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Letters to the Editor 

Questioning Kisonak

Did [Seven Days film critic] Rick Kisonak and I even see the same movie [Movie Review: “Philomena,” December 4]? The Philomena that I and 92 percent of Rotten Tomatoes critics saw was funny, touching and cleverly written, and boasted a typically excellent performance from Judi Dench. Rick has displayed some pretty erratic judgment this year, as evidenced in his reviews of Blue Jasmine and The Conjuring, two other films other critics overwhelmingly loved but he hated. At the same time, he gave Grown Ups 2 three stars! It got 7 percent on Rotten Tomatoes.

Nicholas Cook

Peru, N.Y.

Drug War Isn’t Working

Kudos to Vermont Chief Justice Paul Reiber for his comments on the failure of the war on drugs [“Vermont’s Chief Justice Is Speaking Out Against the Drug War: Is Anyone Listening?” December 4]. Ever since President Nixon rededicated our national effort of drug prohibition, we have spent $1 trillion, and what do we have to show for it? Drugs have crept into every corner of this country; our prisons are overflowing (more people are in prison for drug offenses in the U.S. than the total number imprisoned in Europe for all offenses); Mexico, our third largest trading partner, is nearly a failed state (50 to 60 percent of Mexico is controlled by the cartels); drugs are widely available in schools across the country; the polluting of pristine rainforest from cocaine processing labs continues (estimates range between 100,000 and 150,000 gallons of chemical waste poured directly on the ground per year); widespread corruption within law enforcement, corrections and the financial services industry — just to name a few. ??

By speaking out on the issue, Chief Justice Reiber has created an opportunity to debate the merits of an alternative to prohibition — that we might fix what is broken before it claims more lives and dollars. This December marks the 99th anniversary of the Harrison Narcotics Tax Act; it is high time for that debate to occur and I challenge all elected officials to comment on the salient remarks of our courageous chief justice.

Peter Stevenson

Waitsfield

Rowell Notes

[Re “In the Sparsely Populated NEK, a Classical Music Series Thrives,” October 30]: Just a note to say that Mary Rowell of Craftsbury, a truly superb violinist and concertmaster of the Radio City Music Hall Orchestra, is also a member of the Craftsbury Chamber Players and sister of Dave Rowell (bass, Rick & the Ramblers and the WDEV Radio Rangers) and Frances Rowell (another great string player in the Chamber Players). She was a cofounder of the ETHEL quartet.

Danny Coane

Montpelier

Ethical Treatment

Ken Picard finds that patients are very satisfied with the quality of care they receive in concierge practice [“What’s Up, Doc?” November 13]. He also finds a policy statement by the American Medical Association that this type of practice creates “ethical concerns that warrant careful attention.” This particular statement by the AMA is so vague as to provide no meaningful guidance for physician conduct. ?

The AMA Code of Medical Ethics contains many sections. Read in its entirety, it affirms repeatedly that individual physicians are duty-bound to serve their individual patients, not populations. The framework of Green Mountain Care creates ethical problems of far greater concern than concierge practice. The state’s plan for payment reform envisions an elaborate system of financial rewards and penalties that will be used to shape the everyday clinical decisions of physicians toward the cost-saving goals of the state, which can often conflict with physicians’ ethical responsibilities to promote optimal clinical care for individual patients in accordance with their personal values.

In addition, physicians who participate in Green Mountain Care will not have the final authority to direct the use of electronic clinical records they create, an authority that is central to fulfilling the ethical responsibility to protect patient confidentiality. ??

I applaud Mr. Picard for raising the issue of medical ethics. It may seem tedious and technical to actually read medical codes of ethics in a comprehensive way, but if it is glossed over, quality of care for individual patients will be degraded. Green Mountain Care only amplifies the loss of confidentiality and care-limiting financial incentives that already pervade all systems of third-party reimbursement. Concierge practice is just one form of direct-pay practice, the whole point of which is to eliminate third-party influences that are destructive to the patient-physician relationship.

Every payment model, current and proposed, should be subjected to close ethical scrutiny. Concierge and other forms of direct-pay practice provide an antidote for the serious ethical problems created by third-party reimbursement.?

Robert S. Emmons, M.D.

South Duxbury

Quieter Than They Were

The Vermont Air Guard 134th Fighter Squadron has had some pretty noisy aircraft over the years [Last 7, “Prepare for Takeoff,” December 4]. Prior to the F-16 they had the twin-engine F-4 Phantom, and even the EB-57B Canberra Bomber, also a twin-engine plane. ?When I was at UVM from 1969 to 1973, they flew the F-102A Delta Dagger. I remember them blasting over the top of Mount Mansfield at low altitude, scaring the heck out of us skiers. Years later, a friend of mine in Atlanta recalled being one of those pilots and enjoying the practice immensely.?

These jets were clearly audible on takeoff from my perch at Coolidge Hall (the “highest place in Burlington”) but their noise was not nearly as annoying as that made by my fellow students. By far the noisiest aircraft I have ever heard was a 707 passenger jet that seemed to hang in the air over our dorm as it climbed out.? Engine technology improvements have made for generally quieter and more fuel-efficient planes over the years, and traffic patterns are more respectful of those on the ground.

You’d probably have to go back a long way to find a better time than now.

Peter Magoon

Randolph Center

Foie Gross

Bravo, Harry Bliss, for your insightful, apropos cartoon [“Bliss,” November 27]. Foie gras is a product of convenience and ignorance: It’s convenient to ignore the means of obtaining it because there is no justifiable reason to sell or eat it but for self-serving profit or gratification. Wouldn’t it be remarkable if we were all conscientious, responsible business owners and consumers making decisions based on a broader outlook of the world rather than what will simply fatten our wallets and guts?

Lisa Vear

Shelburne

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