Articles Posted in Ethics

fdanulogo-300x126As snarky youngsters might say, “Well, OK, Boomer:” Federal watchdogs keep looking more than a little pitiful as they find they not only have fallen behind the times but keep racing to chase trends and technologies that have zoomed beyond their control.

In the meantime, consumers suffer the consequences.

Recent news reports show, for example, how vaping youths already may have found a big work-around with federal crackdowns on e-cigarettes and how social media has become a viper’s nest of not only quackery but a dubious diamond mine for Big Pharma exploitation.

practicefusion-300x169Federal prosecutors have provided 145 million reasons why enthusiasts may want to curb their exuberance about how high tech will work miracles in the U.S. health care system.

That’s because investigators have ferreted out “abhorrent” conduct by Practice Fusion, a San Francisco firm that specialized in electronic health care records software, according to the U.S. Attorney’s Office in Vermont.

“During the height of the opioid crisis, the company took a million-dollar kickback to allow an opioid company to inject itself in the sacred doctor-patient relationship so that it could peddle even more of its highly addictive and dangerous opioids,”  Christina E. Nolan, U.S. Attorney for the District of Vermont, said in a statement. Practice Fusion, she added,  “illegally conspired to allow [a] drug company to have its thumb on the scale at precisely the moment a doctor was making incredibly intimate, personal, and important decisions about a patient’s medical care, including the need for pain medication and prescription amounts.”

The public’s health and safety sometimes find protections in the civil justice system and sometimes under regulators’ threat. Here’s hoping that whatever means are required, just and proper outcomes result.

For women, two separate suits have sought a modicum of justice for sexual abuse of talented young gymnasts by a predatory caregiver and damages tied to the maker of what has become a notorious material for supposed surgical repairs in the pelvic area.

For parents, the positive but potentially inconvenient recent news is that regulators finally have cracked down on risky baby sleepers, ordering the recall of tens of thousands more of them.

califgovnewsomBig Pharma, with its relentless price gouging, may finally have poked in the eye the wrong people. But even as patients wait to see if hospitals, and now states and insurers, can beat down skyrocketing drug prices, isn’t it past time for more public shaming for doctors who persist in writing excessive, dubious, and downright risky prescriptions?

Although the Trump Administration and Republicans in Congress have failed to deliver on repeated promises to attack excessive costs for prescription drugs, the state of California and now leading insurers are following some hospitals in tackling the problem.

Calif. Gov. Gavin Newsom (shown, above right), in unveiling his state budget, told lawmakers that he wants the Golden State to consider contracting with generic drug makers to produce products that would cost less and be sold under a California label. As the Los Angeles Times described the still-to-be fleshed out gubernatorial plan:

mlk-300x207With the nation taking a holiday to celebrate the remarkable life of the Rev. Dr. Martin Luther King and his pioneering push for Americans’ civil rights, it may be worth remembering that his far-reaching visions of equality and social justice were deeply unpopular in their time, as was he.

King infuriated many, including in medicine and health care, observing, for example, that:

“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”

dresserfallikea-300x169Doctors, hospitals, insurers, politicians, and businesses may assail the civil justice system over sums it awards to people who have proven they have been harmed. But as significant as some judgments may be, they may be exactly what judges and juries decide may be required to get institutions and enterprises to stop stubborn wrongs.

Is $215 million enough in a federal case, for example, to get the University of Southern California to learn the hard lesson that it needs to listen and to act swiftly if  coeds and nurses complain about  inappropriate sexual behavior of  its student health service staff?

Is $46 million sufficient to get Ikea to fix, recall, and inform the public yet more about the dangers to children of pieces of its furniture that can tip over and kill kids — the latest victim being Jozef Dudek, 2?

hal9000-300x225In recent years, doctors, hospitals, and popular media have promoted emerging treatments to the public with enthusiasm that in each case would turn out to be overblown. Just consider the red-hot chatter that once surrounded regenerative medicine, precision medicine, gene therapy, or immunotherapy. And now, it may be the turn of artificial intelligence to be hyped hard in health care.

Caveat emptor, as Liz Szabo reported for the Kaiser Health News Service. She sets the stage, thusly, about developments in a field that might worry some who remember Hal 9000 from “2001: a Space Odyssey”:

“Health products powered by artificial intelligence, or AI, are streaming into our lives, from virtual doctor apps to wearable sensors and drugstore chatbots. IBM boasted that its AI could ‘outthink cancer.’ Others say computer systems that read X-rays will make radiologists obsolete. ‘There’s nothing that I’ve seen in my 30-plus years studying medicine that could be as impactful and transformative’ as AI, said Dr. Eric Topol, a cardiologist and executive vice president of Scripps Research in La Jolla, Calif. AI can help doctors interpret MRIs of the heartCT scans of the head and photographs of the back of the eye, and could potentially take over many mundane medical chores, freeing doctors to spend more time talking to patients, Topol said. Even the Food and Drug Administration ― which has approved more than 40 AI products in the past five years ― says ‘the potential of digital health is nothing short of revolutionary.’”

drugslockedup-300x264Hospitals, clinics, and other health care settings — and those who staff them — aren’t immune to the ravages of the opioid crisis and its related abuse of prescription and illicit drugs. For patients, their caregivers’ addictions can have serious consequences, including a less-discussed nightmare: diversions of their drugs.

Lauren Lollini, a psychotherapist and a patient-safety advocate, has penned a powerful and scary Op-Ed for Stat, a health and medical news site. She describes how, while undergoing a relatively routine kidney stone removal at a respected Denver hospital, she was infected with hepatitis C — a draining and chronic liver disease that is blood-borne and is often associated with drug abusers. Lollini, however, had been healthy and did not use drugs. So, how did she get so sick? As she explained:

“[An investigation by the] Centers for Disease Control and Prevention, showed that I and at least 18 others had been infected with hepatitis C by Kristen Parker, a technician at Rose Medical Center who had tested positive for the disease before she was hired. She stole patients’ fentanyl-filled syringes off medication trays, injected herself with the painkiller, then refilled the syringes with saline. In the summer of 2009 — about three months after I learned I had hepatitis C — Parker was arrested in one of the biggest hospital drug diversion incidents to date. In 2010, she was sentenced to 30 years in prison.”

zenmagnets-1-150x150Consumers may need to give a few seasonal gifts a second look about their safety and other health-related issues:

docprescriptionpad-300x238Although it’s always important to remember in research studies that associations don’t prove causation, findings from two separate works should raise serious concerns about doctors’ independence and judgment in prescribing drugs and reporting conflicts of interest about payments from makers of medical devices.

That’s because doctors who get money from drug makers in connection with a specific medication tend to prescribe that drug “more heavily” than colleagues who don’t get similar cash, ProPublica, a Pulitzer Prize-winning investigative site, has found.

And doctors who are among those receiving the highest compensation from surgical and medical device manufacturers show some of the biggest discrepancies between the sums they report for institutional conflicts of interest and what a federal database of payments shows, according to  physician-researchers at the University of California, Irvine (UCI).

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