Hot Topics: Health Care

Blog Posts (5633)

December 14, 2018

More Brain Death Cases Going to Court

I have collected and written about a number of brain death cases that have recently gone to courts in the United States, Canada, and the UK.  But most court cases are difficult to find, because they are handled on an expedited basis in local tria...
December 13, 2018

“The Babies are the Experiment”

By Jon Holmlund   The Thursday, Dec 13 edition of the Wall Street Journal carries this headline:  “Doubts Arise Over Gene-Editing Claim.”  The work behind the recent report that the world’s first two gene-edited babies had been born has been publicly discussed, but the details have not yet been published for full scientific review.  Apparently …

Continue reading "“The Babies are the Experiment”"

December 13, 2018

Measures of Physician Quality Don’t Measure Up

Physician reimbursement increasingly depends upon measures of healthcare quality. Physicians who fall short on quality measures now face financial penalties. But it might be quality measures, themselves, that are falling short, according to a study conducted by the American College Physicians. … Continue reading

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December 13, 2018

He Jiankui’s Genetic Misadventure, Part 2: How Different Are Chinese and Western Bioethics?

When the world’s first research on editing the genes of human embryos by Chinese scientists  was published in an international journal in 2015, a report in the New York Times characterised the key issue involved as “a scientific ethical divide between China and West.” Earlier this year, an article in the magazine Foreign Policy by… Read more

The post He Jiankui’s Genetic Misadventure, Part 2: How Different Are Chinese and Western Bioethics? appeared first on The Hastings Center.

December 12, 2018

Is Your Boss Discriminating Against You Because You Smoke?

Obamacare gave employers permission to charge smokers up to 50% more for health insurance, as a way to incentivize healthier behavior. But to make sure smokers had a fair chance to avoid these penalties, the law required employers to provide tobacco cessation … Continue reading

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December 12, 2018

Medical Bankruptcy Is Much Less Common Than Elizabeth Warren Tells You

Elizabeth Warren describes medical bills as “the leading cause of personal bankruptcy” in the United States. She bases that opinion in part on her own research, in which she and her collaborators surveyed people who had experienced personal bankruptcy, asked them whether they’d … Continue reading

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December 12, 2018

At the End of Life: The Physician's Role, Responsibility, and Agency

Join me in Seattle for "At the End of Life: The Physician's Role, Responsibility, and Agency." This national two-day conference is Sept. 13 and 14, 2019, at the University of Washington in Seattle. We will explore the complex issues—professional, moral, and legal—facing physicians caring for dying patients. 

Physicians have the privilege and duty to care for patients at the end of life. Sometimes a physician’s actions factor into a patient’s death; such as discontinuing life-support (including ventilators, cardiac devices, and dialysis), clinically supporting patients who voluntarily stop eating and drinking (VSED), providing palliative sedation, and in states where it is legal, prescribing a lethal dose of medication to a dying patient. These cases have clinical, legal, ethical, sociocultural, and psychological dimensions that are often challenging for physicians to navigate.

At this conference, we'll set the stage for ongoing discussion of these practices and the issues physicians caring for dying patients often face, as both medical technology and patients’ requests for planned death evolve.

Speakers other than me include (among many others):

  • J. Randall Curtis
  • Linda Ganzini
  • Timothy Quill
  • Haider Warraich

December 11, 2018

My Pediatrician

By Puja Nayak “Doctor,” I say, my voice fading. I hear footsteps running and my eyes shut. Hours later, I have a wire in me. I try and pull it out but my doctor stops me. “No, don’t do that sweetie.” I give her a look. I don’t understand why I’m here. My head is […]
December 11, 2018

Religious Exemption from Brain Death - Taquisha McKitty

Tomorrow, the Ontario Court of Appeal hears oral arguments in the case of Taquisha McKitty. While Taquisha was determined and declared death in September 2017, she remains in the ICU at the William Osler Health System. Taquisha's family argues th...
December 10, 2018

Jiankui He: A Sorry Tale of High-Stakes Science

In response to news of the world’s first babies born in China from gene-edited embryos, Sam Sternberg, a CRISPR/Cas9 researcher at Columbia University, spoke for many when he said “I’ve long suspected that scientists, somewhere, would rush to claim the ‘prize’ of being first to apply CRISPR clinically to edit the DNA of human embryos,… Read more

The post Jiankui He: A Sorry Tale of High-Stakes Science appeared first on The Hastings Center.

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Published Articles (89)

American Journal of Bioethics: Volume 18 Issue 11 - Nov 2018

Just Policy? An Ethical Analysis of Early Intervention Policy Guidance Ibrahim Garba, Leila Barraza & Elizabeth Hall-Lipsy

AJOB Primary Research: Volume 9 Issue 3 - Nov 2018

Freezing fertility or freezing false hope? A content analysis of social egg freezing in U.S. print media Lisa Campo-Engelstein, Rohia Aziz, Shilpa Darivemula, Jennifer Raffaele, Rajani Bhatia & Wendy M. Parker

AJOB Primary Research: Volume 9 Issue 3 - Nov 2018

Taking societal cost into clinical consideration: U.S. physicians’ views Alissa R. Stavig, Hyo Jung Tak, John D. Yoon & Farr A. Curlin

AJOB Neuroscience: Volume 18 Issue 3 - Sep 2018

Telling the Truth About Pain: Informed Consent and the Role of Expectation in Pain Intensity Nada Gligorov

AJOB Neuroscience: Volume 18 Issue 3 - Sep 2018

Punishing Intentions and Neurointerventions David Birks & Alena Buyx

American Journal of Bioethics: Volume 18 Issue 9 - Sep 2018

The Ethics of Smart Pills and Self-Acting Devices: Autonomy, Truth-Telling, and Trust at the Dawn of Digital Medicine Craig M. Klugman, Laura B. Dunn, Jack Schwartz & I. Glenn Cohen

American Journal of Bioethics: Volume 18 Issue 8 - Aug 2018

When Parents Refuse: Resolving Entrenched Disagreements Between Parents and Clinicians in Situations of Uncertainty and Complexity Janine Penfield Winters

American Journal of Bioethics: Volume 18 Issue 8 - Aug 2018

The Harm Principle Cannot Replace the Best Interest Standard: Problems With Using the Harm Principle for Medical Decision Making for Children Johan Christiaan Bester

American Journal of Bioethics: Volume 18 Issue 8 - Aug 2018

Are Organ Donors Really Dead: The Near-Irrelevance of Autoresuscitation Robert M. Veatch

AJOB Primary Research: Volume 9 Issue 2 - Jun 2018

Cross-cultural perspectives on decision making regarding noninvasive prenatal testing: A comparative study of Lebanon and Quebec Hazar Haidar, Meredith Vanstone, Anne-Marie Laberge, Gilles Bibeau, Labib Ghulmiyyah & Vardit Ravitsky

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News (2141)

December 11, 2018 9:15 am

The CRISPR Baby Scandal Gets Worse by the Day (The Atlantic)

Before last week, few people had heard the name He Jiankui. But on November 25, the young Chinese researcher became the center of a global firestorm when it emerged that he had allegedly made the first crispr-edited babies, twin girls named Lulu and Nana. Antonio Regalado broke the story for MIT Technology Review, and He himself described the experiment at an international gene-editing summit in Hong Kong. After his talk, He revealed that another early pregnancy is under way.

It is still unclear if He did what he claims to have done. Nonetheless, the reaction was swift and negative. The crispr pioneer Jennifer Doudna says she was “horrified,” NIH Director Francis Collins said the experiment was “profoundly disturbing,” and even Julian Savulescu, an ethicist who has described gene-editing research as “a moral necessity,” described He’s work as “monstrous.”

December 7, 2018 9:15 am

Policy Recommendations: Control and Responsible Innovation of Artificial Intelligence (The Hastings Center)

A major international project at The Hastings Center released policy recommendations for the development of artificial intelligence and robotics to help reap the benefits and productivity gains and minimize the risks and undesirable social consequences.

“Research, innovation, and the deployment of AI and robotic systems are proceeding rapidly, and so, too, is the emergence of a transdisciplinary community of researchers in AI and the social sciences dedicated to AI safety and ethics,” states the executive summary to the final report. “The Hastings AI workshops played a seminal role in catalyzing the emergence of this worldwide network of organizations and individuals.” The Hastings Center’s project, Control and Responsible Innovation in the Development of AI and Robotics, was funded by the Future of Life Institute and led by Wendell Wallach, a senior advisor at The Hastings Center and a scholar at Yale University’s Interdisciplinary Center for Bioethics. Wallach is an internationally recognized expert on the ethical and governance concerns posed by emerging technologies, particularly artificial intelligence and neuroscience. Project participants included Stuart Russell, of the University of California, Berkeley; Bart Selman, of Cornell University; Francesca Rossi, of IBM; and David Roscoe, a Hastings Center advisory council member.

December 6, 2018 4:15 pm

Should We Edit the Human Germline? Is Consensus Possible or Even Desirable? (The Hastings Center)

On the one hand, reports of a rogue scientist, He Jiankui, who contravened the scientific and ethical norms that should guide the development of human genome editing reinforces the need for clarity about those norms and international monitoring of advances in the field. On the other hand, it shows the weaknesses and limitations of voluntary efforts – like the summit – to guide scientists’ practices. They lack any real enforcement power on their own, and have largely served to ensure that human genome editing research can continue, rather than promote reflection on whether we should edit the human germline in the first place.

December 6, 2018 9:00 am

If you’re single with cancer, you may get less aggressive treatment than a married person (The Washington Post)

If you are divorced, widowed or never married and develop cancer, watch out. You may get less aggressive treatment than your married friends.

We’ve often heard about studies showing that married adults are more likely to survive cancer than singles. But buried in those same studies is another finding that hasn’t made the headlines. When surgery or radiotherapy is the treatment of choice, patients with spouses are more likely to get it.

December 4, 2018 9:15 am

‘From Nothing to Gangbusters’: A Treatment for Sickle-Cell Disease Proves Effective in Africa (The New York Times)

A drug that protects children in wealthy countries against painful and sometimes lethal bouts of sickle-cell disease has been proven safe for use in Africa, where the condition is far more common, scientists reported on Saturday.

More research remains to be done, experts said, but knowing that hydroxyurea — a cheap, effective and easy-to-take pill — can safely be given to African children may save millions of youngsters from agonizing pain and early deaths.

“I think this is going to be amazing,” said Dr. Ifeyinwa Osunkwo, who directs a sickle-cell disease program in Charlotte, N.C., but was not involved in the new study.

December 3, 2018 2:12 pm

Medical Detectives: The Last Hope for Families Coping With Rare Diseases (KQED Science)

All over the country, specialized strike teams of doctors are giving hope to families who are desperately searching for a diagnosis.

The medical sleuths have cracked more than a third of the 382 patient cases they’re pursuing, according to a recent paper in the New England Journal of Medicine.

December 3, 2018 9:00 am

Watching My Patient Die, Remotely (The New York Times)

As more and more hospitals have adopted electronic medical records, their records have become linked and you can follow your patients, virtually, hundreds of miles away.

December 2, 2018 9:00 am

Battle Against Ebola in Congo Pits Medical Hope Against Local Chaos (The New York Times)

A vaccine and new treatments are on hand, but the outbreak is in an area rife with unpredictable gunfire, bandits and suspicion of outsiders.

December 1, 2018 9:00 am

This high school was rocked by an HIV scare 10 years ago (The Washington Post)

Ten years ago, Jennifer Wyms was a 17-year-old junior at Normandy High School in Wellston, Mo. She was the captain of her school’s hip-hop dance team and enjoyed going to the mall with friends. But when a health scare engulfed her St. Louis community, it cast a shadow on her high school experience.

A letter from school officials sent to parents and guardians in October 2008 relayed the news that epidemiologists with the St. Louis County Department of Health had grounds to believe that HIV may have been transmitted among some students — as many as 50 students at Normandy High School could have been exposed, it said.

“Everybody wanted to know, who had it? Where it came from? Why our school?” Wyms told The Washington Post.

November 30, 2018 3:15 pm

Dangerous Infection Tied To Hospitals Now Becoming Common Outside Them (NPR)

Named from the Greek kloster, for spindle, a class of bacteria known as Clostridia abounds in nature.

Staining deep violet under the microscope, they appear as slender rods with a bulge at one end, like a tadpole or maple seed. They thrive in soil, marine sediments and humans. They live on our skin and in our intestines.

And sometimes, they can kill you.

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