[1eyedjack]

In all of the international furore that has blown up over the freeing of al-Megrahi, there is one question that to my mind is deafening in its absence.

I am no doctor and will happily be corrected (which may account for the silence on the issue), but my understanding is that:

1) Prostate cancer has an excellent prognosis for treatment, if caught early enough
2) Testing for prostate cancer in its early stages is a trivial matter

Among the general public, the death rate from prostate cancer is much higher than it needs to be, mainly through apathy of the public in actively seaking testing and diagnosis in its early stages.

Prisoners in a civilised society should expect to receive medical care as part of the cost of their maintenance in prison. Feel free to disagree with that statement, but that is my opinion. Prisoners do not have the same degree of control over their medical care as do members of the public generally, and I would have expected the responsibility for routine low-cost screening for life-threatening conditions to be vested in the prison authority.

Al-Megrahi, it now appears, was allowed to develop prostate cancer to the point at which treatment was no longer possible. The obvious question that this raises is, were the prison authorities negligent in allowing this situation to develop? Presumably, had the condition been diagnosed and treated while such was possible, the question of his early release would never have arisen.

It is of course possible that the condition was detected in its early stages, despite which treatment failed, as is inevitable in a small proportion of cases. But I would at least have thought that the question would have been aired in the public domain. Maybe it has and I missed it.

[OleBerg]

Not that I in any way believe it would be beyond the British system, to let it happen. I feel fairly confident however, that you will not feel ill from prostate cancer, before it is to late.

Personally I have never been tested, even though the test is simple. How about you?

[Winstonm]

A digital inspection can help a physician gauge whether or not the prostate is enlarged but is not foolproof.

The issue in virtually all cancers is whether or not it has metastasized, meaning spread to other organs. Once cancer has metastasized, it is too late to effect a cure.

[shintaro]

Perhaps they had a sure fire cure for this 'persons' alledged incurable cancer

Just Hang him

[barmar]

In the US, PSA tests are routine for men starting around age 50 (assuming you have decent health coverage), and this is how prostate cancer is usually detected early. But I wonder whether it's common to give this test to prisoners.

One person's comment bugged me when al-Megrahi was released. Someone was quoted on the BBC, saying that he shouldn't have been released on compassionate grounds, because where was his compassion when he killed all those people? Although I recognize the desire for revenge, shouldn't civilized people be above this? Shouldn't we show ourselves to be better than them, rather than sinking to their level?

I'm not Christian, but isn't this the essence of Jesus's "turn the other cheek" philosophy? And its not like he's being let off scot free, he's been in prison for many years already. All he's getting is his last few months, and he's still going to be suffering due to the cancer.

[PassedOut]

barmar, on Aug 31 2009, 10:54 PM, said:

Although I recognize the desire for revenge, shouldn't civilized people be above this? Shouldn't we show ourselves to be better than them, rather than sinking to their level?

I think so too.

[Winstonm]

Btw, PSA (prostate specific antigen) is not completely reliable and it is sudden and rapid change in psa that is more troubling than absolute level (this according to an oncologist I questioned about this subject when in nursing school.)

Biopsy is still the only conclusive proof of cancer cells.

Quote

Although I recognize the desire for revenge, shouldn't civilized people be above this? Shouldn't we show ourselves to be better than them, rather than sinking to their level?

I don't view this as religious compassion but human compassion. I have no problems allowing this man to go free, especially with the cloud of doubt over his guilt. It certainly wouldn't be the first time there has been a wrongful conviction.

[helene_t]

There is no screening program for prostate cancer in the UK.

http://www.cancerhel...t.asp?page=2719

Btw I agree with Jesus and Barmar.

[Lobowolf]

barmar, on Aug 31 2009, 10:54 PM, said:

Although I recognize the desire for revenge, shouldn't civilized people be above this? Shouldn't we show ourselves to be better than them, rather than sinking to their level?

Setting aside the wrongful conviction argument and assuming that he's guilty, I don't think that leaving in prison until he dies (or executing him, for that matter) would be sinking to his level, and we'd still be 'better' than him in that
1) He was given a trial, and
2) The person punished as a result was guilty of a horrific crime, as opposed to the innocent people arbitrarily killed by him.

There's a wide continuum, and in this case, I don't think a release is unreasonable (though I wouldn't do it, if it were solely up to me), but almost regardless of what is done with him, there's no danger of anyone doing the deciding being at his level.

As a general point, I think it's flawed rationale to compare, apples to apples, anything done as societal punishment of criminal guilt to something done to an innocent person. For instance, let's say we have a guy convicted of kidnapping...maybe he held a young woman against her will for 6 months. No rape, no murder, just took her off the street and locked her up in his basement. Should we not send him to prison? Is it "sinking to his level" to confine him involuntarily? That's exactly what he did. Are we no better than him if we give him a 6-month jail sentence?

[hrothgar]

For me, the over ridding principal is that of the "Rule of Law"

The Scots legal system provides for compasionate release.

If the Scots decide that they want to change theiir legal system, they are welcome to do so.

The US shouldn't expect the Scots to violate their established system.

[Lobowolf]

hrothgar, on Sep 1 2009, 10:23 AM, said:

For me, the over ridding principal is that of the "Rule of Law"

The Scots legal system provides for compasionate release.

If the Scots decide that they want to change theiir legal system, they are welcome to do so.

The US shouldn't expect the Scots to violate their established system.

I don't think your overriding principle resolves the issue. The Rule of Law seems to be that it's discretionary. Most are granted, but that implies that some are not, even for people who meet the criteria. So failing to grant compassionate release in a given case wouldn't appear to violate the rule of law in Scotland (though it may violate a tradition; I didn't find anything to suggest whether "most are granted" means 51% or 75% or 99%). But it doesn't seem as if anti-release comments have to do with expecting Scotland to violate their system, but rather to exercise their discretion differently while still operating within their system.

[1eyedjack]

There is a risk of thread drift. Whether it was appropriate that he be released is a question worthy of considered debate, but a separate issue from my OP.

As I see it there are four basic possibilities, the fourth of which can be subdivided into two:
A-) He was tested, and the test failed to indicate cancer
B-) He was tested, the test indicated cancer, but the treatment failed (I think it fair to assume that he would have been offered treatment once detected)
C-) He was offered the test and declined to participate
D-) He was not offered the test, in which case
....D-1) That failure was an act of neglect on the part of the prison authority, or
....D-2) The prison authority had no such duty of care as to extend to that offer.

In cases A, B, C or D-2, there is no question of censure of the prison authority.
However, considering for a moment the possibility of case D-1, I do not regard it as necessary that the available test be 100% accurate in detecting the cancer, nor the subsequent treatment in the event of a positive test have a 100% success rate, for the failure to offer the test to be an act of neglect on the part of a party with the power, authority and duty to offer it.

Had there been a national screening program, then I suspect that the case in favour of there being a duty on the part of the prison authority to offer the test is very much stronger than without such a program. That said, I am unconvinced that the absence of such a program conclusively absolves the prison authority of that duty of care where it remains possible for an individual outside of prison to seek such a test despite the absence of formal program and more difficult for someone within the prison to pursue it in the absence of proper oversight.

Nor do I believe that the prison authority should be absolved of a responsibility to offer such testing just because the public at large may be less diligent in their pursuit of health than might be desirable.

It is possible that the test was there for the taking at the prisoner's request, without any proactive effort required on the part of the prison authority, and the prisoner is assumed to take that responsibility as he would outside of the prison gates. That would form a subcategory of case D-2.

As I said at the outset in not so many words, any one of cases A, B, C or D-2 may account for the current state. But we will not know unless the question is asked, and so far no-one with a "Voice" has posed the question, as far as I can tell. Perhaps Al-Megrahi can be expected to sue the prison authority if case D-1 applies, either to benefit his estate, or to embarass the prison authority, or both, and the absence of such action might indicate that case D-1 does not apply.

It may be that the question is subject to medical (or negotiated) confidentiality, although it seems odd that his medical condition was released at all in that case.

[Lobowolf]

If I had to guess, I suspect that the testing is done, and probably at the prison's prompting, but less often (quite likely significantly less so) than is optimal. If you could, say, find all cases by testing, and cure all cases if you find them within a year, then you'd be fine with an annual test. But I'd bet the most likely scenario would be that prisoner's get their annual test every, say, 3 years.

[helene_t]

Did you read the article I linked to, Lobowolf? Things may be different in the US. Here in UK, most physicians don't believe in testing patients that don't show symptoms. I suppose he would have been offered a test if he went to the prison doctor with urination complaints.

[Lobowolf]

helene_t, on Sep 1 2009, 01:27 PM, said:

Did you read the article I linked to, Lobowolf? Things may be different in the US. Here in UK, most physicians don't believe in testing patients that don't show symptoms. I suppose he would have been offered a test if he went to the prison doctor with urination complaints.

I hadn't, but I went back and read it; thanks for the reminder that it was up there.

[Winstonm]

Quote

As a general point, I think it's flawed rationale to compare, apples to apples, anything done as societal punishment of criminal guilt to something done to an innocent person

I agree with the underlying principle but reserve the right to on occasion condemn societal punishment as the more extreme and cruel - Nazi laws concerning Jews come to mind.

[barmar]

I didn't mean to imply that imprisonment is sinking to his level. I was mainly addressing the "we shouldn't be compassionate because he wasn't" point. We demonstrate our humanity by being humane, even to those who don't deserve it.

Considering how much cruelty and evil there is in the world, I'd like to see the "civilized" people going overboard on the compassionate side. I'm not suggesting that we don't punish people for wrongdoing, but when opportunities like this arise, we can take them.

I can understand not agreeing with the decision to release him, it was clearly a borderline decision (today the Scottish Parliament announced that they disagreed with the decision). But the degree of outrage leveled at him for it seems unwarranted. Compassion should be encouraged.

[mike777]

I think many posters and most of the world confuse compassion with Grace.

If Scotland is in the Grace business...ok....but just say so........


I am all for following the law...but if the law is ........money....oil...say so.......



If the law is the scum of the earth should not die in prison but get a hero's welcome home...with no "sorry" I killed hundreds........ok...just say so.........

[Winstonm]

Quote

If the law is the scum of the earth should not die in prison but get a hero's welcome home...with no "sorry" I killed hundreds........ok...just say so.........

Which scum of the earth do you mean, Mike, the ones who fictionalized a reason to invade Iraq and kill 100,000 Iraqi nationals?

[luke warm]

Winstonm, on Sep 3 2009, 07:08 AM, said:

Quote

If the law is the scum of the earth should not die in prison but get a hero's welcome home...with no "sorry" I killed hundreds........ok...just say so.........

Which scum of the earth do you mean, Mike, the ones who fictionalized a reason to invade Iraq and kill 100,000 Iraqi nationals?

he probably means the one being discussed in this thread