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Author Archive: Craig Klugman

About Craig Klugman


by Craig Klugman, Ph.D.

One of the changes that the Trump administration tried to make to the Affordable Care Act was to eliminate the requirementthat employer insurance plans cover the full cost of contraception. The new rules would have allowed businesses and nonprofits a religious and moral exemption from providing such coverage beginning this past Monday. Under the Obama administration, the Courts carved out exemptions for businesses that were religious in nature or that were privately run by a family of faith (see Little Sisters v. Burwelland Burwell v. Hobby Lobby). These efforts continued attempts under claims of religious libertythat people and companies should not be compelled to act in ways their religious and philosophical belief held was immoral—such as providing contraception and abortion.…

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BioethicsTV (January 8-10, 2019): #NewAmsterdam; #ChicagoMed

Jump to New Amsterdam (Season 1; Episode 10): Physician compassion maintains unjust medical system; Jump to Chicago Med (Season 4; Episode 10): Offense against our own; Parents in the OR


New Amsterdam (Season 1; Episode 10): Physician compassion maintains unjust medical system

An elderly woman arrives at the ED in the throes of her third heart episodeof the week. She needs an implantable defibrillator but her insurance will not cover the procedure or the device. Reynolds wants to charge the cost to the community fund (i.e. charity), but Goodwin is not available to approve (he’s having his own medical emergency).…

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by Craig Klugman, Ph.D.

Threats to privacy and confidentiality swirl around. Each day the newspaper seems to report on stories that show the erosion of this fundamental human right. This week alone was a report on the ability of an artificial intelligence to accuratelydiagnose disease simply by looking at a photographic portrait. The National Institutes of Health is exploring whether all newborns should automatically have their DNA sequenced to screen for genetic disease. Another article explains how Facebook is reporting to law enforcement officials when there are posts and patterns of behavior that indicate a user may be suicidal (part of the smartphone psychiatris tmovement).…

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by Craig Klugman, Ph.D.

A new year is a time for thinking about the past and looking forward to the future. Over winter break, I read Yuval Noah Harari’s book, Homo Deus, a futurist book that examines what the future of humanity may look like given our current technological trajectories. Reading the book was entertaining, and it also raised many questions of what the future of ethics and bioethics might hold if Harari’s predictions hold. To begin this new year then, I want to spend some time thinking about the [lack of] future of bioethics.

The starting point for this discussion is to consider the sources or our moral and ethical authority in our past, present and future.…

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by Craig Klugman, Ph.D.

I recently received an email from a community organization which asked the following question: “Are there any ethical issues with our community health plan selling its medical records to a private company?” This is not an example of a new occurrence. A spate of news in recent months suggests efforts by various private companies to get a hold of private medical records with the goal of finding a way to profit off this information (the commodification of our information). Consider Sloan Kettering’s dealto sell its pathography samples and records to Paige.AIto develop artificial intelligence to help in treating cancer (and with lots of conflicts of interests for the administrators who put together the deal).…

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by Craig Klugman, PhD

Jump to The Good Doctor (Season 2; Episode 10): Epidemic & Virtue Ethics; Jump to Chicago Med (Season 4; Episode 9): Not following patient wishes

The Good Doctor (Season 2; Episode 10): Epidemic & Virtue Ethics

This episode revolves around an unidentified pathogen invading the ED when two patients are brought in immediately after their flight from Malaysia lands. Both of them die and the ED is quarantined: All ambulances are diverted and walk-ins are sent away. Rather than panicking people, their coming and going from the ED is slowed down or delayed. Once Tyler— the EMT who brought in the patients—becomes sicker, Lim lets everyone know that they are on lock down and no one is leaving.…

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by Craig Klugman, Ph.D.

Federal kickback rules state that a pharmaceutical manufacturer or medical device producer cannot pay providers or patients to recommend or prescribe their products. The Anti-Kickback Statute [42 U.S.C. § 1320a-7b(b)], “is a criminal law that prohibits the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs(e.g., drugs, supplies, or health care services for Medicare or Medicaid patients)”. This law is one of a group that is intended to protect federal health payment programs from fraud and from conflicts of interest (for example, a physician is not permitted to refer patients to other businesses that they own [42 U.S.C.…

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by Craig Klugman, Ph.D.

Jump to Public Lectures; Jump to The Good Doctor (Season 2; Episode 9): Empathy-Sex offenders and prisoners

The Resident (Season 2; Episode 9): Oral directives and “the talk

When Hawkins’ father (Winthrop) collapses, he is brought to Chastain (the hospital he owns) even though he asks to be taken somewhere else. He has a stricture that is affecting blood flow to his intestine that could become life threatening. In his consent process, he says anyone but Bell can do the surgery; his doctors go over the risks and benefits to surgery.  The chief of general surgery says that she has all of her patients complete an advance directive, a task that Nevins says is part of the standard of care.…

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Updated November 28 at 8:30am EST

by Craig Klugman, Ph.D.

The film GATTACA turned 20 years old this year. The premise of that film is a society where DNA is viewed as predictive of everything: Your intelligence, physical abilities, your health, even how long you will live. People soon learn to live within the limits of their DNA and not to push for more. In one particular scene, a couple visits their local neighborhood geneticist and orders up their child, choosing the most favorable genes as well as some tweaks to avoid common diseases. That scene took one step closer to reality when Chinese researcher He Jiankui announced the birth of two children whose DNA was altered to make them more resistant to HIV.…

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by Craig Klugman, Ph.D.

Jump to The Resident (Season 2; Episode 8): Fraudulent medical devices; Unfinished stories; Jump to The Good Doctor (Season 2; Episode 8): Vaccination, Stories and Marital Counseling; Jump to New Amsterdam (Season 1; Episode 8): Undue influence; Cultural accommodation; overworked physicians

The Resident (Season 2; Episode 8): Fraudulent medical devices; Unfinished stories

Henry is a young boy who comes to the ED after he has a grand mal seizure on the little league field. A physician orders a third medication to treat his disorder. The doctor enters the orders online, which triggers a message to the pharmacy, to the insurance company for approval, and then an oversight company that reviews all records.…

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