Articles Posted in Ethics

mom-300x171Big Medicine can paper over its troubles with basic fairness by slapping fancy terms on them: take “health and gender disparities,” for instance. But doctors, hospitals, and the rest of us can’t make medical care more equitable, accessible, safe, and affordable without looking at inequities, square on.

That’s why the New York Times, Washington Post, and Associated Press deserve credit for recent deep digs into the struggles of women, poor women, and especially black women with modern medicine:

juul-300x197Big Tobacco, Big Sugar, and technology may be targeting the well-being of young people faster than regulators can prevent them from heading back to the future in a bad way:  Teens getting hooked on nicotine, while tots take in excess calories with super sweet breakfast cereals.

The Wall Street Journal and the New York Times each have big take-outs, reporting on the “explosive” and “epidemic” trend, mostly by more affluent teens, of vaping with so-called e-cigarettes,  notably a hot new device called the Juul.

It’s about the size of a computer flash drive, and it uses fruity-flavored liquids to deliver a jolt of nicotine — more than what users might get by puffing a pack of old-fashioned cigarettes.

kidtv-300x225If Americans want to battle obesity, including among youngsters, one place to start is avoiding unhealthy food products hawked relentlessly by major league sports advertisers.

Weight woes plague grownups and show no signs of letting up — they’re increasing, instead, with 40 percent of Americans found to be obese in 2015 and 2016, a sharp increase over a decade earlier. The picture’s no prettier for young people, with the latest federal data showing the percentage of children ages 2 to 19 who are obese increased from 14 percent in 1999 to 18.5 percent in 2015 and 2016.

With studies showing that junk food and empty calories contribute significantly to making the nation an excessive waist-land, Vox, an online information site, deserves credit for pointing out how pervasive, insidious, and even accepted it has become for sports fans — especially young enthusiasts — to be barraged by advertising for fast and unhealthful meals, sugar-laden drinks and cereals, and foods full of fats, empty calories, and excess salt.

Seroquel-25mg-300x195In a display of just how corruptive big money has gotten to be in modern medicine, Big Pharma keeps getting dubious doctors to write so-called off-label prescriptions for powerful anti-psychotic medications — no matter their proven harm to patients nor big settlements drug makers have been forced to pay.

The Washington Post deserves credit for its investigative dissection of AstraZeneca and its “blockbuster” product, Seroquel (generic name quetiapine). It’s a medication developed to treat severe cases of schizophrenia.

Instead, as has occurred with several other drugs of its kind, doctors — in response to major marketing and sales campaigns by AstraZeneca — have decided this wallop-packing drug can be given for uses for which there is less or little evidence. The Washington Post says doctors write abundant Seroquel scripts for patients with an “expansive array of ills, including insomnia, post-traumatic stress disorder and agitation in patients with dementia.”

redfieldPresident Trump’s latest rant  that drug dealers should face capital punishment fell flat in the face of new revelations on what’s going on with the fight against opioid drug overdoses and abuse that have become the leading killer of Americans younger than 50.

It turns out that states have failed to spend hundreds of millions of dollars in funding appropriated by Congress to battle the abuse of prescription painkillers, potent synthetic versions like fentanyl, and illicit drugs like heroin.

Politico reported that the Obama Administration, in the 21st Century Cures Act, passed by the Congress and signed into law by the president as 2016 ended, provided more than $1 billion over two years in grants to help states attack the opioid crisis.

cnnopioids-300x130Doctors already taking heat for selling out  their prescription pads for financial gain may want to brace themselves for new anger from patients, regulators, and lawmakers over two sets of data detailing unsavory links between MDs’ payments from Big Pharma and their opioid drug prescribing.

CNN, Harvard University, and CareDash.com — a site that says it seeks to serve low- to middle-income patients with reliable health care information — have examined national prescribing data, finding links between Big Pharma pay and doctors’ ordering of prescription painkillers central to a nationwide epidemic of abuse.

CNN, with Harvard, reported its findings:

shulkin-240x300More than 100,000 patients in the area surrounding the nation’s capital rely on a flagship hospital for what should be blue-chip care. They deserve better than the continuing scandal that envelops not only the VA Medical Center in Washington, D.C., but also its parent Department of Veterans Affairs.

Investigators have excoriated the VA and its leader for failing to address problems in the agency’s medical facilities nationwide but especially in Washington, because officials, as USA Today reported,  “had been informed of the issues repeatedly since 2013.”

The news organization added that investigators concluded “a culture of complacency and a sense of futility pervaded [VA] offices at multiple levels,” such that, “In interviews, leaders frequently abrogated individual responsibility and deflected blame to others. Despite the many warnings and ongoing indicators of serious problems, leaders failed to engage in meaningful interventions of effective remediation.”

bloodcells-300x150Soaring prescription drug prices aren’t just an economic or policy-making puzzle, they’re also a constant nightmare for millions of Americans, whether their conditions are common, chronic, or rare.

Or as reporters Katie Thomas and Charles Ornstein wrote recently in the New York Times:

The burden of high drug costs weighs most heavily on the sickest Americans. Drug makers have raised prices on treatments for life-threatening or chronic conditions like multiple sclerosis, diabetes and cancer. In turn, insurers have shifted more of those costs onto consumers. Saddled with high deductibles and other out-of-pocket costs that expose them to a drug’s rising list price, many people are paying thousands of dollars a month merely to survive.

frail-300x150Although patient advocates long have pressed Big Medicine to eliminate unnecessary care — waste in the health care system that some experts estimate adds as much as $765 billion annually in needless costs — it may be past due for a public condemnation of a notably extreme example of this practice: The all too frequent, unhelpful surgeries for the old, many of whom are at the end of life.

Liz Szabo of the independent, nonprofit Kaiser Health News Service, and National Public Radio deserve credit for their report, detailing how 1 in 3 Medicare patients undergoes a serious procedure, “even though the evidence shows that many are more likely to be harmed than to benefit from it.”

As the story explains:

Big Pharma’s notorious middle-men, aka prescription benefit managers or PBMs, are coming under yet more fire — this time over so-called gag orders that they impose on pharmacists they work with, preventing these front-line health care providers from telling patients about cheaper options for drugs.

The New York Times reported that states are leading the push, and soon may be joined by the federal government, to bar companies from preventing this money-saving practice.

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