And Where Was the ADA… ?

When Doug Burns’ neck was on the line last month, getting close to being jailed for a case of hypoglycemic confusion, where was the American Diabetes Association? That was my question. I was told the advocacy group provided “legal counsel,” but even after interacting with Doug’s lawyer, I didn’t really see the value-add. So I did a little digging, mainly to find out how much I could depend on this very-visible-but-rather-monolithic organization in times of need. Are they really there for the “little guys” when bad things happen due to our diabetes?

Where I ended up was on a long telephone call with Michael Greene, Chair of the ADA’s Legal Advocacy Fund and a private malpractice lawyer in Portland, OR. (Michael has diabetes himself, along with his son Adam, a regular reader here and creator of a unique new online D-management system currently in beta testing.)

DM) OK, so what was it that the ADA did for Doug, and for cases like his across the country?Police_brutality

MG) I personally acted as Doug’s co-counsel. We strategized, and helped his lawyer with expert testimony. The publicity was an important tactic — applying pressure to (the DA’s office) to recognize that they couldn’t prove the case, that they had misacted.

DM) As Mr. Universe, Doug was a high-profile case. You can’t possibly get personally involved in every one, or…?

No. Doug is on the local ADA leadership counsel in San Jose, CA, so he had an immediate pipeline to us. The ADA’s legal advocacy function kicked off 1993, and now actually supports a staff of six plus a volunteer committee of 12, and an adjunct attorney network of 300. There’s also a medical network of 150 doctors and other professionals providing expert input.

We get over 300 calls a month – mostly employment and school issues, but also on incidences involving licensing, insurance, police situations, and “oddball stuff,” like people being told they can’t take insulin into a concert.

DM) So discrimination against people with diabetes is really that widespread?

MG) Discrimination is largely based on ignorance. The misconduct calls we get are invariably because the police don’t know enough about diabetes, or don’t understand the importance of getting medical help immediately.

Honestly, stuff like (Doug’s case) happens every day in every city in the US.

DM) So you’re constantly coming to the rescue. But didn’t the ADA urge Doug to counter-sue?

MG) I don’t know where you got that information about counter-suing.

Our concern is primarily with the criminal aspect of it. We don’t believe having a low blood glucose is criminal conduct. The reports showed clearly that there was a medical problem, and the police didn’t recognize it. Our advice is first and foremost to help get the person with diabetes out of the case, so they don’t go to jail. Whether they choose to take the offensive and sue the police later on is a separate issue.

They could still be guilty of “negligence” for purposes of a civil lawsuit. For example, in incidents of car accidents, did the drivers get into the car already low?

We’re not in the business of excusing inappropriate conduct. We’re in the business of protecting people when they are being singled out for their disease and treated unfairly because of it.

DM) Understood. But isn’t the ADA also working to help train police to better deal with diabetes-related situations?

MG) Yes, as the number of people with diabetes mushrooms, and use of insulin skyrockets, this is only gonna get bigger. They are going to be forced to prepare their personnel better.

Ada_police_video After the case in Philadelphia where a number of people with diabetes died in police custody, we created a police training video and sent it out to thousands of police departments around the country. We’re also looking at offering live training seminars.


DM) I’ve actually viewed that video, and it still seems hard to discriminate between the symptoms of hypoglycemia and say, drugs or alcohol…

MG) It’s not black and white. It’s definitely a judgment call. The issue is, how quickly do they escalate the situation to the use of force? Do they look for a medical ID bracelet? Do they call for medical backup? Training includes everything from keeping sugar soda available to posters in the station house to better tracking of the medical conditions of people brought in.

I guess the training was a success: no one’s died in Philadelphia in recent years because they were not given their insulin. And the lag time in getting (patients) to people who could treat their diabetes is much, much better.

DM) OK, so if one of our community is arrested during a hypoglycemic episode we can really call you?

MG) We have enough money in our slush fund to get you out of any jail. It’s called bail money.

Thank you, Michael, and staff at the ADA Legal Advocacy Fund. You have no idea how comforting that is :)

10 Responses

  1. Rosalind Joffe
    Rosalind Joffe June 12, 2007 at 4:57 pm | | Reply

    As an MS’er (living with multiple sclerosis), I’ve been “accused” several times over the past 30 years of being tipsy, drunk or not in control. Bad balance can do that to you. I’ve never wondered why people draw the conclusions that they do? I’ve just wondered why they have to be so rude about it? Or, why can’t they apologize when I explain why I can’t walk a straight line? We all “profile” – draw conclusions based on limited info. But, we also need to always recognize that the info is limited by what we perceive, rather than the reality of the situation.

    Rosalind Joffe http://www.keepworkinggirlfriend.com

  2. Vicki
    Vicki June 12, 2007 at 8:23 pm | | Reply

    I hope his statement that “People {diabetics}don’t die because they don’t have their insulin” was shorthand for something (but what?). As an insulin-taking diabetic I KNOW that’s simply not true. Diabetics on insulin can die of a hypo if they take too much insulin. But that’s not the same thing. And if they don’t have their insulin and eat a meal they’re going to go hyper, but that’s not going to kill them, at least not right away. So what was he trying to say?

  3. Sarah
    Sarah June 12, 2007 at 9:51 pm | | Reply

    Vikki, *Type 1* diabetics (not Type 2′s who take insulin) CAN go into a coma a die within 24 hours without any insulin. Even if they don’t eat.

    By the time the person gets to the hospital in DKA, the damage to their brain, heart, and kidneys may be irreversible. It is a crime to not allow a diabetic to have their insulin. It’s like removing someone from a iron lung and leaving them to die.

    It’s a good reason for a Type 1 diabetic to stay out of jail. Type 1 diabetics and cops need to stay far, far, away from each other. It’s bad enough we get arrested for having a low blood sugar.

  4. Sarah
    Sarah June 12, 2007 at 9:55 pm | | Reply

    Sorry, Vikki if I misunderstood what you were trying to say. I just hope these people realize that Type 1 diabetics need access to food, their tester, and insulin *at all times*.

  5. Sarah
    Sarah June 12, 2007 at 10:01 pm | | Reply

    P.S. There have been many documented cases of Type 1 diabetics dying in police custody. Many more have gone into comas with lasting damage. For some reason, ignorant people seem to think that Type 1 diabetics don’t need daily insulin.

    Perhaps it’s because most diabetics are Type 2, and that’s all anyone ever hears about. Everyone’s obese grandma who takes a pill, and is fine.

  6. Lauren
    Lauren June 12, 2007 at 10:25 pm | | Reply

    I agree that the issues of public hypoglycemia and insulin dependence are more relevant to type 1′s, who can find themselves in dangerous situations VERY quickly. Again I am dismayed by the attorney’s reference to the “diabetes epidemic” in a discussion of issues that largely affect type 1′s. It’s important to reiterate that there are two distinct types of diabetes. The lack of awareness about this is a MAJOR part of the problem.

    I am not reassured by the ADA’s response to Doug’s case. Amy’s call to action reverberated through the community while the ADA seemed strangely silent. I had no idea they were even involved.

    As for going on the offensive, why is that always seen as a negative thing? Think of all the court cases in this country that have forced the government to guarantee people’s rights — someone had to “go on the offensive” to bring those issues to the forefront. I am all for lawsuits in cases of police mishandling of medical emergencies. I still think one of the reasons the D.A.’s office was so aggressive in pressing charges against Doug was to divert attention from the horrible actions of the police department. When the D.A.’s office dropped the charges, they expected us to be so grateful we’d drop the issue. Of course public hypoglycemia isn’t a crime — the way the police handled it, however, IS. We won’t forget this, and the ADA shouldn’t either.

  7. Lauren
    Lauren June 12, 2007 at 10:34 pm | | Reply

    I hear you, Sarah. I never refer to myself as “diabetic” without prefacing it with “type 1.” Fortunately I work in the medical field, so I’m spoiled — most people I work with understand the difference between the two types. However the world at large does not … and that’s the scary part.

  8. Adam Greene
    Adam Greene June 12, 2007 at 11:45 pm | | Reply

    Hi Lauren,
    I have to disagree with you about the ADA’s role in cases like these. Lets step away from the details of this case, because I honestly don’t any of the decisions that were made behind closed doors.

    The ADA’s legal consul’s first goal is to provide legal advice and to help you out where needed; it isn’t necessarily to draw attention to your case. Sometimes publicity is exactly what is warranted, but they should *not* go on a publicity offense on their own accord. I personally would not be comfortable asking legal advice from anyone if they were going to make me a poster boy for their cause without my express consent.

    That doesn’t mean the ADA is always silent in these matters; quite the contrary. A very good summary was published in the NYTimes this past december:

    http://www.nytimes.com/2006/12/26/health/26workplace.html?ex=1181880000&en=6b88fd8aa17f1bf0&ei=5070 (reg. required)

    The ADA is building up a very good advocacy resource at:

    http://advocacy.diabetes.org

    of which the legal and discrimination component plays an important role.

    I’m *very* glad Amy covered this situation in her blog and that it seemed to be so helpful! I just think blogs like DiabetesMine and the ADA’s legal consul can play different roles, both are needed, and that is how it should be.

    Lauren, I should point out that I am more than slightly biased in this matter because Michael Greene is my father ;) That isn’t to say I always agree with him, but I know he is very passionate about legal advocacy and has been heavily involved with the ADA for over two decades. His commitment is absolute. And more heartening than that is that the Legal Consul’s office is not just him; it is a large group and they are *dedicated*.

    good debate!!!

    Warm Regards,
    Adam

  9. Lauren
    Lauren June 13, 2007 at 12:14 am | | Reply

    Ah, a fellow night owl! Thanks for your perspective, Adam.

  10. Vicki
    Vicki June 13, 2007 at 6:26 am | | Reply

    I need to clarify that I am, in fact, a type 1 diabetic, (LADA, like Amy), so my comment wasn’t coming out of confusion about the difference between type 1 and 2 diabetes. And I’m not saying that type 1 diabetics WILL NOT die if they don’t have access to insulin. Just that it wouldn’t happen immediately. I guess I wasn’t too clear about that.

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