Articles Posted in Ethics

covervf-300x210As the nation’s opioid and drug overdose crisis deepens, it can be hard to watch as the “Not My Fault” crowd clucks about its blamelessness in pushing potent painkillers that have played a part in killing more Americans in 2016 and 2017 alone than lost their lives in the Vietnam War.

The latest NMF protagonists include:

NaitoRon Naito already had been rebuffed by one specialist about the severity of his illness. He was awaiting in a doctor’s examining room for his lab test results and a consultation with a second expert about his already advanced cancer. What happened next stunned the Portland, Ore., resident. But now he’s doing something to help other patients in this way too common situation.

Naito overheard his doctor and a medical student talking about him and his lab results as they passed by the open room door, saying a tumor in his pancreas was “5 centimeters,” and was “very bad.”

That was the way Naito, who has practiced as an internist for 40 years, learned his condition was terminal. The cruel delivery of that crucial news convinced him that he needed to spend what time he has left working with his medical colleagues about their communication skills, especially in conveying the news to patients that they are dying.

bruinlogo-300x225USC, Ohio State, Michigan State, and now, UCLA: How can big universities, with all the supposedly smart folks who head them, be so blind and deaf to student complaints that school personnel may be sexually abusing them? And why do academics keep getting caught up in situations where they appear to or may be covering up wrongdoing against the young?

Officials at the University of California Los Angeles find themselves apologizing profusely for failing to disclose that they knew of accusations of inappropriate conduct by a gynecologist on the school’s staff while treating patients in university facilities, the Los Angeles Times reported.

Women say that Dr. James Mason Heaps wrongly touched their private parts, and UCLA learned of the accusations in 2017, putting the longtime staff gynecologist on leave in 2018. The school, however, did not disclose why Heaps was gone — until criminal charges were filed against him in recent days and he pleaded not guilty to them in court.

Praise be: Churches nationwide are leaping in with their congregations’ blessing and financial support, putting up small sums to buy up and wipe out one of the huge shames of the American health care system: patients’ medical debt.

The faithful work with RIP Medical Debt, a nonprofit organization based in Rye, N.Y., that provides the know-how to many kinds of donors to help eliminate bills that can crush patients and their loved ones for a lifetime, the Kaiser Health News service reported. Roxie Hammill wrote how this all works in modern medicine:

wheelinghospital-300x111As hospitals boost their size and power to push their profits even higher, they’re also raising alarms with federal regulators over their too cozy relationships with doctors who are pulling down big pay from them now as part of their staffs.

Uncle Sam long has sought to ensure that the billions of tax dollars that get spent in the health care system don’t become medical spoils, riches that get passed around a select few through kick-back and self-referral schemes. These are barred by regulation, notably in Medicare- and Medicaid-funded care, and by the “Stark law.”

Jordan Rau of the Kaiser Health News service reported that a hospital in Wheeling, W. Va., has gotten regulators attention by lavishing pay and perks on specialists in its employ, including $1.2 million a year for a pain specialist and $770,000 annually and 12 weeks’ vacation for a cardiothoracic surgeon. The money is far higher than what such experts command in the area and it’s more surprising because the treatment areas these high-paid doctors work in are big financial losers for Wheeling Hospital.

childrensunclogo-300x51Although big hospitals may love to pat themselves on the back and boost their profits and professional standings by claiming to offer “comprehensive” services, children may suffer and die due to the reality versus the hubris of institutions’ excessive initiatives with specialized care.

Officials at the University of North Carolina blew past anguished warnings from their own pediatric cardiology staff of significant problems in the pediatric heart surgery program at the medical center’s children’s hospital, the New York Times reported. Brushing aside their concerns about a lack of resources within and to support the program, UNC declined to make public, as most similar specialty efforts do, key performance measures. They would show that the UNC pediatric heart surgery program had a higher death rate than “nearly all 82 institutions that do publicly report” this and other measures of patient care.

The newspaper, in a rare move, has internal tape recordings of doctors disputing among themselves whether dwindling resources, staff departures, and other problems meant that UNC should do what many of the specialists demanded — take a long hard look at what was going wrong, and, in the meantime, refer sick kids to other institutions to safeguard their care.

pills-300x200With Big Pharma pressing the limits in promoting and pricing prescription medications, patients and their advocates long have hoped that generic drugs might be difference-makers on costs and practices. Those positive wishes, however, may be dying out by the day.

The attorneys general of dozens of states have sued major generic makers including Teva, Pfizer, Novartis and Mylan, accusing them of conspiring to inflate generic drug prices by as much as 1,000%, the New York Times and other media organizations reported.

The makers’ price-fixing affected more than 100 generics, including “lamivudine-zidovudine, which treats H.I.V.; budesonide, an asthma medication; fenofibrate, which treats high cholesterol; amphetamine-dextroamphetamine for A.D.H.D.; oral antibiotics; blood thinners; cancer drugs; contraceptives; and antidepressants,” the New York Times said.

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Even as more felony charges may follow in drug epidemic, sleep med warning suggests pill popping stays too popular

Five top executives at a major drug maker have been convicted of criminal racketeering for their aggressive and deceptive marketing of a fentanyl spray in a case that prosecutors long have said may warn corporate leaders about their culpability in the nation’s opioid painkiller crisis.

Federal jurors deliberated for 15 days before finding guilty John Kapoor, founder and CEO of drug maker Insys (shown at right). Jurors also convicted Richard M. Simon, former Insys national director of sales; Sunrise Lee and Joseph A. Rowan, both former regional sales directors; and Michael J. Gurry, former vice president of managed markets. As the New York Times described the case against them:

doud-300x175An estimated 400,000 Americans have died due to opioid drug overdoses between 1999 and 2017 — and the fatalities only are increasing. By 2025, according to expert forecasts, there will be 700,000 more opioid deaths. Prosecutors now are saying  that at least some of the causes of this crisis are nothing less than criminal behavior by people wearing white coats and ties.

Federal and state prosecutors are bringing felony charges against doctors and Big Pharma executives as if they were street drug dealers and crime bosses.

This formal faulting for the nation’s opioid crisis hasn’t yet spread widely among drug makers, those at the pinnacle of the pharma pipeline. The legal war, however, has resulted in aggressive steps by federal prosecutors accusing not only scores of doctors across seven states with improperly prescribing painkillers for cash and sex, but also with officials filing for the first time drug-trafficking charges against a major pharmaceutical distributor and two of its former executives.

Candida-aurisWhen big hospitals are locked in bare-knuckle battles against debilitating and deadly bacterial and fungal infections sweeping their institutions, don’t patients have the right to know about these situations that might affect their lives and care? According to some hospital insiders, no.

The New York Times reported that a “culture of secrecy” prevails in hospitals as they combat “super bugs,” bacteria that have become resistant to antibiotics and now fungi that have evolved immunities to antifungals.

The newspaper found the institutional opposition to making public outbreaks of hospital-borne infection as it followed up its own scary page one story about the global spread of Candida auris, a drug-resistant fungus that preys on patients who already are hospitalized and may have compromised immune systems.

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