karen Keys-Gamarra, who is reported here to have systematically abused her position to pursue a Black father and his parents for the crime of loving and caring for his daughter while male.

The child’s mother was a junkie who exposed her baby to cocaine. The father is a gainfully employed paramedic in Stafford County with a clean record and clean drug tests. His own mother is a registered nurse and his father a retiree.

The GAL got an order from an Arlington J&D judge to take the child from the home of her father and grandparents last night.

The authors have practiced world-class investigative journalism in describing the case and the system — Arlington J&D judge, GAL and Child Protective Services — that worked together to seize the little girl. And put a gag order on her father and his parents.

If ethics violations were a crime, based on this reporting this case would be a Class 1 felony.

Now nobody in the system will comment.

Ms. Nomani and Ms. Tisler comment for them.  Thoroughly and compellingly.

4 Comments

Posted in Children and families, Civil Rights, Courts and law, Ethics, Government Oversight, Law enforcement, Parental Rights, Scandals, Social services

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Profoundly Unethical: UVa Children’s Hospital Hides Child Gender Transition Information from Public Scrutiny

Posted on December 1, 2022 by | 30 comments

UVa Children’s Hospital courtesy UVa

by James C. Sherlock

I published a series of articles earlier this year that criticized the University of Virginia Children’s Hospital on its approach to gender transition in minors as young as 11.

As a result, the hospital made at least some movement towards change by announcing it was assigning pediatric clinical psychologists to join that program, previously dominated by endocrinologists.

I saw that move as an indication that the minors who came to the clinic would be treated first for anxiety, depression and ongoing emotional issues before being considered for insertion into the hormone-to-surgery pipeline.

That now may be the case, though there is no case flow diagram published. But nothing else has apparently changed except for the elimination of the public information on which I based my criticisms.

There is growing concern among many doctors and other healthcare professionals as to whether medical transition is the best way to proceed for those under aged 18. I have written extensively that several countries have pulled back from medical treatment and instead are emphasizing psychotherapy first.

UVa Children’s is a state hospital. Hiding information from the public to avoid scrutiny cannot be an option.

I call on the Board of Visitors to direct the hospital to improve transparency in the UVa Children’s Hospital web presentations on gender transitions in minors.

Without this, the hospital is guilty of misleading the public.  The removal of previously-available public information shows they are doing this on purpose. Continue reading →

30 Comments

Posted in Children and families, Culture wars, Ethics, Government Oversight, Health Care

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Physicians, Hospitals and Gender Dysphoria in Minors- Fundamental Disputes

Posted on October 7, 2022 by | 22 comments

By James C. Sherlock

What about the doctors in this controversy?  What about hospital and state oversight?  What do laws and regulations require and on what are they silent?

We’ll look.

The dispute among physicians on the treatment of gender dysphoria in minors is primarily an ethical one.  They agree on the diagnosis and some of the medical effects of hormone treatments.  They agree:

  • that gender dysphoria (GD) in childhood describes a psychological condition in which children experience a marked incongruence between their experienced gender and the gender associated with their biological sex;
  • that with the onset of puberty, the emotional turmoil can be significant and needs to be dealt with. (They disagree on how to deal with it);
  • that puberty blockers stop puberty;
  • that puberty blockers cause emotional distress and some increasingly concerning side effects, but achieve the physical results sought;
  • that once a child has puberty blocked, he or she is very likely to proceed to cross-gender hormones;
  • that cross-gender hormones also “work” in a medical sense, meaning they cause the physical changes sought by the physician, and at some level sterilize the patient;
  • that, once transitioned with cross-gender hormones, the minor will be dependent upon them for the rest of his or her life to maintain the gender reassignment; and
  • that there are no scientific clinical studies that have tracked the health of transitioned minors as they have grown into adults.  What little is available are surveys, not clinical follow-ups.

They agree that transitioned persons as a group go on to have very difficult lives. We have the data on that, just not on their health outcomes from the transition treatments.

They also agree that action or inaction and the types of action chosen involve moral judgments. But they disagree on what is moral here.

The progressive view is that these interventions are life-saving and gender-choice-affirming.  Those who oppose the interventions consider them unethical and dangerous experiments on minors unequipped to make such decisions. Some also consider them immoral.

The ethical debates among physicians start early in the process with different interpretations of “first, do no harm.”

In Virginia in 2020, Governor Northam and the General Assembly put a thumb on the scale.

Continue reading →

22 Comments

Posted in Children and families, Ethics, Government Oversight, Health Care

“Puberty Blockers Are Wonderful” – UVa Children’s Hospital

Posted on September 26, 2022 by | 44 comments

by James C. Sherlock

How do people communicate?

Generally by words and visuals and, in person, with body language. The art and science of marketing and sales is one of the bulwarks of any economy — and any political system.

My article on the hard selling of hormone treatments — puberty blockers and cross-gender use of estrogen and testosterone — by UVa Children’s Hospital Transgender Youth Health Services has drawn a lot of attention.

Two of the most famous lines from the video and its transcript are:

Puberty blockers are wonderful. They provide sort of a break.

Well. What child and parent wouldn’t want a break? Is there ice cream?

That enthusiastic endorsement caused me to check out the FDA warnings on puberty blockers.

Wonderful is not the first word that comes to mind. Continue reading →

44 Comments

Posted in Culture wars, Ethics, Government Oversight, Health Care, Parental Rights

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Hormone Treatment of Transgender Adolescents in Virginia – New Concerns

Posted on August 19, 2022 by | 23 comments

by James C. Sherlock

We have discussed at length the controversial policies of the American Academy of Pediatrics (AAP).

It is time to consider the impact of Great Britain’s ongoing National Health Service Review of its transgender support to children and young people.

It offers new concerns about clinical challenges in the diagnosis and treatment of gender dysphoria in adolescent patients, especially the safety of puberty blockers.

And it causes us to discuss what has been going on for years at the University of Virginia Children’s Hospital Transgender Youth Health Services.  

It is a state hospital that has treated hundreds of patients from the earliest stages of puberty with both puberty blockers and cross-gender hormones. Continue reading →

23 Comments

Posted in Culture wars, Ethics, Health Care, Insurance, Parental Rights, Psychology, Virginia Law

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Progressives in Virginia In Position to Overrule Parental Objections to Invasive Child Gender Dysphoria Treatment

Posted on August 17, 2022 by | 87 comments

by James C. Sherlock

The Virginian-Pilot, in an editorial, bemoaned Governor Youngkin’s endorsement of a policy that would require schools to tell parents about their kids’ transexual identity expressions at school.

It’s as though the potential consequences of such a policy have never crossed his mind.

The sure consequences of opposing that policy were not discussed.

The Pilot brain trust did not address, and perhaps did not care, that a child in Virginia must have a diagnosis of gender dysphoria as a predicate for mental health treatment. And, of course, for physically invasive treatments.

Most Virginians think parental/guardian consent is required for all of that. It certainly should be. But it won’t be if progressives find the right judge.

Medical ethics should help protect kids, but will not. Progressive medical providers think themselves to be doing the best thing for the child, even with the dangerous, irreversible and ghastly treatments to which some providers subject children diagnosed as gender dysphoric.

Neither will judicial ethics. Read the papers every day for things that progressives think best for all of us. Progressive judges will think themselves to be doing the right thing as well.

Virginia is thick with progressive doctors and judges. It is thicker with parents.

The progressives need to be stopped by changes in Virginia law. This is a very complicated subject.  So the background discussion will be extensive.

Continue reading →

87 Comments

Posted in Children and families, Civil Rights, Courts and law, Culture wars, Education (K-12), Ethics

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Elaine Luria: Facebook Fat Cat

Posted on May 17, 2022 by | 8 comments

Second congressional district Representative Elaine Luria. Photo credit: Virginian-Pilot

Kerry Dougherty

Memo to Rep. Elaine Luria: When you’ve lost the far-left Daily Beast, you may be in trouble.

In a surprisingly tough May 12 piece headlined “The Dem May Hate Facebook But Her Stock Portfolio Doesn’t,” Daily Beast political reporter Roger Sollenberger skewered Luria for publicly criticizing Facebook, while owning between $1 million and $5 million worth of stock in the company.

“Those holdings, owned jointly with her husband, make her the largest Facebook shareholder in Congress and might appear to undercut the force of her criticism,” Sollenberger wrote.

Might?

It definitely makes her look hypocritical.

If Luria genuinely believes that Facebook traffics in misinformation why would she hold stock in the company? Better yet, why would she spend hundreds of thousands of dollars advertising on the platform? Continue reading →

8 Comments

Posted in Ethics

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