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Author Archive: Craig Klugman

04/29/2016

BioethicsTV: Boundaries are Black and White on Grey’s

by Craig Klugman, Ph.D.

Reaching back to its roots, Grey’s Anatomy in its 12th season has been investigating more professional and ethical challenges in medicine. The April 28th episode (Season12: Episode 21) focused on questions of boundaries of why physicians should not treat their loved ones.

The first story was about a resident dating a former patient. Since the key term is former such a move may not be a pragmatic choice, but it does not violate professional boundaries (unless the physician is a psychiatrist in which case the APA says it may never be okay to date a former patient).…

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04/26/2016

BioEthicsTV: A night of consent issues on ChicagoMed

by Craig Klugman, Ph.D.

On this week’s episode of ChicagoMed (Season 1; Episode 15) issues of consent was the main focus. The first major storyline concerned a 16-year-old in abdominal pain who enters the ED with her father, a heroin addict. Although in pain and in need of a diagnostic endoscopy, the patient refuses any and all medications: She fears that even one dose will turn her into the addict that her father has been for her entire life. The doctors try the endoscopy without anesthetic or pain medications and they are unable to get through the procedure. Dr. Charles, the psychiatrist, does a capacity examination of the patient and finds that not only is she rational and reasonable, but given her father’s history, she has reason to be wary.…

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This entry was posted in Clinical Ethics, Featured Posts, Informed Consent, Reproductive Medicine and tagged , . Posted by Craig Klugman. Bookmark the permalink.

04/21/2016

Clarifying the Rules: No media in patient treatment areas

by Craig Klugman, Ph.D.

In January, I wrote about the case of Mark Chanko, a patient run over by a truck whose death was recorded for a real-life medical show and was later viewed on television by his horrified widow who had never been asked for permission for the airing. Now a settlement with federal regulators announced today will forever tighten health privacy recording restrictions in the hospital. In short, to film patients in the hospital, you have to get their consent before recording, not after as has been the procedure for most real-life medical shows.

New York Presbyterian Hospital is paying $2.2 million in penalties to the U.S.…

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04/20/2016

Stinging Doctors: Recording Your Own Surgery

by Craig Klugman, Ph.D.

Ethel Easter expressed outraged this week at what her health care team said about her during her surgery in Texas last year. She claims that before her operation she was flagged as a difficult patient and instead of talking to her doctors at that time, she hid a recording device in her hair. Listening to the recording after her operation, she heard the medical staff discussing her as a “handful” and making other disparaging comments.

This case comes after “D.B.” in 2013 accidentally left his cell phone in record mode during a procedure. The insulting comments made while he was sedated led to a $500,000 payment for medical malpractice and defamation.…

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This entry was posted in Clinical Ethics, Featured Posts, Informed Consent and tagged . Posted by Craig Klugman. Bookmark the permalink.

04/14/2016

Review Your Directives this National Healthcare Decisions Day

by Craig Klugman, Ph.D.

April 16 is National Healthcare Decisions Day (NHDD), a day dedicated to advance care planning—having conversations about end of life care and perhaps completing advance directives. According to the official website, “National Healthcare Decisions Day exists to inspire, educate and empower the public and providers about the importance of advance care planning.”

Nathan Kottkamp, a health law attorney in Richmond, Virginia and member of several hospital ethics committees founded this event as Virginia Advance Directives Day in 2006. Lawyers, nurses, health care associations, doctors, and community agencies supported that first day. Two years later, he took the model national with the first NHDD.…

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04/07/2016

BioethicsTV: “Heartbeat” tackles therapeutic misconception

by Craig Klugman, Ph.D.

On episode 4 of Heartbeat, the heroine, Dr. Panttiere has received hospital funding to try an experimental cancer treatment on 5 patients. The intervention uses laparoscopic surgery to implant radioactive pellets directly into tumors. The show presents a good debate on the values of enrolling patients because the characters discuss the hope of more time versus providing patients with comfortable quality of life at the end of life. The side-by-side contrast is quite literal as the camera shows Panttiere sitting next to her paramour, Dr. Harrison. The camera pans between the two doctors and the patient/potential subject, sitting on the other side of the table.…

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04/06/2016

Paternalists at the Gate: Those With Privilege Fight to Keep It

by Craig Klugman, Ph.D.

One of the main concepts that most medical ethics instructors teach to their students is that of autonomy—self governance. I usually explain that this evolved in response to the age of paternalistic medicine. During the civil rights movement, where voiceless groups were demanding a voice, patients were among those who received a voice through autonomy. However, recent legislation suggests that the age of paternalism has returned anew, but this time medical authority is wielded by legislators and not physicians trying to ensure their continued privilege in society.

Consider that the state of Indiana signed a bill that makes it illegal for a person to have an abortion on the basis of a test that shows the fetus has “disability or defect such as Down syndrome.” This is the second law of its kind in the nation, following on North Dakota’s “fetal anomaly” ban in 2013.…

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04/06/2016

BIOETHICSTV: Chicago Med-BIID, post mortem egg retrieval, scope of practice and forgiveness

by Craig Klugman, Ph.D.

This week on Chicago Med brought 3 new ethical issues as well as the unsatisfying resolution to a story arc.

Story 1 begins with a patient brought into the ED after trying to saw off his arm in the hardware store. The doctors are able to save it but the patient is upset. Dr. Charles, the psychiatrist, realizes the patient suffers from Body Integrity Identity Disorder (BIID) which is characterized by people feeling a part of their body is not theirs. They often desire to amputate that foreign part of themselves. The patient agrees to counseling and therapy.…

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04/04/2016

BIOETHICSTV: House of Cards Shuffles The Deck on Organ Allocation

by Craig Klugman, Ph.D.

BioethicsTV is an occasional bioethics.net feature where we examine bioethical issues raised in televised medical dramas.

This past weekend I was binging on House of Cards, season 4. Although this is not a medical drama, a story arch this season is relevant to this column.

If you have not watched yet, please be warned that this post is a big spoiler. Read no further if you care about such things.

One of the storylines this season is about President Underwood being shot and most of his liver removed. The doctors hope that the organ will regenerate but it does not.…

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This entry was posted in Featured Posts, Organ Transplant & Donation and tagged , . Posted by Craig Klugman. Bookmark the permalink.

03/24/2016

BIOETHICSTV: “Heartbeat” is Flat

by Craig Klugman, Ph.D.

This week another new medical show premiered; this time on NBC. Heartbeat follows the story of Dr. Alex Pannttiere one of the few female heart surgeons and chief innovations officer at fictional St. Matthews Hospital in Los Angeles. This series is based on the book Heart Matters by Dr. Kathy Magliato.

The second episode (#102) features a case of conjoined twins who have shared every moment of their lives. The two patients are as different as two people can be, but they share a liver, spleen, parts of a pelvis, and parts of the circulatory system (though both has her own heart).…

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This entry was posted in Featured Posts, Media and tagged , , . Posted by Craig Klugman. Bookmark the permalink.