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Author Archive: Craig Klugman

About Craig Klugman

05/02/2018

From Westworld to the Rest of the World: Time to Regulate the Mining of Third Party Data

by Craig Klugman, Ph.D.

You do not have control over your ideas, your passions, or even your DNA anymore. Your biological material and your ideas may be taken without your awareness of it. You do not need to consent anymore, for people to take the products of your body or mind. This fact was highlighted in the Season 2 premiere of HBO’s Westworld, a show that echoes many of our high tech, dystopian fears of AI, robotics, and humans relieved of their civil veneer.

Before the show premiered in 2016, their website had a hidden “Terms of Use” for anyone who expressed interest in visiting the fictional park (a great marketing gimmick).…

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

04/27/2018

BioethicsTV (April 23-27): #TheResident, #ChicagoMed, #CodeBlack

by Craig Klugman, Ph.D.

The Resident (Season 1; Episode 11): Placebos, CYA, Office politics; Chicago Med (Season 3; Episode 17): Promise-making, Denial Brain death (PVS or coma); Code Black (Seasons 3; Episode 1): Do no harm, HIPAA

The Resident (Season 1; Episode 11): Placebos; CYA; Office politics

We learn that the hospital’s motto is “Incredible things are happening here.” That’s ironic because the incredible clearly isn’t meant to be seen in a positive light.

Pravesh is rotating through the ED. His first case is a woman who looks up diagnoses online and then convinces herself she has the disease. He determines that she is perfectly fine and goes to discharge her when his attending says to pick one of her complaints and “write her some sort of placebo prescription” for it.…

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04/26/2018

War Against Science 3.0: The EPA, Doublespeak, and Obfuscation

by Craig Klugman, Ph.D.

Transparency is a good thing. In ethics courses, we teach that doctors should be transparent to their patients, being truthful and disclosing information. In research, we teach that researchers should be transparent, sharing their methods, analysis, results and increasingly their data, for peer review. Transparency builds trust and is an important backbone to science and medicine. However, like all prima facie values, there are also limits to transparency. Under ethical notions of confidentiality, legal notions of privacy, and HIPAA, the names and identifying details about patients and subjects must be kept secret to protect them. Their private health information could be used against them in employment, housing, and relationships.…

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04/24/2018

BioethicsTV (April 16-20): #TheResident, #ChicagoMed, #GreysAnatomy

by Craig Klugman, Ph.D.

The Resident (Season 1; Episode 10): Self-doctoring; nonmaleficence; the problem with hospitals…; Chicago Med (Season 3; Episode 16): Compassionate lying; choosing gender; medical error; Grey’s Anatomy (Season 14; Episode 20): #METOO

The Resident (Season 1; Episode 10): Self-doctoring; nonmaleficence; the problem with hospitals…

After Conrad has a run-in with a skateboard while jogging, he hobbles into the hospital with a sprained ankle. He refuses a colleague’s offer to look at it, or at least to put him in a soft boot. Instead, he goes to the pharmacy and lies, stating that a bottle of cortisone ordered for a patient broke.…

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04/17/2018

The End is Nigh: Bioethics and Antibiotic Resistance

by Craig Klugman, Ph.D.

 ‘We’re out of Options’: Doctors Battle Drug-Resistant Typhoid Outbreak – 13 April 2018

New Concerns Over ‘Super Gonorrhea’ That’s Resistant to All Drugs – 4 April 2018

‘Nightmare’ bacteria, resistant to almost every drug, stalk U.S. hospitals – 3 April 2018

In 1997, I was a new graduate student at the University of Texas Medical Branch, starting my PhD after earning my masters degrees. I presented a paper at the SHHV, AAB, SBC combined meeting in Baltimore on Towards A Communitarian Medicine: Ethics and Responsibility in Anti-Microbial Drug Resistance. I proposed that as a society we needed to address the impending crisis in effective antibiotics by rationing the most powerful, the newest, and the most innovative of these drugs.…

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04/13/2018

BioethicsTV (April 9-13): #ChicagoMed Saving one twin; faking a license; cost of care

by Craig Klugman, Ph.D.

Lots of medical dramas were on hiatus this week but will be back.

Chicago Med (Season 1; Episode 15): Saving one twin; faking a license; cost of care

A set of conjoined twins comes to the ED with one of the twins in heart failure. Their separation surgery is scheduled in 10 weeks to give the hospital time to be prepared and to give the twins time to grow and gain strength. But if one twin dies, the other one will soon follow. Latham says that if they try to separate the twins, there is no chance either will survive; but if they concentrate on just saving one—allowing the second to die in the process—then the odds for the one twin improve.…

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

04/10/2018

DNA Testing for Baby’s IQ

by Craig Klugman, Ph.D.

In the 1997 film GATTACA, when a child is born, a reading of their DNA is done within minutes. The analysis includes things like the child’s IQ and major health concerns. The readings determine the person’s life—what schools they can attend and even what jobs they can have. While presented as a dystopian fantasy, just such a scenario is being spun by behavioral geneticist Robert Plominin his Nature Reviews Genetics article titled “The new genetics of intelligence.”

Plomin says “Intelligence is highly heritable and predicts important educational, occupational and health outcomes better than any other trait.

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

04/06/2018

BioethicsTV (April 2-6): #ChicagoMed; #GreysAnatomy

by Craig Klugman, Ph.D.

Chicago Med (Season 3; Episode 14): Record checking; off label use; scope of practice; Grey’s Anatomy (Season 14; Episode 18): Experimental treatment; Saying goodbye

Chicago Med (Season 3; Episode 14): Record checking; off label use; scope of practice
Psychiatry resident Dr. Reese figures out that her father is a diagnosed psychopath. Her attending, Dr. Charles apologizes to her, letting her know that he could not have told her because to do so would have broken physician-patient confidentiality. However, how she figured it out was by looking at her father’s chart. While Charles was ethical in preserving confidentiality, Reese demonstrated a lack of ethics by checking her father’s chart.…

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04/04/2018

Rise of Neopaternalism

by Craig Klugman, Ph.D.

This week I was teaching autonomy and paternalism to my Introduction to Bioethics class. We talked about how one of the founding myths of bioethics is that we saved patients from paternalistic medicine by forcing a turn to autonomy: Instead of being objects on which doctors did medicine, we became subjects with whom doctors worked to heal. My students felt this was all fine and good in theory, but in practice it seemed to them that healers and patients are actually losing freedom. Our conversation led me to wonder if we have entered the age of neopaternalism.…

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03/30/2018

BioethicsTV (March 26-30): #TheGoodDoctor; #ChicagoMed

by Craig Klugman, Ph.D.
The Good Doctor (Season 1; Episode 18-Season Finale): Medical errors and battery; Chicago Med (Season 3; Episode 13): Who gets the heart? Mercy killing

The Good Doctor (Season 1; Episode 18-Season Finale): Medical errors and battery
A fraternity pledge brings his fellow student to the ER with a compound ankle fracture. He then develops a bowel problem and then disseminated intravascular coagulation (DIC-where he both bleeds out and clots at the same time). From his pledge brother, we learned that he has eaten detergent pods which is what likely caused the bowel problems. When he does not improve, Kalu and Park decide to talk with the pledge who brought in the patient: Kalu treats a cut on his hand and draws blood after fixing the cut to “check for infection.” The pledge agrees.…

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This entry was posted in BioethicsTV, End of Life Care, Featured Posts, Organ Transplant & Donation and tagged . Posted by Craig Klugman. Bookmark the permalink.