Blog RSS Blog.

Author Archive: Maurice Bernstein

About Maurice Bernstein

06/02/2014

The Ethics of Delay: A Good or a Bad?

by Maurice Bernstein, M.D.

Delay, something late or postponed, can be looked upon as either ethically good or ethically bad. The difference depends on the basis for the delay, whether it was intentional and, if so, what purpose and what was the outcome. Unintentional delays, may be either a good or a bad depending on its origin and the outcome. Intentional delays may be the result of following the Precautionary Principle. The Principle emphasizes the need to be aware of the consequences of an action or inaction.  If the action is necessary to prevent known harm then the action should be carried out. …

Full Article

This entry was posted in Clinical Ethics, Featured Posts, Health Care. Posted by Maurice Bernstein. Bookmark the permalink.

03/04/2014

Tampering With Evolution? “Three Parent Embryos”

by Maurice Bernstein, MD

Babies are born with  a progressive neurometabolic disorder with a general onset in infancy or childhood, often after a viral infection, but can also occur in teens and adults.  The disease is seen on MRI as dead or dying tissue within the brain and though the child appears normal at birth,  in a few months to two years of age, though earlier or later,  there is loss of basic skills and finally the child may have  heart, kidney, vision and breathing complications.  What is this disorder?  It is a congenital disease carried by the mitochondrial DNA genes of the mother and called  Leigh’s Disease. …

Full Article

This entry was posted in Clinical Trials & Studies, Featured Posts, Genetics, Reproductive Medicine and tagged . Posted by Maurice Bernstein. Bookmark the permalink.

09/16/2013

Patient Informed Consent For The Teaching Hospital “Trainee” Care: Informing Realistic Scenarios

by Maurice Bernstein MD

Informed consent is the ethical and legal hallmark for the support of patient decision-making in medicine.  Though the ethics of patient communication of facts without deceit has been part of medical consideration for generations, it wasn’t until the landmark decision Schloendorff v The Society of the New York Hospital in 1914 that informed consent became United States law.  Informed consent has been also been emphasized from the aspect of medical ethics, in recent decades, as decision making has moved from physician paternalism to patient autonomy.  Patients awaiting medical/surgical procedures are currently given variable content and amounts of information about their illness and the procedure itself and the risks and outcomes anticipated.…

Full Article

This entry was posted in Clinical Ethics, Featured Posts, Informed Consent. Posted by Maurice Bernstein. Bookmark the permalink.

07/24/2013

Doctors Who Torture: Why No Punishment?

Maurice Bernstein, MD

Torture has been in the United States’ “backyard” for a number of years. The forced feeding of Guantanamo detainees who are on “hunger strike” is a current example.  One issue beyond the ethics of forced feeding anyone, detainee or not, is what role a physician plays in such an activity and whether such participation should be part of the profession of medicine. Physicians have been used both in the United States and around the world to lend their “professional expertise” when it comes to virtually facilitating and monitoring the process of torture. The problem of physician complicity with torture and other war crimes has been a part of medical ethics since the trial of Nazi doctors in Nuremberg after World War II. …

Full Article

This entry was posted in Featured Posts, Politics and tagged , , . Posted by Maurice Bernstein. Bookmark the permalink.

07/16/2013

Are Clinical Ethicists Looking in Wrong Directions?

Clinical ethicists are those who perform ethics consultations regarding patient care and who also may teach and write about a host of issues that pertain to that care.  These ethicists are often physicians but also may be philosophers, social work...

Full Article

This entry was posted in Health Care and tagged , . Posted by Maurice Bernstein. Bookmark the permalink.

07/09/2013

"As a Patient: I Am My Own Doctor. Trust Me"

Could there be the possibility that medicine and the medical system including the schools that teach medicine and the organizations and governmental agencies which set standards all have become paternalistic toward the patient as a person and toward th...

Full Article

This entry was posted in Health Care and tagged , . Posted by Maurice Bernstein. Bookmark the permalink.

07/09/2013

"As a Patient: I Am My Own Doctor. Trust Me"

Could there be the possibility that medicine and the medical system including the schools that teach medicine and the organizations and governmental agencies which set standards all have become paternalistic toward the patient as a person and toward th...

Full Article

This entry was posted in Health Care and tagged , . Posted by Maurice Bernstein. Bookmark the permalink.

07/06/2013

Patient Modesty: Volume 56

I am sure that everyone can spot the "chaperon"  for the patient in this classic photograph of the operating room used at Johns Hopkins Hospital from 1892 to 1927.  And I am sure that everyone can find the "gawkers"  who are present in t...

Full Article

This entry was posted in Health Care and tagged , . Posted by Maurice Bernstein. Bookmark the permalink.

07/06/2013

Patient Modesty: Volume 56

I am sure that everyone can spot the "chaperon"  for the patient in this classic photograph of the operating room used at Johns Hopkins Hospital from 1892 to 1927.  And I am sure that everyone can find the "gawkers"  who are present in t...

Full Article

This entry was posted in Health Care and tagged , . Posted by Maurice Bernstein. Bookmark the permalink.

07/01/2013

Moses’ Basket: Not the Right Basket for Professional Support








This is an apparently supportive advice delivered to one who is in some emotional or physical distress. And though one may find this advice displayed on numerous church boards for the public's humorous consideration, it "Have hope, don’t give up – remember Moses was once a basket case, too"  provides an example, in my opinion, of how clinical advice if given from a physician to a patient should not be expressed.  I believe the patient deserves such communication of advice be based upon facts which are presented with clarity and free of ambiguity and, in fact, free of humor. To me, humor can degrade any empathy by the physician that is appropriate  to be transmitted to a patient in distress. I think it says to the patient, what you are experiencing is, to me, partly a joke.

In contrast, the example, I selected, while attempting to convey some sort of a supportive message for those who read it and need it, there is a derogatory but also that humorous tone, along with the use of non-factual ambiguity in order to make the point of the message.  The facts which are missing are that "basket case" as defined by Merriam-Webster in its original World War I expression represented "a person who has all four limbs amputated" or it's more modern use "a person who is mentally incapacitated or worn out (as from nervous tension); also : one that is not functioning well or is in a run-down condition." Obviously, this does not apply to Moses, in the biblical description of his relationship to a "basket".

 Trust is an essential part of the doctor-patient relationship, trusting the doctor's decisions and intentions is critical for the acceptance by the patient of the doctor's advice. While there are some patients who, on questioning, may not want all the facts of their condition displayed to them in one sitting and a few actually desiring others to know but not themselves, I doubt that any want the doctor to finally tell untruths, misleading information or add humor related to the patient's emotional and physical distress.  Now I suspect that some of my visitors here may disagree with my commentary and may find some value to the patient for the doctor to present the advice in the form found written on those church displays.  If so, I would like to read your view.  ..Maurice.

 Graphic: Photograph taken by me today at a neighborhood church and modified with Picasa3.

Full Article

This entry was posted in Health Care and tagged , . Posted by Maurice Bernstein. Bookmark the permalink.