Keith Burgess-Jackson, J.D., Ph.D.

Here.

To the Editor:

In “Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis” (front page, July 12), you quote a virtualist physician who says, “I don’t have people knocking on the door and saying, ‘Doc, we need you in another room.’”

Why, then, does the accompanying photo show an employee at the same company sitting in front of eight computer screens like an air traffic controller?

There is value in a physician’s being in the same room as a patient. There is value in knowing a patient’s history, background, medication history and stressors.

A good doctor respects nuance. Watching a patient walk, sensing his demeanor, feeling her rash, seeing her tremor and feeling his pulse contribute to making a correct diagnosis; these physical signs cannot be ascertained by a stranger on a screen.

A “trustworthy face” chosen online is not equivalent to an in-person, patient-physician relationship developed over time. It never will be.

SHARON LEWIN

New York

The writer is an internist and infectious disease specialist.

Donald Trump is the best thing to have happened to the Republican Party in a long time. Most Republicans in office are no different from Democrats on issues such as illegal immigration, abortion, homosexual "marriage," and free trade. Trump doesn't play the game. He doesn't go along to get along. He isn't interested in political power for its own sake. People love that about him, and it has Republicans quaking in fear. Go, Donald, go!

Addendum: John McCain is one of the sleaziest, slimiest, most dishonorable people I have known. What kind of man blames his female running mate for his electoral loss? What kind of man disparages the very people who voted for him, merely because they disagree with him about illegal immigration? What kind of man loves making deals with Democrats when those Democrats are pushing an anti-American agenda? What kind of man refuses to criticize Barack Obama (and even defends him) for fear of being labeled a racist? I love it that Donald Trump responds to him in kind. No amount of abuse would be too much for this creep.

Addendum 2: Here is Trump's campaign website.

Here is the final kilometer of today's stage of the Tour de France. The stage winner was Andre Greipel of Germany, who averaged 28.83 miles per hour for 113.7 miles. The Tour ends in Paris a week from today.

Here.

Here.

To the Editor:

In my experience as a doctor, the true failing of the medical community is underreporting suspected abuse. Child Protective Services and the legal system are doing too little, too late. I believe that the vast majority of physicians interact with parents who exhibit the “warning signs” of medical child abuse fairly frequently. For a situation to qualify as suspected medical child abuse, there has to be suspected harm to the child. Physicians are not in the habit of reporting parents to Child Protective Services who are perceived as demanding or overbearing, as the writer seems to suggest.

Disgruntled parents and patients are free to give their account of an illness or situation to the media. The doctors and hospitals who treat the patients are constrained by privacy laws and therefore unable to give their version of events. One should always keep this in mind when reading an article like this.

JULIE KOCH

North Wilkesboro, N.C.

Seven-Inning Felix (11-5) didn't make it past the sixth inning this afternoon in a 2-1 loss at Yankee Stadium. He threw 97 pitches to get 18 outs, which works out to 145.5 pitches for nine innings. No wonder he can't pitch a complete game! Felix is on track for 18.5 victories and his team, the Seattle Mariners, is on track not to make the playoffs for the 14th consecutive season. The American League Cy Young Award winner this year will probably be Dallas Keuchel of the Houston Astros, who is 12-4 with an earned-run average of 2.12 and 127 strikeouts. Felix is 11-5 with an earned-run average of 2.77 and 117 strikeouts. Keuchel's team is in the playoff hunt; Felix's team is not.

Whereas treating people as less (or more) than they are simpliciter is non-comparatively unjust, treating people as less (or more) than they are, relative to another or others, is comparatively unjust. If Adam and Barry are both trustworthy, then to praise the trustworthiness of Adam but to refuse similarly to praise Barry is to treat Barry unjustly, not only non-comparatively, but also comparatively, if it is to treat him as comparatively lower when he is not. Similarly, if Adam and Barry are equally untrustworthy, then (undeservedly) to praise Adam as trustworthy but refuse similar praise to Barry would be to treat Barry as comparatively lower when he is not. For that reason it may be described as unjust to Barry, even though non-comparatively he is treated as he deserves. And if Adam is trustworthy and Barry is not, then to praise both for their trustworthiness is to treat Adam as no more worthy of praise than Barry, when in fact he is. Again this may be described as treating Adam unjustly even though he is treated as he is from a non-comparative perspective: he is treated as if he were not comparatively higher, when in fact he is. The basic principle of comparative justice, then, is that comparative treatment should reflect comparative status: people are done a comparative injustice if they are treated as if their status, relative to others, is lower than in fact it is.

A consequence of this basic principle is that, as the familiar dictum says, equals should be treated as equals, and unequals as unequals.

(Geoffrey Cupit, Justice as Fittingness [Oxford: Clarendon Press, 1996], 28-9)

Here are scenes from today's stage of the Tour de France. The stage winner, Stephen Cummings of Great Britain (who rides for a South African team), averaged 25.23 miles per hour for 110.9 miles. Some French fans think Chris Froome's Team Sky is doping. Someone threw urine on him during today's stage, and one of his teammates was punched by a spectator.

Addendum: Here is video of Froome discussing the incident.