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01/11/2014

From ProPublica: There’s Gold in Pharma Data

Thanks once again to Charles Ornstein at ProPublica:http://www.propublica.org/article/big-data-big-pharma-big-money--we're brought up to date on the big bucks generated by the firms like IMS Health called "prescription drug information intermediaries."...

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This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

01/10/2014

Loyola Bioethics Institute Study Finds Medical Students Concerned About Becoming Desensitized to Dying Patients

Loyola’s Neiswanger Institute Study Finds Medical Students Concerned about Becoming Insensitive When Dealing with a Dying Patient  Click here to watch the video interview with Mark Kuczewski, PhD conducted by Randi Belisomo The imminent death of a patient is riddled with emotions for a patient and family as well as the medical team. A study based […]

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01/10/2014

Rounding Up Scientific Journals

Adriane Fugh-Berman and Thomas G. Sherman

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This entry was posted in Health Care and tagged . Posted by Susan Gilbert. Bookmark the permalink.

01/10/2014

It’s the Ventilator’s Fault

by Craig Klugman, Ph.D

If you were from a foreign nation looking at the United States news right now, you would think that this was a nation that had declared war on death. Or perhaps we could state it better as a total denial of death. In California, Jahi McMath, a teenage girl who has been medically and legally dead for nearly a month (death certificate was issued December 12) has been moved to an unnamed facility and given surgical procedures to introduce air, water, and food more easily while her body continues to degrade and decay. And in Texas, Marlise Munoz, a woman who may be brain dead or may be in a persistent vegetative state (the hospital isn’t saying and the experts are split), is being maintained because of the hospital’s interpretation of a state law, so that she can be used as an incubator to keep her 14-week old fetus growing despite the wishes of her parents and husband that she be disconnected from the ventilator and supportive measures.…

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This entry was posted in End of Life Care, Featured Posts. Posted by Craig Klugman. Bookmark the permalink.

01/09/2014

Exploiting despair – the death of Jahi McMath

  With the onslaught of media coverage of the Jahi McMath case it is time for a public debate on whether or not the loss of upper and lower brain function should determine death.  Brain death is the cessation of any brain activity in the uppe...

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01/08/2014

It’s All about Freedom—Only Not That Way


I generally ignore op-ed columns by Jonah Goldberg, who claims to be a conservative columnist but who appears actually to be an anti-liberal columnist—whatever liberals believe, he’s agin it. I happened to catch sight of a passage in his column in the January 8, 2014 Houston Chronicle, however, that seems to offer an instructive commentary on economism vs. progressive/liberal thinking.

Here’s what Goldberg has to say:

One of the wonderful things about America is that both the left and right are champions of freedom. The difference lies in what we mean by freedom. The left emphasizes freedom as a material good, and the right sees freedom as primarily a right rooted in individual sovereignty.

Goldberg then goes on to attack such horrible liberal folks as the Soviets and Franklin Roosevelt for assuming that freedom meant showering you with all sorts of material goodies.

Well, let’s have a look. With regard to the first part of Goldberg’s statement, I entirely agree—to the extent that I had intended to call the book that I thought about writing, as a sequel to The Golden Calf, Visions of Freedom. (I may yet get around to writing it but that’s another matter.) I completely agree that at the root of the difference between economism and progressive thought lies in alternative views of human freedom.

Predictably, however, Goldberg then immediately goes off track. Let’s take his ideas in reverse order. He suggests that for the right (i.e., economism), freedom is “a right rooted in individual sovereignty.” As I have shown both in this blog and in The Golden Calf, this is a partial truth. Economism recognizes exactly one form of “sovereignty” and “right,” which is to be a buyer and seller in the so-called “free” market, which does not in actuality exist anywhere. When push comes to shove, no other “right” is important, and all other so-called rights must give way to the all-powerful market and its high priests.  So to argue that it’s the left that has confused freedom with mere material things is at best a highly selective view of what’s really going on.

Next we come to the claim that for the left, “freedom” means one thing only, freedom from material want, the solution of which is a nanny state giving each of us stuff, and so robbing us of our (real) freedom and responsibility. Let’s look at this in two stages. First, the much-maligned FDR, in his “four freedoms” speech that included “freedom from want,” made the point that still seems valid—that a person who is in some theoretical sense free, and yet is starving, or naked, or homeless, or lacks basic medical care, is in no real sense free. This person is a slave to material deprivation. Without some basic set of the material conditions necessary for a minimal human life—not everything imaginable, not wealth, but a very basic minimum—a person cannot be “free” in any meaningful sense of the term.

That’s hardly a complete philosophical theory of what freedom might mean in a world that has broken loose from the ideology of economism. The next stage, therefore, is to ask which thinkers have taken us the farthest in recent years toward fleshing out what Roosevelt apparently had in mind, in a way that represents a defensible and justifiable framework for a decent and just society. That theory, in my view, is the capabilities approachdeveloped by philosopher-economist Amartya Sen and philosopher Martha Nussbaum. Perhaps the most accessible account is in Nussbaum’s Creating Capabilities: The Human Development Approach (2011).

On the Nussbaum-Sen account, what makes humans truly free is having certain capabilities that are consistent with a life of human dignity. Some of these capabilities, such as rights of political participation, require mostly that people leave us alone and not interfere with our free exercise of our capacities. Other capabilities require that we have at least minimal levels of material goods provided for us—such as the capabilities that require nutrition, shelter, health care, and education. On a capabilities approach, human dignity is a multi-faceted idea, and it’s arbitrary to say that the only rights worthy of the name are “negative” rights (much beloved by conservatives) merely to be left alone, or “positive” rights (presumably, much beloved by leftists) to get stuff given to you. Depending on the specific human capacity, both positive and negative rights are important.

The fleshing out of such a theory requires first that we explain what human dignity requires, and we see that material wealth, or all sorts of material goods, are hardly included; we only need a basic minimum. The next requirement is that we ask what a just, fair, and decent society is obligated to do toward providing each citizen with these basic rights and needs; and again there could be a lot of argument about what’s required, from and for whom, and why. I don’t have space here to try to develop such an account (hence the need for the book). But the bottom line, contra Goldberg, is that such an account can be given; it’s intellectually rich; and it cannot be adequately captured in caricaturish attacks on Soviet Communism or the usual bogeymen of the right. (And yes, by the way, the right to buy and sell in the market—real markets, not fake ones—to try to advance one’s own economic position, is included by Sen at least as a critical human capability, but only one of many.)

I’m quite confident that if the American public could be presented with two basic accounts of freedom—the capabilities approach suitably worked up and fleshed out, and the economism version presented honestly—the capabilities approach would win.  If I’m wrong, so be it. The whole purpose of my work on economism is to earn the alternative views a fair hearing.

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This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

01/08/2014

It’s All about Freedom—Only Not That Way


I generally ignore op-ed columns by Jonah Goldberg, who claims to be a conservative columnist but who appears actually to be an anti-liberal columnist—whatever liberals believe, he’s agin it. I happened to catch sight of a passage in his column in the January 8, 2014 Houston Chronicle, however, that seems to offer an instructive commentary on economism vs. progressive/liberal thinking.

Here’s what Goldberg has to say:

One of the wonderful things about America is that both the left and right are champions of freedom. The difference lies in what we mean by freedom. The left emphasizes freedom as a material good, and the right sees freedom as primarily a right rooted in individual sovereignty.

Goldberg then goes on to attack such horrible liberal folks as the Soviets and Franklin Roosevelt for assuming that freedom meant showering you with all sorts of material goodies.

Well, let’s have a look. With regard to the first part of Goldberg’s statement, I entirely agree—to the extent that I had intended to call the book that I thought about writing, as a sequel to The Golden Calf, Visions of Freedom. (I may yet get around to writing it but that’s another matter.) I completely agree that at the root of the difference between economism and progressive thought lies in alternative views of human freedom.

Predictably, however, Goldberg then immediately goes off track. Let’s take his ideas in reverse order. He suggests that for the right (i.e., economism), freedom is “a right rooted in individual sovereignty.” As I have shown both in this blog and in The Golden Calf, this is a partial truth. Economism recognizes exactly one form of “sovereignty” and “right,” which is to be a buyer and seller in the so-called “free” market, which does not in actuality exist anywhere. When push comes to shove, no other “right” is important, and all other so-called rights must give way to the all-powerful market and its high priests.  So to argue that it’s the left that has confused freedom with mere material things is at best a highly selective view of what’s really going on.

Next we come to the claim that for the left, “freedom” means one thing only, freedom from material want, the solution of which is a nanny state giving each of us stuff, and so robbing us of our (real) freedom and responsibility. Let’s look at this in two stages. First, the much-maligned FDR, in his “four freedoms” speech that included “freedom from want,” made the point that still seems valid—that a person who is in some theoretical sense free, and yet is starving, or naked, or homeless, or lacks basic medical care, is in no real sense free. This person is a slave to material deprivation. Without some basic set of the material conditions necessary for a minimal human life—not everything imaginable, not wealth, but a very basic minimum—a person cannot be “free” in any meaningful sense of the term.

That’s hardly a complete philosophical theory of what freedom might mean in a world that has broken loose from the ideology of economism. The next stage, therefore, is to ask which thinkers have taken us the farthest in recent years toward fleshing out what Roosevelt apparently had in mind, in a way that represents a defensible and justifiable framework for a decent and just society. That theory, in my view, is the capabilities approachdeveloped by philosopher-economist Amartya Sen and philosopher Martha Nussbaum. Perhaps the most accessible account is in Nussbaum’s Creating Capabilities: The Human Development Approach (2011).

On the Nussbaum-Sen account, what makes humans truly free is having certain capabilities that are consistent with a life of human dignity. Some of these capabilities, such as rights of political participation, require mostly that people leave us alone and not interfere with our free exercise of our capacities. Other capabilities require that we have at least minimal levels of material goods provided for us—such as the capabilities that require nutrition, shelter, health care, and education. On a capabilities approach, human dignity is a multi-faceted idea, and it’s arbitrary to say that the only rights worthy of the name are “negative” rights (much beloved by conservatives) merely to be left alone, or “positive” rights (presumably, much beloved by leftists) to get stuff given to you. Depending on the specific human capacity, both positive and negative rights are important.

The fleshing out of such a theory requires first that we explain what human dignity requires, and we see that material wealth, or all sorts of material goods, are hardly included; we only need a basic minimum. The next requirement is that we ask what a just, fair, and decent society is obligated to do toward providing each citizen with these basic rights and needs; and again there could be a lot of argument about what’s required, from and for whom, and why. I don’t have space here to try to develop such an account (hence the need for the book). But the bottom line, contra Goldberg, is that such an account can be given; it’s intellectually rich; and it cannot be adequately captured in caricaturish attacks on Soviet Communism or the usual bogeymen of the right. (And yes, by the way, the right to buy and sell in the market—real markets, not fake ones—to try to advance one’s own economic position, is included by Sen at least as a critical human capability, but only one of many.)

I’m quite confident that if the American public could be presented with two basic accounts of freedom—the capabilities approach suitably worked up and fleshed out, and the economism version presented honestly—the capabilities approach would win.  If I’m wrong, so be it. The whole purpose of my work on economism is to earn the alternative views a fair hearing.

Full Article

This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

01/08/2014

Exploiting despair – the death of Jahi McMath

With the onslaught of media coverage of the Jahi McMath case it is time for a public debate on whether or not the loss of upper and lower brain function should determine death.  Brain death is the cessation of any brain activity in the upper brain as well as the lower brain or brain stem. The McMath case should be distinguished from the Terri Schiavo case where only upper brain function was in question. Ms. Schiavo was not determined to be brain dead, but rather a living person in a persistent vegetative state. Brain death is established by numerous objective...

The post Exploiting despair – the death of Jahi McMath appeared first on Clinical Bioethics Blog.

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01/03/2014

Patient Modesty: Volume 62

The argument of what all healthcare providers are thinking in terms of sexuality, sexual feelings and sexual intent when they are attending to patients of either gender is truly an empty argument since we will never know.  And as Don (writing in V...

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This entry was posted in Health Care and tagged . Posted by Maurice Bernstein, M.D.. Bookmark the permalink.

01/03/2014

An ICU Nurse Discusses Brain Death

Aimee Milliken

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This entry was posted in Health Care and tagged . Posted by Laura Haupt. Bookmark the permalink.