Tuesday
Oct282003
Terraclient
Tuesday, October 28, 2003 at 11:32PM TIP OF THE DAY
Terraclient
Tuesday, October 28, 2003 at 11:32PM Terraclient
Monday
Oct272003
Advance Directives
Monday, October 27, 2003 at 11:26PM TIP OF THE DAY
ADVANCE DIRECTIVES
What are your medical wishes?
During the Florida Senate debate, all parties agreed that if Terri Schiavo had expressed her wishes, in writing, then she could have died with dignity. But she did not. The result was years of litigation which has cost hundreds of thousands of dollars and ripped a family apart. Could this happen to you or your family?
As a competent adult, you have the right to decide to accept or refuse any medical treatment. "Competent" means you understand your condition and the results your decision may have. As long as you are competent, you are the only person who can decide what medical treatment you want and do not want to receive. Your doctors will give you information and advice about the pros and cons of different kinds of treatment, but only you can choose whether to say "yes" or "no." You can say "no" even if the treatment you refuse might keep you alive longer and even if your doctor or your family wants you to have it.
Someday, however, you may become too sick to make your own decisions about your medical care. If that happens, then decisions will have to be made for you. If you have not given any instructions, no one will know what you would have decided. Do you want a guardian ad litem, the courts, or even Governor Jeb Bush to make those decisions for you? If not, you need to make your wishes known, preferably in writing.
The following may help you to understand your rights:
What is an advance directive?
Advance directives are documents signed by a competent person giving direction to healthcare providers about treatment choices in certain circumstances. There are two types of advance directives. A durable power of attorney for healthcare allows you to name an individual to act for you and to carry out your wishes. A living will allows you to state your wishes, in writing, but does not necessarily name a patient advocate.
Why have an advance directive?
Many people have strong feelings about the kind of medical care they would like to receive or refuse in certain circumstances. The Terri Schiavo case makes that abundantly clear. An advance directive allows you to state clearly your feelings.
What decisions should be considered?
- Who would you like to make medical treatment decisions for you if you become unable to do so?
- How do you feel about ventilators, surgery, resuscitation (CPR), drugs or tube feeding if you were to become terminally ill? If you were unconscious and not likely to wake up? If you were senile? If like Terri Schiavo, you were in a persistent vegetative state?
- What kind of medical treatment would you want if you had a severe stroke or other medical condition that made you dependent on others for all your care?
- What sort of mental, physical, or social abilities are important for you to enjoy living?
- Do you want to receive every treatment your care-givers recommend?
What is a durable power of attorney for healthcare?
It is a legal document that allows you to name an adult to be your advocate and to make healthcare decisions for you. You can pick a family member, friend or any other person you trust, but the person you choose must be willing to serve. A durable power of attorney can be used to accept or refuse any treatment. If you want your patient advocate to be able to refuse any treatment and let you die with dignity, you need to say so specifically in the durable power document. A durable power goes into effect only when you are not able to make decisions for yourself.
Must you have a durable power of attorney for healthcare?
No. You have this option, and no one can require you to have a durable power of attorney. You can make your wishes known by talking with your family or doctors or by writing them down, but unless you have a durable power of attorney, a patient advocate that you selected does not have legal authority to act for you. The factual dispute in the Terri Schiavo case was whether her wishes were orally conveyed to her husband who stated that she did not want extraordinary medical care, or whether she never gave any instructions and would want all medical options available provided to her which is what her parents maintain.
As an aside, suggestions were made during the floor debate in Florida Senate on the Terri Schiavo legislation that only written directives should be recognized in the future. If that should become part of Florida law, then oral directives would no longer be a viable option. Many in the right-to-life movement would like to end recognition of oral directives and would also like to prohibit the withdrawal of food and water as an acceptable end-of-life option. In other words, individuals like Terri Schiavo could not have feeding tubes removed even if they specifically expressed that directive either orally or in writing.
Must you give written instructions about your treatment?
No, it is not necessary under current law. The Terri Schiavo case, however, clearly demonstrates why it is better to do so. You can simply name a patient advocate. But, remember that your advocate can only have life-sustaining care stopped if you say so in your durable power of attorney. It is better to have written instructions because then everyone can read them and understand your wishes. Another option is a "living will" which delineates your healthcare choices and is quite similar in many respects to the durable power of attorney. Or, you can simply make sure your family and care-givers know what you want if you were to get sick. It is vitally important for hospitals and your doctors to understand your wishes otherwise they are inclined not to withhold treatment, if that is your wish, for fear of possible medical malpractice claims or being drawn into a family dispute. Writing them down makes it clear exactly what you want and avoids the tragedy of the Schiavo family.
Must you make decisions now about your future medical treatment?
No. You do not have to have a durable power of attorney or a living will and you do not have to tell anyone your wishes. You can still make treatment choices while you are competent. If you are no longer competent, but you have made sure your family and care-givers know what you would want, it will be easier to follow your wishes. If you have not made your wishes known to family and care-givers, a court may have to name a guardian ad litem to make decisions for you. That person may or may not do what you would like to have done.
Legal advice is not required. There are lots of excellent forms (particularly for living wills which are generally preferred in Florida) available from different organizations including the Florida Senate (www.floridasenate.gov) and Aging with Dignity (www.agingwithdignity.com). Of course, your attorney can help you prepare a document taylored to your specific wishes. [Another good source: www.partnershipforcaring.org]
Medical treatment decisions are difficult. It is easy to put them off. Nonetheless, each of us needs to think carefully about our wishes in advance, discuss the options with our family, friends, lawyers, clergy and healthcare professionals, as appropriate, and make plans for our future healthcare needs.
I fully expect the Florida Legislature to entertain legislation in the 2004 regular session to limit the right of individual patient choice where there is no written advance directive, and perhaps to disqualify certain family members in favor of a guardian ad litem in such circumstances.
If there is to be anything positive to be learned from the tragedy of Terri Schiavo, it is that we all have an obligation to ourselves and our families to make our end-of-life healthcare wishes fully known. Let's not procrastinate any longer!
Wednesday
Oct222003
Googling Contacts
Wednesday, October 22, 2003 at 11:25PM TIP OF THE DAY
Google puts your cards on the tableBY MONTY PHAN
Newsday
Michael Schrage calls it his ''Google Rule'': Before meeting a business acquaintance for the first time, he uses the search engine to familiarize himself with the person's work, which often makes the rendezvous go more smoothly.
Because the information is usually public, no one has yet confronted him about how he gets it. But that's not to say the subject of ''Googling'' hasn't made for any uncomfortable moments. One time, a woman he was seeing said she had looked up Schrage's name on Google before the date.
'My immediate reaction was, `Oh, my God,' '' said Schrage, a Manhattan- and Boston-based author and research affiliate at MIT's Media Lab. 'My second reaction was, `What did she read, information about me as a person or my work?' ''
In this age of Googling, it's all fair game. Searching on a phone number could bring up a name, address and a link to an Internet map of your home. It may also include your personal Web page, Web log postings, class-reunion biography, messages posted on bulletin boards and on-line resumes.
DOUBLE-EDGED SWORD
It's the flip side of cyberconvenience. Computer users value Google for what it reveals about others but worry about what it may reveal about them.
Privacy concerns were raised two years ago when Google began its PhoneBook service. Google argued that it was simply taking publicly available information and putting it to its own use. Indeed, other websites had been doing the same thing.
But it's perhaps the most basic example of how ease of information has come at the sake of relative obscurity. Before the Internet, you could get the same information by looking up a person's name in the phone book and finding the address on a map.
''You had to do a lot more footwork before,'' said Jayne Hitchcock, an Internet privacy and cybercrimes consultant and president of the Maine-based group Working to Halt Online Abuse. ``You had to go to these places in person, but now you don't have to anymore.''
HUB HUBBUB
The Google PhoneBook feature caused a small stir because of the search engine's reputation as a mainstream site that's much more frequented than Switchboardcom or others that provide similar information.
A Google spokesman said the site received few complaints, and it does allow users to remove their listings from its search engine by clicking on the phone icon next to their names and numbers and filling out an online form.
NO EASY FIX
But Hitchcock said that the same information would still be on other online phone directories and that removing listings from those sites would be pointless since the phone companies send out new, updated databases yearly.
The only way to remove your phone listing from such sites is to get an unlisted number, which some are hesitant to do because it requires notifying contacts of the new number, Hitchcock said.
Part of Google's power is that it is the most popular search engine among U.S. Web users, according to May figures provided by comScore Media Metrix to the website SearchEngineWatch.com. But Google is fighting to maintain its hold as Yahoo, and Microsoft try to make gains in the search engine market.
The idea is to attract legions of users who have myriad reasons for searching online.
Lisa Hagen, the manager of the upscale Hotel Bel Air in Los Angeles, said she uses Google to research the lives of every new client. For example, if a guest is passionate about race cars, the hotel staff will arrange for tickets to an exotic car show in town.
Schrage, the author and MIT research affiliate, said Google had helped him solidify business relationships but that he never uses it to look up personal contacts for fear that it might prejudice him.
NOT ALWAYS HELPFUL
Of course, there are pitfalls.
Amy Vecchione, 45, of Glen Ridge, N.J., was recruited in 1999 to work for an Internet software company in San Francisco. Upon arriving, she was questioned about her involvement with an online newsletter called Swine Line, dedicated to a band called Pig. She found out that it was a different Amy Vecchione, but she wondered if that information would have influenced the hiring decision had the search been performed before she was offered the job (which she has since left).
Hitchcock, the Internet privacy consultant, said a friend of hers was on a first date when the man the friend was with asked about the friend's drunken-driving arrest, which he found via Google. That really upset the friend, Hitchcock said.
''Your name is probably going to end up on the Internet,'' Hitchcock said, ``if it's not there now.''
Monday
Oct202003
Beware of ultra-fast USB hype
Monday, October 20, 2003 at 11:24PM TIP OF THE DAY
(AP) -- It seems every gadget maker is hopping on the Universal Serial Bus. Beware of ultra-fast USB hype
USB, as it is commonly known, has emerged as a standard for all the cables and software drivers that connect computers with anything digital, from CD burners and MP3 players to keyboards, scanners and cameras.
But not all USB connections are equal, and products that flaunt the latest version, USB 2.0, aren't necessarily as speedy as consumers might expect.
While a growing number of devices feature USB 2.0, some actually transfer data at the slower speed of its predecessors. Also, there's a significant difference between "full-speed" and "hi-speed" USB 2.0.
An industry group behind the USB standard is partly to blame for the muddled jargon, though it is trying to clear up confusion by issuing official logos and labeling guidelines for manufacturers.
These are only guidelines, however. Ultimately, the labeling and any fine print that either informs or misleads the public is still up to individual companies.
Some do a better job than others. For USB, truth in labeling may not arrive until device makers see how many customer complaints they get after the holiday season, said Richard Doherty, analyst with The Envisioneering Group.
First introduced in 1996, the USB standard allows instant communication between a computer and myriad devices with a new small plug as an alternative to two older formats.
Unlike the older "serial" or "parallel" ports, a single USB connection with a hub can handle multiple devices simultaneously. USB is also "hot swappable," which means users no longer need to reboot their computers when they want to plug or unplug their USB-enabled devices.
USB 2.0, a successor to the popular USB 1.1 standard, started appearing in mid-2001 and is now being built into almost all new personal computers. Meanwhile, the number of digital devices compatible with USB 2.0 is expected to quadruple from last year to more than 151 million shipped worldwide in 2003, according to market research firm In-Stat/MDR.
USB 2.0 offers greater bandwidth and a data transfer rate of up to 480 megabits per second -- 40 times faster than the 12 Mbps maximum of USB 1.1.
That improved performance is behind much of the USB 2.0 hype now found in retail stores.
Speedy vocabulary
The words "USB 2.0," "ultrafast," and "super hi-speed" are prominently displayed on products and signs all along the aisles of external hard drives, CD burners, media card readers, scanners, digital cameras, or USB hubs and adapter cards.But USB 2.0 doesn't always mean "40x faster."
The creators of USB 2.0 -- a team made up of Intel Corp., Microsoft Corp., Hewlett Packard Co., the former Compaq Computer Corp., Agere Systems, NEC Corp. and Royal Philips Electronics -- made the standard fully backward compatible so it would work with the gadgets people already own.
That's why USB 2.0 actually encompasses three speeds: the original USB speed of 1.5 Mbps, aka "low-speed USB"; 12 Mbps, aka "full-speed USB" or USB 1.1; and 480 Mbps, aka "hi-speed USB."
Some manufacturers have confused consumers by using the USB 2.0 label for products that don't necessarily support its fastest data transfer rates.
Furthermore, some devices, such as keyboards, only need the 1.5 Mbps data rate to work. And the flash memory used in many cameras and so-called keychain drives is, like many USB 2.0 consumer printers, far slower than USB 2.0's top speed.
Devices that actually do process large chunks of data at as much as 480 Mbps include CD burners and newer hard drives.
There's an additional consideration in buying USB 2.0 products.
Your computer needs to have a USB 2.0 port to take advantage of the faster data transmission. Many computers built before 2002 have USB 1.1 ports, limiting them to 12 Mbps.
The chairman of the USB Implementers Forum, Jeff Ravencraft, says users have not flooded product makers with complaints about misleading labels: "There may be some confusion, but I can't say there's a lot."
But some members of the trade association acknowledge that the industry's message could have been clearer.
"We were trying to portray that USB 2.0 is faster and backwards compatible. What came out of that was the faster message, and the common usage became USB 2.0 means faster speed," said Dan Harmon, a product marketing manager at Texas Instruments.
Wednesday
Oct152003
Kids' Site
Wednesday, October 15, 2003 at 11:15PM TIP OF THE DAY
Kids' Site