Articles Posted in Ethics

zantac-300x169Big Pharma’s slavish devotion to maximizing profits and “enhancing shareholder value” has led industry executives to shove the manufacture of their products to far-flung shores. The dubious consequences of these moves have become clear not only with common, over-the-counter medications but also — with potentially tragic results — with drugs needed in the war on the Covid-19 pandemic.

Even before the world was terrorized by the coronavirus outbreak in China, safety advocates warned about serious “supply chain” issues in drug making, with one small lab sounding alarms about Zantac, a widely used over-the-counter heartburn pill.

Valisure, a commercial pharmacy that sought to distinguish itself by testing and assuring consumers of the quality of the drugs it sold, provided the federal Food and Drug Administration its lab tests and analyses as evidence that Zantac (aka ranitidine) was contaminated with, what the New York Times has described as, “a type of nitrosamine called N-nitrosodimethylamine, or NDMA, which is believed to be carcinogenic in humans and is found in a variety of products, including cured meats.”

aged-alexboyd-300x200The Covid-19 pandemic is forcing many Americans to think and act on tough issues they otherwise might wish to avoid, and they’re getting thoughtful reminders on ways they may want to proceed with advanced or end-of-life medical planning and decisions on whether to keep elderly loved ones in nursing homes and other long-term care facilities or to bring them into their residences.

These are hard topics to deal with in the best of times. But failing to do so can leave families with not only a lifetime of regrets but also possibly significant financial consequences. Americans long have insisted that they want to have maximum control over medical decisions that affect their care.

So, thinking ahead about our own advanced medical plans, and revisiting the institutional care of beloved seniors may not only be appropriate, but necessary as the world struggles with the Covid-19 pandemic and medical caregivers are overwhelmed and may be stretched to their limits.

logowalmart-300x117Walmart and Johnson and Johnson, two of America’s corporate titans, each acted in ways that helped to fuel the opioid crisis that federal experts estimate claims 128 Americans’ lives each day, news media investigations show.

Walmart ignored repeated complaints from its own pharmacists and permitted the over-subscribing of logojj-300x57hundreds of thousands of potent prescription painkillers by sketchy doctors across the country, with the company’s refusal to deal with rising problems leading federal prosecutors to ready hefty civil and criminal cases, according to ProPublica, a Pulitzer Prize-winning investigative site.

The retailing giant, however, pulled powerful political strings, with Trump Administration officials stepping in to stymie potential lawsuits and criminal charges against Walmart — despite a previously secret settlement the company earlier had signed, pledging to step up its oversight of prescription drugs it sold, ProPublica reported. Reporters Jesse Eisinger and James Bandler wrote:

drugpromotrump-300x178President Trump has stormed past accepted professional practices and triggered alarms about ethical decision making by caregivers, as he persists in his noisy advocacy for treating seriously ill patients with Covid-19 infections with an unproven pair of prescription drugs.

Promoting this drug regimen — on social media and in White House news conferences — has pitted the onetime real estate developer and reality show host with an undergraduate economics degree squarely against Dr. Anthony Fauci, one of the nation’s foremost infectious disease experts at the National Institutes of Health.

They have squared off publicly, with the leader of the free world talking about how he “feels good” about giving patients two, long-used antimalarial drugs — chloroquine and hydroxychloroquine (aka plaquenil) — while Fauci has insisted such prescribing has no basis now, and, at best, should be subjected to rigorous clinical trial to determine their effectiveness.

faucifacegrimace-300x210Even as Covid-19 wreaked unprecedented harms, there also have been actions that might lead even the most jaded observer to cry out:  What were these people thinking?

The pandemic’s global toll has risen to hundreds of thousands of infections and thousands of deaths. The U.S. toll at the end of the third week in March, the New York Times reported, exceeded 21,000 infections and nearly 300 deaths, with 1 in 5 Americans also now living under tough restrictions that have shut non-essential businesses, schools, colleges and universities, restaurants, gyms and health clubs, and sports and cultural events.

In the throes of such calamitous circumstances,  consider:

RobertWilkieVA-150x150One of the nation’s largest health systems faces yet more serious questions about its leadership and external meddling in the quality and safety of its care. So, once again taxpayers may be asking themselves, with anger, What the heck is going on now at the top of the Department of Veterans Affairs?

Internal watchdogs have formally opened an investigation of Roger Wilkie, the VA’s chief, over allegations that he used his office and authority to dig up dirt on a Democratic aide who complained that she had been propositioned and groped by a man in the main lobby of the Medical Center here in the District of Columbia.

The claims were investigated, and authorities declined to pursue it further, including with the filing of any charges.

Mallinckrodtlogo-300x137
The civil justice system has scored a win in curtailing what once was a major maker of much abused and lethal prescription painkillers: Mallinckrodt, a global drug making giant, has agreed to send its opioids-making generics division into bankruptcy as part of a $1.6 billion settlement to settle thousands of opioid damage claims by state and local governments.

As the New York Times reported of the hefty deal:

“The agreement was endorsed by 47 states and U.S. territories along with a committee of lawyers representing thousands of cities and counties … The money, to be paid into a cash trust over eight years, will be used to underwrite the costs of opioid addiction treatments and related efforts across the country … Under the terms of the agreement, the United States division of Mallinckrodt that produces generic opioids would file for Chapter 11 bankruptcy. After a bankruptcy judge approves the restructuring plan, an initial payment of $300 million would be disbursed to plaintiffs to alleviate the opioid crisis, with the remaining $1.3 billion to be paid out over eight years. Other divisions of the company, which has its headquarters abroad and also produces branded drugs, are not filing for bankruptcy. Mallinckrodt is the first opioid company to reach even a tentative national settlement agreement with municipal governments and most of the states.”

bluereport-300x128The University of Michigan is investigating allegations that Robert E. Anderson, former head of the university health service and physician to UM football teams coached by Bo Schembechler and Lloyd Carr, sexually assaulted youthful patients across decades.

Anderson worked for the university for more than 30 years and died in 2008. As the New York Times reported:

“Michigan said its campus police department had opened an inquiry last summer, after Warde Manuel, the athletic director, received a message from a former student who said that Anderson had engaged in abuse during medical exams in the ’70s. During the investigation, Michigan said, other people described ‘sexual misconduct and unnecessary medical exams,’ including at least one allegation that wrongdoing had occurred in the ’90s.”

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.”

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