Articles Posted in Ethics

hospicenyer-300x123What happens when the highly vulnerable — older, sick, injured, and debilitated people — get left in the hands of profit-obsessed private enterprises operating under woefully lax regulatory oversight? Big messes abound, as news organizations have reported after taking deep dives into the workings of the “hustle” of for-profit hospice programs, or the chronic  staffing shortages that prevail at far too many private nursing homes.

Sure, this is a hectic time of the year, and it can be a challenge to carve out the time to pore over the painstaking reporting of fine journalists who race to make public their major investigations before the year’s end (including to qualify for major professional prizes).

Still, for anyone concerned about destructive failures in the U.S. health care system, how they blow up over time, and how they get ignored until they become crises, the reports by ProPublica, the New Yorker, and USA Today are important reading.

philipslogo-150x150While critics long have ripped the Food and Drug Administration for its weak oversight of medical devices and its too cozy relationships with their makers, the federal agency and a Dutch global conglomerate have given millions of U.S. consumers a big, infuriating, prolonged exposure to just how bungled the oversight of this industry can be.

As 2022 races to its close, the Wall Street Journal has reported on this costly, inconvenient, and unacceptable mess, as has the New York Times. And now, so has Stat, the science and medical news site, which wrote this about the “flaws in device oversight” as so many regular folks have experienced with the FDA, manufacturer Philips, and CPAP (continuous positive airway pressure) and BPAP or BiPAP (bilevel positive airway pressure) devices:

“The ongoing recall of millions of breathing devices made by Philips has been botched and belabored at nearly every turn: It took more than a decade after users first reported the soundproofing foam in their CPAP and BPAP machines breaking down for Philips to issue a recall. Even after the recall notice was issued, it failed to reach many patients, and many are still waiting on their promised replacement devices or refunds, some of which had to be recalled themselves. More than a year after the recall, the FDA has received more than 90,000 reports about problems with the devices, including 260 … deaths reportedly associated with the products. The [FDA] has pulled out all the stops — including regulatory orders not deployed in decades — to force Philips to contact users about the recall and replace the devices in a timely manner.

tksgiving-300x177Millions of us will have much to give thanks for during the annual holiday, which, like several of its recent versions, again will be a time of health wariness and uncertainty, too.

The seasonal feast — which brings so many the joy of not only a grand meal but also the pleasure of gathering with friends, family, and other loved ones — will be more costly than any in recent memory due to economic inflation and supply chain problems, the Associated Press reported:

“Americans are bracing for a costly Thanksgiving this year, with double-digit percent increases in the price of turkey, potatoes, stuffing, canned pumpkin, and other staples. The U.S. government estimates food prices will be up 9.5% to 10.5% this year; historically, they’ve risen only 2% annually. Lower production and higher costs for labor, transportation and items are part of the reason; disease, rough weather and the war in Ukraine are also contributors.”

agedhands-150x150The Biden Administration is encountering stiff industry opposition but is forging ahead with plans to announce in coming months major regulatory reforms that advocates hope finally will force nursing homes to meet minimum staffing guidelines to care for some of the nation’s most vulnerable.

The tragic devastation of long-term care facilities and their residents by the coronavirus pandemic demonstrated the dire need for federal regulators to set baseline standards for nursing and other front-line resident care, critics say.

Their arguments have been bolstered by lawsuits against nursing homes and their subsequent disclosure of harms done to seniors, the sick, and injured — those who are so debilitated that they require substantial living assistance but too often do not get it due to substandard staffing and profit-driven decision-making by facilities’ owners and operators.

walmartlogo-300x117Walmart has offered to pay $3.1 billion to settle thousands of lawsuits filed against the deep-pocketed retailing giant, accusing it of complicity through its nationwide pharmacy operations in the lethal opioid abuse and overdose crisis.

The Bentonville, Ark., -based company insists it committed no wrong and the states, counties, cities, Indian tribes, and others who sued Walmart said it did not have as large a part as other pharmacy chains in inundating the country with powerful, prescribed painkillers.

Still, Walmart joins CVS and Walgreens in settling rather than confronting those who have found sustained success in seeking justice in the civil system, various news organizations have reported.

ciggy-166x300Consumers, politicians, and federal regulators should not make the mistake of thinking that Big Tobacco somehow will go, as the poet put it, quietly into that good night.

The fortunes are still too big to be made in peddling products that persist as some of the greatest preventable threats to Americans’ health, industry players keep reminding us all — most recently by suing to block California voters upholding a ban of flavored tobacco and by taking a last-minute investors’ reprieve to reorganize a pioneering vaping company that was on the brink of bankruptcy.

The Golden State had not even finished tallying its midterm 2022 votes when RJ Reynolds marched into federal court to challenge the newly and overwhelmingly approved referendum to allow a two-year-old state law to take effect barring within weeks the sale of flavored tobacco and vaping products. As the New York Times reported:

ACEP-300x98Almost three dozen leading groups representing a range of doctors, specialists, and other health workers have called on the Biden Administration to deal urgently with the long-running but increasing and dangerous practice of hospitals allowing their emergency care facilities to be overwhelmed because they also are parking patients waiting for rooms and treatment.

This “boarding” crisis, already at breaking points for many exhausted ER staffs, will worsen and imperil patients even more if the nation gets hit — as growing indicators suggest is occurring — with a “tripledemic,” a choking load of coronavirus, flu, and other respiratory infections serious enough to require hospitalization.

The American College of Emergency Physicians (38,000 members), has been joined by the American Medical Association, the American Nurses Association, American Academy of Emergency Medicine (8,000 members) and groups representing family doctors, allergists, anesthesiologists, radiologists, osteopaths, psychiatrists, and many others in a recent letter to the administration, reporting:

charitycarehospitalskff-300x209Already sick, injured, and debilitated by age and other circumstance, U.S. patient-consumers get battered with misleading information from shady firms about insurance coverage under the Medicare program and with too little word from hospitals about too spare charitable care that could help the beleaguered with bankrupting medical bills.

Democratic investigators for the U.S. Senate Finance Committee have ripped outfits hustling private Medicare plans to seniors, saying that companies have, among other sketchy practices uncovered, “posed as the Internal Revenue Service and other government agencies, misled customers about the size of their networks, and preyed on vulnerable people with dementia and cognitive impairment,” the New York Times reported.

The investigators said they have cataloged dubious behaviors by vendors in 14 states of Medicare Advantage programs. The newspaper earlier has reported those health plans have become a highly lucrative line of business for insurers. They overstate how sick their patients are to put a bigger bite on taxpayers’ financial support of health coverage for those 65 and older, with Advantage plans enrolling a huge chunk of seniors now.

betterworkplacemurthy-300x263Although the still-chugging U.S. economy is providing workers with more employment opportunities than many economists expected, it is always tough to leave a job, even with the highly publicized trend of “quiet quitting” supposedly in full force.

Still, no less an authority than Dr. Vivek Murthy, the U.S. Surgeon General, has warned Americans that too many of their workplaces put their health and mental health at risk. He has called on employers large and small to practice the Golden Rule, better share companies’ good fortunes, and to improve regular folks’ work-life balance. Stat, a science and medical news site, quoted Murthy’s statement on toxic workplaces and needed changes, thusly:

“As we recover from the worst of the pandemic, we have an opportunity and the power to make workplaces engines for mental health and well-being. It will require organizations to rethink how they protect workers from harm, foster a sense of connection among workers, show workers that they matter, make space for their lives outside work, and support their growth. It will be worth it because the benefits will accrue for workers and organizations alike.”

healthrecords-150x150Patients have hit a red-letter day in the long, too-difficult struggle to win control of a crucial part of their care — their electronic medical care records. Hospitals and other caregiving institutions no longer can block access to these documents, with federal law now holding them accountable for any runarounds they may try.

As Stat, a medical and science news site,  reported:

“Under federal rules taking effect [Oct. 6,2022], health care organizations must give patients unfettered access to their full health records in digital format. No more long delays. No more fax machines. No more exorbitant charges for printed pages. Just the data, please — now. ‘My great hope is that this will turn the tide on the culture of information blocking,’ said Lisa Bari, CEO of Civitas Networks for Health, a nonprofit that supports medical data sharing. ‘It’s a ground level thing to me: We need to make sure information flows the way patients want it to.’”

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