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Author Archive: Craig Klugman


In California, Vaccination is the Law

by Craig Klugman, Ph.D.

This week, California governor Jerry Brown signed Senate Bill 277. This law mandates vaccinations for all children who attend a school (public or private) in the state. The only exemption is when a physician certifies that a vaccine “is not considered safe for the child.” The big change in this new law is the removal of the “personal belief” exemption from vaccination. No longer can a religious or philosophical belief exempt a child from receiving an immunization.

California has been at ground zero for conversations about vaccination. Earlier this year, the Disneyland park in Anaheim, California was the center of a massive national measles outbreak among unvaccinated children.…

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Can An Advance Directive Ever Justify Cessation of Eating in an Alzheimer’s Patient?

by Craig Klugman, Ph.D.

Margot Bentley did what end-of-life care advocates say we should all do—she completed an advance directive. She wrote hers in 1991 when she was working as a nurse and stated that she did not resuscitation, surgery, respiratory support, or nutrition and hydration.

Today she is at the center of a legal battle in Canada. At age 83, she has suffered from Alzheimer’s disease for the last 16 years. She is non-responsive. Her family wants to follow her wishes by stopping feeding and taking her home to die comfortably. The long-term care facility where she resides said no and put an order in her chart to call police if the family tried to remove her.…

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MERS: Another Lesson in Quarantine and Health Disparity

by Craig Klugman, Ph.D.

At the G7 meeting this week, the developed nations which compose the Group of 7 pledged to “wipe out Ebola.” With over 11,000 Ebola-related deaths worldwide since March 2014, this certainly is worth public health efforts and funding.

While the “world leaders” focus on Ebola, which of course made small incursions in to the U.S. and Europe, a new epidemic lurks on the horizon—MERS. Middle East Respiratory Syndrome was first reported in September 2012 in Saudi Arabia. It can infect anyone of any age and its method of transmission is not well understood. The primary methods appears to be animal to human.…

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Quantified Self: Your Life in Data

by Craig Klugman, Ph.D.

How much did you sleep last night? How many calories did you burn? How many steps did you walk? What was your average resting heart rate? How many calories did you consume? What was your blood oxygen level? If you were a part of the “Quantified Self” movement, then you would have all of these numbers logged on your wearable, your mobile, your phone, your tablet, and your laptop.

The Quantified Self movement is an attempt to use technology to keep track of all physiological aspects of a person’s life. The goal is to quantify yourself by taking biometric measurements so that you can track your health.…

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“Should I feel badly that I acted unethically?”

Ms. Barnard is a business woman who has opened a medical clinic across the street from an existing facility. She suspects that the Other Clinic is “playing unfairly” by not having a physician on site. Since a physician costs a lot of money to employ, the Other Clinic could be undercutting the competition if this were true as well as violating their state license. Ms. Barnard asks her employee, Roger, to visit Other Clinic posing as a patient and seeing if indeed there was a physician present. Roger made an appointment for a check up for a fictional trip: He asked for anti-malaria medications for travel to sub-Saharan Africa.…

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Dare to Fail

by Craig M. Klugman


  1. The fact of becoming exhausted or running short, giving way under trial, breaking down in health, declining in strength or activity, etc.
  2. The act of failing to effect one’s purpose; want of success; an instance of this. (Oxford English Dictionary 2015, entry 67663)

There is not enough failure in our modern world. I am not talking about the kind of failure that comes from not trying or being neglectful, but rather the failure that comes from working hard to achieve a goal and not making the mark.

If one does not fail, then one has not tried to excel.…

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Raging Against the Dying of the Light

by Craig Klugman, Ph.D.

When do we die? The legal and medical answer is we are dead when we either (a) have experienced total loss of all brain function or (b) cessation of cardiopulmonary activity. The biological answer is that we are dead when as an organism we have lost our ability for integrated function—that is enough parts have ceased to function that the organism cannot be put back together again. That moment we call “death” is in a real way, quite arbitrary. It takes much longer for our tissues and cells to die once the integrity is lost.

I am in the second half of the academic quarter, teaching a course on Death & Dying.…

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Cost of Compassionate Use is Simply Too High

by Craig Klugman, Ph.D.

Johnson & Johnson’s Janssen Pharmaceutical Company announced that it has contracted with New York University’s Division of Medical Ethics to assemble an external Compassionate-Use Advisory Committee (CompAC) to examine requests for investigational new drugs (INDs) outside of clinical trials. Arthur Caplan will lead this group, which will be composed of bioethicists, physicians, and patient advocates. The goal of this group is to provide recommendations on which patients should be given compassionate use access to experimental drugs.

This step is a reaction to increasing publicity on compassionate use as well as 17 states having passed “Right to Try” laws that allow residents of those states to directly contact drug companies to request experimental drugs.…

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AJOB Announces Two New Editors

The American Journal of Bioethics (AJOB) is delighted to announce two new additions to its esteemed Editorial Team.

John Lantos, Associate Editor

John Lantos, MD, is Director of the Children’s Mercy Hospital Bioethics Center in Kansas City.  Prior to moving to Kansas City, he was a Professor of Pediatrics at the University of Chicago, where he was also Chief of General Pediatrics and Associate Director of the MacLean Center for Clinical Medical Ethics.

Dr. Lantos has held many leadership positions in bioethics and pediatrics.  He is past president of both the American Society of Bioethics and Humanities as well as the American Society of Law, Medicine, and Ethics. …

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Why Doctors Should Audio Record Patient Encounters

by Craig Klugman, Ph.D.

In Dave Eggers’ novel, The Circle, a behemoth tech company makes it popular for people to wear cameras and to live broadcast every minute of their lives (except for time in the bathroom). The goal is to remove secrets and to improve behavior because if you thought you were being watched all the time, you would always behave well (drawing on Bentham and Foucault’s ideas of the panopticon).

Much has been written about using cameras to protect ourselves. To combat racial injustice and claims of abuse, many police departments have adopted the use of body cams for officers.…

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