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04/09/2014

US jury orders Takeda, Eli Lilly to pay $9 billion in damages over Actos

[FirstWordPharma] A US jury ordered Takeda and Eli Lilly to pay a combined $9 billion in punitive damages after finding that the companies concealed the cancer risks associated with the diabetes therapy Actos (pioglitazone). The jury also awarded compensatory damages to the plaintiff of nearly $1.5 million in the first federal lawsuit related to the […]

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04/09/2014

Bentley Family Appeals British Columbia Supreme Court Ruling on Advance VSED

In early February, the Supreme Court of British Columbia issued a 44-page decision in Bentley v. Maplewood Seniors Care Society (2014 BCSC 165).  I analyzed and critiqued the decision in the Spring 2014 issue of the Journal of Clinical Ethics…

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

04/08/2014

AMC Leaders on Corporate Boards—A Modest Proposal

Dr. Roy Poses over at Health Care Renewal has for some time been speaking out about conflicts of interest posed by leaders of academic medicine and supposedly “not-for-profit” health systems who also rake in big bucks for sitting on the boards of large corporations such as drug companies and other firms that often do business with those same health centers. He most recently called attention to a research letter in JAMA that provides some of the first data on the frequency of these ties (see link in blog post):
http://hcrenewal.blogspot.com/2014/04/finally-article-in-large-circulation.html

Dr. Poses notes a number of serious ethical concerns that result from these board relationships. He is most worried about the way that a small group of very wealthy corporate insiders seem to have formed an old-boys-and-girls club that runs not only the corporate sphere but increasingly the world of health care as well, and how in the process the interests of ordinary folk get left behind. There is also the narrower question of the role of these people on those corporate boards which forms a sort of Catch-22. These corporations, as we have detailed ad nauseam in this blog, often take actions that go against the public interest. If (say) a university president is a member of the board of directors, then the prez presumably should speak up and demand that the corporation cease and desist all such behaviors. If the prez says that really, don’t blame him, he has no control over that behavior, then he is admitting that he’s failed in his role as a corporate overseer, which is what legally the board of directors is supposed to be about.

In the middle of this debate I have one of my occasional modest proposals. It does not address the deeper issues, which would entail leaders of academic medical and health centers not being on those corporate boards at all–but see my Modest Prediction at the end.

Whenever do-gooders like us complain about these conflicts of interest, apologists for the One Percent crowd claim that after all, these board relationships are very valuable for the university or the AMC or the health system. They expose the board to the presumably enlightened views of academic and health care leaders. They expose the leaders to important information about what’s happening on the corporate side, thereby stimulating productive university-industry partnerships for the future. So how could anyone be so narrow-minded as to object to these relationships?

Hence my modest proposal—demand that any academic or health care leader who serves on a corporate board do so without pay and at his/her own expense for travel and lodging. If their being on the board is so all-fired valuable to the academic or health institution, then let that board service be a part of the CEO’s job at that institution. Last I heard, none of these high rollers were being underpaid for their leadership roles. They have funds to cover their activities if they travel on university or hospital business, so why not regard board service under that category?

I would along with the modest proposal make a modest prediction. If you ceased paying these CEOs personally for their board service, commonly nowadays in the six-figure-per-year range, suddenly none of these CEOs would want to be on corporate boards any more. So much, if so, for all the wonderful intellectual advantages of board service and industry relationships.

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This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

04/08/2014

In US, Vaccine Denial Goes Mainstream

This article provides a brief snapshot of the alarming trend of vaccine denial, with an especially insightful observation at its conclusion. For information on the importance of vaccination and links to further sources, see these blog posts from the Seattle Times and Discover. [Yahoo News] Washington (AFP) – Kathleen Wiederman is not staunchly against vaccines. She […]

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04/08/2014

Polarized

I recently reread a very informative New Yorker article by Ryan Lizza, called the Obama memos. I have assigned the article to my undergraduate health policy class, to help them understand the political climate surrounding the passage of The Affordable … Continue reading

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

04/08/2014

Heavy Drinkers to be Considered for NHS Liver Transplants in the UK

[The Guardian] People with a severe drink-related liver disease are to be considered for transplant for the first time, reopening the debate over whether people who are thought to bring ill health on themselves deserve expensive treatment. The decision by the NHS‘s blood and transplant service (NHSBT) comes at a time when there is a national shortage […]

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04/08/2014

Birth Control and the Battle against Ovarian Cancer

Article by BEI Young Professionals member Jessica Hahne. Originally published in the February 2014 issue of Survivor’s Inbox: A Newsletter of the Survivorship Clinic at Yale Cancer Center. Known among doctors as “the cancer that whispers,” ovarian cancer begins with mild symptoms that often slip past early detection. While 1 in 72 women are affected by ovarian cancer[1], only […]

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04/08/2014

Advance Directives & Nursing Home Stays Associated with Less Aggressive End-of-Life Care for Patients with Severe Dementia

A new study in Health Affairs shows some material benefits of advance directives:  ”Advance Directives and Nursing Home Stays Associated with Less Aggressive End-of-Life Care for Patients with Severe Dementia.”

The authors found that that nearly …

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

04/08/2014

New Book on Advance Directives

The preface of a new book on advance directives rightly notes that “many ethical and policy issues remain in need of further exploration.”


Part I – History of Advance Directives and Prerequisites for Validity

  • 1. Historical Review of Advance Directives (Alfred Simon) 
  • 2. Personal Capacity to Anticipate Future Illness and Treatment Preferences (Marie-Jo Thiel) 
  • 3. Advance Directives in Psychiatry (Jochen Vollmann)

Part II – Defining the Scope of Advance Directives

  • 4. On the Scope and Limits of Advance Directives and Prospective Autonomy (Robert Olick)
  • 5. Revocation of Advance Directives (Ralf Jox)
  • 6. Limitations to the Scope and Binding Force of Advance Directives: the Conflict Between Compulsory Treatment and the Right to Self‑Determination (Jacqueline Atkinson & Jacqueline Reilly)
  • 7. Advance Directives in the Context of Imprisonment (Bernice Elger)

Part III – Effects on Family, Friends and Professional Relations

  • 8. Advance Directives and the Physician-Patient Relationship: A Surprising Metamorphosis (Mark Aulisio)
  • 9. Advance Directives and the Role of Family and Close Persons – Legal Provisions and; Challenges (Margot Michel) 
  • 10. Advance Directives and the Ethos of Good Nursing Care (Settimio Monteverde)

Part IV; Ethical Challenges

  • 11. Advance Directives Between Respect for Patient Autonomy and Paternalism (Manuel Trachsel et al)
  • 12. The Use of Advance Directives in the Context of Limited Resources for Healthcare (Ruth Horn & Ruud ter Meulen)
  • 13. From Legal Documents to Patient-Oriented Processes: The Evolution of Advance Care Planning (Tanja Krones & Sohaila Bastami)

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

04/07/2014

Calorie Counts on… Stairs? Interesting Nudge

Just came across an interesting way to try to motivate people to exert themselves: post calories-burned-counts on the stairs. Would that work for you?  For me, it would probably make me look down while walking up, only to trip, fall … Continue reading

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