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Author Archive: Craig Klugman

About Craig Klugman


by Craig Klugman, Ph.D.

In 1983, NBC broadcast an alien invasion limited series calledV. In one episode, as the U.S. devolves into a tyranny, the military invades scientific labs and finds—inside the filing cabinets (it was pre-computer days)—cures for cancer and other diseases that were simply never released because companies made more money treating disease than curing it. From that 36 year old television image has come a modern reality—Pfizer may have a drug that improves the chances of preventing Alzheimer’s Disease, but they won’t pay for the clinical testing.

Enbrel is a $5 billion per year prescribed biologic medication approved in 1998 for rheumatoid arthritis.…

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by Craig Klugman, Ph.D.

Last week, the World Health Organization (WHO) re-defined workplace burnout as a syndrome consisting of “feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.”  The change still does not define burnout as a medical problem and it is not new since it appears in the International Classification of Diseases version 10 as well. What it does is provide a focus on the increasing stress that we face by jobs that demand more time, effort and productivity while giving us less in return.…

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by Craig Klugman, Ph.D.

In 2017, Texas passed an abortion burial law. As part of Texas Senate Bill 8 , this provision would have required that health care facilities ensure that an aborted embryo or fetus was treated like all human remains. This means the remains would have to be handled by a funeral director and disposed of via burial or cremation. The remains could not be disposed alongside medical waste, which is incinerated. This law never took effect as a federal judge ruled the requirement adds “significant burdens on women seeking an abortion or experiencing pregnancy loss” and that it conveyed “minimal, if any, benefits.”

This week, however, the U.S.…

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by Craig Klugman, Ph.D.

I am a man writing about abortion. I am a bioethicist outraged that a bunch of JDeities believe they know more about medicine than doctors, and more about a woman’s body than a woman living in her body. I am a citizen incensed that a bunch of legislators are trying to force their narrow view of morality on a nation that has prided itself on freedom and individual liberty. I am a scholar petrified that these moves are intended to favor one religion over all others and to subjugate women to second class citizen status.

The story begins in 2003 when the U.S.…

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by Craig Klugman, Ph.D.

New Amsterdam (Season 1; Episode 22): Max’s Impossible Choice<; Chicago Med (Season 4; Episode 21): Choosing between life and certain death

New Amsterdam (Season 1; Episode 22): Max’s Impossible Choice

Max Goodwin is at home resting from his chemotherapy after stepping down temporarily from his medical director position. Dr. Bloom knocks on the door to talk to him and finds Max covered in blood, his wife’s. Georgia is fairly far along in her pregnancy and has experienced previa: She is bleeding out. Max calls for an ambulance which seems to be impossibly far away and unable to get there.…

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Exploring ethical issues in medical dramas

The Resident (Season 2; Episode 23): Unrepresented patient and substance abuse; Chicago Med (Season 4; Episode 20): Violating a patient’s autonomy; organ trafficking

The Resident (Season 2; Episode 23): Unrepresented patient and substance abuse

A middle-aged man comes to the ER unable to speak and without ID. The staff gives him the name “Sunflower”. He is presumed to be homeless based on the state of his clothing and dirt under his fingernails; thus, without insurance. But Chastain is a private hospital. How much do they do for him? Pravesh says that an MRI for his condition is the standard of care, so that is what they do—we know he’s stretching the reality here to help his patient.…

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by Craig Klugman, Ph.D.

Medical School Interviewer: “If you could, please tell me why you decided to apply to medical school and pursue a career in medicine?”

Applicant: “So that I could refuse to treat the godless heathens.”

Interviewer: “Under U.S. rules, that is your right. Welcome to Med School.”

Under a new rule, the Trump Administration has strengthened a religious liberty clause that protects health care workers who refuse to perform procedures or treat patientsthat violate their religious beliefs. The rule allegedly attempts to protect these health care providers from having to perform abortions, sterilizations, assisted suicide, global health, hearing screening, vaccination, mental health treatment, and even to follow an advance directiveif that legal and safe procedure violates their moral conscience, even if inaction would result in the death of the patient.…

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by Craig Klugman, Ph.D.

Exploring bioethical issues in television medical dramas

New Amsterdam (Season 1; Episode 19): Privatizing the VA; The Resident (Season 2; Episode 22): Organ buying; Grey’s Anatomy(Season 15; Episode 23): Insurance Fraud

New Amsterdam (Season 1; Episode 19): Privatizing the VA

A veteran has a stroke while driving and injures a police officer. We learn that the driver was diagnosed two years earlier with bladder cancer, which has led to his current stroke. He could not get treatment because the VA closed the urology division in a rush toward privatization. The voucher to get care elsewhere only covers 75% of the cost of care and the patient cannot afford the rest.…

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by Craig Klugman, Ph.D.

In the last few years, the hospital where I serve on the ethics committee has seen a dramatic uptick in the number of patients placed on extracorporeal membrane oxygenation (ECMO). ECMO is an amazing technology because it can maintain a body even after “severe neurologic impairment or multiorgan failure”. With its ability to replace heart and lung function, a body can be maintained long after the heart, lungs, and even brain have failed.

In ECMO, the machine replaces the lungs (and sometimes the heart). The blood circulates outside the body where it oxygenates and releases carbon dioxide and then returns to the body.…

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by Craig Klugman, Ph.D.

Now that you have submitted your taxes, it’s time to consider your death. April 16th is National Health Care Decisions Day, an annual effort to encourage people to think about their end of life care choices and to engage in conversation with others.

In August, I wrote about my attempts in revising and rewriting my end-of-life planning documents including my last will and testament, but mostly focusing on my dissatisfaction with current advance directive forms that require you to make broad choices and really do not speak to who the person is. I talked about my effort to create a narrative advance directive, one that speaks to who I am as a person, what I value in life, and what an acceptable quality of life is for me.…

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