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Author Archive: Craig Klugman

01/28/2015

Still Alice: A Portrait of Familial Alzheimer’s Disease

by Craig M. Klugman, Ph.D.

This past weekend I spent a cold, snowy day in the theater watching the movie Still Alice. Julianne Moore plays Alice Howland, a renowned neurolinguistics professor at Columbia University who is diagnosed with familial, early onset Alzheimer’s Disease. The film opens with Howland celebrating her 50th birthday where she has a momentary lapse in thought. We next see her giving a lecture at UCLA where she loses her place in giving a presentation. Then she is jogging through the campus where she has taught for decades and finds that she recognizes nothing.

The film shows Moore’s doctor visits as she seeks a diagnosis, her heartbreaking revealing of her disease to her family members, and how she and her life changes dramatically—and in a brief period of time—as she becomes someone else.…

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

01/23/2015

ACA Report Card: One Year of Obamacare and the Individual Insurance Mandate

by Craig M. Klugman

The United States has passed a milestone, the first year of the Affordable Care Act’s insurance mandate. This is the requirement that all U.S. residents have health insurance whether through an employer, an organization, or via the insurance marketplaces. Opponents of the ACA (also known as “Obamacare”) feared that this act would destroy the country by decimating the economy, creating a federal government takeover of healthcare, forcing employers to drop coverage, workers quitting who no longer need their employer-based health insurance, and companies cutting workers to stay below minimum thresholds.

The results of the first year are positive.…

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

01/14/2015

Worrying about patient satisfaction only harms the patient

by Craig Klugman, Ph.D.

Anyone who has been in a hospital in the last 9 years has encountered a patient satisfaction survey. This national survey provides rankings of hospitals based on how satisfied patients are with their experience. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) “is a survey instrument and data collection methodology for measuring patients perceptions for their hospital experience.” For anyone who works in a hospital, the results of this survey can mean raises, firings, and changes of position.

The Centers for Medicaid & Medicare Services and the Agency for Healthcare Research and Quality developed this 27 question survey that has been administered to all hospital patients after discharge since 2006.…

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01/06/2015

Cassandra C: Right to refuse treatment or protecting a minor*

by Craig Klugman, Ph.D.

In Connecticut, a 17-year-old girl is being kept in a hospital room under court order. She is restrained to her treatment bed when she is given chemotherapy that neither she nor her mother want. Cassandra C. is a young woman who was diagnosed with Hodgkin’s lymphoma in September 2014. She underwent surgery to remove a lymph node and then chose not to receive further treatment. She left the hospital with her mother, Jackie Fortin, to allegedly seek a second opinion, out-of-state.

According to Fortin and her attorney, Cassandra believes that chemotherapy is toxic to the body and has long-term negative effects.…

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This entry was posted in Clinical Ethics, Featured Posts, Health Regulation & Law, Pediatrics and tagged , . Posted by Craig Klugman. Bookmark the permalink.

01/01/2015

The Year in Bioethics That Was

by Craig Klugman, Ph.D.

Happy New Year. As has become a tradition at the bioethics.net blogs, the ending of one year and beginning of another is a time for reflection, for reviewing that year that has passed and planning for the year to come.

In 2014, bioethics.net is pleased to have had 15 bloggers contribute to our 84 posts. A very big thank you to these insightful scholars: Maurice Bernstein, Jennifer Blumenthal-Barby, Arthur Caplan, Nanette Elster, Ellen Fox, Steven Miles, Kayhan Parsi, Thaddeus Pope, Keisha Ray, and guest bloggers Rachelle Barina, Bandy Lee, Barron Lerner, Nuriel Moghavem, Devan Stahl, and Eric Swirsky.…

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

12/29/2014

A Monkey’s Uncle: A Nonhuman Person in an Argentinean Zoo

by Craig Klugman, Ph.D.

A court in Argentina has ruled that Sandra, an orangutan is a nonhuman person who is deserving of some rights. Animal rights groups suggest that includes a right to privacy. If true, then Sandra is being illegally kept in a zoo where she often covers her head to avoid being gazed upon by zoo visitors.

Orangutans (a Malayan word meaning “person of the forest”) are not monkeys, but rather are an Asian species of the great apes (genus pongo) native to Borneo and Sumatra. They are arboreal creatures and very solitary. Considered among the most intelligent primates, orangutans have been observed using tools for hunting fish; processing fruits, nuts, seeds, and vegetables; collecting honey; and fishing for termites.…

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

12/11/2014

The CIA Torture Report: Health, Medicine & Ethics

by Craig Klugman, Ph.D.

On Tuesday, December 9, the U.S. Senate Select Committee on intelligence released its long awaited report on CIA interrogation and torture. This 500-page executive summary details the results of six years of investigations that covered over 6 million pages of records. What was discovered is that torture was more brutal and extensive than reported, that information was kept secret, that the programs were mismanaged and lacked oversight, and that most likely no information came out of it.

Anyone wishing to read the report can find it here. The length and detail of the document, not to mention its graphic content, make it difficult to go through.…

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

12/08/2014

Text Messaging: A Cure for Common Nonadherence?

by Craig Klugman, Ph.D.

According to research studies on medication usage, nearly 22% of all e-prescriptions and 28% of new prescriptions are not filled. For heart medications among people who have experienced a heart attach, one-half to two-thirds (depending on the medication) of patients were nonadherent to a prescription regimen. Patient adherence to medication is related to the disease, side effects, how long they are treated (there is a drop off after 6-months of treatment), complexity of the regimen, severity of disease, and cost of the medication.

Nonadherence can increase the cost of treating patients. Estimates on that cost vary but range from $100 to $290 billion each year and $7,800 per patient.…

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

11/21/2014

Doused Counties: Banning Tobacco Sales in Massachusetts

by Craig Klugman, Ph.D.

The small city of Westminster, Massachusetts is voting on whether to become the first town in the nation to ban sales of tobacco products, e-cigarettes, and bubblegum-shaped smoking implements within its limits. Many cities already have bans on selling tobacco to minors, smoking bars, businesses, offices, and even in public. The drugstore giant CVS has banned sales of tobacco products from its stores. But this is the first time that a city is making the sale of tobacco and e-cigarettes illegal.

The reasons for the smoking ban are simple. In this town of 7,400, there has been concern that tobacco companies use marketing to create new smokers.…

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

11/18/2014

Elderspeak: Words Can Hurt

by Craig Klugman, Ph.D.

During the season premiere of the HBO comedy, Getting On, I noticed the excessive use of toddler-speak toward patients portrayed as being elderly. The show takes place in a senior rehab/hospice unit in a community hospital. Whenever one of the health care providers (physician or nurse) was speaking to one of the patients, they tended to use baby talk—higher pitch, lilting tone, longer spaces between words, elongated space around vowels, and using simple, shortened words. When speaking to a baby or a toddler, such tones may help them to learn language, provide amusement, and get their attention.…

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This entry was posted in Clinical Ethics, Cultural, Featured Posts, Health Care. Posted by Craig Klugman. Bookmark the permalink.