Additional Titles









Illegal Aliens & EMTALA










Dr. Madeleine Cosman, Ph.D., JD
July 5, 2005


Iron pipes and the iron lung helped patients survive polio in the 1950s. Metal tubing (and ceramic and glass tubes and pipettes) for medical devices soon were replaced by hard, rigid plastic made of polyvinylchloride (PVC). PVC pipes were dramatic improvement over metal. But because PVC originally was not flexible, PVC connectors and elbows were required to make curves and turn corners.

Few parts of the human anatomy are strictly straight or turn at 90-degree angles. Medical and surgical care that required catheters for breathing, feeding, excreting, intravenous medicating, or blood transfusion required long, painful hospital stays with patients hooked up to large, expensive machines that necessarily were constantly monitored.

But 50 years ago a brilliant softener for PVC was invented that made rigid plastic flexible. It revolutionized medicine and surgery worldwide and saved billions of lives.


The plastic softener called DEHP, di-ethylhexyl phthalate, suddenly created life-saving flexibility for patients who could be treated safely in hospitals, at home, at work, at a trauma site, and in an ambulance. Elegant tiny catheters now could be crafted for anatomies of premature infants to provide them the breath, food, and waste removal that enabled them to survive. Trauma patients now could survive on intravenous fluids and blood while in transit until arrival at a hospital emergency room or operating theater. Adults otherwise tied to bed or oxygen machinery now could wear nearly invisible nasal tubes connected to portable air machines and continue ambulatory, productive life.

Flexible vinyl catheters for oxygen breathing tubes, infant airways, neonatal rescue tubes, kidney dialysis, intravenous medicating, feeding tubes, and flexible plastic bags for fluids, for medication, for blood collection, blood storage, and blood transfusion have transformed medicine and surgery. Flexible plastic allows efficient outpatient care that decreases overall medical costs, diminishes need for hospital stays and medical personnel, lessens patient morbidity, and reduces patient mortality. Flexible intravenous tubings and bags improve health and well being of billions of patients worldwide. Large numbers of these patients are children.

During the half century of medical phthalate use, about 9 billion patient days of acute care use have been analyzed plus 2 billion patient days of chronic care use. These have yielded unequivocal medical benefits and no known, verifiable medical detriments. Every year more than 500 million IV bags are used in the United States to deliver blood, medication, and other essential fluids to sick and injured patients. Eighty percent of these are made of PVC treated with phthalates. Baxter International makes most of these life-saving products.

No plasticizer or plastic softener other than DEHP has ever been subjected to as much testing for toxicity and as comprehensive testing for safety. For fifty years the scientific community has known that minute amounts of phthalate leach out from PVC medical devices. But all valid scientific evidence shows that these phthalate products are harmless. They cause no adverse health effects in humans.

DEHP has been studied incessantly by the chemical industry, especially by the Chemical Manufacturers Association (CMA) Phthalate Esters Panel in the United States. Phthalates have been investigated by the Food and Drug Administration (FDA).

When the FDA recently invited respected physicians, toxicologists, and scientists to discuss "Plasticizers: Scientific Issues in Blood Collection, Storage, and Transfusion" at a scientific forum, every expert refuted the idea that phthalates have potential negative health effects. Each participant supported the continued use of plasticized medical products.

Former U.S. Surgeon General Dr. C. Everett Koop, chairman of a blue-ribbon panel of independent scientists, concluded in his written report that phthalate esters, DEHP, used in medical devices are absolutely safe for use, and "without DEHP, a wide range of lifesaving medical devices --such as blood bags, cardiac and urinary catheters and a variety of surgical instruments and gadgets -- would lack either the flexibility, transparency, or shelf life to be of much use."

Greenpeace and Health Care Without Harm, however, claim that phthalates might damage people, might be carcinogens, and might affect the testes in infant boys exposed to the chemical. The alleged harm from phthalates is based on animal studies, apparently on rodents. The studies seem also to include unpublished findings that certain baby and adult alligators exposed to phthalates developed shrivelled penises. (Henry Lamb of Freedom 21 reported in 1994 on a similar campaign against chlorine that generalized from the alligators� penises to genitalia of Congressmen!) No human child or adult has shown adverse effects from phthalates in the half century of testing and successful use.

Yet, Greenpeace laments, "ironically, the very medical products that sustain�children's lives also contaminate their bodies with DEHP." While no reputable medical group has provided verifiable scientific proof of phthalate dangers that Greenpeace and Health Care Without Harm claim, the Environmental Protection Administration (EPA) classes phthalates as a probable human carcinogen. The EPA states that animal studies show that DEHP can damage the heart, liver, testes and kidneys, and interfere with sperm production. California included DEHP in its Proposition 65 list of chemicals that cause birth defects or reproductive harm.


Greenpeace and Health Care Without Harm threatened manufacturers with accusation of political insensitivity to the environment, with endangering vulnerable sick children, and with ruinous class action lawsuits for potential injuries caused by their phthalate-containing products. Baxter International, one of the world�s largest suppliers of flexible medical plastics, caved in to non-scientific but politically incendiary complaints. Other manufacturers are following Baxter�s lead to use alternatives to PVC and phthalate.

Health Care Without Harm has influenced its members to stop ordering Baxter products unless Baxter conforms to the medical activist group. Threats are powerful because Health Care Without Harm consists of several hundred medical, environmental, and social action organizations that meld Greenpeace, the Sierra Club, 41 hospitals (such as Beth Israel Medical Center in New York, New England Medical Center, hospitals of Catholic Health Care West), and such diverse assemblages as the American Nurses Association, Oncology Nursing Society, American Public Health Association, Breast Cancer Fund, and Endometriosis Association.

The Precautionary Principle of possible harm is honored despite five decades of total absence of scientific proof of actual phthalate dangers and total absence of demonstrable negative effects of phthalates. The Precautionary Principle has coerced hospitals and clinics worldwide to stop using PVC intravenous tubes and bags. To escape from political pressures, medical facilities are dumping a known, safe, and effective high technology in favor of an unknown, potentially less safe, and more expensive technology. Inevitably this will lead to deaths of those who otherwise could be saved by delivery systems for medicine and blood that use plastic IV tubing and bags.

Critically ill male infants are thought more at risk than any other patients because almost all of the brilliant multiple tubings keeping them alive are flexible PVC treated with DEHP. Which would intelligent parents choose? To save their fatally ill child�s life by breathing tubes and medicine administered by phthalate-flexible intravenous tubing? Or to not treat their child because of theoretical minuscule risk of his future wrinkled penis? Most parents joyously would welcome their son alive even with mature genitals that wrinkle like an alligator�s. Life with phthalate risk is superior to death with perfect infantile genitalia. Greenpeace and Health Care Without Harm want to eliminate all risk and therefore eradicate the vulnerable ill male child from the imperfect promised land of America.


Attacks against phthalates extend beyond hospitals and clinics to homes and commerce. Phthalates are a family of industrial chemicals that soften almost all poly vinyl chloride (PVC) plastics. Phthalates also are solvents in cosmetics and other consumer products. People encounter DEHP and other phthalates in beauty products, PVC toys, vinyl shower curtains, car seats, even wallpaper.

Phthalate risks are described as actual not as theoretical by a tricky use of the words can damage that implies �theoretically has potential ability to harm� and also �will harm particular individuals.� HCWC maintains that phthalates can damage the liver, kidneys, lungs and reproductive system, particularly the developing testes. HCWH does not state that the effects in animal studies are not transferred to human beings. Yet HCWH has compiled a comprehensive report about the risks associated with aggregate exposure to phthalates.

HCWC claims to work with several government agencies that already have concluded that patients are likely to be exposed to potentially unsafe amounts of DEHP while receiving medical care. Therefore HCWC praises its work with health care providers and manufacturers to replace DEHP-containing products with safer, affordable alternatives. The FDA, however, correctly worries that alternatives may not be as safe and certainly not as thoroughly studied.

The Precautionary Principle likewise could eliminate any alternative to phthalate for the substitute theoretically could be potentially as toxic as phthalate could be potentially toxic. The logical result of such illogic is the possibility of prohibiting all medical and surgical excellences that currently depend on elegant flexible plastic tubing, such as cardiac catheterization, kidney dialysis, blood transfusion, and even nutrition and hydration. The Precautionary Principle is bound to increase medical costs while it shortens human lives.


Attacks against plastics are brilliantly orchestrated to achieve the Silent Spring Effect. DDT, the most valuable pesticide in the world, was banned in 1972 by one book and one ruling by one man. Rachel Carson�s Silent Spring falsely blamed DDT for the supposed disappearance of birds whose eggshells were said to crack from DDT, causing baby birds to die. That unscientific research led to the ruling by EPA director William Ruckelshaus that manufacture and use of DDT must stop. Ruckelshaus prohibited DDT despite 9300 pages of testimony from experts that DDT did not appreciably harm birds� eggs and that DDT is not a human carcinogen. DDT is not mutagenic and not teratogenic, not causing birth defects, to man. (J. Gordon Edwards, J AmerPhysSurg, 03)

A half billion people--over 400 million people in Africa alone--annually die of malaria because no more effective anti-malarial than DDT has yet been discovered. Greenpeace, Health Care Without Harm, the Sierra Club, the Wilderness Society, Earth First, Rainforest Action, Beyond Pesticides, and National Resource Defense Council are among the ideological environmental organizations that forbid DDT-use in any Third World country to which they give money.

The World Bank, United States Agency of International Development (USAID), WHO, UNICEF, and the European Union withhold necessary money to any country that uses DDT. As Paul Driessen and Niger Innis demonstrate, this green activism is eco-imperialism that leads to massive black death. (Paul Driessen is senior policy advisor for the Congress of Racial Equality and Center for the Defense of Free Enterprise, and author of Eco-Imperialism: Green Power, Black Death.

Kenya�s Akinye Arunga explains that �Cute indigenous lifestyles simply mean indigenous poverty, indigenous malnutrition, indigenous disease, and childhood death.� The powerful video, �Voices from Africa: Biotechnology and the subsistence farmer� (presented by Cyril Boynes, Congress of Racial Equality director of international programs at the biotechnology conference in the United Nations General Assembly hall on January 18, 2005) revealed that the same ideology that helped ban DDT is banning the lives of Africans and other subsistence societies worldwide. (

Radical environmental activists prevent poor Africans from acquiring modern farming methods, adequate electricity, and pesticides to control diseases such as malaria. As Dr. Driessen proves, the anti-biotechnology crusade effectively creates natural population control by depriving the Third World of food and of life. While some dangerous eco-activists are guilty merely of sincere ignorance or conscientious stupidity, others practice deliberate eco-manslaughter.

The Silent Spring method that worked to obliterate DDT has been used to attack chlorine and other valuable chemicals that preserve human health. The seven-part strategy (a variation on Henry Lamb�s four-part analysis) is dazzlingly effective, melding pseudo-science, emotion, and political action to protect the vulnerable young. For DDT the critical imperiled creatures were baby birds. For phthalates, the endangered creatures are baby boys.

The seven steps usually follow this pattern:

(1) create a "scientific" study that predicts a public health disaster
(2) release the study to the media before scientists can review it
(3) generate an intense emotional public reaction
(4) develop a government-enforced solution
(5) intimidate Congress into passing it into law
(6) coerce manufacturers to stop making the product
(7) bully users to replace it or obliterate it

Health Care Without Harm and public health advocates from Interfaith Center on Corporate Responsibility, a faith-based North American coalition, are trying to Silent Spring all valuable plastics and eliminate them from hospitals.

Coincidentally they intend to Silent Spring plastics from homes, businesses, and world commerce.

Likewise committed to eliminating phthalates is Physicians for Social Responsibility (PSR). PSR started in Boston in 1961 and continues as a group of medical practitioners who are anti-war, anti-nuclear, anti-self-defense, and anti-dangerous chemicals, especially �persistent organic pollutants�. Their aim is to end the manufacture and use of phthalates as one of the �the 12 worst toxic chemicals poisoning the earth and its inhabitants.� PSR is accustomed to successful social action, having claimed long ago that children take into their bodies a by-product of nuclear weapons testing, strontium-90. PSR clamored for the Limited Test Ban Treaty and in 1963 the end of U.S. atmospheric testing of nuclear weaponry, for which it shared the 1985 Nobel Peace Prize.

Physicians Committee for Responsible Medicine (PCRM) does not limit its actions to speeches, essays, and scientific meetings. PCRM has close ties to the Animal Liberation Front (ALF) and the Earth Liberation Front (ELF), both of which are considered domestic terrorist organizations because of their arson and physical attacks against property. Jerry Vlasek, M.D., of Los Angeles, CA., sometimes speaks for ALF. In May, 2005, ALF continued its attacks on the families of pharmaceutical executives, such as those associated with Forest Laboratories in Long Island, NY, accusing them of being �puppy killers� because of their connection with Huntingdon Life Sciences in Britain that tests medicines and household products on animals.

Members of PCRM and PSR are members of the International Society of Doctors for the Environment (ISDE) that supports the elimination of putatively toxic chemicals such as phthalates. Founded in 1990, and located in Geneva, Switzerland, ISDE is a global non-governmental organization (NGO) uniting 10,000 medical doctors, scientists, and health professionals who promote ideas on the environment, health, and toxic chemicals. Their audiences are local medical communities, government policy-makers, corporations, the World Health Organization, and the United Nations.

Healing Without Harm is the mantra of the Teleosis Institute (meaning self-realization). These health care professionals �in service of the global environment� �partner� with others for social and environmental change and who share their vision for Ecologically Sustainable Medicine (ESM). Run by a Berkeley, CA, chiropractor and homeopath, Teleosis aims for sustainable, cost effective, resource-preserving, widely available medical practices that meet �environmental challenges across the globe� and provide for �current and future needs of the global population.� Related is the visionary magazine called Symbiosis, Journal of Ecologically Sustainable Medicine.

Anti-phthalate scientists seem dedicated more to political ideology than to scientific method, more to passion for global governance than to American sovereignty, more to peace and passivity than to triumph over any enemy national, biological, or chemical.

Green power-mongers muster sanctimonious smugness to Silent Spring DDT for use in Africa because it might harm Arctic polar bears, baby birds, and young plants. The true record, however, is glisteningly clear. When South Africa ignored green ideas and used DDT, it slashed malaria by 80% in 18 months and by 93% in three years. That is how America long ago became malaria-free. Ecuador risked green ire, used DDT, and reduced malaria incidence by 60%. (Driessen)

Not far away, however, Bolivia banned DDT and malaria increased 80%. The great triumph of the anti-DDT �Roll Back Malaria� campaign, according to a recent WHO-UNICEF report, is that since inception of its work in 1998, global malaria disease and death rates increased only by 10%. Recall that half a billion African people die annually because of deprivation of DDT in their environment.

Physicians, scientists, and environmentalists who insist on Silent Springing DDT, phthalates, and other discoveries, inventions, and technologies that save human lives, but possibly could harm animals and plants, arrogantly consider all strands in the great web of life equal. Scientists, physicians, and ideologues committed to the biodiversity web ignore the 400 million radiant black human threads that each year malaria cuts short in Uganda, Ethiopia, Kenya, and other parts of Africa.

If those malaria-killed half billion people had not died but instead lived, thrived, and reproduced, the population of the globe would have vastly increased. Green power seems to favor black death.

Subscribe to the NewsWithViews Daily News Alerts!

Enter Your E-Mail Address:

Green power also favors white death. Eco-imperialists pay for biodiversity at high human cost. When eco-imperialists attack the products of medical progress in the chemicals and technology that affirm and extend human life, the deaths they cause are involuntary. People who die from lack of DDT or lack of phthalate-softened breathing tubes do not choose to exchange their lives to enable a polar bear or a vernal pool or a spotted owl to live. But when eco-imperialists attack the ideas of medical progress that affirm and extend human life, they expect people voluntarily to die because they accept a duty to die. That is the triumph of irrational altruism, the voluntary sacrifice of self. Altruism violates reason, individualism, language, capitalism, private property, human dignity, and human integrity.

Part 1 , Part 3,

NOTE! Madeleine Cosman is one of the featured speakers at the upcoming Freedom 21 conference in Reno, NV. held this July 14, 15, & 16, 2005 at the Nugget Casino Resort. DON'T MISS IT! BE THERE!

� 2005 Madeleine Cosman - All Rights Reserved

E-Mails are used strictly for NWVs alerts, not for sale

Dr. Cosman is a medical lawyer located in California. Her forthcoming book in 2005 is Who Owns Your Body?: Doctors and Patients Behind Bars. She lectures worldwide on medical law and medical policy, has testified before Congress on medical law issues, and has spoken in Washington for Cato Institute and Galen Institute. She wrote the ABCs of the Clinton Medical World for Congress in 1993. A Director of California Rifle and Pistol Association, she writes "Guns and Medicine" for Firing Line. One of her 15 published books was nominated for the Pulitzer Prize, National Book Award, and was a Book of the Month Club Dividend Selection.

Madeleine promotes free-market, patient-centered medicine, and Health Savings Accounts.

Her J.D. is from New York's Cardozo School of Law, Ph.D. from Columbia University, M.A. from Hunter College, and B.A. from Barnard College. She is a member of the New York State Bar, New Jersey Bar, American Bar Association's Health Law Section, and American Inns of Court. Madeleine is Professor Emerita of City College of City University of New York and a Life Fellow of the New York Academy of Medicine.











Attacks against phthalates extend beyond hospitals and clinics to homes and commerce. Phthalates are a family of industrial chemicals that soften almost all poly vinyl chloride (PVC) plastics.