Let’s Get the Facts First

Guest View article on pain medicine & the opioid epidemic by Dr. Paul T. Davis in the The Courier (Findlay, OH), November 5, 2019, A4.

A moving & humane argument concerning medicare and opioid prescriptions*


This is a thumbnail photo of Dr. Davis's essay, published in 'The Courier' of Findlay, OH.

Printable PDF

There is no question that every reasonable and effective method to stop the opioid epidemic should be investigated, and if proven effective, implemented. The horrors and wrecked lives this epidemic have caused are all too real to many people of all ages.

However, we must remember that the opioid epidemic was primarily caused by prescribing these medicines for those with chronic pain not caused by cancer.

In the “Other View” op ed published on Nov 2, 2019, Senators Shelley Capito and Jeanne Shaheen are featured claiming that Medicare encourages over-prescribing of opioids. They are correct in that there have been articles published showing that the number of prescriptions in the Medicare population is rising.

They are also correct that their publicizing this problem has great “optics” and could help their political careers.

However, what is missing from the reports is very important. How many of these prescriptions were written for treatment of cancer pain?

In the 1970’s I watched my friend die in agony with pancreatic cancer because his doctors were afraid of losing their licenses if they gave him adequate pain medicine. They would not treat his pain because of the fear they would addict him.

In his last six weeks of life, he never slept more than 10 to 15 minutes at a time because of the severe, unrelenting pain.

Fast forward to the early part of this century when I had to watch another friend suffer needlessly. He had multiple myeloma, a cancer that causes severe bone pain all over the body. He was getting adequate amounts of pain medicine until well-meaning politicians crafted laws that restricted access to these medicines. It affected everyone, regardless of legitimate need.

These laws did little to curb the over-prescribing of opioids judging by how bad the epidemic got even after they were passed.

But what it did do what make it very difficult for him to get the pain medicine he needed. Anything less than a narcotic, in a big dose was totally worthless.

This is a plea for more information before this gets worse. Medicare-age patients are the most likely to have cancer, and treatment of cancer pain has been a great medical victory in the last 40 years.

Well-meaning laws enacted without considering the collateral damage that could be done to those with a true need would be a horrible tragedy. Or should I say, make a horrible tragedy even worse than it is for the cancer-patients in need.

By all means make it less financially rewarding for inappropriately prescribing opioids for non-cancer pain, but it is too easy to craft a bad policy than it is to fix it later.

We as a society must protect those in the greatest need.

We must ensure that the right drugs are available to the right patients in a timely manner, while keeping harmful treatments of any kind away from everyone.

Get the facts before writing a bad law.

Dr. Paul T. Davis

Dr. Paul T. Davis.

Dr. Paul T. Davis of Findlay, OH, is a retired family physician and former Program Director of the University of Findlay’s Physician Assistant Master’s program. See also the coverage on NPR.org of Dr. Davis and his daughter, Liz Moreno, after she received a bill calling for payment of $17,850 for a urine test.


* I (Eric Thomas Weber) received and read a scan of the printed version of this article in early November and was deeply moved. Wanting to share it, I visitedThe Courier’s’ Web site, and then reached out to them when I could not find it there. I learned that they do not post the essays of guest columnists online, and so I requested permission to share the essay here. As I have lived in Mississippi and presently now live in Kentucky, two states deeply affected by drug addiction, I believe it all the more important that our lawmakers and policymakers think carefully and humanely about the kinds of rules that they establish concerning opioids.

This article is republished here with the permission of the author and of the staff of The Courier of Findlay, Ohio. 

The post Let’s Get the Facts First first appeared on Eric Thomas Weber.

Video: US Judge Carlton Reeves on “Race and Moral Leadership”

Now that I’m finally catching up with my grant reporting obligations, I’m returning to work from October of 2015. We snagged some nice pictures of Judge Reeves while he was here and we recorded the video of the open forum discussion we held. U.S. District Judge Carlton Reeves of Mississippi’s southern district caught my attention in particular with the speech he delivered at the sentencing case of a racially motivated murder in Jackson, MS. NPR called his speech “breathtaking,” and it certainly is.

U.S. District Judge Carlton Reeves.

When I read it I was so moved that after a period of absorbing his deeply thoughtful remarks, I felt compelled to write to him and tell him how much what he said meant to me and to Mississippi. On a whim, I ventured to invite him, were he willing and ever able, to come talk with one of my classes, particularly on the Philosophy of Leadership. He got back to me the same day to say that he would be delighted to come. That’s the kind of guy this now famous judge is. [Video is at the bottom of this post]

Here’s the bio on Judge Reeves that NPR put together after his speech had garnered over a million downloads. It was a profound honor to have Judge Reeves meet with my students and me for lunch, my class soon after, and then the campus and Oxford community members who came to hear and speak with him. Judge Reeves is also famous and to some controversial for his judgments on prayer in school and on same-sex marriage. Progressive Mississippians came to meet the judge to thank him for his leadership and several called him a hero to them. Judge Reeves explained at our lunch and to my class that when he was growing up, his moral heroes in Mississippi were federal judges.

U.S. District Judge Carlton Reeves, in October 2015, talking with students at lunch.

Photo by Thomas Graning/Ole Miss Communications

The interesting thing about Judge Reeves’s position is that people think that judges must not be activists. Does that mean that they should not really speak up much on public issues? Judge Reeves thinks that they should. A judge should not be prejudiced in making his or her judgment on a particular case, but may, and Reeves argues should, voice their concerns about larger social issues and movements. I asked Judge Reeves whether he had been criticized for delivering the speech that he did at the sentencing for the murder of James Craig Anderson. Judge Reeves said just the opposite happened. If anything, people had issued threats because he upheld the Constitutional prohibition on governmental establishment of religion in public schools. For speaking up as he had, he explained, he had only received very positive feedback.

U.S. District Judge Carlton Reeves in October 2015 speaking at an open forum discussion on "Race and Moral Leadership in the U.S. Judicial System."

Photo by Thomas Graning/Ole Miss Communications

A judge holds a complex and interesting kind of leadership position, which is why I was eager to hear Judge Reeves talk about “Race and Moral Leadership in the U.S. Judicial System.” I certainly gained a great deal from his visit, and I welcome you to watch this video of the forum we held with Judge Reeves. Here it is:

If you can’t see this video in your RSS reader or email, then click here.

Follow me on Twitter @EricTWeber and “like” my Facebook author page to connect with me there.

Making Networked Sharing Socially Beneficial, Not Just Predatory and Profitable

Every time Uber, the Web-based taxi intermediary, enters a new city, it provokes controversy about its race-to-the-bottom business practices and bullying of regulators and politicians.  The problem with Uber and other network-based intermediaries such as Lyft, Task Rabbit, Mechanical Turk and others, is that they are trying to introduce brave new market structures as a fait accompli. They have only secondary interest in acceptable pay rates, labor standards, consumer protections, civic and environmental impacts or democratic debate itself. 

Rather than cede these choices to self-selected venture capitalists and profit-focused entrepreneurs, some European cities and regional governments came up with a brilliant idea:  devise an upfront, before-the-fact policy framework for dealing with the disruptions of the “sharing economy.”

If we can agree in advance about what constitutes a socially respectful marketplace – and what constitutes a predatory free-riding on the commonweal – we’ll all be a lot better off.  Consumers, workers and a community will have certain basic protections. Investors and executives won’t be able to complain about “unlevel playing fields” or unfair regulation. And public debate won’t be a money-fueled free-for-all, but a more thoughtful, rational deliberation.

Now, if only the European Union will listen to the Committee of the Regions (CoR)!  The CoR is an official assembly of regional presidents, mayors and elected representatives from 28 EU countries. It routinely expresses its views on all sorts of major policy issues that may have local or regional impacts. In December, the CoR submitted a formal statement about the “sharing economy” to the EU in an opinion written by rapporteur Benedetta Brighenti, the deputy mayor of the municipality of Castelnuovo Rangone, in the province of Modena, Italy. 

read more

Forcing Government Action on Climate Change: Two Noteworthy Legal Initiatives

While much of the momentum to fight climate change is focused on political channels, there are parallel efforts using law to force government to take specific, enforceable actions to reduce carbon emissions. It’s a difficult battle, but in recent weeks two notable initiatives have gained further momentum – a court ruling relying on the public trust doctrine and a new human rights declaration that has broad international support.

The court ruling is related to a series of lawsuits brought by young people invoking the public trust doctrine to force governments to protect the atmosphere. Orchestrated by the advocacy organization Our Children’s Trust, the Atmospheric Trust Litigation suits have been filed in all state courts and in federal courts.

On November 19, one of those lawsuits succeeded. A superior court judge in Seattle issued a ruling that strongly recognizes the public trust doctrine as a applying to the atmosphere.  The case sought to uphold science-based plans for carbon emissions reductions developed by Washington State’s Department of Ecology, as a way to protect the atmosphere for eight young people (the plaintiffs) and future generations. 

The ruling is especially significant because it echoes a recent ruling by a New Mexico court that also strongly upholds the constitutional principle that the public trust doctrine applies to the atmosphere.

COP21 negotiators, are you listening?

read more

Farewell Burns Weston, Questing Legal Mind and Dear Friend

Until the very end, my dear friend and colleague Burns Weston was passionate, hard-driving and committed to changing the world.  That’s why I was stunned to learn that Burns passed away yesterday, a few weeks shy of his 82nd birthday.  When he failed to make a scheduled telephone call, friends checked his condo and found him dead.  Burns was a well-known international law and international human rights scholar at the University of Iowa College of Law.  He was also founder of its noted Center for Human Rights.

I met Burns about seven years ago when he was a professor for one semester a year at Vermont Law School.  He was writing a major legal treatise about climate change, and one element of the essay dealt with the commons.  A mutual friend, the polymath Roger G. Kennedy, introduced us, and the gravitational pull of Burns’ essay quickly drew me in. It was an irresistible disruption in my life that got me thinking a lot about environmental law and the commons.

Soon we were working together on a variety of projects:  a major scholarly book, chapters in anthologies, law review articles, grant proposals. In the course of it all, Burns exposed me to a great deal of human rights and international law, and he helped clarify their potential and limits for re-imagining international governance, environmental law and the actualization of human rights. For my part, I introduced Burns to the loose but growing network of international commoners and commons literature. He quickly realized that the commons is not just complementary to human rights; the two are long-lost partners with affirmative synergies. 

Our conversations became more serious and, with a bit of serendipitous funding, we embarked upon a grueling book project, Green Governance:  Ecological Survival, Human Rights and the Law of the Commons, published in 2013 by Cambridge University Press.  It was a bold attempt to reimagine environmental law and policy through the lens of human rights and the commons.  We wanted to envision new ways to actualize human rights principles and commons practices at global and regional levels.  We wanted to think beyond the framework of the nation-state and international treaty organizations.  We wanted to think beyond the standard forms and institutions of law itself.

Burns attacked these questions with the enthusiasm of a first-year law student and the sagacity of a gray eminence.  He really wanted to come up with creative legal solutions, and he wasn’t afraid if they might require social and political struggle. Now that’s not a quality you find in your average law professor, let alone one in his seventies. Burns had a bold and questing temperament, and did not let himself be confined by the disciplinary blinders of law. That’s why, following the publication of Green Governance, Burns wanted to continue our explorations.  So we founded the Commons Law Project to see if we could propose an architecture of law and public policy to address climate change and other urgent ecological problems.

read more

Highly Recommended: Capra & Mattei’s “The Ecology of Law”

An important new book offering a vision of commons-based law has just arrived!  The Ecology of Law:  Toward a Legal System in Tune with Nature and Community, argues that we need to reconceptualize law itself and formally recognize commoning if we are going to address our many environmental problems.

The book is the work of two of the more venturesome minds in science and law – Fritjof Capra  and Ugo Mattei, respectively. Capra is a physicist and systems thinker who first gained international attention in 1975 with his book The Tao of Physics, which drew linkages between modern physics and Eastern mysticism. Mattei is a well-known legal theorist of the commons, international law scholar and commons activist in Italy who teaches at Hastings College of the Law in San Francisco, and at the University of Turin. He is also deputy mayor of Ch­ieri in the northern region of Italy.

The Law of Ecology is an ambitious, big-picture account of the history of law as an artifact of the scientific, mechanical worldview – a legacy that we must transcend if we are to overcome many contemporary problems, particularly ecological disaster. The book argues that modernity as a template of thought is a serious root problem in today’s world.  Among other things, it privileges the individual as supreme agent despite the harm to the collective good and ecological stability. Modernity also sees the world as governed by simplistic, observable cause-and-effect, mechanical relationships, ignoring the more subtle dimensions of life such as subjectivity, caring and meaning.

As a corrective, Capra and Mattei propose a new body of commons-based institutions recognized by law (which itself will have a different character than conventional state law).

It’s quite a treat to watch two sophisticated dissenters outline their vision of a world based on commoning and protected by a new species of “ecolaw.” Capra and Mattei start their story by sketching important parallels between natural science and jurisprudence over the course of history. Both science and law, for example, reflect shared conceptualizations of humans and nature.  We still live in the cosmological world articulated by John Locke, Francis Bacon, Rene Descartes, Hugo Grotius and Thomas Hobbes, all of whom saw the world as a rational, empirically knowable order governed by atomistic individuals and mechanical principles. This worldview continues to prevail in economics, social sciences, public policy and law.

read more

Who May Use the King’s Forest? The Meaning of Magna Carta, Commons and Law in Our Time

The relationship between law and the commons is very much on my mind these days.  I recently posted a four-part serialization of my strategy memo, "Reinventing Law for the Commons."  The following public talk, which I gave at the Heinrich Boell Foundation in Berlin on September 8, is a kind of companion piece.  The theme: this year's celebration of the 800th anniversary of Magna Carta and its significance for commoners today.

A video version of my talk can be seen here -- along with a talk on P2P developments by my colleague Michel Bauwens, and general discussion with the audience moderated by Silke Helfrich.

Thank you for inviting me to speak tonight about the 800th anniversary of the Magna Carta and the significance of law for the commons.  It’s pretty amazing that anyone is still celebrating something that happened eight centuries ago!   Besides our memory of this event, I think it is so interesting what we have chosen to remember about this history, and what we have forgotten.

This anniversary is essentially about the signing of peace treaty on the fields of Runnymede, England, in 1215.  The treaty settled a bloody civil war between the much-despised King John and his rebellious barons eight centuries ago.  What was intended as an armistice was soon regarded as a larger canonical statement about the proper structure of governance.  Amidst a lot of archaic language about medieval ways of life, Magna Carta is now seen as a landmark statement about the limited powers of the sovereign, and the rights and liberties of ordinary people.

The King’s acceptance of Magna Carta after a long civil war seems unbelievably distant and almost forgettable.  How could it have anything to do with us moderns?  I think its durability and resonance have to do with our wariness about concentrated power, especially of the sovereign.  We like to remind ourselves that the authority of the sovereign is restrained by the rule of law, and that this represents a new and civilizing moment in human history.  We love to identify with the underdog and declare that even kings must respect something transcendent and universal called “law,” which is said to protect individual rights and liberties. 

In this spirit, the American Bar Association celebrated Magna Carta in 1957 by erecting a granite memorial at Runnymede bearing the words “Freedom Under Law.”  On grand public occasions – especially this year – judges, politicians, law scholars and distinguished gray eminences like to congregate and declare how constitutional government and representative democracy are continuing to uphold the principles of Magna Carta.  More about that in a minute.

read more

Legal Innovations in Beating the Bounds (cont.), Part III of Law for the Commons

Today's post is the third in a four-part series derived from my strategy memo, "Reinventing Law for the Commons."  This excerpt continues with Part II, "Legal Innovations in Beating the Bounds," with "clusters" #5 through #9. The collection of entries here are now posted on a Commons for the Law wiki hosted by the Commons Transition website.

5.  Co-operative Law

There are a number of legal and organizational innovations transforming co-operatives these days, making them moreoriented to commoning and the common good than just marketplace success. However, these innovations are geographically dispersed and not necessarily widely known, even within the co-operative movement.  One of the most notable new organizational forms is the multistakeholder co-operative (or “social and solidarity cooperative”), which has been rapidly proliferating in recent years.  It got its start in Italy in 1963 when families in Italy joined forces with paid care workers to develop co-operatives to provide social care, healthcare and educational services. This new paradigm collectivizes and centralizes basic overhead services (administration, personnel, accounting, etc.) and in this way empowers smaller social economy ventures (similar to “omni-commons,” see section #8 below). 

In a sense, multistakeholder co-ops regularize governance for co-stewardship of commons spaces and moves away from rigid bureaucratic methods that increasingly don’t work.[1]  Multistakeholder co-ops now employ more than 360,000 in paid jobs, including the disabled, the formerly imprisoned and marginalized people, and more than 40,000 volunteers.  Social co-operatives have spread to all regions of Italy and today number more than 14,000, making it a significant sector of the Italian economy that is neither market- nor state-based.  Today there are multi-stakeholder co-operative movements in Quebec in Canada and in a wide number of countries in Europe including France, Spain, Poland, Hungary, Finland and Greece[2].

read more

Legal Innovations in Beating the Bounds: Part II of Law for the Commons

Below, a continuation of yesterday's post from the strategy memo, "Reinventing Law for the Commons," Part II of the four-part piece.

II.  Legal Innovations in Beating the Bounds:  Nine Promising Fields of Action 

Part II surveys the enormous amount of legal innovation going on in various commons-related fields of action.  The point of this section is to identify specific initiatives that are trying to transform the legal paradigm or carve out new “protected zones” of enforceable rights within existing legal frameworks.  I have identified nine major “clusters” of interesting experimentation and ferment:

1.  Indigenous Commons   

2.  Subsistence Commons in the Global South       

3.  Digital Commons       

4.  Stakeholder Trusts

5.  Co-operative Law 

6.  Urban Commons  

7.  Localism            

8.  New Organizational Forms     

9.  Re-imagining State Policy to Empower Commons   

Today's post focuses on the first four "clusters"; tomorrow's deals with #5 through #9.  And the final day will deal with Part III:  The Strategic Value of Developing Law for the Commons, and Part IV:  Next Steps.

The list of clusters and examples in Part II is not comprehensive.  It is merely a first attempt to assemble the fragments of commons-based legal innovation into a new mosaic that makes key, unifying themes more visible.  (I invite readers of this memo to inform me of any worthy additions by contacting me at david/at/bollier.org.)  Some examples may belong in two or more clusters, which I’ve tried to indicate with cross-references.  In Part III, I will reflect on the political and philosophical implications of the examples of Part II, followed by a discussion in Part IV of practical steps that might be taken to consolidate and extend Law for the Commons as a coherent body of legal activism.

read more

Why Is Market Fundamentalism So Tenacious?

One of the great economists of the twentieth century had the misfortune of publishing his magnum opus, The Great Transformation, in 1944, months before the inauguration of a new era of postwar economic growth and consumer culture. Few people in the 1940s or 1950s wanted to hear piercing criticisms of “free markets,” let alone consider the devastating impacts that markets tend to have on social solidarity and the foundational institutions of civil society. And so for decades Polanyi remained something of a curiosity, not least because he was an unconventional academic with a keen interest in the historical and anthropological dimensions of economics. 

As the neoliberal revolution instigated by Reagan and Thatcher in the 1980 has spread, however, Polanyi has been rediscovered.  His great book – now republished with a foreword by Joseph Stiglitz – has attracted a new generation of readers. 

But how to make sense of Polanyi’s work with all that has happened in the past 70 years?  Why does he still speak so eloquently to our contemporary problems? For answers, we can be grateful that we have The Power of Market Fundamentalism:  Karl Polanyi’s Critique, written by Fred Block and Margaret R. Somers, and published last year. The book is a first-rate reinterpretation of Polanyi’s work, giving it a rich context and commentary.  Polanyi focused on the deep fallacies of economistic thinking and its failures to understand society and people as they really are. What could be more timely?

The cult of free market fundamentalism has become so normative in our times, and economics as a discipline so hidebound and insular, that reading Polanyi today is akin to walking into a stiff gust of fresh air.  We can suddenly see clear, sweeping vistas of social reality.  Instead of the mandarin, quantitative and faux-scientific presumptions of standard economics – an orthodoxy of complex illusions about “autonomous” markets – Polanyi explains how markets are in fact embedded in a complex web of social, cultural and historical realities.

read more