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Source: Vanderbilt University School of Nursing; www.nursing.vanderbilt.edu

Source: Vanderbilt University School of Nursing; www.nursing.vanderbilt.edu

Today, Diane Rehm’s radio program included an hour-long discussion on the role of nurse practitioners with Reid Blackwelder, MD, family physician and president-elect of the American Academy of Family Physicians; Mary Agnes Carey, senior correspondent for Kaiser Health News; Ken Miller, PhD, RN, CFNP, nurse practitioner and associate dean of The Catholic University of America School of Nursing; and Sandra Nettina, MS, ANP, nurse practitioner at Columbia Medical Practice in Columbia, Md., and past president of Nurse Practitioner Association of Maryland.

There was one thing missing from this otherwise great discussion of the issues related to nurse practitioners being able to practice with full authority (without legally mandated physician collaboration or supervision). Nurse practitioners bring additional knowledge and skills to their practice that are just what primary care needs. They understand patient-centered care, listening carefully and responding to what patients and families say they need and want. They are experts in health education and counseling, as well as care coordination. These skills matter when we’re trying to transform our health care system into one that emphasizes health promotion, wellness, and chronic care management.

Most discussion of nurse practitioners’ roles center around their ability to diagnose and treat disease. They are prepared to do so with common acute and chronic conditions, and they know when to refer patient with symptoms of uncommon diseases to physicians–and without a legal mandate to do so, as has been shown in about a third of the states in the U.S. But we need a primary care system that can focus more on preventing diseases, promoting health, and helping patients to be knowledgale about and capable of promoting their health.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

[caption id="attachment_6044" align="aligncenter" width="480"] Source: Vanderbilt University

Source: www.MaddowBlog.msnbc.com

Source: www.MaddowBlog.msnbc.com

This week, the U.S. Supreme Court will hear oral argument in two cases on marriage equality.  Hollingsworth v. Perry is a challenge to California’s Proposition 8, a 2008 ballot initiative that amended the state constitution to prohibit recognition of same-sex marriage. U.S. v. Windsor challenges Section 3 of the Defense of Marriage Act (DOMA), a federal law declaring that “‘marriage’ means only a legal union between one man and one woman as husband and wife, and the word ‘spouse’ refers only to a person of the opposite sex who is a husband or a wife.” The law thus bars same-sex couples, even those who are married in states that recognize their union, from rights or benefits available to other married couples. Lower courts in both cases ruled against these laws as violations of  the U.S. Constitution’s guarantees of equal protection under the 5th Amendment (DOMA) and the 14th Amendment (Proposition 8).

Public sentiment on marriage equality has evolved rapidly in recent years. In a March ABC-Washington Post poll 58% responded that it should be legal for same-sex couples to marry. (A 2003 ABC-Post poll found support for same-sex marriage among only 37% of respondents). Especially among younger Americans, support for marriage equality is consistently strong, reaching across racial, ethnic, party and religious lines.

Dire predictions about the consequences of allowing same-sex marriage have , not surprisingly, simply not been borne out in those states (or the growing list of countries) that currently recognize it. Many people who previously opposed same-sex marriage have shifted their opinions, in some cases because their concerns for sons, daughters, other loved ones or close friends who themselves are Lesbians or gay men has made the issue more personally compelling for them.  The recent announcement by Sen. Rob Portman (R-OH) that he now supports marriage equality is one example. Other prominent political figures have declared their support as well, citing marriage equality as a matter of fairness, including President Obama as well as both Hillary and Bill Clinton (who, as President,  had signed DOMA into law in 1996). Over 100 prominent Republicans signed on to an amicus curiae (friend of the court) brief filed by Ken Mehlman, a former Chair of the Republican National Committee and George W. Bush’s 2004 campaign manager, supporting marriage equality.

Source: www.MaddowBlog.msnbc.com

Source: www.MaddowBlog.msnbc.com

This week, the U.S. Supreme Court will hear oral argument in two cases on marriage equality.  Hollingsworth v. Perry is a challenge to California’s Proposition 8, a 2008 ballot initiative that amended the state constitution to prohibit recognition of same-sex marriage. U.S. v. Windsor challenges Section 3 of the Defense of Marriage Act (DOMA), a federal law declaring that “‘marriage’ means only a legal union between one man and one woman as husband and wife, and the word ‘spouse’ refers only to a person of the opposite sex who is a husband or a wife.” The law thus bars same-sex couples, even those who are married in states that recognize their union, from rights or benefits available to other married couples. Lower courts in both cases ruled against these laws as violations of  the U.S. Constitution’s guarantees of equal protection under the 5th Amendment (DOMA) and the 14th Amendment (Proposition 8).

Public sentiment on marriage equality has evolved rapidly in recent years. In a March ABC-Washington Post poll 58% responded that it should be legal for same-sex couples to marry. (A 2003 ABC-Post poll found support for same-sex marriage among only 37% of respondents). Especially among younger Americans, support for marriage equality is consistently strong, reaching across racial, ethnic, party and religious lines.

Dire predictions about the consequences of allowing same-sex marriage have , not surprisingly, simply not been borne out in those states (or the growing list of countries) that currently recognize it. Many people who previously opposed same-sex marriage have shifted their opinions, in some cases because their concerns for sons, daughters, other loved ones or close friends who themselves are Lesbians or gay men has made the issue more personally compelling for them.  The recent announcement by Sen. Rob Portman (R-OH) that he now supports marriage equality is one example. Other prominent political figures have declared their support as well, citing marriage equality as a matter of fairness, including President Obama as well as both Hillary and Bill Clinton (who, as President,  had signed DOMA into law in 1996). Over 100 prominent Republicans signed on to an amicus curiae (friend of the court) brief filed by Ken Mehlman, a former Chair of the Republican National Committee and George W. Bush’s 2004 campaign manager, supporting marriage equality.

Joy Jacobson is the CHMP’s poet-in-residence. Follow her on Twitter: @joyjaco.

As soon as the “delinquent” verdict came in on Sunday in the Steubenville rape case—Trent Mays and Ma’lik Richmond were convicted in juvenile court of raping an unconscious 16-year-old girl and photographing themselves in action—the nasty tweets began appearing. “But it’s the girl’s fault too,” read one. “She is 16 and got drunk till she passed out.” The author of that tweet has since apologized for his victim-blaming. Others were on the receiving end of such outrage that they deleted their Twitter accounts, while a few have staunchly defended their position that the girl was asking for it—“just a loose drunk slut.” tumblr_inline_mjttwzL9e11qawfnh

It’s a shockingly pervasive attitude about a dismayingly prevalent crime. If you do a Google news search using the terms “drunk” and “rape” you will find thousands of references to the Steubenville case, but it is far from the only one.

  • Last December Dennis Hanson and Bojan Vuckovic, in Fort Collins, Colorado, allegedly raped and injured two young women whom they had given shots of vodka. Hanson made a video of the event on his cell phone, which was recently played in court. Hanson was heard saying, “Do you want me to [expletive] you? Just tell me yes. Nod your head. . . . Can I do whatever I want to you?”
  • Last summer Gregory Basped and Lester Green “picked up” a woman at a Sheboygan, Wisconsin, bar, and when she passed out they raped her in her home. The two men were sentenced to five and eight years, respectively, in prison. 
  • Markley Charles was convicted in Norristown, Pennsylvania, of attacking a 15-year-old girl who was unconscious at a party. “He took advantage of her youth, her level of intoxication and the fact that she was passed out for his own sexual gain,” the judge said

And let’s not forget the two New York City police officers, Kenneth Moreno and Franklin Mata, acquitted in 2011 of raping an intoxicated woman in her apartment—a case complicated by the fact that “defense lawyers pounced on the credibility of the woman because she was very drunk on the night in question and did not remember many details,” the New York Times reported.

They pounced on the credibility of the woman because she was drunk. It really is that blatantly sexist, isn’t it? Yes, says Helen Redmond in a post called “Is Alcohol the New Short Skirt?”—a look at our society’s condemnation of the woman who drinks as louche and loose and deserving of whatever she gets. Perhaps that’s what is at the root of the invective heaped on the 16-year-old rape victim in the Steubenville case; she has received death threats and other forms of condemnation from both men and women via social media. “Society puts the onus on women to keep themselves safe and avoid dangerous situations,” Redmond says. “So if a woman is drunk, she isn’t taking her personal security seriously and is responsible for what happens to her.”

This to me defines “rape culture”—that we live in a world where too often a woman’s inability to consent to sex means she’s fair game. Redmond cites a study of more than 1,800 men, of whom 120 admitted to committing “acts of interpersonal violence, including rape, battery, and child physical and sexual abuse”; 80% of those said they had assaulted women incapacitated by drugs or alcohol.

It evidently has to be said again and again that the only thing that constitutes sexual consent is an actual “yes.”

Circleof6_BeautyShot_WEBOne tool that could empower young women is the Circle of 6 cellphone app, which allows a user to send out a “help” message to the six chosen friends in her circle if a date gets uncomfortable or she needs a ride home. It seems brilliant; in a country where only 54% of rapes are reported and a small fraction of those end up with convictions, we will need lots of innovations like this to begin to turn around the attitudes that underlie these crimes.

CORRECTIONS, April 2: In the original post I had incorrectly stated the number of men in this study who had claimed to have raped women. It was 120, not 1,800. Also, I added the word “allegedly” to the discussion of the case of Dennis Hanson and Bojan Vuckovic, who have not yet been convicted of the crimes they’ve been charged with.

Joy Jacobson is the CHMP’s poet-in-residence. Follow