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Author Archive: Craig Klugman

03/22/2017

Texas Considers Letting Doctors Lie to Patients

by Craig Klugman, Ph.D.

The Texas Senate just passed a new bill (SB 25) that would shield doctors from a lawsuit if a baby is born with a disability even if the doctor knew of the concern and chose not to tell the parents. Opponents of the bill say that it permits doctors to lie to their patients if the doctor believes that knowledge might lead the woman to choose an abortion. The Houston Chronicle reports the bill’s aim is to “chip away at abortion rights.”

The Texas law does not go as far as a 2015 Arizona law that mandated physicians lie to patients by telling them that an abortion can be reversed.…

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03/17/2017

Ethics of the Trump Budget: The Social Contract is Dead

by Craig Klugman, Ph.D.

President Trump released his blueprint for a 2018 federal budget. From an ethical standpoint, the President seems to operates from a Hobbesian standpoint—life is nasty, brutish and short. However, unlike Hobbes who believed that we came together to protect ourselves from this reality, the new budget seems to encourage this idea. The new budget makes deep cuts to all social and scientific programs while boosting the military. In Hobbesian terms, Trumps’ social contract is all about bullying outsiders while leaving insiders in a state of hopeless diffidence.

Since World War II, the United States has invested heavily in science and technology, developing transportation, and building a better world (and winning wars).…

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03/07/2017

The Ethics of the New GOP Health Plan – Violating Justice & Solidarity

by Craig Klugman, Ph.D.

Whatever one may think of the Affordable Care Act (ACA), it began with noble intentions. The ACA was built on a philosophy of providing more people not only with access to health insurance but also with assistance to pay for it. The goal was not to derive a right to health care for all Americans, but rather to provide a level playing field for all people to purchase health insurance. Toward that aim, the ACA made some tough calls—requiring insurance for everyone so that the payments of the young and healthy would subsidize the needs of the ill whose ranks in the insurance pools were likely to grow.…

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03/03/2017

Talking to the Media

by Craig Klugman, Ph.D.

On Chicago Med this week (Season 2; Episode 15), Dr. Rose is trying to save the life of a window-washer whose platform breaks and he plunges 33 stories. Dr. Rose is getting coffee from a cart, outside the hospital when the media ask him for news of the window-washer. The administrator has told him that all media requests are to go through her. However, he holds an impromptu press conference talking about the patient and how hopeful he is for survival. The administrator witnesses this spectacle and dresses him down. Working with the media can be an important part of working in health care, providing an opportunity to educate the public on important health conditions and issues.…

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

03/03/2017

BioethicsTV: Communication Challenges

by Craig Klugman, Ph.D.

Chicago Med (Season 2, Episode 15) focused on problems with communication These ranged from offered a guide to when not to work with the media, violating HIPAA, to talking to students about dangerous treatments.

Violating HIPAA

One regulatory issue crosses several storylines this week: As I was watching, my spouse pointed out multiple violations of HIPAA. In the waiting room, the desk clerk calls patient’s names out loud when their turn to be seen arrived. My physician-spouse felt this was wrong and that most hospitals would have assigned patients a number to preserve confidentiality. In a second instance, a man who brings a woman into the ED after she collapses on the street (an apparent stroke) asks about her condition.…

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02/24/2017

Good facts, calm deliberation, and wise counsel

by Craig Klugman, Ph.D.

“Facts do not cease to exist because they are ignored” – Aldous Huxley, Proper Studies (1927)

A recent exchange on the bioethics listserv began with a panicked message that the Presidential bioethics commissions website (bioethics.gov) has gone dark. A flurry of messages asked what this might mean for bioethics and for meaningful moral discourse in the Trump administration. Soon, cooler heads prevailed explaining that Georgetown retains the repository of all of the several commissions and that the website came down on January 20, at the transition of power. When there is a transition of administration, it is standard (in the internet age) for websites to come down from old programs and to change while new staff and programs are instituted.…

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This entry was posted in Ethics, Featured Posts, Philosophy & Ethics, professional ethics, Science and tagged . Posted by Craig Klugman. Bookmark the permalink.

02/24/2017

BioethicsTV: Substituted Judgment

by Craig Klugman, Ph.D.

On Grey’s Anatomy (Season 13, Episode 14) two cases lead to questions about who makes decisions for patients. In the first story, a young woman wanders into the ED disoriented and talking about snakes in a hat to denote to the viewer that she has a mental illness and lacks capacity. She is filthy, homeless, and lacks identification. The woman collapses because her very old pacemaker malfunctions. Two cardiologists in the room agree that she needs the surgery and this is all that the viewer sees of consent. There is no interaction with social work or calls to the police to identify her, to look for missing persons reports, or to circulate her image and description.…

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02/17/2017

BioethicsTV: Mass Casualties & Triage

by Craig Klugman, Ph.D.

Chicago Med (Season 2; Episode 14). Over the last few years I have been working in the area of crisis standards of care. In fact, just today I presented the conclusion of 3 years of work on an ethics white paper to the state of Illinois crisis standards of care task force leadership. Serendipitously, tonight’s episode of Chicago Med dealt with a limited mass casualty situation: A multiple car pile-up on a freeway brings a large number of patients to the hospital. However, there is a major snowstorm and there is no chance of additional personnel or supplies coming to the hospital.…

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02/13/2017

The Death of Aid-in-Dying in DC

by Craig Klugman, Ph.D.

I recently gave a talk to a local chapter of a national physicians’ health care group where I was talking about what end of life could look like under a single payer health care system. Several of the attendees were advocates of aid-in-dying and were hoping I was going to talk about that issue as well. I did not as there was so much else to talk about regarding proposals for health care plans to replace the ACA and comparing death and dying in the US with countries that have a single-payer system (In short, no one is great at it; we aren’t doing so badly in comparison, and having a single payer system does not correlate with having good end of life).…

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02/03/2017

A Solution In Search of A Problem: Streamlining the FDA

by Craig Klugman, Ph.D.

A professional association for regulatory affairs posted an article on Wednesday reporting Trump’s comments “calling for a massive overhaul of US Food and Drug Administration (FDA) regulations.” Trump issued an executive that called for reducing the number of federal regulations (for each new one created, two must be retired). And he met with the heads of pharmaceutical companies, where he said that he plans to cut taxes, FDA regulations and approval times. He also criticized the companies for selling drugs that were too expensive. The two events combined suggest that Trump will try to reduce the FDA and its power.…

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This entry was posted in Clinical Trials & Studies, Featured Posts, Pharmaceuticals, Politics and tagged . Posted by Craig Klugman. Bookmark the permalink.