Kort Explores conundrums of the human condition

The balance between individual liberty and state power has moved
considerably in favor of the state since America's founding over two
centuries ago. There has been a lot of talk lately, and even some
tangible efforts to reclaim some of the rights and freedoms that have
been assumed by the State.

There are in theory ways for the citizens to reclaim lost liberties,
forcing the State to surrender powers it's reluctant to give up.
However, when citizens attempt to regain lost liberties, the initial
opposition will only be the beginning of the struggle. The State may
officially recognize a judicial ruling or citizen passed initiative, but
the innate nature of the complex bureaucracy that functions as the State
will find ways to express substantial resistance if not outright
hostility to any externally imposed constraints.

A liberty that is sufficiently obstructed that it becomes unusable
achieves the same end result as a liberty overtly denied by force.
Liberties that citizens seek to recover through the ballot box can be
easily lost to artificial obstacles and obstructions that make it
impossible to exercise those recovered liberties.

The internal dynamics of the State are driven at least in part by the
complex turf wars and empire building that have evolved within the
hierarchy over time. The natural tendency of each individual within a
hierarchy is to first preserve and protect whatever power and position
he has attained regardless of the changing external purpose of that
hierarchy. This natural tendency results in a collective resistance to
external attempts to alter or eliminate any hierarchy.

An instructive example of the way government bureaucracies are likely to
respond to externally imposed restrictions of their powers, is provided
by the reaction of the state bureaucracy to the citizen initiative
imposed Oregon Medical Marijuana Act (OMMA). The citizens of Oregon
passed medical marijuana initiatives twice by substantial margins, and
have soundly rejected every opportunity to re-criminalize medical
marijuana. There can't be any confusion as to the expressed will of the
citizens.

Most citizens of Oregon probably think they successfully reclaimed a
lost right through the power of the ballot box. It's over and done with,
and that's the end of it. However, a small regulatory agency, buried
deep in the bowels of the state bureaucracy, is getting close to
effectively voiding that recovered right by making it technically
impossible to use it.

The abuses of this handful of unelected bureaucrats are in turn
protected from the citizens they intend to harm by the refusal of the
State bureaucracy to effectively investigate and police itself. A truly
motivated reformer could in theory clean out this nest of vipers, but
there is little indication that either incumbent or likely challengers
see doing so as in their self-interest. No politician is going to take
on any part of the entrenched bureaucracy unless overwhelming political
pressure makes it unavoidable. It's much easier to distract the public's
short attention span with grand oratory and carefully staged photo-ops
of bravely saving the nation from the latest contrived crisis or
imaginary looming disaster, than to take on the complex web of
allegiances and conflicting interests that permeate the vast State
bureaucracy.

OMMA requires that a State licensed doctor confirm at least once a year
that a patient suffers from a condition covered by the act. Only around
a quarter of the doctors in Oregon have so far been willing to cooperate
with their patients who would benefit from using medical marijuana. If
those quarter could be intimidated or eliminated, there wouldn't be any
doctors left willing to file the required state forms. All legal use of
medical marijuana would be ended within a year – not because the State
overtly denied or obstructed the citizen passed initiative, but because
"all of the doctors in Oregon" refused to provide their patients with
the necessary paperwork. On the surface it would appear that medical
professionals had unilaterally rejected medical marijuana as a
beneficial medicine. Prohibition would effectively be restored with the
popular wisdom being that it was medical science that put an end to the
misguided temporary aberration of legal medical marijuana.

The Medical Board has been targeting in particular the doctors who serve
in the special clinics for patients with medical records of a covered
condition, but whose primary care physician can't or won't sign their
state forms. Two of the Medical Board's current prime targets are Voter
Power and Dr. Dover.

Voter Power is the nonprofit organization that was largely responsible
for the passage of the original OMMA initiative. It was also one of the
first organizations to offer a clinic to help patients with covered
conditions obtain OMMA cards. Dr. Dover is an enlightened physician who
was impressed by the medicinal effectiveness of marijuana, and agreed to
work weekends in Voter Power's clinic(s).

The Medical Board of Oregon has aggressively harassed both Voter Power
and Dr. Dover, trying to create a public perception that they are
dangerous incompetents who should not be allowed to provide medical
services to the citizens of Oregon. I happen to be uniquely positioned
to have substantial personal knowledge of both Voter Power and Dr.
Dover. I've been intimately involved in Voter Power for over a decade,
and Dr. Dover is currently my primary care physician.

Based on my personal knowledge, observations, and experiences, it's
clear to me that the Medical Board has lied and willfully concealed the
truth in its efforts to wrongfully cause harm to Dr. Dover. From my
personal observations of the Board's activities over the past decade,
I'm further convinced that the Medical Board's attacks on Voter Power
and Dr. Dover are part of a larger ongoing agenda to artificially
obstruct the legal use of medical marijuana in direct violation of the
express will of the citizens.

I've lived with my somewhat unique set of conditions for roughly sixty
years, and for most of my lifetime the mainstream medical profession has
arbitrarily refused to accept that my daily reality could exist. While
most of the medical establishment has now grudgingly "discovered" my
condition, there are still some doctors who cling to the old blind
denials of reality.

As a result, during most of my lifetime encounters with doctors have
tended to be more obstructive than beneficial. I've come to appreciate
the tremendous value of a doctor who is interested in working with me to
find optimal solutions to my somewhat unique condition(s). I've also
learned to avoid the callously incompetent "cookbook" doctors who simply
look up a handful of arbitrary indicators in a drug company manual, and
then prescribe whatever patent medicine the drug companies have paid
enough fees, costs, and bribes to get approved for that condition/page
in the manual.

I've been seeing Dr. Dover for several years and have been quite pleased
with his abilities. He has addressed all of my medical needs, made
various suggestions over the years that I try to follow, and given me
reasonable medical advice whenever I've requested it. I have no
complaints about his competence or service. Nor am I aware of anything
else that would make me want to seek a different doctor. It's my
intention to continue to see Dr. Dover as my primary practitioner for
the foreseeable future.

I've read the documents involving Dr. Dover and the Medical Board. What
I find disturbing in these documents are not the obviously contrived
accusations, but rather the clear pattern of abuse and gross disregard
for the facts by the Medical Board.

Not surprisingly, the Medical Board is now seeking to suppress public
knowledge of their misconduct by sealing the records of their actions.
As I write this article the documents are still available on the web,
but the Medical Board has already requested a "protective order" that
"all documents filed in this hearing be restricted from disclosure". The
"protective order" claims to be needed to protect patient
confidentiality and comply with the Federal Health Insurance Portability
and accountability Act.

I've read the documents and there are no disclosures of patient
information or violations of patient confidentiality, and certainly no
legitimate justification for restricting public access. I've had to
become familiar with HIPAA in my professional capacity, and can find no
HIPAA concerns in the records the Medical Board wants to suppress. The
only purpose I can see for the "protective order" is to protect the
Medical Board from public exposure of its outrageous actions and gross
violations of the public trust.

The only documents exempted from the "protection order" would be the
Board's baseless "original and amended Complaint and Notice of Proposed
Disciplinary Action". It's hardly surprising that the Board sees no
problem with public exposure of its unfounded malicious accusations and
unjustified threats to cause harm to Dr. Dover. What they are
aggressively seeking to "protect" (as in hide from public knowledge) is
the evidence that clearly shows that their accusations are baseless
fabrications, and that their "proposed disciplinary actions" are in
reality nothing more than a despicable attempt to coerce complicity with
the Board's intention to indirectly eliminate the legal use of medical
marijuana.

What the Medical Board doesn't want the public to know about is that
they are aggressively targeting for administrative persecution those
Oregon doctors who have dared to allow their patients to use the safest,
most effective, and least toxic medicine available for conditions
authorized by OMMA. They don't want the public to know about their
agenda to eliminate all Oregon doctors who are willing to place the
wellbeing of their patients above the venal self-interests of the drug
prohibitionists and the pharmaceutical industry. They don't want the
public to know that they are actively trying to make it impossible for
patients to use the rights that the citizens granted them through the
passage of OMMA.

Most of all, the Medical Board doesn't want the public to know just how
willing they are to intentionally inflict unnecessary pain and suffering
on the citizens of Oregon in order to protect the power and profits of
the medical extortionists that the Board really represents. They would
much rather condemn countless patients to suffer terrible harm or even
die from the adverse side effects of inferior products manufactured by
the powerful pharmaceutical industry, than allow citizens to use a safe,
nontoxic, highly effective herbal medication that a patient can grow in
his garden.

The story actually starts over a decade ago when the citizens of Oregon
voted for OMMA in spite of the strenuous objections of the drug
prohibitionists and the medical establishment. The act requires the
recommendation of a licensed doctor, but initially there were very few
doctors willing to cooperate. Patients with covered conditions but whose
doctors were unwilling to provide them with the required form, were
obliged to seek a doctor who would. Voter Power was one of the first to
set up a clinic to serve this temporary need.

The basic concept was that a patient could bring his medical records
detailing his covered condition to the clinic. The clinic doctor would
review his records and do a physical exam to confirm the diagnosis in
his records. If the clinic doctor was satisfied that the patient was
suffering from a covered condition, he would provide the physician form
that the patient needed to obtain an OMMA card. The clinic staff would
then assist the patient in filling out the rest of his paperwork and
assembling his application to conform to the Health Division's
requirements.

The purpose of these clinics was to provide a temporary solution to the
reluctance of the medical establishment to accept the legalization of
medical marijuana that was imposed by a vote of the people. The
expectation was that the need for the clinics would rapidly decline as
the medicinal value of marijuana was demonstrated - which would in turn
lead to its being accepted by the medical establishment. A decade after
the passage of OMMA the number of enlightened doctors willing to put the
welfare of their patients above their own self-interest has grown to
over 3,000, but much of the medical establishment continues to
arbitrarily deny the obvious positive results.

The inevitable result of the refusal of the majority of doctors to
respect their patients and provide the best care possible, has been that
a handful of clinic doctors end up having to sign the majority of OMMA
forms. This situation should have been recognized as a shameful
indictment of the doctors who refused to cooperate, but has instead been
perverted into an insinuation of misconduct by the clinic doctors who
stepped up to fill the very real needs of the patients.

It says a lot about the Medical Board's twisted perspectives when daring
to provide patients with the safe nontoxic medication that is the most
effective medication available for their condition becomes evidence of
misconduct. On the other hand, the Medical Board actively encourages the
prescribing of dangerous toxic substances with life-threatening side
effects, that only provide inferior results for patients, but are very
effective at returning high profits to the pharmaceutical industry. Even
worse, the Board is actively trying to enforce the arbitrary denial of
effective care to patients with terminal illnesses and/or chronic
debilitating pain when the most effective medicine available doesn't
enrich and empower the medical extortionists the Board really
represents.

It's up to the reader to decide whether the Medical Board encouraged
Dr.Z to file his complaint, or whether he initiated it himself for his
own reasons. Dr.Z allegedly has a history of cocaine addiction and
inappropriate sexual behavior. This would seem to give him an obvious
interest in currying favor with the Medical Board. He has filed
complaints against Voter Power in the past. The Medical Board has
obligingly turned a blind eye to his "flaws", and allowed him to
continue to practice medicine in Oregon.

Similarly, it's largely a matter of conjecture at what point Dr.Z became
involved in Patient-X's failed attempt to con Dr. Dover into approving
him for an OMMA card without adequate medical documentation of a covered
condition. What is known is that Patient-X went to the Voter Power
Clinic in Medford, Oregon, and unsuccessfully tried to get approved for
OMMA by claiming a condition his medical records didn't support, and
which wouldn't necessarily qualify even if he could prove he had it.

Dr. Dover's role at the clinic was just to verify the prior diagnosis of
a condition covered by OMMA, based on a review of the patient's medical
records, and a basic physical exam. He was there solely to confirm or
deny, not to diagnose or treat undocumented conditions. Patients were
required to supply medical records dated within the last year showing
that they were currently under care for their condition by their primary
care physician. If a patient wanted Dr. Dover to provide comprehensive
primary care, he would have to make arrangements to see Dr. Dover at his
private practice.

It threw a monkey wrench into the scheme when Dr. Dover properly refused
to approve Patient-X for an OMMA card. Having failed in his objective,
Patient-X attempted to cover his tracks by removing all copies of his
records when he left the clinic. In the process he also apparently
managed to grab the records of another patient as well.

Patient-X then allegedly went to Dr.Z and related a substantially
altered account of his experience at the Voter Power clinic. He further
claimed that Dr. Dover had recorded another patient's data on a clinic
form having his name at the top, and his data on the other patient's
form.

It's very difficult for me to understand how the alleged mixing of
patient forms could physically have happened during a clinic. Each
patient writes his own name on his forms, and carries them into the
examination room. At the end of the examination they're given back to
the patient to take to the staff for copying and assembly of his Health
Division package. The staff might have more than one patient's documents
in hand at a given time, but by then the documents would have already
been in their final form. This could explain how Patient-X managed to
gain possession of another patient's completed forms while he was
surreptitiously removing his own, but not how the other patient's data
could have been written on his form.

On the other hand, it's easy to imagine how such documents could have
been manufactured by Patient-X or Dr.Z.

Incredibly, the Medical Board, Dr.Z, and Patient-X went ahead with their
scheme as if Dr. Dover had actually done something wrong – which in this
case would have been to improperly approve Patient-X. When he didn't
oblige them, they proceeded to charge him with misconduct for NOT
approving Patient-X. It certainly gives the impression that they were
intending to use Patient-X's suspicious clinic visit as the basis of a
complaint regardless of what Dr. Dover actually did.

The initial accusations sound to me like they were simply adapted from
charges that had previously been used against doctors in conventional
office practice. They're obviously aimed at checking the usual boxes in
a set of established criteria for disciplining typical doctors for
typical problems. However, in this case they accused Dr. Dover of
improperly doing things that would be entirely outside of his proper
functions and responsibilities at a special purpose clinic. For example,
he was accused of improperly suggesting a hazardous commercially
manufactured drug to Patient-X at a clinic where the only medication the
doctor is authorized to recommend (if any) is medical marijuana. Note
that he is only accused of "suggesting" this drug – there is no actual
evidence of this happening, only highly suspect heresy provided by a
drug addicted sexual predator with strong incentives to curry favor with
the Medical Board.

Even more outrageous were the accusations of negligence for not doing a
comprehensive medical work-up and exhaustive diagnosis for each patient
– duplicating the work already performed by their primary care
physicians and documented in their medical records. They even accused
Dr. Dover of "misdiagnosing" at a clinic where the doctor is
specifically restricted to just confirming a prior diagnosis of a
condition covered by OMMA by the patient's primary care physician.

The jarring contradictions between the Medical Board's accusations and
the very limited range of medical services Dr. Dover actually provided
at the Voter Power clinics, make it hard to believe Dr. Dover's accusers
had any meaningful knowledge of his activities at the clinic, or any
real knowledge of anything he'd actual done wrong. On the other hand,
the jarring contradictions do make it easy to believe that someone
fabricated these baseless accusations for the sole purpose of wrongfully
causing harm to Dr. Dover, Voter Power, and the citizens of Oregon.

The one area where there was at least the potential for tangible
evidence was in the Medical Board's accusation of improper record
keeping based on the strangely conflated clinic forms. Patient-X had
removed the originals of these forms from the clinic, and was in sole
possession of the only copies for an unknown period of time. Neither Dr.
Dover or the Voter Power Clinic staff had copies of the original
contents, nor were they allowed to independently verify the legitimacy
of the documents allegedly provided to the Medical Board by Patient-X
and/or Dr.Z.

The Medical Board must have suspected that the documents were
questionable because they refused to allow Dr. Dover to see them for
over two years - even though a large part of their complaint was based
on them. They even held hearings during which Dr. Dover was obliged to
respond to questions regarding these documents, with the full knowledge
that at the same time as they were interrogated him about the documents
they were also stonewalling his requests to actually see them.

It's easy to see that from the Medical Board's perspective, allowing the
defendant to see the contrived evidence against him would likely have
resulted in annoying complications and delays. They weren't going to
allow anything the defendant did to change their predetermined outcome,
so why bother? The defendant was the only one who cared, and he
certainly didn't count. The Board just carried on with their intended
parade of meaningless rituals, contemptuously oblivious to the
objections, information requests, and formal discovery demands of the
defendant.

Denying the defendant the right to see the evidence that is being used
against him is commonly associated with corrupt kangaroo courts
persecuting the innocent, not with a legitimate pursuit of truth and
justice. But then the Medical Board appears to have had little interest
in pursing truth and justice in any part of this appalling abuse of
power.

It certainly appears obvious to me that the Board's intention all along
was to punish Dr. Dover for daring to recommend a safe, nontoxic
medication that the Board intends to arbitrarily deny to the citizens of
Oregon. They started with an predetermined outcome, and were simply
"back-filling" a justification for what they intended to do regardless
of the real facts. The farcical hearings and biased inquiries were just
the empty meaningless rituals that needed to be checked off the list
before the Board could impose their predetermined result.

I think it's reasonable to assume that the Medical Board never expected
anyone to dare to connect the dots and point out the disturbing patterns
in their actions. After all, any doctor who wants to continue practicing
medicine in Oregon has good reason to fear the Medical Board's wrath.
The Governor, who is nominally in charge of the Medical Board, is
unwilling to interfere since he personally supports the Board's
objective of denying the citizens of Oregon the right they thought they
restored by voting for OMMA. As a doctor, his medical license could also
be in jeopardy after he leaves office if he angers the Board while
serving as Governor.

The State Attorney General's office has already declared that it is
unwilling to investigate the Medical Board's abuses of power. As a major
part of the law enforcement hierarchy, they have a strong vested
interest in the continuation of marijuana prohibition. Drug prohibition
provides the justification for countless agency budgets, and creates an
artificial need for legions of government employees, consultants, and
contractors. Any decriminalization of prohibited substances directly
threatens the self-interests of a vast network of interdependent
hierarchies. Small wonder there is so much resistance to ending the
destructive insanity of the war on some drugs and all of our rights.
There are a lot of paychecks and pensions that depend on continuing the
destructive insanity regardless of the real costs to individuals and
society as a whole.

The details in this example of bureaucratic resistance to an attempt by
the citizens to regain a right previously lost to the State, are
arguably specific to the Oregon Medical Board. However, the general
pattern will be common to most if not all entrenched bureaucracies whose
power and positions would be diminished or eliminated by the restoration
of rights and freedoms to the citizens.

Changing the law via the ballot box will only be as effective as those
entrusted with enforcing the law allow it to be.

As long as an entrenched bureaucracy remains, the will of the people
will only mean what that bureaucracy is willing to let it mean.