Articles Posted in Ethics

Hospitals keep getting bigger, but how about better for their patients, too? The data suggest that the prices they charge are rising in part due to industry consolidation, but consumers also need to be extra skeptical of national, direct-to-patient appeals about the advantages of various institutions.

Credit is due to the New York Times for scrutinzing the frenzy of hospital mergers and consolidations that now exert huge sway over patients’ choices, care, and costs:

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Dr. Otis Brawley, formerly of the American Cancer Society

The rising flood of health care hype, bunk, and conflicts of interst really can harm patients, as has just been emphasized by a $105-million jury verdict, the brave actions of a leading patient advocacy expert, and the commentary of an expert health researcher and New York Times columnist.

In a more perfect world, a patient like Dawn Kali, 45, and a mother of four, wouldn’t give the time of day to the wild claims of Robert Oldham Young. Both live in San Diego, and when she was diagnosed with cancer, she told a court that she found Young persuasive.

docnrecordsUncle Sam more than ever wants it to happen, and patient advocates are pushing hard, too. So, why, when technology can make it easier than ever to do so, must patients struggle still to get easy, convenient, low- or no-cost access to invaluable electronic records about their own health care?

Judith Graham, a columnist focusing on aging issues for the Kaiser Health News Service, has written a timely, troubling update on perplexing challenges consumers still confront when trying to secure their electronic health records (EHRs).

She cites a study recently published by Yale researchers who gathered information from 83 leading hospitals that purport to assist their patients with EHR access. The experts swept up policies and forms the institutions said patients would need, then contacted them, telling hospital staffers not that they were academic researchers but that they were checking on behalf of an elderly relative in need of their records and how soon and how difficult and costly might it be to get them? This is an everyday dilemma for consumers, and the institutions should have dealt with these requests with ease and alacrity.

crowdfunding-300x150Although the sky-high cost of providing medical care to sick or injured friends and loved ones might seem good reason to encourage community altruism to the nth degree, new technologies that have made it easy, fast, and convenient to “crowd source” online donations also may be sending well-intentioned gifts to dubious and dangerous types of treatment.

A new  study by researchers in Atlanta and New York shows that campaigns on GoFundMe and other social media platforms, sought to raise tens of millions of dollars, and brought in millions for sketchy health-related applications. Experts found “1,059 campaigns that raised money for five unproven or possibly risky treatments: homeopathy or naturopathy for cancer, hyperbaric oxygen for brain injury, experimental stem cell therapy for brain or spinal cord injuries, and long-term antibiotics for chronic Lyme disease,” reported Stat, an online health and medicine news site.

CNN reported that online solicitations were targeted to allow patients to seek dubious therapies at “clinics” in Germany and Mexico (homeopathic or naturopathic cancer care), New Orleans (hyperbaric oxygen for brain injury), and Panama, Thailand, India, China, and Mexico (“stem cell” treatment).

anversaTreatments with “stem cells,” therapies that already were sliding into disrepute due to hyped claims and inappropriate use, took another big hit to their scientific credibility when two respected institutions announced they were retracting 31 published studies claiming stem cells could help patients with damaged hearts.

Harvard Medical School and Brigham and Women’s Hospital in Boston jointly denounced Piero Anversa, a once celebrated cardiologist who had worked at both institutions but left in 2015, for putting out false or fabricated data for dozens of studies he and colleagues published. The works — contrary to accepted science — purportedly showed that damaged heart muscle could be regenerated with stem cells, a type of cell that can transform itself into a variety of other cells.

The medical journals that have published Anversa’s studies must decide for themselves their course of action now with his work. The experts at Retraction Watch, a nonprofit that monitors science publishing and pulled papers as part of an effort to provide greater transparency to the scientific process, say it is rare for one researcher to have so many studies determined to be flawed and subject to removal from public view.

usc-300x279Yet another big university is learning a costly lesson about the perils of ignoring rogue doctors and their harming of vulnerable young people: The University of Southern California has offered to pay $215 million to settle federal lawsuits by hundreds of coeds who say they were sexually harassed and abused by the head gynecologist at the Los Angeles school’s health service.

Women who ever saw Dr. George Tyndall at a campus clinic may receive $2,500 each, while those with claims they were sexually abused by him could be paid up to $250,000 each.

USC said its proposed, tentative settlement has not been reviewed and approved by a federal judge who has been assigned a class-action suit involving hundreds of women.

mitchAt a time when Americans experience high anxiety and financial insecurity due to medical costs — with more than 20 percent of those with health insurance experiencing trouble paying for necessities, more than a quarter of them saying they had bills in collection, and 13 percent forced to borrowed money as a result of illness — politicians and special interests are closing the midterm campaigns as if they can prank voters. Just how gullible do they think the electorate can be?

Republican congressional candidates, after howling about the Affordable Care Act and campaigning unsuccessfully to repeal it in dozens of votes for years, including in the first of the Trump Administration, now are claiming to constituents that they support key parts of Obamacare.

Even as GOP state attorneys general argue in a pending federal court case to gut ACA protections on preexisting conditions, minimum benefits, and lifetime limits, Republican candidates are telling voters, counter factually, how much they embrace and support those Obamacare components. They’re trotting out sad tales about their own relatives’ illnesses to claim to support a position that they opposed in legislative votes and actions just weeks ago.

Nobelmedal-300x295The 2018 Nobel Prizes represent a pinnacle of global  recognition for path-breaking research, but the awards also surface some less than noble aspects of modern science and medicine.

This year’s prizes cast a spotlight on breakthrough findings on  how to take off the immune system’s natural brakes to allow it to attack cancer, and on speeding evolutionary processes so enzymes and bacteria-fighting viruses can be harnessed to create compounds helpful to mankind. Advances in these areas promise to improve and lengthen  lives around the planet.

And it was terrific at a time of so much gender-based discrimination and abuses of women in science, technology, engineering, mathematics, and medicine, to see prestigious prizes, finally, awarded to two women in chemistry (the fifth such Laureate) and physics (the third).

aspirinDoctors subject older patients to risky, costly, invasive, and painful tests and treatments, perhaps with good intention but also because they fail to see that the seniors in their care are individuals with specific situations with real needs that must be considered.

If  physicians too readily accept conventional wisdom in their field, for example, they may push patients 65 and older to take low-aspirin, with the popular but mistaken belief that this practice will help prevent heart attacks, strokes, and dementia. This doesn’t work, and, it increases the risk in seniors of “significant bleeding in the digestive tract, brain or other sites that required transfusions or admission to the hospital,” the New York Times reported.

The newspaper cited a trio of studies, published in the New England Journal of Medicine and based on “more than 19,000 people, including whites 70 and older, and blacks and Hispanics 65 and older. They took low-dose aspirin — 100 milligrams — or a placebo every day for a median of 4.7 years.”

abcshow-300x188Big hospitals can’t exploit patients and violate their privacy by throwing open their facilities to Hollywood for television shows that plump institutions’ reputations. And academic medical centers need to think twice before letting their leaders strike cozy deals to enrich a choice few insiders by hawking important diagnostic information collected with best intentions by medical staff from patients for decades.

The roster of hospitals dealing with black-eyes from recent negative news stories about their activities includes well-regarded institutions in Boston and New York —  Boston Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital, and Memorial Sloan-Kettering Cancer Center.

Federal regulators busted the Boston hospitals with fines settled for just under $1 million for “inviting film crews on premises to film an ABC television network documentary series, without first obtaining authorization from patients,” reported the U.S. Health and Human Services’ department’s Office of Civil Rights.

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