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Author Archive: Craig Klugman

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10/12/2018

BioethicsTV (October 8-12, 2018): #TheResident #TheGoodDoctor #ChicagoMed #GreysAnatomy

by Craig Klugman, Ph.D.

“Exploring ethical issues in TV medical dramas”

Jump to The Resident (Season 2; Episode 3): Saline shortage, pressure to bill; Jump to The Good Doctor (Season 2; Episode 3): Structural discrimination against women; surrogate decision-making; Jump to Chicago Med (Season 4; Episode 3): Best interest of a child; faith versus science; Jump to Grey’s Anatomy (Season 15; Episode 4): Fraud, assault, lies, and the ethics police

Medical dramas this week seemed to focus on two themes: 1. The poor treatment of female physicians and 2. Doctors committing fraud to manipulate patients and insurance companies into doing what they want.…

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10/09/2018

A Little Dab Will Do Ya: Fact and Fiction of the Radiation Debate

by Craig Klugman, Ph.D.

My father tells the story of how when he was a child, shoe stores had boxes into which you could slide your feet, shod in potential new shoes. This “shoe fitting fluoroscope” would display a x-ray of your feet so that you could see how well your shoes fit. In the 1950s, there were 10,000 of these devices in use throughout the United States. Perhaps even worse, store clerks would put their hands in the devices to squeeze the shoes to check for fit.

Even back then, the recommendation was that children not use these devices more than 12 times per year to limit radiation exposure.…

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This entry was posted in Featured Posts, Health Policy & Insurance, Health Regulation & Law, Science and tagged , . Posted by Craig Klugman. Bookmark the permalink.

10/05/2018

BioethicsTV (October 1-5)

by Craig Klugman, Ph.D.

Jump to The Resident (Season 2; Episode 2): Rising drug costs Jump to New Amsterdam (Season 1; Episode 2): Cultural accommodation; medicating schoolkids Jump to Chicago Med (Season 4; Episode 2): Withholding support; withdrawing support

The Resident (Season 2; Episode 2): Rising drug costs

In its sophomore year, this show seems to be shying away from ethical issues and the gross incompetence of its fictional hospital and exchanging it for hope; hope that hospitals can cover their costs and meet patient needs.

One storyline begins with a nurse saying, “Because you’re a minor, we have to wait on your mom” to a teenage patient in the ED.…

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09/28/2018

BioethicsTV: (September 23-28): #TheResident, #NewAmsterdam, #ChicagoMed

by Craig Klugman, Ph.D.

Jump to New Amsterdam (Seasons 1; Episode 1): Infectious disease; mistaken diagnosis; Jump to The Resident (Season 2; Episode 1): Emergency preparedness, risky surgery, and dehumanizing technology; Jump to Chicago Med (Season 4; Episode 1): Deaf culture

This week is the beginning of the new television season and the popularity of the medical drama is evident as a total of 5 prime time dramas hit the airwaves (The Resident, The Good Doctor, New Amsterdam, Chicago Med, and Grey’s Anatomy). In the first week of the season, however, many of these shows seemed to avoid ethical dilemmas, taking a turn toward the personal relationships of the main characters rather than difficult choices.…

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

09/27/2018

Investigative Genealogy: Guilty by Familial Association

by Craig Klugman, Ph.D.

This week I was on a panel discussing the topic of genealogical searchingrunning a DNA sample found at a crime scene against criminal, public and commercial DNA databases with the goal of not finding a suspect, but to find a relative of the suspect. This familial searchinvolves the National DNA Index System (NDIS) and investigative genealogy, which is looking in commercial (e.g. 23andMe, Ancestry) and public (GEDMatch) DNA databases for a familial match. The latter is what was done in the Golden State Killercase.

In most states, when a person is convicted of a crime, their DNA is uploaded to NDIS, which currently has nearly 18 million records.…

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09/21/2018

When Morality Isn’t So Moral: Price Gouging in Big Pharma

by Craig Klugman, Ph.D.

“I think it is a moral requirement to make money when you can…to sell the product for the highest price” Nirmal Mulyeto the Financial Times

I have been haunted by the above quote, first reported in the Financial Times on September 11. Mulye, CEO of Nostrom Laboratories, raised the price of an old (1953), formerly inexpensive, antibiotic by 404 percent to nearly $2,400 per bottle (from about $475). Mulye explains his rationale at first by saying that the drug’s only competitor raised their price to $2,800, so his move is really a bargain. He also claims that he has a duty to his stockholders to give them a return for their investment, thus the need to raise the fees.…

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

09/13/2018

The Efficient Life is Worth Living

by Craig Klugman, Ph.D.

I have been thinking a lot about the idea of efficiency lately. About 6 years ago, I was listening Andrew Tarvin, an improv comedy colleague of mine—now professional “Humor Engineer: give a TED-like talk on the notion of “efficiency” as a driver in his life. At the time I thought, “Yes, I resemble that idea.” When people ask me (as they often do), “How do you accomplish everything you do” I always jokingly reply, “I do not sleep much and I don’t have kids.” While those are true statements, the real reason is that I have tried to cultivate an efficient life.…

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

09/07/2018

RACeing to Deregulate: Can We Afford Less Oversight of Gene Transfer Research?

by Craig Klugman, Ph.D.

 “As gene therapy continues to change, so must the federal framework set up to oversee it.”-Francis Collins & Scott Gottlieb

In one of his first acts of office, Trump ordered executive agencies to reduce regulations. Supporters believed this would remove obstacles to innovation and bringing new products to market faster. Critics believed that this move would diminish health and safety protections, putting the public at potential risk. The NIH heard this message loud and clear as it has proposed reducing, and in some cases eliminating, regulations governing gene therapy experiments.

In case you have any doubt of the motivation, check out the NIH “admin” blog on its own website: “From Emerging to Emerged: Streamlining Gene Therapy Oversight.”Francis Collins, NIH Director echoes this reasoning in his NIH letter when he states: “With the evolution of the field of gene therapy, duplication in reviews and paperwork have sometimes occurred without a commensurate increase in protecting participant safety.”

In a New England Journal of Medicineeditorial, Collins and FDA commissioner, Scott Gottlieb, argue for this new position.…

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08/31/2018

FDA Approves Birth Control App: Ethics of Representation and Provider Counseling

by Craig Klugman, Ph.D.

“What do you call a couple that practices the rhythm method?”
“Parents”

This old joke is getting a modern twist as the FDA approvesNaturalCycles, a mobile app for charting fertility and determining what days are safe for sexual activity with a low risk of conceiving. According to the NaturalCycleswebsite, a user (i.e. a woman) takes her temperature everyday (using a special device) and that information is recorded in the app. She also records her menstrual dates. Using “a smart algorithm”, the app tells you what days are safe for having (unprotected) nonreproductive sex. The app service costs $79 per year (or $9.99 per month) and has over 900,000 users worldwide.…

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08/23/2018

My Advance Directive: A Narrative Approach

by Craig Klugman, Ph.D.

One of my summer projects has been to undertake the most dreaded of adult tasks, updating my last will and testament and advance directive. Although I teach my students that everyone should have an advance care planning and end-of-life documents written in the state in which they reside, it has taken me 5 years to motivate myself to take my own advice. Although I teach my students that an advance directive should be reviewed and updated at least every five years (because when I have seen them challenged it is often on the basis that they are old—“Aunt Sally filled this out 15 years ago, she had no idea what her life would end up being like”), I have not updated mine in 10 years.…

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This entry was posted in End of Life Care, Featured Posts, Informed Consent. Posted by Craig Klugman. Bookmark the permalink.