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Author Archive: Craig Klugman

About Craig Klugman

08/07/2018

Popular Insurance Pre-Existing Conditions Ban Under Threat

by Craig Klugman, Ph.D.

Do you have pre-existing health conditions? Approximately 23 percent of Americans do.

According to the University of Pittsburgh Medical Center, a pre-existing condition is “a medical condition that occurred before a program of health benefits went into effect.” Healthcare.gov defines it as “A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can’t refuse to cover treatment for your pre-existing condition or charge you more.” That means if an adult had a childhood disease, that’s a pre-existing condition. The problem with the healthcare.gov definition is that it is dependent on the Affordable Care Act (ACA) remaining intact, an increasingly unlikely scenario.…

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07/31/2018

Credentialing Exam is A Battle for Power and Soul of Bioethics

by Craig Klugman, Ph.D.

Like most members of the American Society for Bioethics & Humanities (ASBH), I received an email last week geared toward enticing me to sign up to take the new Healthcare Ethics Consultant accreditation exam. The email offered a teaser question (one that really made no sense) and a link to view 15 sample questions to encourage me to pay $450 to take a test and get a Good Ethicist seal of approval. After going through these sample questions and seeing the answers (I got 13 out of 15 “correct”), I can say that with this new exam, my greatest and wildest fears for our field have come true.…

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07/23/2018

Ethics of War AI: Keep the Humans in Charge

by Craig Klugman, Ph.D.

In 1967, the original Star Trek premiered “A Taste of Armageddon” wherein the U.S.S. Enterprise visits a planet that has ended the destructive nature of war. In its place, they have a computer that simulated battles between warring planets. This artificial intelligence would then produce a list of casualties and those people would report to euthanizing centers to be killed. This way, the residents said, they could preserve the infrastructure while keeping war real.

Lethal autonomous weapons systems are being developed by many countries around the world (including the U.S., Russia, China, and the UK).…

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

07/11/2018

Secret Twin Experiments & Bioethics.net 15 seconds of fame

by Craig Klugman, Ph.D.

On the advice of a family friend, I went to see the new documentary, Three Identical Strangers. All that I knew going into the story was that it was about a set of triplets, separated at birth who discover each other later in life. The first part of the film is about how they learned of each other. One ended up going to a small college where a second twin had been a student the previous year. A good friend was floored by the resemblance, especially when he learned that both men had the same birthdate and were adopted from the same agency.…

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07/06/2018

Certifying Clinical Ethics: Fracturing Bioethics

by Craig Klugman, Ph.D.

After an effort of nearly a decade, bioethics is taking a big step toward professionalization. Under the American Society for Bioethics & Humanities, the Healthcare Ethics Consultant Certification Commission has launched a health care ethics consultant certification program (HEC-C). According to the Commission website, “the HEC-C credential endorses your knowledge of key concepts in healthcare ethics and affirms your expertise, competence, and skillset.” The process includes reviewing one’s skills in assessment, analysis, consulting process, evaluation and quality improvement, moral reasoning, general health care ethics issues and concepts, as well as knowledge of health care systems, clinical context, local health care organization policies, and health law.…

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07/05/2018

BioethicsTV (June 27-July 4): #CodeBlack

Code Black (Season 3; Episode 10): Patients Asking Doctors to Lie to Family Members; Code Black (Season 3; Episode 11): Law enforcement pressuring nurse for blood draw

by Craig Klugman, Ph.D.

Code Black (Season 3; Episode 10): Patients Asking Doctors to Lie to Family Members

A mother arrives at the ED with her adult son. The mother has fallen down and hit her head. She has a history of brain cancer which went into remission 4 years ago. An MRI scan shows that the cancer has returned. The patient does not want her son to know—she does not want to burden him.…

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

07/03/2018

One Human’s Condition in the Post-Factual Age

by Craig Klugman, Ph.D.

It may be hard to believe, but I have been having trouble writing this blog lately. I blame the Supreme Court. My writer’s block began with a series of USSC rulings that were anti-choice, anti-social justice, and anti-fairness. Then came the bombshell that Justice Kennedy was retiring. While he was a conservative on many issues, he was a social moderate on many others such as reproductive choice and civil rights. His work is part of the reason that today my marriage is legal in every state in the union.

I thought I was alone in having this incessant need to check the news multiple times a day out of fear that I would miss out on something important.…

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

06/19/2018

Trumps Willing Executioners: Why We Should Just Say No

by Craig Klugman, Ph.D.

In 1996, Daniel Goldhagen published Hitler’s Willing Executioners: Ordinary Germans and the Holocaust, where he argued that most Germans were complicit in the Holocaust because anti-Semitism was a key part of national identity. By knowing about the genocide and going along with things (or trying to stay safe and out of trouble), the average citizen allowed the Holocaust to happen.

The same seems to be happening today. Most major medical societiesand even a large number of bioethicists have come outagainst the U.S. government policy of separating children from parents at the border who are trying to escape violence and poverty in their home countries, and then interning the children in cages and tent camps.…

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This entry was posted in Education, Ethics, Featured Posts, Justice, Pediatrics, Politics and tagged , , . Posted by Craig Klugman. Bookmark the permalink.

06/13/2018

Over-Screening, Rigid Protocols, and Changing Guidelines: A Personal Journey Through the Looking-Glass

by Craig Klugman

A new JAMAarticle reports on a US Preventive Services Task Force recommendation against routine ECG in patients without symptoms of heart disease: “For asymptomatic adults at low risk of CVD events (individuals with a 10-year CVD event risk less than 10%), it is very unlikelythat the information from resting or exercise ECG (beyond that obtained with conventional CVD risk factors) will result in a change in the patient’s risk category….”The report states that over-screening can lead to harms such as “invasive procedures, overtreatment, and labeling.”Such advice follows with recent suggestions against many preventive screenings that were de rigueur just a few years ago for prostate cancer, breast cancerand more (the one exception is a recent expansion of colon cancer screening).…

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

06/04/2018

BioethicsTV (May 30, 2018): #CodeBlack Patient racism and DNRs

by Craig Klugman, Ph.D.

Code Black (Season 3; Episode 5): Patient Racism

A middle-aged-white patient needs an appendectomy. As he is being wheeled to surgery, he is beside the chief of surgery and a new trauma surgery resident. The patient is jovial and says he feels a connection with the resident. The patient states that he wants the resident to do his surgery. The resident responds that he is still learning and they are lucky to have the best surgeon in the hospital. The patient insists and says he does not even want the chief in the OR. What becomes clear is that the patient is making this request because the resident is white and the chief is black.…

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