Friday, August 26, 2016

The Association Between Insurance and Transfer of Noninjured Children From Emergency Departments.

Compared to children with health insurance, children without insurance were more likely to be transferred from the emergency department to another hospital, than to be admitted for inpatient care within the same hospital. Ann Emerg Med. 2016 Aug 20. pii: S0196-0644(16)30262-1.

Comment: This is not supposed to happen according to ethical and legal guidelines. There appears to be at least a subtle perhaps subliminal effect upon clinicians. This emphasizes the need for universal health insurance.

Wednesday, August 24, 2016

Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014.

Euthanasia or assisted suicide in the Netherlands has been done for patients with psychiatric disorders and the primary health issue. Those undergoing euthanasia or assisted suicide for psychiatric disorders in the Netherlands are mostly women (70%), and of diverse ages (32% over 70, 44% 50 to 70, and 24% 30 to 50). Although consultation with other physicians was extensive, 24% of cases involved disagreement between the consultants. JAMA Psychiatry. 2016 Apr;73(4):362-8

Comment: The most troubling finding of this study was that 11% of cases did not get an independent psychiatric review prior to undergoing euthanasia or assisted suicide.

Friday, August 19, 2016

Human Trafficking: a Form of Modern Day Slavery

Human trafficking has been reported in all 50 US states, and includes forced labor and sexual exploitation. The victims frequently present to the hospital and medical clinics for treatment, providing an opportunity for health professionals to intervene. Ann Intern Med. 2016 Aug 9.

Comment: The key here is awareness. By recognizing that modern day slavery exists and remains too common, health care professionals are more likely to recognize the victims and take action to help end the human trafficking.

Saturday, August 13, 2016

Altruism in organ donation: an unnecessary requirement?

The authors of this article argue that altruistic motivation is not necessary in order to allow organ donations.
J Med Ethics. 2014 Feb;40(2):134-8

Saturday, December 6, 2014

The Good and Bad of Medical Social Media

QUESTION: is social media a valuable outreach tool for physicians?

METHODS: expert debate


Dr Anne Marie Cunningham takes the view that physicians should have a strong social media presence. Physicians benefit from access to a global community of peers and leaders. 

Professor DeCamp argues that the use of social media places doctors at a professional and ethical risk and is essentially a waste of time. Social media makes it more difficult to maintain a distinction between the private and the professional aspects of a physician's life.

CONCLUSION: Both experts agree that specific guidelines and guidance are needed to ensure that physicians optimally benefit from social media and avoid known risks.

J R Coll Physicians Edinb. 2013;43(4):318-22

Saturday, November 29, 2014

Harmful Research on Children

Against Harmful Research on Non-Agreeing Children.
BACKGROUND: The Code of Federal Regulations permits harmful research on children who have not agreed to participate.

QUESTION: should harmful research be allowed on non-agreeing children? Do children have the right to not agree to be research subjects? Or are their parents the sole decision makers?

DISCUSSION: pediatric research by its nature (investigation of the unknown) may result in harm to the research subjects. When children do not agree to participate, can their parents over-rule their decision? Currently, the answer to this question is "yes", however, the author of this article believes that the answer should be an unqualified "no." 

Bioethics. 2014 Sep 24;

Sunday, November 9, 2014

Does the Government Pervert Bioethics?

The road being paved to neuroethics: A path leading to bioethics or to neuroscience medical ethics?
In 2013, U.S. President Barack Obama started the Presidential Commission for the Study of Bioethical Issues.  Concerns were expressed that government involvement in bioethics may have unforeseen and possibly dangerous repercussions to medicine.

The author emphasizes that the lessons of history chronicle that wherever governments have sought to alter medical ethics and control medical care, the results have frequently been perverse and disastrous, as in the examples of the communist Soviet Union and National Socialist (Nazi) Germany.
  •  Soviet and Nazi doctors' dark descent into ghastly experimentation and brutality was a product of convoluted ethics and physicians willingly cooperating with authoritarianism citing utilitarianism in the pursuit of the 'collective' or 'greater good.' 
Thus in the 20(th) century, as governments infringed on the medical profession, even the Liberal Democracies have not been immune to the corruption of ethics in science and medicine.