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Author Archive: Craig Klugman

10/13/2017

BioethicsTV (October 9-13, 2017): Drinking on transplant list; big pharma in pandemics; mortality forces morality

The Good Doctor (Season 1; Episode 3): A Patient Takes A Drink While on the Transplant List

This week, a patient is finally at the top of the list for a heart transplant. The heart is at a hospital on the other side of the Bay and through a series of obstacles, getting the liver to the hospital while still viable becomes a challenge. At the same time, a final series of blood tests shows that the patient had a drink. The viewer is told that to be eligible for the transplant, the patient cannot have had alcohol for the prior 6 months.…

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10/11/2017

In Our Own Words: A Challenge to Share Our Own Stories

by Craig Klugman, Ph.D.

In a recent issue of Academe, sociologist Arlene Stein says that the disconnect of academia and the rest of the world is especially acute now, in a time when anti-intellectual fervor is flowing from the highest levels of the government. She states, “in the longer term, scholars need to be doing a better job of communicating what we do to those outside the so-called ivory tower… Telling stories about our work to those outside of university settings must be part of this strategy.“

by MK Czerwiec (ComicNurse)

In part, I think Stein means that we need to share our work (teaching and research) outside of the academy by speaking in public and by writing for public audiences.…

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

10/06/2017

BioethicsTV (October 2-6, 2017): Communication Issues and Assisting Suicide

by Craig Klugman, Ph.D.

The Good Doctor (Season 1; Episode 2); Communication (lying, stealing credit; keeping silent)

This week’s episode of this new drama was about communication, specifically on the topic of lying. In the first storyline, a patient arrives with stomach pain which turns out to be an invasive, advanced, and complicated tumor. The patient is concerned because she is the only parent to her son who is getting married in a week and she wants to be there. Resident surgeon Claire Brown tells the patient that they will take care of her and that if she has surgery, she promises the patient will not die and will be at the wedding.…

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10/05/2017

Livestreaming Surgery: New guidelines raise questions of who benefits

by Craig Klugman, Ph.D.

The Internet and social media have raised hosts of new ethical issues in the health care world: Should doctors friend their patients? Should med students post photos of their cool cases? Should doctor diagnose people online? The general answer for these questions has been no: “Friending” a patient is a boundary crossing, posting patient photos is a confidentiality violation and diagnosing a patient online (not through a formal telemedicine process) violates standards of care. But some online technologies have been adopted in full such as emailing your doctor and interacting with your health care provider through an online portal.…

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09/29/2017

BIOETHICSTV: Gender-change surgery; coercing consent; conflict of interest and impaired judgement

by Craig Klugman, Ph.D.

Late September means the beginning of a new television year. This week saw the return for the 14th season of Grey’s Anatomy and the introduction of a new medical drama, The Good Doctor. However, the first major bioethical dilemma of the new season came from an unlikely place—a new science fiction show.

The Orville (Season 1; Episode 3): Forced Gender Surgery on a Newborn
The first significant BioethicsTV episode came from an unexpected place, a new science fiction show called The Orville. This show is an off-brand Star Trek and shares a creator with several of the franchises of that fictional universe.…

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09/28/2017

Social Justice Trumps Fancy Tech In This Week’s Bioethics News

by Craig Klugman, Ph.D.

Some weeks when I think about what my blog will be about, there are very few relevant items in the news. And then some weeks there are too many things to talk about. This week is one of the latter. Besides the Graham-Cassidy bill (which I discussed in detail last week), there is the lack of any movement on renewing the CHIP program, the patient who may have had a change of consciousness after vagus nerve stimulation, or even the Ohio law that does not allow minors to consent for their own treatment in any circumstances, meaning that teenagers in labor cannot have pain relief (i.e.…

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09/22/2017

Another (Un)Health Care Bill Forced onto Us

tby Craig Klugman, Ph.D.

Americans still tend to think of human rights violations as abridgments of free speech and religion, and extreme crimes against humanity, such as slavery, torture, and arbitrary detention. These are correct, but incomplete. Economic and social rights (which include the right to health, and can be thought of as the core of social justice) are a vital part of a human-rights-based ethical code.George Annas, American Journal of Bioethics (September 2017)

This coming week (probably Wednesday), the GOP Senate leadership plans to bring to a vote yet another health care reform bill, Graham-Cassidy. The bill was written by Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI).…

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

09/15/2017

Medical Gawking Case Points to Need for Culture Change

by Craig Klugman, Ph.D.

According to a news report in The Washington Post, a number of medical staff at a Pittsburgh hospital have been reprimanded over a gross violation of a patient’s privacy. The patient was under anesthesia and a crowd of staff gathered to watch and take photos of “a patient’s genitals with a foreign object protrusion.” Many photos were shared with others. The “crowd” was significant and consisted of more people than those involved with the patient’s care. According to one person interviewed in the investigation (who took a picture of the patient when requested to do so): “There were so many people it looked like a cheerleader type pyramid.”

I am friends with many health care providers and I have seen them post pictures of unusual surgeries on Facebook, or sent me a text with a picture with a caption like, “can you believe this thing?” I have been told stories of surgeons inviting people to take a look at a patient’s unusual anatomy during a procedure.…

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This entry was posted in Cultural, Featured Posts, Informed Consent, Media, Privacy, professional ethics and tagged , . Posted by Craig Klugman. Bookmark the permalink.

09/08/2017

Harvey and Irma: Bioethics in Natural Disasters

by Craig Klugman, Ph.D.

This is a time of disaster. Last week Hurricane Harvey devastated Southeast Texas, a place where I did my doctoral studies. This week we are awaiting Hurricane Irma, the strongest hurricane to head toward South Florida in 25 years. My family lays in the path of that coming storm. I first became interested in natural disaster in 1989 when my college campus was jolted by a 7.1 earthquake in Northern California.

Bioethics has a role in responding to and preparing for these natural disasters. Most every state, large city and county, and most hospitals have been working on crisis standards of care plans.…

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08/29/2017

Taking Patient Autonomy Out of the DNR

by Craig Klugman, Ph.D.

The Texas government has passed SB 11 an act “relating to general procedures and requirements for certain do-not-resuscitate orders; creating a criminal offense.” As of April 1, 2018, one can be jailed for offenses involving DNR orders.  When new laws are passed they often require new regulations to interpret them as well as statements from the state attorney general on how they are to be enforced and viewed. While those steps have not yet been taken, the threat to physician practice and patient autonomy in this law necessitates taking a further look at it now.…

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