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Author Archive: Craig Klugman

About Craig Klugman

12/12/2018

Hospitals Selling Patient Records To Data Brokers: A Violation of Patient Trust and Autonomy

by Craig Klugman, Ph.D.

I recently received an email from a community organization which asked the following question: “Are there any ethical issues with our community health plan selling its medical records to a private company?” This is not an example of a new occurrence. A spate of news in recent months suggests efforts by various private companies to get a hold of private medical records with the goal of finding a way to profit off this information (the commodification of our information). Consider Sloan Kettering’s dealto sell its pathography samples and records to Paige.AIto develop artificial intelligence to help in treating cancer (and with lots of conflicts of interests for the administrators who put together the deal).…

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12/11/2018

BioethicsTV (December 3-5): #TheGoodDoctor, #ChicagoMed

by Craig Klugman, PhD

Jump to The Good Doctor (Season 2; Episode 10): Epidemic & Virtue Ethics; Jump to Chicago Med (Season 4; Episode 9): Not following patient wishes

The Good Doctor (Season 2; Episode 10): Epidemic & Virtue Ethics

This episode revolves around an unidentified pathogen invading the ED when two patients are brought in immediately after their flight from Malaysia lands. Both of them die and the ED is quarantined: All ambulances are diverted and walk-ins are sent away. Rather than panicking people, their coming and going from the ED is slowed down or delayed. Once Tyler— the EMT who brought in the patients—becomes sicker, Lim lets everyone know that they are on lock down and no one is leaving.…

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12/04/2018

Deregulating Anti-Kickback: More Than A Kick in Patients’ Wallets.

by Craig Klugman, Ph.D.

Federal kickback rules state that a pharmaceutical manufacturer or medical device producer cannot pay providers or patients to recommend or prescribe their products. The Anti-Kickback Statute [42 U.S.C. § 1320a-7b(b)], “is a criminal law that prohibits the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs(e.g., drugs, supplies, or health care services for Medicare or Medicaid patients)”. This law is one of a group that is intended to protect federal health payment programs from fraud and from conflicts of interest (for example, a physician is not permitted to refer patients to other businesses that they own [42 U.S.C.…

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This entry was posted in Featured Posts, Health Regulation & Law, Pharmaceuticals, Politics, Social Justice and tagged . Posted by Craig Klugman. Bookmark the permalink.

12/03/2018

BioethicsTV (November 26-30): #TheResident; TheGoodDoctor

by Craig Klugman, Ph.D.

Jump to Public Lectures; Jump to The Good Doctor (Season 2; Episode 9): Empathy-Sex offenders and prisoners

The Resident (Season 2; Episode 9): Oral directives and “the talk

When Hawkins’ father (Winthrop) collapses, he is brought to Chastain (the hospital he owns) even though he asks to be taken somewhere else. He has a stricture that is affecting blood flow to his intestine that could become life threatening. In his consent process, he says anyone but Bell can do the surgery; his doctors go over the risks and benefits to surgery.  The chief of general surgery says that she has all of her patients complete an advance directive, a task that Nevins says is part of the standard of care.…

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11/27/2018

Birth of Twins from Embryo Editing Raise Ethical, Legal, and Social Issues

Updated November 28 at 8:30am EST

by Craig Klugman, Ph.D.

The film GATTACA turned 20 years old this year. The premise of that film is a society where DNA is viewed as predictive of everything: Your intelligence, physical abilities, your health, even how long you will live. People soon learn to live within the limits of their DNA and not to push for more. In one particular scene, a couple visits their local neighborhood geneticist and orders up their child, choosing the most favorable genes as well as some tweaks to avoid common diseases. That scene took one step closer to reality when Chinese researcher He Jiankui announced the birth of two children whose DNA was altered to make them more resistant to HIV.…

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11/24/2018

BioethicsTV (November 19-23, 2018): #TheResident, #TheGoodDoctor, #NewAmsterdam

by Craig Klugman, Ph.D.

Jump to The Resident (Season 2; Episode 8): Fraudulent medical devices; Unfinished stories; Jump to The Good Doctor (Season 2; Episode 8): Vaccination, Stories and Marital Counseling; Jump to New Amsterdam (Season 1; Episode 8): Undue influence; Cultural accommodation; overworked physicians

The Resident (Season 2; Episode 8): Fraudulent medical devices; Unfinished stories

Henry is a young boy who comes to the ED after he has a grand mal seizure on the little league field. A physician orders a third medication to treat his disorder. The doctor enters the orders online, which triggers a message to the pharmacy, to the insurance company for approval, and then an oversight company that reviews all records.…

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11/16/2018

BioethicsTV (November 13-16): #TheGoodDoctor, #ChicagoMed

by Craig Klugman, Ph.D.

Jump to The Good Doctor (Season 2; Episode 7): Directed donation; Jump to Chicago Med (Season 4; Episode 8): DNR Tattoos and Ethics Committees

As many of our favorite medical dramas head to their fall finales, they focused more on sentimental stories in the personal lives of characters, or feel good cases that did not raise any ethical issues.

The Good Doctor (Season 2; Episode 7): Directed donation

The ethical issue in this week’s episode is located in a storyline about a man who comes to the ED after injuring himself with a nailgun. One nail punctures his kidney which has to be removed but, by a genetic fluke, the man was only born with one kidney.…

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11/15/2018

#InMyLane: Gun Violence and an Ethical Health Care Response

by Craig Klugman, Ph.D.

Since January 1, 2018 through November 15, the United States has seen 311 mass shootings that have killed 339 people and injured 1,249. The Centers for Disease Control & Prevention (CDC), shows that gun deaths are on the rise (mass shootings, all shootings, accidents, suicides, etc.). Shootings are the third leading cause of death in children aged 10-19 years and are responsible for 74% of all homicides. Having a gun in the home is a risk factor for death by gun whether accidental, deliberate, or unintended (a person with Alzheimer’s, a child playing).  According to the Harvard Injury Control Center, there are 265 million guns in the hands of civilians (the entire US population is about 320 million).…

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11/11/2018

BioethicsTV (November 5-9): #TheResident, #TheGoodDoctor, #ChicagoMed

by Craig Klugman, Ph.D.
Jump to The Resident (Season 2: Episode 7): Phase 1 testing; Bad devices; Jump to The Good Doctor (Season 2; Episode 6): Patient stories vs. scans; emotional vs. technical perspectives; Jump to Chicago Med (Season 4; Episode 7): Crisis Ethics: Who gets the dose?

The Resident (Season 2: Episode 7): Phase 1 testing; Bad devices

This episode dealt with two large ethical issues—phase 1 testing of new drugs and the lack of FDA oversight of medical devices. When a patient comes in with multiple organ failure, blindness, and hearing loss, Hawkins suspects poisoning. The culprit turns out to be a flawed hip replacement (metal on metal) that sheds cobalt and steel into his body.…

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11/06/2018

Docsplaining: Health Humanities Are Not the Canary in the Dangerous Coal Mine

by Craig Klugman, Ph.D.

Doc• splain (/’däk splān) verb. Informal. (of an MD) explaining (something) to someone, typically a PhD, in a manner regarded as condescending or patronizing

At the 2018 Meeting of the American Society for Bioethics & Humanities, we were treated to two excellent plenary sessions: Jonathan Metzl on gun violence and Despina Kakoudaki on Frankenstein. The third plenary was a bit of an aggravating mystery to those of us in the audience who work in the health humanities and have built careers around that field.

David Sklaris a professor emeritus of emergency medicine at the University of New Mexico and is the editor-in-chief-of Academic Medicine, the major journal about medical education.…

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