Wednesday, May 30, 2001

High court muddles
church-state issue

The issue: The U.S. Supreme Court turns
down an appeal on a ruling that a display
of the Ten Commandments on government
property violates separation of church and state.

SEPARATION of church and state remains one of the more aggravating legal -- and philosophical -- quandaries in the country due to the U.S. Supreme Court's dodging of the issue. The latest opportunity was cast aside with rare passion, with the court allowing to stand a Circuit Court ruling that sets some areas of the country against others. More lawsuits are sure to follow because of the high court's refusal to decide what constitutes government endorsement of religion.

The latest case dealt with a 6-foot granite marker, bearing the Ten Commandments, that has stood since 1958 on the lawn of the city hall in Elkhart, Ind. The marker is one of scores that have been donated nationally by the Fraternal Order of Eagles, a civic organization. Two residents of the town, backed by the American Civil Liberties Union, sued to get the marker taken off the site. A divided panel of the 7th U.S. Circuit Court of Appeals last year ordered the town to get rid of the marker, and the town appealed the ruling.

Four of the Supreme Court's nine justices must agree to consider an appeal for it to be heard fully; most are rejected in a summary fashion without disclosure of the vote and with no comment. In this case, though, three justices -- Chief Justice William H. Rehnquist and Justices Antonin Scalia and Clarence Thomas -- issued a statement that they disagreed with the rejection, meaning they wanted the court to hear the case.

The monument, Rehnquist wrote for the threesome, "simply reflects the Ten Commandments' role in the development of our legal system." Justice John Paul Stevens responded that the words "I am the Lord thy God," which were inscribed in a font larger than the remainder of the passage, are "rather hard to square with the proposition that the monument expresses no particular religious preference."

The Supreme Court in 1980 ruled that Ten Commandments is "undeniably a sacred text" that is not allowed on public school grounds, but it did not preclude such displays on public grounds elsewhere. Four years later, in a dispute over a city hall Nativity scene at Christmastime, it ruled that government cannot place symbols indicating a religious preference on public property.

The ruling was cited two years later by the ACLU in its successful move for the dismantlement of a large, illuminated cross at Camp H.M. Smith on Halawa Heights.

However, the Supreme Court in 1996 refused to consider the appeal of an appeals court ruling that allowed a Ten Commandments monument to remain in a park near the Colorado state capitol. The effect of the high court's turning away of the appeal in the latest case is that Ten Commandments markers are allowed on government lawns in Colorado but not in Indiana.

Health-care agencies
snub federal law

The issue: Many hospitals and HMOs
do not comply with a requirement that
they report incompetent doctors.

A majority of the nation's hospitals and health maintenance organizations are evidently ignoring a federal law that requires them to report disciplinary actions taken against doctors for incompetence or misconduct.

This noncompliance threatens patient care and places hospitals and HMOs themselves in jeopardy. But the government rarely penalizes these agencies and thus appears to condone their failure to uphold the law.

The inspector general of the U.S. Department of Health and Human Services says that in the last decade, 84 percent of HMOs and 60 percent of hospitals had not reported to the government a single adverse action taken against doctors. Yet, the National Academy of Sciences suspects that as many as 98,000 Americans die each year because of medical error. The academy is reasonably certain that 44,000 deaths can be attributed to medical errors but that another 54,000 are suspect.

The information that HMOs and hospitals file is included in the National Practitioner Data Bank. Hospitals and health-care providers use the data bank to check on doctors' qualifications before employment or affiliations are established. However, these organizations should realize that the data bank is only as good as the information that gets entered.

The Hawaii Medical Services Association, the state's largest medical insurer, is aware of the importance of the law and complies with its requirements, according to Vice President Cliff Cisco. The four or five reports it has filed in the last year involved fraud rather than incompetence, he said. The state's Board of Medical Examiners, which has staff specifically assigned to this task, has had no cases to report in the last six months, and averages about two filings a year.

The U.S. inspector general's report says that some health-care organizations, "in a market more concerned about price than quality," devote few resources to quality assessment and improvement. However, those organizations should recognize that poor-quality care will eventually cost them more when patients suffer at the hands of incompetent doctors.

Published by Oahu Publications Inc., a subsidiary of Black Press.

Don Kendall, President

John Flanagan, publisher and editor in chief 529-4748;
Frank Bridgewater, managing editor 529-4791;
Michael Rovner,
assistant managing editor 529-4768;
Lucy Young-Oda, assistant managing editor 529-4762;

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