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NEWS - Bioethics

The Case For Expensive Antibiotics – WIRED (a few articles per month are free) (via @CarlosdelRio7)

 


The Moral Dilemma of Learning Medicine from the Poor – The Doctors Weight In (free) (via @kennylinafp)

“I learned good skills because I was allowed to practice on people who had no other option.”

 


Abraar Karan: Changing the way we communicate about patients – The BMJ Opinion (free) (via @NUNESDOC)

“Father of 2, retired car salesman and keen on football NOT the colon cancer in Bed 4 – social history brings humanity back to the bedside” (via @hospicedoctor see Tweet)

 


Opinion: Lessons for physicians from ‘The Bleeding Edge’: If you see something, say something – STAT (free)

“…physicians must act decisively when they identify the rare outlier in their midst. To do anything less would risk our credibility. Worse still, it could risk the lives of the people we took an oath not to harm.”

 


Special Issue: Roles of Physicians in Healthy Dying- AMA Journal of Ethics (free articles)

“What the roles of clinicians and patients should be in defining what constitutes a quality dying experience and good care of dying people has received less attention than issues like euthanasia and assisted death. Which parts of dying, if any, should be medicalized and why? What do patients and clinicians need to know about dying and why? The August 2018 issue of the AMA Journal of Ethics explores these and other questions.”

 


Religion and Spirituality in Health Care Practice – AMA Journal of Ethics (free)

“Patient spirituality continues to be an area that clinicians do not discuss as often as they should. Our new issue provides guidance for clinicians on a wide range of issues related to religion, spirituality, and health care”. (via @JournalofEthics see Tweet)

 


Hidden conflicts? – Science Magazine (free for a limited period)

““Pay-later conflicts of interest” have gone largely unnoticed & entirely unpoliced”. (via @cpiller see Tweet)

 


Breathing Tubes Fail to Save Many Older Patients – The New York Times (10 articles per month are free)

“One-third of patients over age 65 die in the hospital after they are put on ventilators. Doctors are beginning to wonder if the procedure should be used so often”.

 


Trying to Put a Value on the Doctor-Patient Relationship – The New York Times (10 articles per month are free)

“In its push for profits, the U.S. health care system has made it difficult for patients to get personal attention from doctors. But what if hands-on medicine actually saves money — and lives?”

 


How Tech Can Turn Doctors into Clerical Workers – The New York Times Magazine (10 articles per month are free)

“The threat that electronic health records and machine learning pose to physicians’ clinical judgment — and their well-being”.

 


Financial Conflicts of Interest Among Authors of Urology Clinical Practice Guidelines – European Urology (free)

“59% Urology Guideline writers received payments from companies AND 37% provided inaccurate COIs forms” (via @daviesbj see Tweet)

 


Plastic Surgery’s Contributions to Surgical Ethics – AMA Journal of Ethics (free)

“Important for plastic surgeons in particular to remember: just because you *can* perform an operation, which might or might not be medically indicated, does not mean you *should* perform the operation” (via @JournalofEthics see Tweet)

 


Authors of premier medical textbook didn’t disclose $11 million in industry payments – STAT (free)

“’The most recognized book in all of medicine’ is also rife with hidden financial conflicts. Should Harrison’s authors be disclosing $11 million in payments from drug and device makers?” (via @caseymross see Tweet)

 


Editor’s Choice: There but for the grace of God . . . – The BMJ (free)

About liability and error in medical practice.

 


New Issue: Graphic Medicine and Health Care Ethics – AMA Journal of Ethics (free articles and commentaries)

 


Payments by US pharmaceutical and medical device manufacturers to US medical journal editors: retrospective observational study – The BMJ (free)

“Industry payments to journal editors are common and often large, particularly for certain subspecialties. Journals should consider the potential impact of such payments on public trust in published research”.

 


Outcomes In Two Massachusetts Hospital Systems Give Reason For Optimism About Communication-And-Resolution Programs – Health Affairs (link to abstract – $ for full-text)

Commentaries: After medical error, apology goes a long way – Stanford University Medical Center, via ScienceDaily (free) AND Conflict Resolution Program: ‘Cause for Optimism’ – MedPage Today (free registration required)

 


Antipsychotic Use With and Without Comorbid Psychiatric Diagnosis Among Adults with Intellectual and Developmental Disabilities – The Canadian Journal of Psychiatry (link to abstract – $ for full-text)

Commentaries: Antipsychotics common for adults with intellectual and developmental disabilities – Centre for Addiction and Mental Health (free) AND Antipsychotics Overused in Intellectually Disabled Adults – Medscape (free registration required)

“Antipsychotics are used inappropriately particularly in vulnerable groups: Poor children; Intellectually challenged; Autistic; Nursing homes. (RT @AllenFrancesMD see Tweet)

 


FDA News Release: FDA approval brings first gene therapy to the United States (free)

Commentaries: A $475,000 cancer drug: Wall Street sees ‘bargain’; patients see ‘completely broken’ system – HealthNewsReview (free) FDA Approves First CAR-T Cell Therapy for Pediatric Acute Lymphoblastic Leukemia – National Institutes of Health (free) AND FDA Approves First Gene-Altering Leukemia Treatment, Costing $475.000 – New York Times (10 articles per month are free) AND The FDA Approves a Landmark Cancer Drug – The Atlantic (free)

“…is a cancer therapy that represents several things at once: a game-changing way to treat cancer through genetic engineering, a novel paradigm for the biotech business, and the latest turn in the debate over just how astronomically expensive a life-saving therapy can be”. (from The Atlantic)

 


China’s embrace of embryo selection raises thorny questions – Nature News (free)

“Fertility centres are making a massive push to increase preimplantation genetic diagnosis in a bid to eradicate certain diseases”.

 


The global crackdown on parents who refuse vaccines for their kids has begun – VOX (free)

See more on mandatory vaccination in our May 29th (see #6) and July 12th (see #5) issues.

“Countries like Italy and Australia are tired of measles outbreaks — so they’re moving to fine anti-vaccine parents”.

 


Iatrogenesis in Pediatrics – AMA Journal of Ethics (free) (RT @JournalofEthics)

New issue with series of articles exploring strategies clinicians need to know to respond to adverse outcomes.

 


First compute no harm – Enrico Coiera, via The BMJ Opinion (free)

“We will need new principles and regulations to govern medical artificial intelligence”

 


Why cancer is not a war, fight, or battle – CNN (free)

Related: He’s a Fighter – The Atlantic (free)

“Cancer is a process, it’s not a war. No winners or losers. Stop military metaphors”. (RT @lucadf see Tweet)

 


‘We are all mutants now’: the trouble with genetic testing – The Guardian (free) (RT @EricTopol see Tweet)

Related: The uncertain future of genetic testing – Mosaic (free)

“With so many unknowns in our DNA, using genetics in medical testing doesn’t always bring the answers – sometimes it brings only doubt”.

 


Viewpoint: The Evolving Story of Overlapping Surgery – JAMA (free) (RT @pash22 see Tweet)

Commentary: 3 steps to restore patient trust in overlapping surgeries – FierceHealthcare (free)

This interesting viewpoint discusses the practice of scheduling overlapping surgeries, in which a qualified practitioner finishes noncritical parts of the first operation while the primary surgeon moves to the next surgery.

 


Quality of Life in Dementia – The AMA Journal of Ethics (free)

“What can clinicians do to normalize the experience of dementia? Our new issue explores the ethics of dementia care” (RT @JournalofEthics see Tweet)

 


Teaching Clinical Ethics at the Bedside: William Osler and the Essential Role of the Hospitalist – AMA Journal of Ethics (free)

“Hospitalists are uniquely positioned to teach ethics and communication in real time on the wards” (RT @JournalofEthics see Tweet)

 


How Should Resident Physicians Respond to Patients’ Discomfort and Students’ Moral Distress When Learning Procedures in Academic Medical Settings? – AMA Journal of Ethics (free)

“Medical institutions should support a culture of “speaking up” to promote the safety of patients AND learners” (RT @JournalofEthics see Tweet)

 


WHO guidelines on ethical issues in public health surveillance – World Health Organization (free)

Commentary: Ethics of public health surveillance: new guidelines – The Lancet Public Health (free)

Public health surveillance: privacy, autonomy, equity, common good need to be balanced. New ethics guidelines” (RT @trished see Tweet)

 


Insurers Battle Families Over Costly Drug for Fatal Disease – The New York Times (10 articles per month are free)

“A new drug can cost over a million dollars, even though it’s unclear if it works. Now, insurers are refusing to pay” (RT @NYTHealth see Tweet)

 


A Piece of My Mind: Speak Up – JAMA (free)

“Verbal and physical attacks against health care workers are common, are underreported, and have lasting consequences in the form of persistent fear”.

 


The pressure of Big Pharma – The Globe and Mail (a few articles per month are free) (RT @CADTH_ACMTS see Tweet)

“Financial conflicts of interest are commonplace in clinical practice guidelines”

 


Who Should Assess the Needs of and Care for a Dementia Patient’s Caregiver? – AMA Journal of Ethics (free)

“Physicians have an obligation to check in on dementia patients’ caregivers, and provide support if necessary” (RT @JournalofEthics see Tweet)

 


The ‘living dead’: prisoners executed for their organs then sold to foreigners for transplants – News.com.au (free)

“I have to fly tonight because they are shooting my donor tomorrow.”

“Here’s an ethics study. Would you accept organ from executed prisoner if it were a matter of your life or death?” (RT @barttels2 see Tweet)

 


Viewpoint: Direct-to-Consumer Medical Testing in the Era of Value-Based Care – JAMA (free)

See also a recent discussion on direct-to-consumer genetic testing in our April 10th issue, see #5

Others disagree: “Dissing every consumer medical test as “low value”. Sorry, that’s not true. It’s called paternalism” (RT @EricTopol see Tweet)

 


Editor’s Choice: Give patients access to their medical records – The BMJ, by Fiona Godlee, editor in chief (free)

Patients are being empowered in decisions regarding their health care, and this is probably a tendency for the future.

 


Correspondence: Trial of Transplantation of HCV-Infected Kidneys into Uninfected Recipients – The New England Journal of Medicine (free)

Transplantation of HCV-infected-kidneys into uninfected recipients seems feasible in this era of direct-acting antiviral agents, maybe shortening waiting times for those willing to take the risk.

 


The Patients Were Saved. That’s Why the Families Are Suing – The New York Times (free)

“Historically, the practice has been “if in doubt, err on the side of aggressive, life-sustaining treatment,””. That might be changing.

 


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