The Error in ‘There’s Nothing More We Can Do’

NY Times

“There’s nothing more we can do.”

These words are often spoken by a physician just before transitioning a patient to hospice and palliative care and are regrettably uttered only days, if not hours, before the person dies. These words leave no room for hope; they make a transition to comfort care a much-feared and often avoided final destination.

Yet here’s the reality: More can always be done. More important, patients know exactly the “more” that they want. The real question is: Why don’t we ask?

“If I had a magic wand, what is it you would wish for today?” This is a question I ask of my patients receiving hospice and palliative care.

No one has ever asked that I rid them of their disease. Rather, I have been met with immediate replies of “make my anxiety go away” or “let me travel to see my family” and “let me go home and sit in my garden.”

These are the things that people say, over and over again, when they are given the opportunity to answer. The real test for physicians, then, is being willing to meet the challenge of discovering our patient’s true wishes, the fulfillment of which may push us well outside our own professional comfort zone.

Sometimes, it is actually the medical team’s best-intended professional wisdom that stands in the way of having patients’ wishes fulfilled. The patient who taught me that, whom I’ll call Ms. Weatherby, was a remarkable 57-year-old with a horrible collection of diseases, which had conspired to stop her lungs from working. [...]

Physicians mostly assume that life support is such an uncomfortable level of medical intervention that no one would ever choose it if they knew no chance for recovery existed and certain death in the hospital would be their only future. Ms. Weatherby challenged that, not in that she thought she would leave the hospital or even the I.C.U. — she knew she wouldn’t. But she defied everyone’s assumptions that life would be too unpleasant and painful in such a setting to be worth living at all. She radiated gratitude.[...]

 The only time doctors are left with “nothing more we can do” is when we fail to ask.

Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts

I am not taking any position on this controversy at this time. I am including the Snopes Review of the matter - which so far is categorized as UNDETERMINED.

The Daily Beast explains that the practice is not illegal and is in fact has been around for a while - even though the general public apparently is not aware of it.

The US-UK divide on sex cases: Statute of Limitations

BBC

Bill Cosby faces a string of allegations of sexual assault but cannot be prosecuted in the US because of the statute of limitations. In the UK there is no time limit in sexual abuse and other serious cases. What explains this difference?

The statute of limitations is effectively an expiry date for allegations of crimes. And that expiry date varies from state to state in the US.

In recent years in the UK, there have been a number of high-profile prosecutions of historical sexual abuse cases. Entertainer Rolf Harris was jailed last year for offences that took place between 1968 and 1986. Broadcaster Stuart Hall was jailed in 2013 for offences between 1967 and 1985. TV weather presenter Fred Talbot was jailed this year for offences that took place in 1975 and 1976. 

Labour peer Lord Janner is currently facing criminal proceedings relating to 22 allegations of sexual abuse against nine children during the 1960s, 1970s and 1980s.

But in the US the law in most states is typically very different.[...]

Thirty-four states have statutes of limitations - with time limits from three years to 30 years. Taking the example of the offence of rape, the three bordering states of Georgia, Florida and Alabama highlight just how uneven the law can be.

Georgia has a limit of 15 years. Victims in Florida must bring their case within four years. But there are no limitations at all across the state border in Alabama. 

Some states do make exemptions if a DNA match is found many years later - although even these can carry time limits.

But even if a perpetrator walks straight into a police station and confesses, there's no guarantee of prosecution.

Bart Bareither did exactly that in Indiana last year. He confessed to raping Jenny Wendt nine years earlier. Wendt hadn't reported the crime as she didn't have DNA evidence to prove it and didn't trust that he'd spend a day in prison. 

And despite Bareither's confession, he won't. Indiana's statute of limitation on rape is just five years.

Since then Wendt has successfully campaigned to change the state's law - now known as "Jenny's Law" - to allow later prosecution if there's DNA evidence or a confession. 

Most of Europe also imposes limitations for sexual abuse proceedings.[...]

The fundamental principle of a statute of limitations is to protect the defendants.

The notion dates as far back as ancient Greece, explains Penney Lewis, a law professor at King's College London. There are two main reasons behind it, she says. 

One is that there should be some finality, so that a person can move on with their life without the constant threat of prosecution hanging over their heads, Lewis says.

The second is about ensuring a fair trial for the defendant, she adds.

"There's a practical matter - it becomes so much more difficult to prosecute cases that occurred years and years ago," says Jennifer Temkin, law professor at City University London. "Memories can fade."

Despite the UK's general lack of statutory limitations on prosecuting historical sexual abuse cases, many were still dropped before trial, says criminal barrister Kama Melly. [...]

We don’t trust drinking fountains anymore, and that’s bad for our health

Washington Post

One sultry day in 2012 , a handful of New Yorkers laid out a rich red carpet in Union Square Park. As a jazz band grooved in the background, vested and begloved hosts led guests to the star attraction: a drinking fountain. The event, called “Respect the Fountain,” was staged by a group with an unlikely mission — to make water fountains cool again.

Fountains were once a revered feature of urban life, a celebration of the tremendous technological and political capital it takes to provide clean drinking water to a community. Today, they’re in crisis. Though no one tracks the number of public fountains nationally, researchers say they’re fading from America’s parks, schools and stadiums. “Water fountains have been disappearing from public spaces throughout the country over the last few decades,” lamented Nancy Stoner, an administrator in the Environmental Protection Agency’s water office. Water scholar Peter Gleick writes that they’ve become “an anachronism, or even a liability.” Jim Salzman, author of “Drinking Water: A History,” says they’re “going the way of pay phones.” [...]

This loss isn’t a result of some major technological disruption. While U.S. consumption of bottled water quadrupled between 1993 and 2012 (reaching 9.67 billion gallons annually), that’s more a symptom than a cause. What’s changed in the past two decades is our attitude toward public space, government and water itself. “Most people over the age of 40 have really positive stories of drinking fountains as kids,” says Scott Francisco, who helped organize the Union Square event with Pilot Projects, an urban design company. The sense today, though, is that “they’re dangerous, they’re not maintained and they’re dirty.”

In short, we don’t trust public fountains anymore. And it’s making us poorer, less healthy and less green.[...]

Today, 77 percent of Americans are concerned about pollution in their drinking water, according to Gallup, even though tap water and bottled water are treated the same way, and studies show that tap is as safe as bottled. [...]

The disappearance of water fountains has hurt public health. Centers for Disease Control researcher Stephen Onufrak has found that the less young people trust water fountains, the more sugary beverages they drink. Studies have found that kids who consume sugary drinks regularly are 60 percent more likely to be obese, and adults who do so are 26 percent more likely to develop Type 2 diabetes. [...]

Feminists applaud Ami Magazines support of ORA and the feminist agenda against accepted halacha

AMI magazine recently devoted their cover story to the issue of Agnuna. Included was a gushing fluff interview with R. Jeremy Stern - the head of ORA.Views expressed directly or indirectly in the article were very supportive of ORA and the feminist agenda. There was not only no attempt to provide the full picture as to the halacha dealing with aguna and ORA conflicts with halacha - but ORA was presented in the best possible light. Rather surprising for a magazine which views itself as representing all Orthodox Jews.

I received the following from a well known dayan who requested that I post it. I could not find any evidence with a google search that this is a real organization - so I am assuming it is a spoof. The ideas however genuine

Salmonella outbreaks attributed to pet animals

   Pediatrics - about health    Pet Turtles and Salmonella

When kids have diarrhea, pediatricians often ask their parents if they have pets at home. Specifically, they may ask if they have reptiles, like pet turtles.

Why?

Turtles and other reptiles can be sources of Salmonella bacteria, especially in infants and younger children. In fact, at least 371 people, including 62 who required hospitalization, have gotten sick after exposure to pet turtles in 41 states in an ongoing Salmonella outbreak since August 2011.

The death in 2007 of a four-week old baby that was traced to Salmonella from a pet turtle also highlights the health risks of having a turtle in their home.

While many parents are aware that you can get Salmonella from chicken, eggs, and, recently, from contaminated peanut butter, they sometimes overlook the risk from pet turtles.

What You Need To Know

• Other reptiles besides turtles, including lizards and snakes, can also carry Salmonella, as can amphibians, such as frogs, toads, newts, and salamanders.
• Children under age five, and children with immune system problems, are most at risk for Salmonella infections, so you shouldn't have a reptile or amphibian in your home if you have a newborn, infant, toddler, or preschool age child at home.
• If you do have a pet turtle at home, don't let it roam around freely, which can contaminate all of the surfaces it walks on, walk around your kitchen, or anywhere you prepare food.
• Don't wash your turtle's water dish or aquarium in your kitchen sink or bathtub, since you might contaminate them with Salmonella if you do.
• Turtles with Salmonella aren't themselves sick and don't have any symptoms.
• The sale of baby turtles has been banned in the United States since 1975, but they are increasingly being sold again in recent years.
• Several reports have documented that free-living turtles do not seem to be carriers of Salmonella, but that is likely because they are living in the wild. If you make a wild turtle a pet and keep it in an aquarium in your home, it may become contaminated with Salmonella too. Kids should wash their hands after handling wild turtles, even if they may not have Salmonella.
• =====================================================

United States Center for Disease Control 

Pet chickens and ducks causing  outbreaks of Salmonella

Live poultry, such as chickens, ducks, geese, and turkeys, often carry harmful germs called Salmonella. After you touch a bird, or anything in the area where they live and roam, wash your hands so you don't get sick!

An increasing number of people around the country are choosing to keep live poultry, such as chickens or ducks, as part of a greener, healthier lifestyle. While you enjoy the benefits of backyard chickens and other poultry, it is important to consider the risk of illness, especially for children, which can result from handling live poultry or anything in the area where they live and roam.

CDC is collaborating with public health, veterinary, and agriculture officials in many states and with the U.S. Department of Agriculture's Animal and Plant Health Inspection Service (USDA-APHIS) to investigate four multistate outbreaks of human Salmonella infections linked to contact with live poultry.

In the four outbreaks, a total of 181 people infected with the outbreak strains of Salmonella have been reported from 40 states as of June 29, 2015. The number of ill people identified in each state is as follows: Alabama (17), Arizona (3), Arkansas (4), California (3), Colorado (2), Delaware (2), Georgia (4), Indiana (3), Iowa (1), Kentucky (4), Louisiana (2), Maine (2), Maryland (4), Massachusetts (1), Michigan (3), Minnesota (6), Mississippi (13), Missouri (1), Montana (3), Nevada (2), New Hampshire (1), New Jersey (3), New Mexico (2), New York (6), North Carolina (3), Ohio (15), Oklahoma (1), Oregon (5), Pennsylvania (12), South Carolina (10), South Dakota (2), Tennessee (6), Texas (5), Utah (4), Vermont (2), Virginia (11), Washington (6), West Virginia (2), Wisconsin (1), and Wyoming (4).

Incredible! Judge sentences 3 children to juvenile detention center for refusing to talk to their estranged father

 update:  JPost   3 children released from detention and sent to camp for the summer

July 10  - A Michigan judge released three Israeli siblings from juvenile detention on Friday two weeks after she sent them there for defying her order that they have lunch with their father when he was visiting from Israel, ABC affiliate WXYZ reported.

At an emergency hearing, Judge Lisa Gorcyca said the children - whose parents have been involved in a custody battle for more than four years - could leave detention and attend a camp for the rest of the summer.

"The court agrees with the children's guardian's recommendation as to the best interests of the children," Gorcyca said this afternoon, reported the Detroit Free Press. "The court finds that is in the children's best interests to grant the father's and the guardian ad litem's motion to allow the children to attend summer camp. Children's Village is to facilitate the transportation."[///]
=====================================

MY Fox Detroit

Three children are in an Oakland County detention center after refusing a court-ordered lunch with their father. 

Protests formed outside the Oakland County courthouse Wednesday after Bloomfield Hills students, parents and teachers learned the Tsimhoni children were sentenced to Children's Village until their 18th birthdays for not wanting to spend time with their dad.

On Tuesday FOX 2 first showed court transcripts which describe exactly how family court Judge Lisa Gorcyca handled a hearing which was suppose to deal with supervised parenting time.

She berated the children, comparing them to Charles Manson and his cult. And claimed they were brainwashed. The judge made threats saying if they didn't apologize and go to lunch with dad they would live in separate cells where they would have to go to the bathroom in front of others.

When they refused to spend time with their father - Judge Lisa Gorcyca found the kids in civil contempt and had the kids locked up.

Larry Dubin, an attorney who has been a law professor at the University of Detroit Mercy for the last 40 years, was also stunned by Gorcyca's decision.

"To treat this like a case of contempt where she sends them away until they're willing to comply with court order seems harsh with respect to young children," Dubin said. "It certainly can raise all kinds of Constitutional issues." 

The judge sided with the father, who is in Israel right now

  Tsimhoni Kids Sent to Jail 

Cognitive Behavior Therapy - is becoming less effective

The Guardian  Everybody loves cognitive behavioural therapy. It’s the no-nonsense, quick and relatively cheap approach to mental suffering – with none of that Freudian bollocks, and plenty of scientific backing. So it was unsettling to learn, from a paper in the journal Psychological Bulletin, that it seems to be getting less effective over time. After analysing 70 studies conducted between 1977 and 2014, researchers Tom Johnsen and Oddgeir Friborg concluded that CBT is roughly half as effective in treating depression as it used to be.

What’s going on? One theory is that, as any therapy grows more popular, the proportion of inexperienced or incompetent therapists grows bigger. But the paper raises a more intriguing idea: the placebo effect. The early publicity around CBT made it seem a miracle cure, so maybe it functioned like one for a while. These days, by contrast, the chances are you know someone who’s tried CBT and didn’t miraculously become perfectly happy for ever. Our expectations have become more realistic, so effectiveness has fallen, too. Johnsen and Friborg worry that their own paper will make matters worse by further lowering people’s expectations.

All this highlights something even stranger, though: when it comes to talk therapy, what does it even mean to speak of the placebo effect? With pills, it’s straightforward: if I swallow a sugar tablet, believing it to be an antidepressant, and my depression lifts, then there’s a good chance the placebo effect is at work. But if I believe that CBT, or any therapy, is likely to work, and it does, who’s to say if my beliefs were really the cause, rather than the therapy? Beliefs are an integral part of the process, not a rival explanation. The line between what I think is going on and what is going on starts to blur. Truly convince yourself that a psychological intervention is working and by definition it’s working.

Perhaps every era needs a practice it can believe in as a miracle cure – Freudian psychoanalysis in the 1930s, CBT in the 1990s, mindfulness meditation today – until research gradually reveals it to be as flawed as everything else. [...]

=====================================

Mindfulness Is Just As Effective As Cognitive Behavioral Therapy In Treating Anxiety, Depression 

Medical Daily   According to a new study out of Lund University in Sweden, mindfulness can be just as effective as your typical therapist who practices cognitive behavioral therapy (CBT), which necessitates focusing on negative thoughts and having a discussion, as well as running experiments, on them.  

The study, led by Professor Jan Sundquist, was held at 16 primary health care centers in southern Sweden. The researchers trained two mindfulness instructors at each health care center during a six-day training course. Participants of the study, who suffered from depression, anxiety, or severe stress, were gathered into groups of 10 for structured group mindfulness treatment. The patients also received a private training program, and were asked to record their exercises and thoughts in a journal. For eight weeks, all 215 of them went through mindfulness therapy, then answered questions about their depression and anxiety. The researchers found that self-reported symptoms of depression and anxiety had decreased during the treatment period.

“The study’s results indicate that group mindfulness treatment, conducted by certified instructors in primary health care, is as effective a treatment method as individual CBT for treating depression and anxiety,” Sundquist said in a press release. “This means that group mindfulness treatment should be considered as an alternative to individual psychotherapy, especially at primary health care centers that can’t offer everyone individual therapy.”

The notion of mindfulness dates back to ancient Buddhism, and is an essential part of the religion. It involves accepting the present moment and focusing on the sensations, feelings, and thoughts that are happening right now. Being able to reduce the extraneous "noise" from anxiety, worrying, and fear can help people focus on and live in the moment, and also allow them to lessen unnecessary stress. [...]

Efraim Cray acquitted of charges of sexually abusing 14 year old girl

 update:   I am pleased to note that I just received an email from a member of JCW's Board of Advisors that JCW has in fact finally posted a news item which acknowledges Cray's acquittal .

http://www.jewishcommunitywatch.org/?s=cray 

I have received some nasty criticism for noting the absence of an acknowledgment of Cray's acquittal on the JCW site - 5 months after it happened. Claims included that I have an agenda against JCW or that I have been bought. Neither accusation is true. I did make an error in my original post when I stated that Cray was listed on JCW's Wall of Shame. He was not but a news item regarding the accusations against him - as well as acquittal on one of the 3 charges -  had been posted. My concern was the fact that the news item of the accusations was still up - after full acquittal - but no mention of the full acquittal itself. The full acquittal was in Februrary while my posted criticism was June 30..

However the issue is rather simple. When an organization such as JCW posts a news item about an individual that he is accused of being a molester - most people take it as  as a serious concern and heavy possibility that it is true. It is therefore reasonable and appropriate that information regarding acquittal should also be posted as soon as possible. I acknowledge that JCW has done a lot of good for the community - but they are not above criticism. I stand by my original concern and I am glad to hear that they have made the appropriate acknowledgment- even though it was made 5 months later. Hopefully news of acquittal will be made in a more timely fashion in the future.

=====================================
Tottenham Journal February 2015 [posted June 30, 2015]

Efraim Cray, 32, was accused of abusing the girl between January 2012 and January 2013.

Cray, of Wellington Drive, South Tottenham, faced three charges of sexual assault by touching at his trial last year, but was acquitted of one charge on the directions of the judge.

He was cleared of the remaining charges at Snaresbrook Crown Court today after the complainant withdrew her allegations, writing a seven-page retraction statement in the presence of an independently-appointed solicitor.

During Cray’s first trial in November, prosecutor Roger Smith-Daniels said they both lived “in a closed community” and the victim, although aged almost 15 at the time, “knew very little about sexual matters... she didn’t know, for example, what the word vagina meant”.

Cray’s first trial collapsed when the girl admitted she had become confused and told lies during her police interview.

Mr Smith-Daniels said: “The complainant in this case has grown up in the ultra-orthodox Jewish community of Stamford Hill and went on to make allegations against other men, including her own brother. [...]

==================

unfortunately the false accusations have not yet been retracted from Jewish Community web site   and a number of blogs

'Utter hypocrite' Todros Grynhaus jailed for 13 years for sex assaults

Jewish Chronicle  A Jewish teacher and rabbi’s son who molested two teenage girls was “an utter hypocrite” who professed his Orthodox faith while “cynically condemning his victims to suffer”, a judge has said.

Todros Grynhaus, 50, was jailed for 13 years and two months on Friday.

He must pay one victim £45,000 and the other £35,000 in compensation as well as prosecution costs of £35,000.[..]

Sentencing him, Mr Justice Timothy Holroyde said: “This was a refined degree of cruelty on your part. You knew what you were doing and you knew what harm you would cause. You are an utter hypocrite. You professed your religion whilst cynically condemning your victims to suffer and giving false evidence seeking to cast blame on them.

“I have no doubt that you felt able to rely on a prevailing attitude of insularity which you hoped would prevent these allegations from ever coming to the attention of the police. You hoped that, at worse, you might have to pay a form of financial penalty as directed at the Beth Din.

“You believed that the combination of the girls’ sexual ignorance and the attitudes of some within your community would make it even harder for your victims to complain about you, and you came close to getting away with it.

“Even when the allegations were reported to the police, I am afraid the evidence I have heard shows that many in your community were taken in by your lying protestations of innocence. Others will have to examine their own consciences, and should reflect that, but for the courage of your two victims, your serious crimes would have gone unpunished.

“You are a highly intelligent man. You knew the consequences of your wicked actions. You saw the distress of the witnesses during the trial. You could have spared them that additional harm but you chose to brazen it out, twice giving evidence which you now admit was untrue. In my judgement there is a significant risk you will commit further sexual offences against a girl or girls.” [...]

n mitigation, Grynhaus’ barrister Jonathan Goldberg QC, said his client had not offended in the past decade and had “profited” from the psychological treatment he received.

“He had outstandingly good character as a neighbour, communal figure and as a teacher,” he said. “Of course, it can be said and rightly so that those people could not see his darker psychosexual side.

“Part of the punishment for this man is the shame and exposure and social ostracisation within the community. This case has erupted like a scandal in a monastery.” [...]

Doctor who gave unnecessary cancer treatment to 553 patients - sentenced to 45 years.

 CNN    Detroit-area doctor who authorities say gave cancer treatment drugs to patients who did not need them -- including some who didn't actually have cancer -- was sentenced Friday to 45 years in prison.
 

Federal prosecutors called him the "most egregious fraudster in the history of this country." To Fata, they said, "patients were not people. They were profit centers."

Fata forfeited $17.6 million that he collected from Medicare and private insurance companies. Some 553 patients received medically unnecessary infusions or injections, prosecutors said.

The hematologist-oncologist gave an emotional apology in court, saying he was "ashamed" of his actions.

"I have violated the Hippocratic oath and violated the trust of my patients," Fata said, according to CNN affiliate WDIV. "I do not know how I can heal the wound. I do not know how to express the sorrow and the shame." [...]

update  his wife allegedly fled to Lebanon with $10s M.

Student Doctor Network

Additional background information

Detroit News

CBS News         The government says a man who took an oath to do no harm instead turned more than 500 of his patients into victims in a shocking case of medical fraud.

Courtroom sketches could not adequately capture the anguish of the victims Tuesday as one by one, they confronted the cancer doctor who prescribed aggressive chemotherapy for patients he knew were not ill, and for those who were, ordering treatments that were excessive while billing medicare $34 million. [...]

Fata has already pleaded guilty to fraud and other charges. A memo from prosecutors demanding a life sentence said Fata would tell his patients they risked death without him. Telling one: "Your life or your money."

From Laura Stedtefeld, whose father died in Fata's care: "You poisoned, tortured and murdered my dad."[..]

A good question is how he got away with this and the answer is Dr. Fata was a well-respected physician backed up by other well-respected physicians and a prominent local hospital. But it was a doctor who worked for him, who ultimately blew the whistle on his actions.

FDA Strengthens Heart Attack, Stroke Warning for Popular Painkillers [NSAIDS]

US News and World Report

The U.S Food and Drug Administration on Thursday strengthened the warning labels for widely used painkillers like ibuprofen and naproxen, saying they can increase the risk of heart attack or stroke.

The FDA is asking people to think carefully about their use of nonsteroidal anti-inflammatory drugs (NSAIDs), particularly if they've already had a heart attack, according to a consumer update on the agency's website.

The agency said it is taking this action based on recent data that shows the risk of heart attack or stroke can increase even after using NSAIDs for a short time.

"They used to say they might cause risk of heart attack or stroke. Now we are saying they do cause increased risk of heart attack and stroke," FDA spokesman Eric Pahon told NBC News.[...]

 Although aspirin is also an NSAID, the revised warning doesn't apply to aspirin, the FDA said.[...]

People with heart disease or high blood pressure should consult a doctor before using an NSAID, the FDA said. 

 However, the agency noted that the cardiovascular risk also is present in people without heart health problems. "Everyone may be at risk -- even people without an underlying risk for cardiovascular disease," said Dr. Judy Racoosin, deputy director of the FDA's Division of Anesthesia, Analgesia and Addiction Products. [...]

I, Pedophile - David Goldberg describes his life as a pedophile

The Atlantic

For almost 20 years, I spent virtually every night of my life in the same manner: Sitting in front of my computer and either trawling the Internet for child pornography or looking at the pictures and videos that were already a part of my collection. No matter how many images I found and regardless of how sleep deprived I felt, nothing would stop me from continuing this perverse pursuit. It was my own carelessness that finally got me arrested, when I used my credit card to order some films that had images of naked boys, although none of these movies were of a sexual nature. One police officer later told me he thought I had gotten caught on purpose, because, subliminally, it was the only way I would stop. He was right about the latter, but not the former. No one who is a pedophile wants to get caught and have their horrifying secret revealed to the world.

In fact, there were some nights—but not too many—when I would dare to sit in my chair after my computer was turned off and imagine how it would feel to get arrested. Would I fall to the ground in the fetal position, would I throw up, burst into tears or perhaps even have a heart attack? When that day finally came for me, I did none of those. After the lead detective read me my rights and asked several questions regarding my computer, a strange calm washed over me. I knew my job as a local newspaper editor and my hobby coaching baseball had both come to an end. Yet the overriding thoughts in my head were not of my past, but more of my future. I knew that I was in a unique position to help others understand the bewildering life of a pedophile. I had never asked to be cursed with this sexual attraction, and I had never hurt a child. In fact, I was always a good role model as a coach, and an upstanding citizen throughout my days. It was the nights that were a problem.

Over the months that followed my arrest, my journalistic instincts took over. I wanted to know how a lifetime of lusting after young children could seem so normal to me on an emotional level, even though I knew rationally that it was a completely deviant lifestyle. I would spend my days longing to get back onto my computer, the way a gourmand anticipates a scrumptious feast. Yet when the computer was turned off, I despised myself for being so aroused while looking at pictures of young children whose lives had been destroyed thanks to their unwilling participation.[...]

The most important thing I've discovered in the 15 months since my arrest isn't the why, but rather what can be done to change the preconceptions and misconceptions that society has when it comes to pedophiles. Most people hear that word and think of the Jerry Sanduskys and abusive Catholic priests of the world. Fewer people think about the millions who grapple with sexual feelings on which they can never act. When someone hears the word “pedophile”, they immediately think of a child molester. Yet the majority of pedophiles do not molest, but instead spend hours looking at child pornography. And as those numbers grow, so does the number of child victims.

I am not advocating the cross-generational lifestyle. In fact, there is never an instance when an adult should engage in sexual behavior with a child. But until we as a society learn that help for those who view child pornography is a far better alternative to incarceration, we are doomed to see the continued proliferation of this problem. Scientists don’t know for certain if there is a correlation between viewing child pornography and offending against children. Wouldn't it be nice to get pedophiles help before we find out for certain? [...]

How many millions of pedophiles throughout the world aren't as lucky as I? How many will never seek help, too scared of the legal and social consequences? How many will continue to create the demand that fuels a malicious child pornography market? Is locking them away for a while the answer? Will the day ever come when we, as a society, reach out and offer them the help they so desperately need?

What Can Be Done About Pedophilia?

The Atlantic    To accompany todays’s first-person essay from David Goldberg, "I, Pedophile," I asked James Cantor, Ph.D., an international expert on pedophilia, to answer some common questions. Dr. Cantor is Associate Professor of Psychiatry at the University of Toronto and the editor-in-chief of Sexual Abuse: A Journal of Research and Treatment. (We have known each other for about 7 years through our common academic interests.)

How is pedophilia usually defined?

Pedophilia is the sexual preference for or a strong sexual interest in children. The term usually refers only to sexual preference for/interest in prepubescent or early pubescent children.

Sometimes people like David Goldberg, the author of the essay, are seen or referred to as "gold star pedophiles" or "good pedophiles." Can you explain what those seemingly incongruous terms mean?

It is extremely important not to confuse pedophilia—meaning the sexual interest in children—with actual child molestation. Not every person who experiences sexual attractions to children acts on those attractions. People who are pedophilic but who work to remain celibate their entire lives are being increasingly recognized as needing and deserving all the support society can give them.

What do you think David means when he refers to people being "too scared of the legal and social consequences" to seek help?

Many jurisdictions have passed mandatory reporting regulations for psychologists and other health care providers. Consequently, when someone who thinks he might be a pedophile comes in for counseling or therapy, the psychologist may be compelled by law to report the person to the authorities. That, of course, can lead to loss of the person’s job, family, and everything else. So, these people have simply stopped coming in at all, and instead of getting help to them, we now have pedophiles circulating in society receiving no support at all. [...]

Is it reasonable to be afraid that, if we recognize pedophilia as a sexual orientation, we will have to consider it socially acceptable?

It is reasonable for questions of social acceptability to be directed at behaviors. People are responsible for their behaviors, not their thoughts or sexual attractions. For example, we very readily acknowledge that a typical heterosexual man will, while just walking down the street, find some women sexually attractive. We would not, however, conclude it is socially acceptable for him to coerce any of those women into sex. Thinking of pedophilia as an innate characteristic that a person did not choose and cannot change can go a very long way in helping society come to a rational response to the problem—one that can help prevent molestation of children.

Can someone be cured of pedophilic desires? For example, could a pedophile through treatment go on to have either no sexual desire or a fundamentally different kind of sexual orientation?

The best treatments we have available for pedophiles help them develop the skills they need to live a healthy, offense-free life and, in some cases, to block their sex drives (if they feel it would help them). We have not yet found a way to convert pedophiles into non-pedophiles that are any more effective than the many failed attempts to convert gay men and lesbians into heterosexuals. [...]

My greatest hope is less about treatment, however, and more about prevention. Despite the fact that many people imagine sex offenders to be insatiable predators or ticking time bombs, only 10−15 percent of sex offenders commit new offenses. I believe we can prevent a much greater number of victims if we put greater energies into early detection and provide support before the first offense occurs, rather than relying only on stronger and stronger punishments after the fact.