Articles Posted in Ethics

kprobes-300x167An innovation in medical treatment — which was supposed to offer more affordable, accessible, and even convenient care — instead may be getting swamped with safety problems that long have plagued hospitals and academic medical centers.

USA Today and Kaiser Health News Service deserve credit for digging into patients’ nightmares with specialized surgical centers, not only those performing “routine” procedures but also those handling increasingly longer, more complex, and difficult operations. The many surgeries, once the province only of big and well-staffed hospitals, put patients at risk, the newspaper reported, saying:

[Our] investigation found that surgery centers operate under such an uneven mix of rules across U.S. states that fatalities or serious injuries can result in no warning to government officials, much less to potential patients. The gaps in oversight enable centers hit with federal regulators’ toughest sanctions to keep operating, according to interviews, a review of hundreds of pages of court filings and government records obtained under open records laws. No rule stops a doctor exiled by a hospital for misconduct from opening a surgery center down the street.

chriscollins-300x201At a time when prescription drug prices keep skyrocketing and Americans pay hundreds of billions of dollars for medications that account for as much as 15 percent of all U.S. health care spending, federal law enforcers provided a rare and jarring sight with the public arrest of a congressman on charges he engaged in insider trading involving an Australian drug maker.

Chris Collins, a Republican who represents a western New York district and was among President Trump’s earliest and most vocal supporters in Congress, insists he committed no wrong. He says he will be exonerated, but he has pulled the plug on his plans to seek reelection in November.

The sordid details of his financial dealings, as laid out in news stories and a damning indictment, however, may keep front and center not only the charges against him but also troubling questions about members of Congress and their private investing, corporate board roles, and especially their tenacity as Big Pharma lapdogs, instead of being watchdogs on behalf of besieged, too often bankrupted American patient-consumers.

VA-300x202So, see, Ike, Marc, and Bruce may be pretty swell guys. They’ve done well in business: Ike in comic books and entertainment, Marc in the law and consulting on white collar crime, and Bruce as a medical  concierge who gets affluent patients in to see big name doctors.

But this odd trio —Ike Perlmutter, Bruce Moskowitz and Marc Sherman — never served in the U.S. military. They’re certainly not veterans. Perlmutter and Sherman have zero experience in health care. And Moskowitz, while a doctor, is a respected primary care practitioner — not someone known for his direct experience in running big, complex operations.

They also, however, happen to be FOT — Friends of (President) Trump. They pay him to belong to his Mar-a-Lago country club. And, apparently at his request and with the assistance of powerful partisans and the acquiescence of sheepish bureaucrats, Perlmutter, Moskowitz, and Sherman have become  “shadow rulers” of the U.S. Department of Veterans Affairs.

cdc-opi-aug-300x227When Big Pharma pursues rapacious profits and regulators snooze, patients suffer terrible consequences, as new revelations about the opioid crisis show.

Kaiser Health News Service , via the Washington Post, and The New York Times both have done excellent investigative digging into drug makers’ role in fueling the prescription painkiller mess that authorities estimate claims 116 lives a day due to overdoses.

Fred Schulte, writing for the independent, nonpartisan Kaiser service, reported that rival makers — seeing how much money Purdue Pharma was making with its powerful and addictive OxyContin drug and that it was encountering law enforcement and regulatory challenges — stepped in with “similarly dangerous painkillers, such as fentanyl, morphine and methadone.”

buckeyes-300x295Soon, many young people  will be back to school and signing up for  sports teams. Many will have to undergo physical exams before they can play.  And it’s a tragic reality that grown-ups may need to think a lot how to protect young people from sexual predators who also are doctors.

That’s because Ohio State University, sadly, has joined the University of Southern California, Michigan State-USA Gymnastics, and Penn State University in the notoriety of dealing with a sexual abuse scandal involving adults and students. In the case of the Buckeyes, it’s Big Ten male wrestlers.

OSU said it had hired an outside law firm to investigate the allegations against Richard Strauss, who had blue-chip credentials and served as the team doctor to university wrestlers roughly from 1979 to 1997. The doctor killed himself in 2005. Lawyers interviewed more than 200 one-time OSU students, with 100 of them accusing Strauss of sexual misconduct, “including former athletes from 14 different sports teams.”

SCImaginvestigation-300x147The federal Food and Drug Administration has turned a blind eye to tens of millions of dollars paid by Big Pharma to doctors who play crucial roles in advising the nation’s prescription drug watchdog on the safety and effectiveness of medications sold for billions of dollars annually to the American public.

Science magazine deserves credit for its investigation of conflicts of interest it found by examining readily available public records on payments received by more than 100 physician advisers to the FDA over a four-year period.

Reporter Charles Piller and graphics editor Jia  You took an important and different look at records, scrutinizing doctors disclosed drug company funding after their service on elite panels that assist FDA staff in the review and approval of products before they can go to market. Under fire by drug safety and other public advocates, and with intense peer pressure, doctors — grudgingly — have come to accept the notion that they should avoid conflicts of interest before sitting on such influential oversight groups.

gary-150x150dryden-150x150The 2018 Stanley Cup may rest for a bit as the pride and joy of enthusiasts in the nation’s capital and of its title-winning team. But as fans of the pro and amateur game look to the future, they may have reason to be downcast about hockey’s most important component: its players.

Author Ken Dryden (photo above, left) has important things to say about them, because he was a goaltender for the Montreal Canadiens and has been enshrined in the Hockey Hall of Fame. The onetime Canadian parliamentarian has pointed out that owners and bosses in the National Hockey League, as illustrated by videotapes of their sworn testimony in a long-running court case, are locking arms and taking a counter-factual position on the damages that players may suffer due to blows to the head they receive in games.

In “infuriating” fashion, NHL Commissioner Gary Bettman (photo above, right), Boston Bruins owner and chairman of the league’s Board of Governors Jeremy Jacobs, other team owners, senior league executives and doctors are playing ostriches, Dryden wrote in a recent Op-Ed in the Washington Post. They’re sticking their head in the sand, insisting that hockey has no issue at all with “chronic traumatic encephalopathy, or CTE. That’s a degenerative brain disease that has been found in athletes including professional hockey and football players, as well as soldiers and others who have suffered repeated brain injuries. Symptoms of CTE include cognitive impairment, depression, emotional instability and suicidal thoughts.”

horse-200x300Big Tobacco seems to have a shiny new billion-dollar Trojan horse. The question now: Will medical scientists be savvy enough to avoid a credibility catastrophe by rejecting funding from  Tobacco’s wealthy new foundation?

Rita Rubin, a seasoned health care writer, reported in the Journal of the American Medical Association that Philip Morris, a global hawker of tobacco wares, has pledged in the next dozen years to pump $960 million into the Foundation for a Smoke Free World. That group, purportedly, aims to fund research “that advances the field of tobacco harm reduction and reduces the public health burden of smoking-related diseases,” Rubin reported.

But this gambit, often referred to in political parlance as “astroturfing,” has been slammed by respected medical and scientific organizations, including the World Health Organization. They have declared it unacceptable for groups that aim to advance the health and well-being of patients to take  “profits from a product responsible for about 1 in every 5 US deaths to fund health research.”

intubation-300x181Grown-ups with the least bit of gray on them may want to step up their thinking on how they want to receive medical care under tough circumstances, especially if they consider a new, clear-eyed and hard-nosed study that dispels any myths about possible life-sustaining “miracles” of artificial breathing machines.

A research team with experts from Boston, San Francisco, and Dallas studied 35,000 cases in which adults older than 65 had undergone intubation and use of mechanical ventilators at 262 hospitals nationwide between 2008 and 2015.

They found that a third of patients intubated died in the hospital.

Collinslab-150x150Mukamal-144x150The National Institutes of Health, perhaps the world’s leading medical research institution, has moved fast to try to fix self-inflicted damage to its reputation caused by a controversial $100-million study on alcohol and its harms.

NIH Director Francis Collins halted the study, and an advisory group backed his action, lambasting researchers for soliciting funding and counsel from the alcohol industry for a work that purported to answer key and fundamental questions about booze but from its outset leaned toward seeing benefit in moderate drinking.

The New York Times deserves credit for digging into the dubious  actions by researchers supported by the National Institute on Alcohol Abuse and Alcoholism, an arm of NIH.

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