Obama Meets C.E.O.’s as Fiscal Reckoning Nears

Luke Sharrett for The New York Times

Ursula M. Burns, chief of Xerox, said the president discussed few specifics of a potential agreement but emphasized that “we cannot go over the fiscal cliff.”

WASHINGTON — President Obama extended an olive branch to business leaders Wednesday, seeking their support as he prepared to negotiate with Congressional Republicans over the fiscal impasse in Washington.

If Congress and the president cannot reach a deal to reduce the deficit by January, more than $600 billion in tax increases and spending cuts will go into effect immediately — a prospect many chief executives and others warn could tip the economy back into recession.

Even so, Mr. Obama has some fence-mending to do before he can count on any serious backing from the business community.

“The president brought up that he hadn’t always had the best relationship with business, and he didn’t think he deserved that, but he understood that’s where things were and wanted it to be better,” said David M. Cote, chief executive of Honeywell. He was one of a dozen corporate leaders invited to meet Mr. Obama at the White House for 90 minutes Wednesday afternoon, after the president’s first news conference since the election.

While Mr. Obama did not present a detailed plan at Wednesday’s meeting or reveal what he would propose in terms of new corporate taxes, he strongly reiterated that he would not allow tax cuts for the middle class to expire. The president, according to attendees and aides, said he was committed to a balanced approach of reductions in entitlements and other government spending and increases in revenue.

With time running out, many people expect the president and Republican leaders in Congress to come up with a short-term compromise that prevents the full slate of tax increases and spending cuts from hitting in January. That would give both sides more time to come up with a far-reaching deal on entitlement spending, even as they work on a broad tax overhaul later next year.

One corporate official briefed on the meeting said that the chief executives came away with a sense that Mr. Obama was poised to present a more formal proposal in the next few days, but that he did not press them for support on particular policies. “It was more of a back and forth,” he said.

The chief executives from some of the country’s biggest and best-known companies, including Procter & Gamble and I.B.M., were not unified on everything, according to one who was interviewed after the meeting.

Many of the executives who described the meeting would speak only on condition of anonymity.

The outreach to business comes as both the White House and corporate America maneuver ahead of the year-end deadline, as well as the beginning of Mr. Obama’s second term. Many executives were put off by what they saw as antibusiness rhetoric coming from the White House in his first term, and many also oppose tax increases on the rich that Mr. Obama favors but would hit them personally.

Both sides have plenty to gain from a better relationship. Business leaders want to buffer their image after the recession and the financial crisis, while Mr. Obama would gain valuable leverage if he could persuade even a few chief executives to come out in favor of higher taxes on people with incomes over $250,000.

Lloyd C. Blankfein, chief executive of Goldman Sachs, publicly endorsed higher tax rates in an opinion article published in The Wall Street Journal on Wednesday.

“I believe that tax increases, especially for the wealthiest, are appropriate, but only if they are joined by serious cuts in discretionary spending and entitlements,” he wrote.

While Mr. Blankfein and other Wall Street leaders have been speaking out about the dangers of the fiscal impasse, only one executive from the financial services industry, Kenneth I. Chenault of American Express, was at Wednesday’s meeting.

Afterward, the corporate leaders seemed pleased with the tone of the meeting but cautious about the prospect of finding common ground with the White House on the budget choices facing Congress and the president.

“I’d say everybody came away feeling pretty good about the whole discussion,” Mr. Cote said. “Now, all of us are C.E.O.’s, so we’ve learned not to confuse words with results. And that’s what we still need to see.”

Ursula M. Burns, chief executive of Xerox, who was also at the meeting, said afterward that it was clear that “we’re going to have to work through some sticking points.” But while “we didn’t get into too many specifics,” she said, it was also made clear that “we cannot go over the fiscal cliff.”

Ms. Burns’s comments about the potentially dire consequences of the fiscal impasse echoed those of other chief executives, including many in the Business Roundtable, which began an ad campaign Tuesday calling on lawmakers to resolve the issue quickly. The Campaign to Fix the Debt, a new group with a $40 million budget and the support of many Fortune 500 chiefs, began its own ad campaign on Monday.

Michael T. Duke, chief executive of Wal-Mart Stores, warned in a statement after the meeting that “before the end of the year, Washington needs to find an agreement to avoid the fiscal cliff.” He said Walmart customers “are working hard to adapt to the ‘new normal,’ but their confidence is still very fragile. They are shopping for Christmas now, and they don’t need uncertainty over a tax increase.”

 

Helene Cooper reported from Washington and Nelson D. Schwartz from New York. Jackie Calmes contributed reporting from Washington.

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I Was Misinformed: The Time She Tried Viagra

I have noticed, in the bragging-rights department, that “he doesn’t need Viagra” has become the female equivalent of the male “and, I swear, she’s a real blonde.” Personally, I do not care a bit. To me, anything that keeps you happy and in the game is a good thing.

But then, I am proud to say, I was among the early, and from what I gather, rare female users.

It happened when the drug was introduced around 1998. I was 50, but after chemotherapy for breast cancer — and later, advanced ovarian cancer — I was, hormonally speaking, pretty much running on fumes. Whether this had diminished my sex drive I did not yet know. One may have Zorba-esque impulses when a cancer diagnosis first comes in; but a treatment that leaves you bald, moon-faced and exhausted knocks that out of your system pretty fast.

But by 1998, the cancer was gone, my hair was back and I was ready to get back in the game. I was talking to an endocrinologist when I brought up Viagra. This was not to deal with the age-related physical changes I knew it would not address, it was more along the feminist lines of equal pay for equal work: if men have this new sex drug, I want this new sex drug.

“I know it’s supposed to work by increasing blood flow,” I told the doctor, “But if that’s true for men, shouldn’t it be true for women, too?”

“You’re the third woman who asked me that this week,” he said.

He wrote me a prescription. I was not seeing anyone, so I understood that I would have to do both parts myself, but that was fine. I have a low drug threshold and figured it might be best the first time to fly solo. My memory of the directions are hazy: I think there was a warning that one might have a facial flush or headaches or drop dead of a heart attack; that you were to take a pill at least an hour before you planned to get lucky, and, as zero hour approached, you were supposed to help things along by thinking beautiful thoughts, kind of like Peter Pan teaching Wendy and the boys how to fly.

But you know how it is: It’s hard to think beautiful thoughts when you’re wondering, “Is it happening? Do I feel anything? Woof, woof? Hello, sailor? Naaah.”

After about an hour, however, I was aware of a dramatic change. I had developed a red flush on my face; I was a hot tomato, though not the kind I had planned. I had also developed a horrible headache. The sex pill had turned into a bad joke: Not now, honey, I have a headache.

I put a cold cloth on my head and went to sleep. But here’s where it got good: When I slept, I dreamed; one of those extraordinary, sensual, swimming in silk sort of things. I woke up dazed and glowing with just one thought: I gotta get this baby out on the highway and see what it can do.

A few months later I am fixed up with a guy, and after a time he is, under the Seinfeldian definition of human relations (Saturday night date assumed) my official boyfriend. He is middle aged, in good health. How to describe our romantic life with the delicacy a family publication requires? Perhaps a line from “Veronika, der Lenz ist da” (“Veronica, Spring Is Here”), a song popularized by the German group the Comedian Harmonists: “Veronika, der Spargel Wächst” (“Veronica, the asparagus are blooming”). On the other hand, sometimes not. And so, one day, I put it out there in the manner of sport:

“Want to drop some Viagra?” I say.

Here we go again, falling into what I am beginning to think is an inevitable pattern: lying there like a lox, or two loxes, waiting for the train to pull into the station. (Yes, I know it’s a mixed metaphor, but at least I didn’t bring in the asparagus.) So there we are, waiting. And then, suddenly, spring comes to Suffolk County. It’s such a presence. I’m wondering if I should ask it if it hit traffic on the L.I.E. We sit there staring.

My reaction is less impressive. I don’t get a headache this time. And romantically, things are more so, but not so much that I feel compelled to try the little blue pills again.

Onward roll the years. I have a new man in my life, who is 63. He does have health problems, for which his doctor prescribes an E.D. drug. I no longer have any interest in them. My curiosity has been satisfied. Plus I am deeply in love, an aphrodisiac yet to be encapsulated in pharmaceuticals.

We take a vacation in mountain Mexico. We pop into a drugstore to pick up sunscreen and spot the whole gang, Cialis, Viagra, Levitra, on a shelf at the checkout counter. No prescription needed in Mexico, the clerk says. We buy all three drugs and return to the hotel. I try some, he tries some. In retrospect, given the altitude and his health, we are lucky we did not kill him. I came across an old photo the other day. He is on the bed, the drugs in their boxes lined up a in a semi-circle around him. He looks a bit dazed and his nose is red.

Looking at the picture, I wonder if he had a cold.

Then I remember: the flush, the damn flush. If I had kids, I suppose I would have to lie about it.

Read More..

I Was Misinformed: The Time She Tried Viagra

I have noticed, in the bragging-rights department, that “he doesn’t need Viagra” has become the female equivalent of the male “and, I swear, she’s a real blonde.” Personally, I do not care a bit. To me, anything that keeps you happy and in the game is a good thing.

But then, I am proud to say, I was among the early, and from what I gather, rare female users.

It happened when the drug was introduced around 1998. I was 50, but after chemotherapy for breast cancer — and later, advanced ovarian cancer — I was, hormonally speaking, pretty much running on fumes. Whether this had diminished my sex drive I did not yet know. One may have Zorba-esque impulses when a cancer diagnosis first comes in; but a treatment that leaves you bald, moon-faced and exhausted knocks that out of your system pretty fast.

But by 1998, the cancer was gone, my hair was back and I was ready to get back in the game. I was talking to an endocrinologist when I brought up Viagra. This was not to deal with the age-related physical changes I knew it would not address, it was more along the feminist lines of equal pay for equal work: if men have this new sex drug, I want this new sex drug.

“I know it’s supposed to work by increasing blood flow,” I told the doctor, “But if that’s true for men, shouldn’t it be true for women, too?”

“You’re the third woman who asked me that this week,” he said.

He wrote me a prescription. I was not seeing anyone, so I understood that I would have to do both parts myself, but that was fine. I have a low drug threshold and figured it might be best the first time to fly solo. My memory of the directions are hazy: I think there was a warning that one might have a facial flush or headaches or drop dead of a heart attack; that you were to take a pill at least an hour before you planned to get lucky, and, as zero hour approached, you were supposed to help things along by thinking beautiful thoughts, kind of like Peter Pan teaching Wendy and the boys how to fly.

But you know how it is: It’s hard to think beautiful thoughts when you’re wondering, “Is it happening? Do I feel anything? Woof, woof? Hello, sailor? Naaah.”

After about an hour, however, I was aware of a dramatic change. I had developed a red flush on my face; I was a hot tomato, though not the kind I had planned. I had also developed a horrible headache. The sex pill had turned into a bad joke: Not now, honey, I have a headache.

I put a cold cloth on my head and went to sleep. But here’s where it got good: When I slept, I dreamed; one of those extraordinary, sensual, swimming in silk sort of things. I woke up dazed and glowing with just one thought: I gotta get this baby out on the highway and see what it can do.

A few months later I am fixed up with a guy, and after a time he is, under the Seinfeldian definition of human relations (Saturday night date assumed) my official boyfriend. He is middle aged, in good health. How to describe our romantic life with the delicacy a family publication requires? Perhaps a line from “Veronika, der Lenz ist da” (“Veronica, Spring Is Here”), a song popularized by the German group the Comedian Harmonists: “Veronika, der Spargel Wächst” (“Veronica, the asparagus are blooming”). On the other hand, sometimes not. And so, one day, I put it out there in the manner of sport:

“Want to drop some Viagra?” I say.

Here we go again, falling into what I am beginning to think is an inevitable pattern: lying there like a lox, or two loxes, waiting for the train to pull into the station. (Yes, I know it’s a mixed metaphor, but at least I didn’t bring in the asparagus.) So there we are, waiting. And then, suddenly, spring comes to Suffolk County. It’s such a presence. I’m wondering if I should ask it if it hit traffic on the L.I.E. We sit there staring.

My reaction is less impressive. I don’t get a headache this time. And romantically, things are more so, but not so much that I feel compelled to try the little blue pills again.

Onward roll the years. I have a new man in my life, who is 63. He does have health problems, for which his doctor prescribes an E.D. drug. I no longer have any interest in them. My curiosity has been satisfied. Plus I am deeply in love, an aphrodisiac yet to be encapsulated in pharmaceuticals.

We take a vacation in mountain Mexico. We pop into a drugstore to pick up sunscreen and spot the whole gang, Cialis, Viagra, Levitra, on a shelf at the checkout counter. No prescription needed in Mexico, the clerk says. We buy all three drugs and return to the hotel. I try some, he tries some. In retrospect, given the altitude and his health, we are lucky we did not kill him. I came across an old photo the other day. He is on the bed, the drugs in their boxes lined up a in a semi-circle around him. He looks a bit dazed and his nose is red.

Looking at the picture, I wonder if he had a cold.

Then I remember: the flush, the damn flush. If I had kids, I suppose I would have to lie about it.

Read More..

BBC Failures Show Limits of Guidelines

LONDON — It was 2004, and the British Broadcasting Corporation was gripped by a crisis over journalistic standards that had led to Parliamentary hearings, public recrimination and the resignations of its two top officials. Vowing change, the corporation established elaborate bureaucratic procedures that placed more formal responsibility for delicate decisions in the hands not of individual managers, but of rigid hierarchies.

The corporation also appointed a deputy director general in charge of news operations; established a “journalism board” to monitor editorial policy; issued numerous new guidelines on journalistic procedures; and put an increasing emphasis on “compliance” — a system in which managers are required to file cumbersome forms flagging dozens of potential trouble spots, from bad language to “disturbing content” like exorcism or beheadings, in every program taped for broadcast.

More crises would follow — the history of the BBC can be measured out in crises — and with each new one, the management team under Mark Thompson, director general from 2004 through mid-September 2012, added more guidelines and put more emphasis on form-filling and safety checks in news and entertainment programs. An organization already known for its bureaucracy became even more unwieldy (the editorial guidelines are now 215 pages long).

But it is these very structures that seem to have failed the BBC in the most recent scandal, in which its news division first canceled a child abuse segment it should have broadcast, and later broadcast one it should have canceled. In the first instance, it appears that people overseeing the program were too cautious, so that top managers were left unaware of its existence; in the second, managers may have relied too much on rigid procedures at the expense of basic journalistic principles.

“They burned their fingers,” said Tim Luckhurst, a journalism professor at the University of Kent who worked at the BBC for 10 years. “They wanted systems that could take responsibility instead of people.”

The recent scandal has had a number of immediate results. Mr. Thompson’s successor as director general, George Entwistle, resigned after just 54 days on the job. (Mr. Thompson is now president and chief executive of The New York Times Company.) Outside investigators were appointed to interrogate BBC employees in at least three different inquiries. A number of lower- and midlevel managers had to withdraw temporarily from their jobs and, facing possible disciplinary action, hired lawyers. And, once again, the BBC is talking about reorganizing structures.

Through a spokesman, Mr. Entwistle declined to comment on the scandal or the BBC’s management practices, saying he was “not doing any media interviews at present.” Mr. Thompson also declined to comment.

But Mr. Entwistle’s temporary successor, Tim Davie, who had previously been director of BBC Audio & Music, acknowledged that changes had to be made. “If the public are going to get journalism they trust from the BBC I have to be, as director general, very clear on who’s running the news operation and ensuring that journalism that we put out passes muster,” Mr. Davie said in his first week on the job. The first thing to do, he said, was to “take action and build trust by putting a clear line of command in.”

This is a complicated scandal in two parts. The first part was over the BBC’s decision last December not to broadcast a report saying that Jimmy Savile, a longtime BBC television host, had been a serial child molester, and instead to broadcast several glowing tributes to his career. The second part was its decision on Nov. 2 to accuse a member of Margaret Thatcher’s government of being a pedophile, an accusation that turned out to be patently false.

But both exposed the problems in a system that seems to insulate the BBC’s director general — who is also the editor in chief — from knowledge of basic issues like what potentially contentious programs are scheduled for broadcast. And both decisions were the result, it seems, of a system that failed in practice, even as it was correctly followed in theory.

Ben Bradshaw, a former BBC correspondent and now a Labour member of Parliament, said the 2004 scandal, touched off by reporting about British intelligence on Iraqi weapons of mass destruction, had created a system based on “fear and anxiety.” The BBC, he added, became “even more bureaucratic and had even more layers, which exacerbated the problem of buck passing and no one being able to take a decision.”

Speaking of the Nov. 2 broadcast, the chairman of the BBC Trust, Chris Patten, said in a television interview that the piece went through “every damned layer of BBC management bureaucracy, legal checks” without anyone raising any serious objections.

Matthew Purdy contributed reporting from New York, and Lark Turner from London.

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At Microsoft, Sinofsky Seen as Smart but Abrasive

On a warm night in late October, Steven Sinofsky stood on a platform in New York’s Times Square, smiling as a huge crowd roared at the unveiling of a Microsoft retail store, where Windows 8 and the company’s new Surface tablet were about to go on sale.

Less than three weeks later, Mr. Sinofsky — who, as the head of Windows, was arguably the second-most important leader at Microsoft — suddenly left the company. His abrasive style was a source of discord within Microsoft, and he and Steven A. Ballmer, Microsoft’s chief executive, agreed that it was time for him to leave, according to a person briefed on the situation who was not authorized to speak publicly about it.

Mr. Sinofsky was widely admired for his effectiveness in running one of the biggest and most important software development organizations on the planet. But his departure, which Microsoft announced late on Monday, parallels in many respects that of Scott Forstall, the headstrong former head of Apple’s mobile software development, who was fired by Apple’s chief executive, Timothy D. Cook, in late October.

Both cases underscore a quandary that chief executives sometimes face: when do the costs of keeping brilliant leaders who cannot seem to get along with others outweigh the benefits?

The tipping point that led to Mr. Sinofsky’s departure came after an accumulation of run-ins with Mr. Ballmer and other company leaders, rather than a single incident, according to interviews with several current and former Microsoft executives who declined to be named discussing internal matters.

One example of the kind of behavior that hurt Mr. Sinofsky’s standing at the company occurred this year at a two-day retreat for Microsoft’s senior executives at the Semiahmoo resort on the coast just below the Canadian border in Washington State. At the meeting, Microsoft’s various division heads were expected to make presentations on their businesses, answer questions and remain to hear their peers repeat the exercise.

When Mr. Sinofsky stood on the first day to speak about the Windows division, he told the group he had not prepared a presentation, and if they wanted to catch up on the progress of Windows 8, they could read his company blog, where he publicly chronicled the software’s development. He answered questions from the audience and then left the resort, while his colleagues remained until the next day, according to multiple people who were present.

Mr. Sinofsky’s early exit and halfhearted presentation were widely noted by his colleagues, irking even his admirers in the company. “He lost a lot of support,” one attendee said.

It wasn’t until this Monday, though, that Mr. Sinofsky and Mr. Ballmer both decided it would be best if Mr. Sinofsky left. Bill Gates, Microsoft’s chairman, supported the move, a person briefed on the matter said. Mr. Sinofsky served as a technical assistant to Mr. Gates in the 1990s.

In an e-mail to Microsoft employees, Mr. Sinofsky said the decision to leave “was a personal and private choice.” Many surprised Microsoft insiders noted that Mr. Sinofsky’s departure was immediate, an unusual arrangement for someone with a 23-year track record at the company. A Microsoft spokesman, Frank Shaw, said Mr. Sinofsky was not available to comment.

Although Mr. Ballmer grew increasingly impatient with Mr. Sinofsky throughout the year, he held back from taking any action earlier to avoid disrupting the release of Windows 8, the most important product Microsoft has unveiled in years, a person with knowledge of his thinking said.

The final decision could not have come lightly. Although many people at Microsoft viewed him as a ruthless corporate schemer, Mr. Sinofsky ran the highly complex organization responsible for Windows as a disciplined army that met deadlines, and he was respected by people on his team.

He achieved hero status within Microsoft several years ago by taking over the leadership of Windows after the debacle that was Windows Vista, a much-delayed operating system whose sluggish performance and technical problems worsened Microsoft’s reputation for mediocre software. Mr. Sinfosky led the development of a new version of the operating system, Windows 7, which was positively reviewed and sold well.

“He did great things with Windows,” said Michael Cusumano, a professor at the Sloan School of Management at the Massachusetts Institute of Technology. “That’s still the core of the company.”

But while Mr. Sinofsky was effective, Mr. Cusumano said, he could be secretive and difficult to get along with, as he learned while dealing with Mr. Sinofsky while Mr. Cusumano was writing a book on Microsoft in the early 1990s. “I could imagine that he burned a lot of bridges and created a bunch of enemies,” he said.

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Kidney Donors Given Mandatory Safeguards

ST. LOUIS — Addressing long-held concerns about whether organ donors have adequate protections, the country’s transplant regulators acted late Monday to require that hospitals thoroughly inform living kidney donors of the risks they face, fully evaluate their medical and psychological suitability, and then track their health for two years after donation.

Enactment of the policies by the United Network for Organ Sharing, which manages the transplant system under a federal contract, followed six years of halting development and debate.

Meeting at a St. Louis hotel, the group’s board voted to establish uniform minimum standards for a field long regarded as a medical and ethical Wild West. The organ network, whose initial purpose was to oversee donation from people who had just died, has struggled at times to keep pace with rapid developments in donations from the living.

“There is no question that this is a major development in living donor protection,” said Dr. Christie P. Thomas, a nephrologist at the University of Iowa and the chairman of the network’s living donor committee.

Yet some donor advocates complained that the measures did not go far enough, and argued that the organ network, in its mission to encourage transplants, has a conflict of interest when it comes to safeguarding donors.

Three years ago, the network issued some of the same policies as voluntary guidelines, only to have the Department of Health and Human Services insist they be made mandatory.

Although long-term data on the subject is scarce, few living kidney donors are thought to suffer lasting physical or psychological effects. Kidney donations, known as nephrectomies, are typically done laparoscopically these days through a series of small incisions. The typical patient may spend only a few nights in a hospital and feel largely recovered after several months.

Kidneys are by far the most transplanted organs, and there have been nearly as many living donors as deceased ones over the last decade. What data is available suggests that those with one kidney typically live as long as those with two, and that the risk of a donor dying during the procedure is roughly 3 in 10,000.

But kidney transplants, like all surgery, can sometimes end in catastrophe.

In May at Montefiore Medical Center in the Bronx, a 41-year-old mother of three died when her aorta was accidentally cut during surgery to donate a kidney to her brother. In other recent isolated cases, patients have received donor kidneys infected with undetected H.I.V. or hepatitis C.

Less clear are any longer-term effects on donors. Research conducted by the United Network for Organ Sharing shows that of roughly 70,000 people who donated kidneys between late 1999 and early 2011, 27 died within two years of medical causes that may — or may not — have been related to donation. For a small number of donors, their remaining kidney failed, and they required dialysis or a transplant.

The number of living donors — 5,770 in 2011 — has dropped 10 percent over the last two years, possibly because the struggling economy has made it difficult for prospective donors to take time off from work to recuperate. With the national kidney waiting list now stretching past 94,000 people, and thousands on the list dying each year, transplant officials have said they must improve confidence in the system so more people will donate.

The average age of donors has been rising, posing additional medical risks. And new ethical questions have been raised by the emergence of paired kidney exchanges and transplant chains started by good Samaritans who give an organ to a stranger.

Brad Kornfeld, who donated a kidney to his father in 2004, told the board that it had been impossible to find good information about what to expect, leaving him to search for answers on unreliable Internet chat rooms. He said he had almost backed out.

“If information is power,” said Mr. Kornfeld, a Coloradan who serves on the living donor committee, “the lack of information is crippling.”

Under the policies approved this week, the organ network will require hospitals to collect medical data, including laboratory test results, on most living donors to study lasting effects. Results must be reported at six months, one year and two years.

Similar regulations have been in place since 2000, but they did not require blood and urine testing, and hospitals were allowed to report donors who could not be found as simply lost.

That happened often. In recent years, hospitals have submitted basic clinical information — like whether donors were alive or dead — for only 65 percent of donors and lab data for fewer than 40 percent, according to the organ network. Although the network holds the authority, no hospital has ever been seriously sanctioned for noncompliance.

“It’s time we put some teeth into our policy,” said Jill McMaster, a board member from Tennessee.

By 2015, transplant programs will have to report thorough clinical information on at least 80 percent of donors and lab results on at least 70 percent. The requirements phase in at lower levels for the next two years.

Dr. Stuart M. Flechner of the Cleveland Clinic, the chairman of a coalition of medical societies that made recommendations to the organ network, said 9 of 10 hospitals would currently not meet the new requirement.

Donna Luebke, a kidney donor from Ohio who once served on the organ network’s board, said the new standards would matter only if enforcement were more rigorous. She noted that the organization was dominated by transplant doctors: “UNOS is nothing but the foxes watching the henhouse,” she said.

Another of the new regulations prescribes in detail the medical and psychological screenings that hospitals must conduct for potential donors. It requires automatic exclusion if the potential donor has diabetes, uncontrolled hypertension or H.I.V., among other conditions.

The new policies also require that hospitals appoint an independent advocate to counsel and represent donors, and that donors receive detailed information in advance about medical, psychological and financial risks.

Read More..

Kidney Donors Given Mandatory Safeguards

ST. LOUIS — Addressing long-held concerns about whether organ donors have adequate protections, the country’s transplant regulators acted late Monday to require that hospitals thoroughly inform living kidney donors of the risks they face, fully evaluate their medical and psychological suitability, and then track their health for two years after donation.

Enactment of the policies by the United Network for Organ Sharing, which manages the transplant system under a federal contract, followed six years of halting development and debate.

Meeting at a St. Louis hotel, the group’s board voted to establish uniform minimum standards for a field long regarded as a medical and ethical Wild West. The organ network, whose initial purpose was to oversee donation from people who had just died, has struggled at times to keep pace with rapid developments in donations from the living.

“There is no question that this is a major development in living donor protection,” said Dr. Christie P. Thomas, a nephrologist at the University of Iowa and the chairman of the network’s living donor committee.

Yet some donor advocates complained that the measures did not go far enough, and argued that the organ network, in its mission to encourage transplants, has a conflict of interest when it comes to safeguarding donors.

Three years ago, the network issued some of the same policies as voluntary guidelines, only to have the Department of Health and Human Services insist they be made mandatory.

Although long-term data on the subject is scarce, few living kidney donors are thought to suffer lasting physical or psychological effects. Kidney donations, known as nephrectomies, are typically done laparoscopically these days through a series of small incisions. The typical patient may spend only a few nights in a hospital and feel largely recovered after several months.

Kidneys are by far the most transplanted organs, and there have been nearly as many living donors as deceased ones over the last decade. What data is available suggests that those with one kidney typically live as long as those with two, and that the risk of a donor dying during the procedure is roughly 3 in 10,000.

But kidney transplants, like all surgery, can sometimes end in catastrophe.

In May at Montefiore Medical Center in the Bronx, a 41-year-old mother of three died when her aorta was accidentally cut during surgery to donate a kidney to her brother. In other recent isolated cases, patients have received donor kidneys infected with undetected H.I.V. or hepatitis C.

Less clear are any longer-term effects on donors. Research conducted by the United Network for Organ Sharing shows that of roughly 70,000 people who donated kidneys between late 1999 and early 2011, 27 died within two years of medical causes that may — or may not — have been related to donation. For a small number of donors, their remaining kidney failed, and they required dialysis or a transplant.

The number of living donors — 5,770 in 2011 — has dropped 10 percent over the last two years, possibly because the struggling economy has made it difficult for prospective donors to take time off from work to recuperate. With the national kidney waiting list now stretching past 94,000 people, and thousands on the list dying each year, transplant officials have said they must improve confidence in the system so more people will donate.

The average age of donors has been rising, posing additional medical risks. And new ethical questions have been raised by the emergence of paired kidney exchanges and transplant chains started by good Samaritans who give an organ to a stranger.

Brad Kornfeld, who donated a kidney to his father in 2004, told the board that it had been impossible to find good information about what to expect, leaving him to search for answers on unreliable Internet chat rooms. He said he had almost backed out.

“If information is power,” said Mr. Kornfeld, a Coloradan who serves on the living donor committee, “the lack of information is crippling.”

Under the policies approved this week, the organ network will require hospitals to collect medical data, including laboratory test results, on most living donors to study lasting effects. Results must be reported at six months, one year and two years.

Similar regulations have been in place since 2000, but they did not require blood and urine testing, and hospitals were allowed to report donors who could not be found as simply lost.

That happened often. In recent years, hospitals have submitted basic clinical information — like whether donors were alive or dead — for only 65 percent of donors and lab data for fewer than 40 percent, according to the organ network. Although the network holds the authority, no hospital has ever been seriously sanctioned for noncompliance.

“It’s time we put some teeth into our policy,” said Jill McMaster, a board member from Tennessee.

By 2015, transplant programs will have to report thorough clinical information on at least 80 percent of donors and lab results on at least 70 percent. The requirements phase in at lower levels for the next two years.

Dr. Stuart M. Flechner of the Cleveland Clinic, the chairman of a coalition of medical societies that made recommendations to the organ network, said 9 of 10 hospitals would currently not meet the new requirement.

Donna Luebke, a kidney donor from Ohio who once served on the organ network’s board, said the new standards would matter only if enforcement were more rigorous. She noted that the organization was dominated by transplant doctors: “UNOS is nothing but the foxes watching the henhouse,” she said.

Another of the new regulations prescribes in detail the medical and psychological screenings that hospitals must conduct for potential donors. It requires automatic exclusion if the potential donor has diabetes, uncontrolled hypertension or H.I.V., among other conditions.

The new policies also require that hospitals appoint an independent advocate to counsel and represent donors, and that donors receive detailed information in advance about medical, psychological and financial risks.

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News Analysis: Petraeus Case Raises Concerns About Americans’ Privacy

Chuck Burton/Associated Press

F.B.I. agents at Paula Broadwell’s home Tuesday. Her e-mails led to unintended consequences.

The F.B.I. investigation that toppled the director of the C.I.A. and has now entangled the top American commander in Afghanistan underscores a danger that civil libertarians have long warned about: that in policing the Web for crime, espionage and sabotage, government investigators will unavoidably invade the private lives of Americans.

On the Internet, and especially in e-mails, text messages, social network postings and online photos, the work lives and personal lives of Americans are inextricably mixed. Private, personal messages are stored for years on computer servers, available to be discovered by investigators who may be looking into completely unrelated matters.

In the current F.B.I. case, a Tampa, Fla., woman, Jill Kelley, a friend both of David H. Petraeus, the former C.I.A. director, and Gen. John R. Allen, the top NATO commander in Afghanistan, was disturbed by a half-dozen anonymous e-mails she had received in June. She took them to an F.B.I. agent whose acquaintance with Ms. Kelley (he had sent her shirtless photos of himself — electronically, of course) eventually prompted his bosses to order him to stay away from the investigation.

But a squad of investigators at the bureau’s Tampa office, in consultation with prosecutors, opened a cyberstalking inquiry. Although that investigation is still open, law enforcement officials have said that criminal charges appear unlikely.

In the meantime, however, there has been a cascade of unintended consequences. What began as a private, and far from momentous, conflict between two women, Ms. Kelley and Paula Broadwell, Mr. Petraeus’s biographer and the reported author of the harassing e-mails, has had incalculable public costs.

The C.I.A. is suddenly without a permanent director at a time of urgent intelligence challenges in Syria, Iran, Libya and beyond. The leader of the American-led effort to prevent a Taliban takeover in Afghanistan is distracted, at the least, by an inquiry into his e-mail exchanges with Ms. Kelley by the Defense Department’s inspector general.

For privacy advocates, the case sets off alarms.

“There should be an investigation not of the personal behavior of General Petraeus and General Allen, but of what surveillance powers the F.B.I. used to look into their private lives,” Anthony D. Romero, executive director of the American Civil Liberties Union, said in an interview. “This is a textbook example of the blurring of lines between the private and the public.”

Law enforcement officials have said they used only ordinary methods in the case, which might have included grand jury subpoenas and search warrants. As the complainant, Ms. Kelley presumably granted F.B.I. specialists access to her computer, which they would have needed in their hunt for clues to the identity of the sender of the anonymous e-mails. While they were looking, they discovered General Allen’s e-mails, which F.B.I. superiors found “potentially inappropriate” and decided should be shared with the Defense Department.

In a parallel process, the investigators gained access, probably using a search warrant, to Ms. Broadwell’s Gmail account. There they found messages that turned out to be from Mr. Petraeus.

Marc Rotenberg, executive director of the Electronic Privacy Information Center in Washington, said the chain of unexpected disclosures was not unusual in computer-centric cases.

“It’s a particular problem with cyberinvestigations — they rapidly become open-ended because there’s such a huge quantity of information available and it’s so easily searchable,” he said, adding, “If the C.I.A. director can get caught, it’s pretty much open season on everyone else.”

For years now, as national security officials and experts have warned of a Pearl Harbor cyberattack that could fray the electrical grid or collapse stock markets, policy makers have jostled over which agencies should be assigned the delicate task of monitoring the Internet for dangerous intrusions.

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France Grants Its Recognition to Syria Rebels

Javier Manzano/Agence France-Presse — Getty Images

Smoke billowed from burning tires as a Syria rebel fired towards regime forces during clashes in the Al-Amariya district of Aleppo in Syria on Tuesday.

PARIS — France announced Tuesday that it was recognizing the newly formed Syrian rebel coalition and would consider arming the group, seeking to inject momentum into a broad Western and Arab effort to build a viable and effective opposition that would hasten the end of a stalemated civil war that has destabilized the Middle East.

The announcement by President François Hollande made France the first Western country to fully embrace the new coalition, which came together this past weekend under Western pressure after days of difficult negotiations in Doha, Qatar.

The goal was to make an opposition leadership — both inside and outside the country — representative of the array of Syrian groups pressing for the downfall of President Bashar al-Assad. Although Mr. Assad is increasingly isolated as his country descends further into mayhem and despair after 20 months of conflict, he has survived partly because of the disagreements and lack of unity among his opponents.

Throughout the conflict, the West has taken half measures and been reluctant to back an aggressive effort to oust Mr. Assad. This appears to be the first time that Western nations, with Arab allies, are determined to build a viable opposition leadership that can ultimately function as a government. Whether it can succeed remains unclear.

Mr. Hollande went beyond other Western pledges of support for the new Syrian umbrella rebel group, which calls itself the National Coalition of Syrian Revolutionary and Opposition Forces. But Mr. Hollande’s announcement clearly signaled expectations that if the group can establish political legitimacy and an operational structure inside Syria, creating an alternative to the Assad family’s four decades in power, it will be rewarded with further recognition, money and possibly weapons.

“I announce that France recognizes the Syrian National Coalition as the sole representative of the Syrian people and thus as the future provisional government of a democratic Syria and to bring an end to Bashar al-Assad’s regime,” said Mr. Hollande, who has been one of the Syrian president’s harshest critics.

As for weapons, Mr. Hollande said, France had not supported arming the rebels up to now, but “with the coalition, as soon as it is a legitimate government of Syria, this question will be looked at by France, but also by all countries that recognize this government.”

Political analysts called Mr. Hollande’s announcement an important moment in the Syrian conflict, which began as a peaceful Arab Spring uprising in March 2011. It was harshly suppressed by Mr. Assad, turned into a civil war and has left nearly 40,000 Syrians dead, displaced about 2.5 million and forced more than 400,000 to flee to neighboring countries, according to international relief agencies.

“It’s certainly another page of the story,” Augustus Richard Norton, a professor of international relations at Boston University and an expert on Middle East political history, said of the French announcement. “I think it’s important. But it will be much more important if other countries follow suit. I don’t think we’re quite there yet.”

Some drew an analogy to France’s leading role in the early days of the Libyan uprising when it helped funnel aid, and later military support, to the rebels who had firmly established themselves in eastern Libya and would later topple Col. Muammar el-Qaddafi. But in Syria, rebels have not been as organized and have no hold on significant amounts of territory — at least not enough to create a provisional government that could resist Mr. Assad’s military assaults. The West has also refused, so far, to impose a no-fly zone over Syria, which was critical to the success of the Libyan uprising.

Andrew J. Tabler, a Syria expert at the Washington Institute for Near East Policy, said that the new coalition would have to create a secure zone in Syria to be successful, and that that step would require support from the United States, which was instrumental in the negotiations that led to the group’s creation but has not yet committed to giving it full recognition.

What the French have done, Mr. Tabler said, is significant because they have started the process of broader recognition, putting pressure on the group to succeed. “They’ve decided to back this umbrella organization and hope that it has some kind of political legitimacy and keep it from going to extremists,” he said. “It’s a gamble. The gamble is that it will stiffen the backs of the opposition.”

Steven Erlanger reported from Paris, and Rick Gladstone from New York. Reporting was contributed by Neil MacFarquhar and Hwaida Saad from Beirut, Lebanon; Nick Cumming-Bruce from Geneva; and Richard Berry from Paris.

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False Posts on Facebook Undermine Its Credibility

SAN FRANCISCO — The Facebook page for Gaston Memorial Hospital, in Gastonia, N.C., offers a chicken salad recipe to encourage healthy eating, tips on avoiding injuries at Zumba class, and pictures of staff members dressed up at Halloween. Typical stuff for a hospital in a small town.

But in October, another Facebook page for the hospital popped up. This one posted denunciations of President Obama and what it derided as “Obamacare.” It swiftly gathered hundreds of followers, and the anti-Obama screeds picked up “likes.” Officials at the hospital, scrambling to get it taken down, turned to their real Facebook page for damage control. “We apologize for any confusion,” they posted on Oct. 8, “and appreciate the support of our followers.”

The fake page came down 11 days later, as mysteriously as it had come up. The hospital says it has no clue who was behind it.

Fakery is all over the Internet. Twitter, which allows pseudonyms, is rife with fake followers, and has been used to spread false rumors, as it was during Hurricane Sandy. False reviews are a constant problem on consumer Web sites.

Gaston Memorial’s experience is an object lesson in the problem of fakery on Facebook. For the world’s largest social network, it is an especially acute problem, because it calls into question its basic premise. Facebook has sought to distinguish itself as a place for real identity on the Web. As the company tells its users: “Facebook is a community where people use their real identities.” It goes on to advise: “The name you use should be your real name as it would be listed on your credit card, student ID, etc.”

Fraudulent “likes” damage the trust of advertisers, who want clicks from real people they can sell to and whom Facebook now relies on to make money. Fakery also can ruin the credibility of search results for the social search engine that Facebook says it is building.

Facebook says it has always taken the problem seriously, and recently stepped up efforts to cull fakes from the site. “It’s pretty much one of the top priorities for the company all the time,” said Joe Sullivan, who is in charge of security at Facebook.

The fakery problem on Facebook comes in many shapes. False profiles are fairly easy to create; hundreds can pop up simultaneously, sometimes with the help of robots, and often they persuade real users into friending them in a bid to spread malware. Fake Facebook friends and likes are sold on the Web like trinkets at a bazaar, directed at those who want to enhance their image. Fake coupons for meals and gadgets can appear on Facebook newsfeeds, aimed at tricking the unwitting into revealing their personal information.

Somewhat more benignly, some college students use fake names in an effort to protect their Facebook content from the eyes of future employers.

Mr. Sullivan declined to say what portion of the company’s now one billion plus users were fake. The company quantified the problem last June, in responding to an inquiry by the Securities and Exchange Commission. At that time, the company said that of its 855 million active users, 8.7 percent, or 83 million, were duplicates, false or “undesirable,” for instance, because they spread spam.

Mr. Sullivan said that since August, the company had put in place a new automated system to purge fake “likes.” The company said it has 150 to 300 staff members to weed out fraud.

Flags are raised if a user sends out hundreds of friend requests at a time, Mr. Sullivan explained, or likes hundreds of pages simultaneously, or most obvious of all, posts a link to a site that is known to contain a virus. Those suspected of being fakes are warned. Depending on what they do on the site, accounts can be suspended.

In October, Facebook announced new partnerships with antivirus companies. Facebook users can now download free or paid antivirus coverage to guard against malware.

“It’s something we have been pretty effective at all along,” Mr. Sullivan said.

Facebook’s new aggressiveness toward fake “likes” became noticeable in September, when brand pages started seeing their fan numbers dip noticeably. An average brand page, Facebook said at the time, would lose less than 1 percent of its fans.

But the thriving market for fakery makes it hard to keep up with the problem. Gaston Memorial, for instance, first detected a fake page in its name in August; three days later, it vanished. The fake page popped up again on Oct. 4, and this time filled up quickly with the loud denunciations of the Obama administration. Dallas P. Wilborn, the hospital’s public relations manager, said her office tried to leave a voice-mail message for Facebook but was disconnected; an e-mail response from the social network ruled that the fake page did not violate its terms of service. The hospital submitted more evidence, saying that the impostor was using its company logo.

Eleven days later, the hospital said, Facebook found in its favor. But by then, the local newspaper, The Gaston Gazette, had written about the matter, and the fake page had disappeared.

Facebook declined to comment on the incident, and pointed only to its general Statement of Rights and Responsibilities.

The election season seems to have increased the fakery.

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