Articles Posted in Ethics

babewithbottle-300x293Americans keep suffering the dire consequences of corporations’ relentless pursuit of profits, their stifling of beneficial competition, and their failure to secure the production of their products. These now include desperately needed, specialized baby formula and contrast dyes used in diagnostic imaging studies for seriously ill and injured patients.

A special place in perdition needs to be reserved for those who have put infants at risk of hunger and illness by allowing the feeding crisis to explode and for boobs who are rushing in with finger-snapping, fact-light, and unworkable actions for parents to respond.

Let’s be clear that the formula mess, bad for all families across the country, hits hardest at the working poor and the poor. As the New York Times reported:

Mallinckrodtlogo-300x137Even as the opioid abuse and drug overdose crisis worsens and breaks annual records for its resulting death toll, the reckoning for parties blamed for fostering the national nightmare is grinding forward.

A federal judge in Cleveland has begun hearing arguments whether three giant pharmacy chains should be fined billions of dollars after a jury in November found them culpable for damages they caused in two Ohio counties in the opioid mess.

And new disclosures are emerging regarding bankrupt drug maker Mallinckrodt, which federal officials have described as the “the kingpin within the drug cartel” of legitimate companies driving the opioid epidemic.

family-300x241While the nation’s pediatricians have announced an important, high-minded goal of eliminating racial bias in the medical treatment of children, working parents and other full-time caregivers for kids need a different kind of help, too, for a growing, serious problem — burnout.

These seemingly different issues share a common discovery point, rooted in challenges made large by the coronavirus pandemic and the recent unrest over social injustices experienced by communities of color, news media reports say.

Medical practitioners of various kinds, including kids’ specialists, have been forced to reexamine their consciences and beliefs even before but especially after the 2020 death in police custody of George Floyd, the AP reported. For pediatricians and their important practice group, this led to a medical reckoning, valuable to all patients but especially those of color:

chromosomes-harvardExpectant parents, doctors, and regulators need to reconsider the rising use of gee-whiz genetic testing as  doubts emerge about popular blood screenings to detect rare prenatal disorders and a costly test relied on by couples undergoing in-vitro fertilization (IVF) treatment.

This is what the New York Times reported about what researchers have found about preimplantation genetic testing for aneuploidy, or PGT-A. It is an increasingly common screening in IVF and has led potential parents to discard embryos as unfeasible or unacceptable due to abnormalities to carry to term:

“PGT-A … has, over the last two decades, become a standard add-on to already pricey IVF procedures. But the test, which can cost anywhere from $4,000 to $10,000, has become controversial over the years as studies have cast doubt on whether it increases birthrates from IVF at all. A growing number of scientists have questioned the widespread use of the test, which leads to tens of thousands of discarded embryos per year and causes many women to believe they may not be able to carry biological children. A new study published last week details 50 patients who underwent transfers of abnormal embryos at the Center for Human Reproduction in New York City … The study reported eight births after 57 transfer cycles of embryos with abnormal genetic testing results since 2015. Seven of the babies were born healthy. The average age of the women in the study was 41 years old.

cancercenterlogoWhile patients often seek treatment at big, fancy hospitals, in part because they are designated as National Cancer Institute centers, these institutions provide a sticker-shock surprise for those receiving their specialized care: They jack up the already sky-high cost of prescription cancer drugs with markups going up from 120% to 630% above what they pay for the medications.

Those are the findings of researchers at the Harvard and Yale medical schools and elsewhere as reported in the Journal of the American Medical Association’s Internal Medicine publication. As they noted with expert restraint:

“The findings of this study suggest that, to reduce the financial burden of cancer treatment for patients, institution of public policies to discourage or prevent excessive hospital price markups on … chemotherapeutics may be beneficial.”

airlinemasking-205x300Hundreds of Americans keep dying each day due to the coronavirus. Tens of thousands of people across the country are reporting they are newly infected with the disease, even as at-home testing lowers this count. Thousands of patients still are hospitalized due to the virus that has killed at least 1 million in this country. But even as worrisome measures of the pandemic rise anew, important ways to battle the deadliest infectious disease outbreak in a century are dwindling.

Health officials are grappling with a federal judge’s ruling, upending nationwide what has been a minimally inconvenient step to quell the pandemic — a requirement for passengers to cover their faces while traveling on public transportation.

The judge — yes, an appointee from the last administration who was deemed by the Bar to be not qualified for her lifetime post — staked out a dubious legal view that federal officials overstepped their authority with the mask order.  U.S. District Judge Kathryn Kimball Mizelle, sitting in Tampa, Fla., asserted among other things in her ruling that she thinks Congress limited the Centers for Disease Control and Prevention to be involved only in “inspection, fumigation, disinfection, sanitation, destruction, or pest extermination.”

dcpolicetweet-300x214The opioid abuse and drug overdose crisis has veered into a frightening new phase in which the rise of the easy-to-make, exceedingly powerful synthetic painkiller fentanyl is causing multiple, interconnected deaths at one time.

The nation’s capital already has experienced this grim situation, which only shows signs of worsening, the Washington Post reported on April 12:

“Ten people in two neighborhoods in Northeast Washington have now died from a lethal batch of fentanyl, police said .. the second mass-casualty incident involving the deadly opioid in the District this year. Police said at least 17 people overdosed on cocaine laced with fentanyl in Trinidad and Ivy City from [April 9-11] and seven of them survived. In January, nine people died after taking a similar concoction in a neighborhood near Nationals Park. Authorities arrested two people in that case and said they do not believe the most recent incidents are connected to the earlier overdoses.”

grief-150x150Death has not taken a holiday in this country. It has, instead, had a field day, with 2021 breaking records, recording 3.465 million American lives lost — 80,000 more than in history-setting 2020, federal statisticians say.

The coronavirus pandemic gets much of the blame for the nation’s grim toll, which was made all the worse because many of the deaths last year, as opposed to the year before, were preventable because safe, effective vaccines became widely available and could have averted debilitating and deadly illnesses for so many.

But Covid-19 was not alone as a killer that rose up to take American lives and to slash a fundamental measure of public health — life expectancy rates. The Associated Press reported, citing information from the federal Centers for Disease Control and Prevention:

academies-300x90The nation’s nursing homes and other long-term care facilities are in dire need of drastic overhaul to dramatically improve the quality and safety of their treatment of the aged, sick, and disabled. They too often now get what one expert has described as “ineffective, inefficient, inequitable, fragmented, and unsustainable” care.

To repair the glaring, longstanding wrongs in these facilities — problems that critics say contributed to 150,000 resident deaths during the coronavirus pandemic — requires sweeping practical, regulatory, and financial changes in an industry focused on profits and resistant to change, according to newly published expert research report by the National Academies of Sciences, Engineering, and Medicine.

The academies, with members who are leaders in their fields, are private, nonprofit institutions that work outside of government to provide objective advice on matters of science, technology, and health.

cdchq-300x180A public health agency once held up as the world’s gold standard will put itself under the microscope and try to diagnose swift, appropriate remedies for the relentless criticism it has received for months of faulty performance in dealing with one of the most lethal infectious disease outbreaks in a century.

The federal Centers for Disease Control and Prevention (CDC) must improve its work in its core functions, including “beefing up the nation’s public health workforce, data modernization, laboratory capacity, health equity, rapid response to disease outbreaks, and preparedness within the United States and around the world,” the agency’s chief, Dr. Rochelle Walensky, has written to her 13,000 expert colleagues. She is insisting, no matter the political risks and practical difficulties, that significant changes must occur, the Washington Post reported, noting of the agency’s much-derided work on the coronavirus pandemic:

“Since the pandemic began more than two years ago, the once-storied agency has been under fire for its pandemic response, from initial delays developing a coronavirus test, to the severe eligibility limits to get the test, to missteps often attributed to Trump Administration meddling. But even under the Biden Administration, the agency’s guidance on masking, isolation and quarantine, and booster doses has been repeatedly faulted for being confusing. A consistent criticism has been the agency’s failure to be agile, especially with analysis and release of real-time data.

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