Articles Posted in Ethics

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.

alzassoc-300x200Although Medicare officials have slammed the door for now on paying for widespread use of a drug targeted for Alzheimer’s treatment, patient advocacy groups have thrown themselves into the battle over Aduhelm and whether taxpayers should pay its hefty price.

Aduhelm is the risky, costly prescription medication with sparse evidence of its purported benefits for those in early stages of cognitive decline.

The giant federal health insurer for seniors will cover Aduhelm only for patients participating in clinical trials that may yield more persuasive evidence about the drug’s safety and effectiveness, Medicare officials have decided. In doing so, they withstood a furious lobbying campaign from the nonprofits Alzheimer’s Association, a leading patient advocacy group reporting more than $400 million in 2021 revenue, and UsAgainstAlzheimer’s, which reported $9 million in 2020 revenue.

sentimscottsc-150x150cathymcmorrisrodgers-150x150While regular folks howl about the need to slash skyrocketing prescription drug costs, Big Pharma is showering lawmakers on Capitol Hill with campaign contributions and favoring Republicans in the House and Senate who show political promise — and an aversion to efforts to ensure the affordability of medications for the sick.

The crushing costs of drugs has returned to the policy-making spotlight as Democrats in the House, with a few defecting Republicans, have approved a bill to limit the soaring price of insulin to $35 a month for most Americans who have insurance and whose health and lives depend on the increasingly unaffordable medication. As the New York Times reported:

“To become law, the bill will need to attract at least 10 Republican votes in the Senate to overcome a filibuster. Some lawmakers involved in the effort have expressed optimism that such a coalition might be possible, but few Republican senators have publicly endorsed the bill yet. Senator Susan Collins, Republican of Maine, has been working with Senator Jeanne Shaheen, Democrat of New Hampshire, on a broader bill related to insulin prices. The bill would have substantial benefits for many of the nearly 30 million Americans who live with diabetes. Insulin, a lifesaving drug that is typically taken daily, has grown increasingly expensive in recent years, and many diabetes patients ration their medicines or discontinue them because of the cost. About one in five Americans who take insulin would save money under the proposal, according to a recent analysis from the Kaiser Family Foundation.

FDA-Logo-300x167Taxpayers and lawmakers may be grasping just how far in the wrong direction the federal Food and Drug Administration has gone in approving prescription drugs for sale on U.S. markets — in too much haste and with too little facts about whether the new drugs really work and are safe.

The issue, of course, may have stormed into public awareness when drug maker Biogen got the FDA to give fast-track approval for Aduhelm. It’s a medication targeted at Alzheimer’s but with light evidence of its benefits to patients. Biogen set such a sky-high price for Aduhelm that Medicare announced one of its biggest, recent premium increases and an expert furor exploded over the med and its approval.

That, in turn, has put the FDA processes under new, intense scrutiny, particularly as critics noted that 14 of 50 new drugs approved last year alone by the agency, including Aduhelm, received expedited review, Axios, the news and information site reported.

convictedtennnurse-150x150While nurses deserve patients’ gratitude and the highest praise for the valiant care they have provided during the coronavirus pandemic, a Nashville case has raised tough questions as to whether and when professional caregivers’ medical errors ought to be criminalized.

Prosecutors decided that some mistakes rise to the criminal level, after considering the evidence against RaDonda Vaught, a former nurse involved in a 2017 fatal drug error.

Vaught, who already has been stripped of her nursing license, has been convicted, NPR reported, of “gross neglect of an impaired adult and negligent homicide after a three-day trial … She faces three to six years in prison for neglect and one to two years for negligent homicide as a defendant with no prior convictions, according to sentencing guidelines provided by the Nashville district attorney’s office. Vaught is scheduled to be sentenced May 13, and her sentences are likely to run concurrently, said the district attorney’s spokesperson, Steve Hayslip.”

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