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08/07/2014

Technology Helps Advance Care Planning – Universal Advance Digital Directive

A radio news report, yesterday, reviews Texas-based My Directives and its Universal Advance Digital Directive (uADD).

Easy to Create
MyDirectives makes it easy to create a state-of-the-art emergency medical directive.  You can answer qu…

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope. Bookmark the permalink.

08/07/2014

The Ethics of Ebola and Scarce and Experimental Drugs

by: J.S. Blumenthal-Barby

Yesterday I was contacted by the L.A. Times to answer a simple question: Should we give people access to the experimental Ebola drug, ZMapp?

The Drug and Clinical Trial Phases
So, I did a little digging to try to find out some more details about the drug. From what I could find in published news reports, the drug was developed by Mapp Biopharmaceutical Inc., with support from the NIH and the Defense Threat Reduction Agency. It has been tested on 8 monkeys. 4 of them were given the treatment 24 hours after being infected and all 4 survived.…

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08/06/2014

Less than Half of Mayo Clinic Heart Surgery Patients Have Advance Directives

Less than half of the patients who underwent a risky heart surgery at the Mayo Clinic between 2008 and 2012 completed advanced directives. (JAMA Internal Medicine 8/4/14)Aortic Stenosis
Mayo researchers focused on patients with aortic stenosis, which o…

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope. Bookmark the permalink.

08/05/2014

Attending to Attention

It’s hard not to notice that the idea of “attention” is on a lot of people’s minds. In just one week my desk received a copy of The Hedgehog Review,, the monthly Turning Points Magazine & Devotional, and an e-mail message from a parent all dealing with this subject. Since the advent of a DSM diagnoses involving deficits of attention (initially linked to hyperactivity), the… // Read More »

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08/05/2014

Health Care Reform Implementation in Minnesota: Mission Advanced But Not Accomplished

A valuable conference on October 24, 2014 in Saint Paul:  ”Health Care Reform Implementation in Minnesota: Mission Advanced But Not Accomplished.”

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope. Bookmark the permalink.

08/05/2014

People First Language Legislation

Last week, Delaware enacted H.B. 416.  The legislation creates no new rights or duties.  But like new legislation in many other states, it improves the vocabulary and terminology in existing law relating to people with disabilities.  



People First Language (“PFL”) legislation is part of a national movement to promote dignity and inclusion for people with disabilities.  PFL specifies that the order of terms used to describe any individual places the person first, and the description of the person second.  For example, when using PFL, outdated terms such as “the disabled” would be phrased as “persons with disabilities.”  This language emphasizes that individuals are people first, and that their disabilities are secondary.


In compliance with PFL guidelines, the new Delaware law amends current references to persons with disabilities throughout the Code by placing the person first and the disability second.  


Also pursuant to PFL, the new Delaware law removes offensive and/or insensitive language from the Code and replaces that language with respectful language.  For example, the Act replaces antiquated and offensive terms such as “mental retardation” and “mental illness” with more appropriate terms like “intellectual disability” and “mental condition,” respectively.
  

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope. Bookmark the permalink.

08/05/2014

The Ethics of Physician Drug Test: Why It’s a Bad Idea

by Craig Klugman, Ph.D.

Pilots do it. Train conductors, air traffic controllers, TSA agents, police offices, fire fighters, Olympic athletes and long haul truckers do it. In eleven states, some recipients of public aid even have to do it. So shouldn’t health providers have to do it?

“It,” of course is drug testing, often random and sometimes for suspicion of use. Jobs that are charged with taking care of the safety of the public (or sometimes that benefit from the public dole) are often drug tested throughout their careers to ensure that they are not using drugs. The presumption is that drug use means placing the public in danger.…

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

08/04/2014

Do OkCupid and Facebook experiment on vulnerable populations?

by Keisha Ray, Ph.D.

A few months ago Facebook announced that some Facebook users were a part of a 2012 experiment. In the experiment Facebook altered the number of negative and positive posts and photos that appeared in users’ newsfeed. In a paper documenting the results of the study, authors noted that by changing what users saw in their feed, Facebook was able to alter moods, emotions, and the kind of posts that people posted. The study was meant to be an experiment in online social interactions and emotional connections.

OkCupid, an online dating site has also recently announced that it has conducted experiments on its date seeking users.…

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This entry was posted in Featured Posts, Informed Consent, Media, Research Ethics. Posted by Keisha Ray. Bookmark the permalink.

08/04/2014

UK Quality Review: Many Patients Not Offered DNAR Option

Last week, the Local Clinical Commissioning Groups, the Leicestershire Partnership NHS Trust and the University Hospitals of Leicester NHS Trust published an innovative “quality review” examination of the health system in Leicester, Leicestershire…

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope. Bookmark the permalink.

08/03/2014

A Cure So Expensive No One Can Afford It

<p>In December 2013, the FDA approved <a href="http://www.sovaldi.com">Sovaldi</a>® (sofosbuvir, Gilead Sciences, Inc.) for treatment of hepatitis C. A truly wonderful <a href="http://www.hcvguidelines.org/full-report/introduction">medical breakthrough</a>, the oral drug effectively <a href="https://www.ncbi.nlm.nih.gov/pubmed/23281974">cures 90% of patients</a> who take it correctly. The online physician resource Web site <a href="http://www.medscape.com/viewarticle/817371">Medscape</a> has referred to this drug as a “game changer.” Clearly it will change the health care delivery game in any number of ways.</p>
<p>But the miracle comes with a catch: the cost is prohibitive. The full treatment course is <a href="http://www.newsweek.com/insurers-worry-84000-hepatitis-c-drug-sovaldi-could-break-bank-252539">so expensive</a> that very few can afford it even with good health insurance. Each pill costs about $1000; patients will need to take the medicine once a day for about 12 weeks for a full course. The total cost will be about <a href="http://www.nytimes.com/2014/03/16/opinion/sunday/how-much-should-hepatitis-c-treatment-cost.html">$90-120,000 per patient</a>. Many are asking how is it possible to justify the cost? <a href="http://jama.jamanetwork.com/article.aspx?articleid=1890401">Is this fair?</a></p>
<p>Of course, the principal difficulty at first glace is that the costs will strain the system to a degree never before seen with the introduction of a new drug. The strain may break the bank. Recently Reuters has reported that one Florida health insurer – WellCare Health Plans – has sustained <a href="http://www.reuters.com/article/2014/07/25/wellcare-health-stocks-idUSL4N0Q047L20140725">significant corporate losses</a> attributable to the fact that Florida requires insurers to prove sofosbuvir to Medicaid patients. It has been reported that 47 state Medicaid programs are covering the drug, and about half have some form of preauthorization. Illinois Medicaid has recently changed its preauthorization criteria to provide the drug only to those patients with advanced liver disease, and to those who can tolerate interferon as an adjunctive treatment, and to <a href="http://www.chicagobusiness.com/article/20140729/NEWS03/140729819/ill…estricts-who-can-get-game-changing-hepatitis-drug">exclude individuals</a> with a history of alcohol or drug abuse. It has been projected that drug availability to California residents alone will add $18 billion to health care costs in one year.</p>
<p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>

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This entry was posted in Health Care, Pharmaceuticals and tagged , , . Posted by Hayley Dittus-Doria. Bookmark the permalink.