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Author Archive: Craig Klugman

11/21/2014

Doused Counties: Banning Tobacco Sales in Massachusetts

by Craig Klugman, Ph.D.

The small city of Westminster, Massachusetts is voting on whether to become the first town in the nation to ban sales of tobacco products, e-cigarettes, and bubblegum-shaped smoking implements within its limits. Many cities already have bans on selling tobacco to minors, smoking bars, businesses, offices, and even in public. The drugstore giant CVS has banned sales of tobacco products from its stores. But this is the first time that a city is making the sale of tobacco and e-cigarettes illegal.

The reasons for the smoking ban are simple. In this town of 7,400, there has been concern that tobacco companies use marketing to create new smokers.…

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11/18/2014

Elderspeak: Words Can Hurt

by Craig Klugman, Ph.D.

During the season premiere of the HBO comedy, Getting On, I noticed the excessive use of toddler-speak toward patients portrayed as being elderly. The show takes place in a senior rehab/hospice unit in a community hospital. Whenever one of the health care providers (physician or nurse) was speaking to one of the patients, they tended to use baby talk—higher pitch, lilting tone, longer spaces between words, elongated space around vowels, and using simple, shortened words. When speaking to a baby or a toddler, such tones may help them to learn language, provide amusement, and get their attention.…

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This entry was posted in Clinical Ethics, Cultural, Featured Posts, Health Care. Posted by Craig Klugman. Bookmark the permalink.

11/03/2014

Rest in Peace Mrs. Maynard

by Craig Klugman, Ph.D.

Over this past weekend, Brittany Maynard took her own life. At 29-years-old, Mrs. Maynard took her prescription for assisted suicide to end her life before her terminal brain cancer pushed her into a quality of life that she found unacceptable. She was young, articulate, and facing a very short lifespan where she would lose control of her body and mind, becoming increasingly dependent on others to complete activities of daily living.

Mrs. Maynard had stated her intention to take her life in an internet message that she sent out into the world. She had moved to Oregon from her home state of California in order to be able to take advantage of the Death with Dignity law there.…

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This entry was posted in Cultural, End of Life Care, Featured Posts, Health Regulation & Law and tagged , . Posted by Craig Klugman. Bookmark the permalink.

10/24/2014

Ebola Fever: “Don’t Panic”

by Craig Klugman, Ph.D.

In The Hitchhiker’s Guide to the Galaxy, author Douglas Adams provided his protagonist with two pieces of advise: don’t panic and always carry a towel. The first is good advice when it comes to Ebola panic.

I was sitting down on the plane in San Diego airport after the American Society for Bioethics & Humanities meeting when I noticed a woman walking down the aisle with a face mask. Being a public health-oriented person, I figured she had tuberculosis and was under order to wear a mask to protect other people’s health. But then a man came aboard with a mask and soon thereafter there was an entire family.…

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10/20/2014

Death From Ebola: What do we do with the deceased?

by Craig Klugman, Ph.D.

In the United States in the year 1900, 52.6% of all deaths were due to infectious disease. the number one cause of death. When these patients died, a family member, friend, or member of a burial society washed their bodies and cleaned them. Their families held wakes and funerals in their homes, often laying out the body in the parlor. They would all go to the cemetery and the body would be buried in a family grave. In 2010, the most recent year for which records have been released, the number one cause of death is heart disease (31.9%) followed by cancer (30.9%).…

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10/16/2014

The Great Ebola Race: An appeal to honor the common good

by Craig Klugman, Ph.D.

In the time of the black plague, people with symptoms were often placed into separate areas. The sick and symptomatic were separated from the general populace.

When ships came into harbors they were often kept there for weeks until it was assured that they did not carry disease with them.

Cities would close their gates to travels to prevent anyone from arriving who might bring disease as well as to protect travelers from disease when it raged within.

When immigrants passed through Ellis Island with symptoms of infectious diseases they were kept on the island until they were better or sent back home.…

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10/14/2014

Why we ignored Ebola until recently

by Craig Klugman, Ph.D.

Ebola burst onto the scene in 1976 when a thirty-old man arrived at the Yambuku Mission Hospital in Zaire complaining of severe diarrhea. He left the hospital two days afterwards and was never found again. In the days and weeks that followed, people who were patients or care providers at this facility when he was there all died after experiencing dehydration, fever, vomiting, diarrhea, and bleeding everywhere. The death rate was staggering, as over 80% of affected patients did not recover.

Since then, the CDC reports there have been 34 distinct outbreaks of the five strains of Ebola.…

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This entry was posted in Cultural, Featured Posts, Health Care, Politics, Public Health and tagged , , . Posted by Craig Klugman. Bookmark the permalink.

10/01/2014

A Primer on Ebola: Ethics, Public Health, and Panic

by Craig Klugman, Ph.D.

Ebola is in the news a lot with the diagnosis of the first case on U.S. soil (excluding the 4 cases of health workers who were repatriated from West Africa after falling ill with the disease). Lots of information is flying around the internet and the news media. The ethics of outbreaks is not a new topic and has been written about extensively in this blog as well as elsewhere. Experts in public health ethics have addressed this issue thoroughly.

Below are some thinking points about Ebola to help put the situation into perspective and to provide some points for reflection.…

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This entry was posted in Featured Posts, Health Care, Politics, Public Health and tagged , , . Posted by Craig Klugman. Bookmark the permalink.

09/30/2014

Dollars to Doctors: Sun Rises on Sunshine Act’s Open Payments Database

by Craig Klugman, Ph.D.

Today, Tuesday, September 29, the Centers for Medicare and Medicaid Services will release most of the Open Payments database. The public will now have access to the monetary value of gifts, marketing, and payments for clinical testing made by the pharmaceutical industry to physicians. The database is being rolled out 12 days later than planned and with one-third of the 2013 data unavailable until June 2015: There have been some glitches including mix-up of names and wrong provider and license numbers entered.

The Open Payment database is a part of the Sunshine Act, a provision of the 2010 Affordable Care Act.…

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09/24/2014

Sophie’s Choice: Can Machines Do Any Better?

by Craig Klugman, Ph.D.

In the 1979 novel Sophie’s Choice by William Styron, the reader meets a Holocaust survivor who was forced in the camps to choose which of her two children would die immediately. Making the choice led to a life of alcoholism, depression, and self-destructive behavior. One interpretation of this novel, later made into an Academy Award winning film (1982), is that having choose whether a loved one lives or dies is a spirit-wrenching decision.

And yet, everyday, health care providers and bioethicists ask legally appointed health care power of attorneys and other designated surrogates to decide whether an incapacitated patient has surgery, receives a feeding tube, is resuscitated, or is intubated.…

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