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Author Archive: Craig Klugman

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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.

05/31/2018

Targeted Medicine: Advertising to the Medically Vulnerable

by Craig Klugman, Ph.D.

Imaging going to the doctor and suddenly finding ads popping up on your phone. Perhaps there’s a discount for receiving a specialized treatment. Another ad might advertise a vitamin or sunscreen. Or you might even get an ad for a competing service down the street. Targeted advertising is when a business or service sends its messages to people who meet a certain pre-determined demographic, in this case being in a certain geographic location. In the world of medicine, people used to receive ads for their diagnoses or other services at their health care provider because patient lists could be sold and used for marketing.…

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

05/22/2018

The Land of the Gagged and the Home of the Complicit: Domestic Abortion Gag Rule is Unethical

by Craig Klugman, Ph.D.

On his fourth day in office, Trump reinstated the Mexico City Rule. The MCR was originally declared by Ronald Reagan in 1984 to prohibit U.S. federal funds from going to non-governmental health organizations if they provide, promote, refer, or mention abortion services unless abortions were given at a separate facility. Last week, Trump announced that he was going to issue a domestic gagrule that would prohibit health care providers who receive federal funding from performing or mentioning abortion as an option to women. In other words, he was going to bring the gag rule home.…

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

05/22/2018

BioethicsTV (May 14-22): #TheResident, #ChicagoMed

by Craig Klugman, Ph.D.

The Resident (Season 1; Episode 14): Treating Loved Ones; Chemo for Healthy Patients ; Chicago Med (Season 3; Episode 20): Doctor and jury

The Resident (Season 1; Episode 14): Treating Loved Ones; Chemo for Healthy Patients

In the season finale, we learn that Hunter has been telling healthy people that they have cancer (when they do not) and giving them chemotherapy. She is committing Medicare fraud and also artificially bumping her success rates at curing cancer. Pravesh informs Lily, a frequent flyer, that she does not have cancer and is a victim of Hunter. The residents tells Bell that they have informed the FBI of the problem and they suggest he suspend Hunter immediately.…

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

05/17/2018

Big Data Studies and Abuse of Fiduciary Duties

by Craig Klugman, Ph.D.

A study published in the May 17th, 2018 issue of Cell, “Disease Heritability Inferred from Familial Relationships Reported in Medical Records,” shows a connection between families and certain diseases at three large urban university medical centers. The researchers took private health information from electronic medical records, identified family trees by matching emergency contacts, examined diagnoses and other health information, and matched that with any tissue samples from biobanks to build a picture of disease heritability. The people whose private health information was used have no idea that the study occurred.

This study is similar to the recent revelation of Facebook data being used and shared without permission if a friend consented to a quiz.…

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This entry was posted in Featured Posts, Informed Consent, Privacy, Research Ethics. Posted by Craig Klugman. Bookmark the permalink.

05/11/2018

BioethicsTV (May 7-11): #ChicagoMed, #GreysAnatomy

by Craig Klugman, Ph.D.

Chicago Med (Season 3; Episode 19): Maternal-Fetal Conflict; Grey’s Anatomy (Season 14; Episode 23): Personal Disclosures of Illness

As the traditional television season comes to a close, many medical dramas have steered away from ethical dilemmas in medical care to heighten the drama among their characters in order to provide strong cliff hangers for the season finale.

Chicago Med (Season 3; Episode 19): Maternal-Fetal Conflict

Tracey Hermann is a 25-year-old pregnant woman (21 weeks) who comes into the ED with shortness of breath and fatigue. Scans show that she has a problem with her mitral valve—a condition she’s likely always had but has only manifested with the added pressure on her body of the fetus.…

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