Readers Write: Detention centers, aid in dying, opioid crisis, name changes, Iran, the declining presence of pianos in homes

Over 20 years ago, a very important study called ACES — Adverse Childhood Experiences Study — changed our health assumptions. Adverse childhood experiences were shown to have profound and persistent effects on adult health and wellness outcomes. The more adverse experiences children have, the more likely they will as adults be susceptible to hypertension, cancer, obesity, unemployment, marital discord, alcoholism and other difficulties. This study has been repeated, including one in Minnesota, with validation of these findings.

One of the principle investigators made many trips to Minnesota to speak about these findings and inform our public policies. When he asked me to summarize, I remember saying, "Count and be kind."

The news of our government's care of immigrant children at our borders is anything but kind. Many of these children have suffered horrific violence and economic deprivation before coming to the U.S. in search of safety. Taking children away from their parents is one of the most traumatizing experiences a child can have. And then exposing them to hardships at the border cruelly exacerbates their ACEs.

As a community expert on trauma, I can attest we are damaging a generation of children. We know this. Can we in good conscience allow this to happen? No. There needs to be outrage and action to demand this stops. These are children, and they deserve protections and kindness.

The writer is a mental health clinician and a professor at the University of Minnesota.

Last weekend, the American Nurses Association recommitted itself to patient-centered care by modifying its former policy that prohibited nurses from participating in medical aid in dying (a practice, like Oregon's "death with dignity" law, that permits terminally ill adults to self-administer medication to hasten an inevitable death). After lengthy discussion and review by its ethics committee, the ANA affirmed that nurses caring for patients at the end of life have an ethical duty to educate themselves about medical aid in dying and must remain objective when responding to patient requests for medical aid in dying. This policy is a welcome shift toward a focus on patient values and priorities while still upholding a nurse's individual right to conscientiously decline to participate.

One out of five Americans currently live in jurisdictions where medical aid in dying is available. I introduced the End-of-Life Options Act in the Minnesota Senate so that terminally ill Minnesotans can have the same access to a peaceful death should their terminal suffering become unbearable. It's no surprise that we nurses, who care for dying patients at the bedside, are setting an example for health care professionals across the nation. I am proud of my profession.

An article in Opinion Exchange on June 25 discussed the impact of eliminating the medical director position for Minnesota's Medicaid program on the opioid crisis ("Position's elimination threatens strategy, lives"). The authors of this article, the members of Minnesota's DHS Opioid Prescribing Work Group, are asking for reconsideration of the removal of this position, as it poses a threat to patients and physicians involved in the Medicaid program, particularly related to prescribing opioids. I agree with this need for reconsideration. A medical director position within the Medicaid program is necessary to act as a leader and voice for the opioid crisis.

In addition, we need physician leaders to support other legislative issues related to the opioid crisis, such as the recent Comprehensive Addiction Resources Emergency (CARE) Act that was recently introduced into Congress on May 8. Eliminating knowledgeable and experienced medical directors poses a threat to passing this essential act, which could provide $100 billion over 10 years in funding to combat the opioid crisis and substance abuse epidemic. It would also provide much-needed support for our Native American populations, which face adversity in fighting this epidemic, as it could provide $400 million in tribal grants. Our state needs to keep more supports in place, such as keeping the medical director position within our Medicaid program, to help pass important legislation in our nation like the CARE Act of 2019.

Piggybacking off a June 21 letter regarding the Monroe High School name change ("St. Paul's Monroe name is stripped," June 19), let's consider this: While the nation debates the worthiness or unworthiness of those we've honored by naming buildings, lakes and avenues after them or erecting statues of them, the only true natives among us continue to be disrespected every day as TV networks, print reporters, commentators and sports fans refer to them as "Redskins."

The name-change debate is, indeed, a good thing, for there are points to be made by all sides, but what's sad is that, just because professional sports teams are private entities, their owners can hold on to racist monikers. Is it possible that, by demeaning Native Americans, we can feel less guilty about their plight? We used that strategy during slavery; you'd think we would have learned our lesson.

Does anyone else recall that we had an agreement with Iran? One where they weren't building nuclear weapons and we weren't stomping around calling for acts of war? Perhaps the former Iran deal didn't fix every issue, but we didn't have to wake up every day worried about whether an ego-fragile president has taken us into another interminable war in the Middle East.

The article about the slow death of the piano in the American living room ("Out of tune," June 22) was another reminder of our growing distance from one another. Think of the emotional and personal intimacy of gathering around a piano with friends and family and singing together. How many of us are truly comfortable with that kind of expressive vulnerability now? Yes, we "connect" across the entire globe on our phones. But it's generally a vicarious, vacant connection compared with the substance and immediacy of human interaction. More to the point, it takes years of dedication to be able to share music through an instrument. What exactly do we get from years of hitting "like"? We're more comfortable passively consuming an experience created for us (i.e., Netflix bingeing) than bringing to life our own thoughts and feelings through music shared with others. I'm only in my late 30s, but I have already seen that chasm widen to the point of absurdity and even alarm during my lifetime.

Let's take a moment to consider whether the slow disappearance of the piano and the utter ubiquity of the smartphone portend good or bad things for humanity.