bioethics

The account of the Virginia-based Red Hen restaurant owner insisting Press Secretary Sarah Sanders leave the premises due to presumed political differences has been playing on a loop of social and mainstream media punditry. This got me thinking about a recent sea change within distinct segments of the medical community when it comes to refusing to allow vaccine-hesitant families as patients at certain practices. The American Academy of Pediatrics (AAP) has gone as far as sanctioning pediatricians kicking them out of a practice by making it official policy that this action can be used as an absolute last resort (see...

Authors of a newly published piece in The New England Journal of Medicine sought to provide an analysis of who ought to be responsible for obtaining a patient’s consent. They conclude, upon discussion of a recent Pennsylvania Supreme Court ruling in Shinal v. Toms which held that a treating physician could not “fulfill through an intermediary the duty to provide sufficient information to obtain a patient’s informed consent,” that this definition is too rigid, inefficient and out of step with shifting team-centered approaches to care delivery. This in itself is a misnomer given medical care has always been driven by teams - including but not...

It was such a privilege and honor for me to be invited by the incomparable Suzi Abrams and Jewish Family & Children’s Services of Southern New Jersey to present on how to be an advocate for yourself or a loved one in the medical realm. To inform from a physician's perspective, I put together a guide on the subject that can be found by scrolling down in this article. The topic of patient advocacy is very close to my heart, so when I was invited to speak by someone I deeply admire who runs an effective, successful program the community vitally needs,...

The use and concept of terms like “genetic testing” or “genome sequencing” as the key to future disease prevention is speculative at best. Besides the generic recommendations of healthy living through improved diet and routine exercise, there isn’t much beyond entertainment value that the commercial products can offer along with an often newly found anxiety. Despite this reality, direct-to-consumer platforms and now health systems (e.g. Geisinger Health System, a health system and health insurance company) continue their marketing campaigns. Attempting to distinguish itself from the former which casts a wide net,...

While our culture is preoccupied with violations of consumer data privacy yielding targeted marketing for shoes, travel or food preferences, law and advertising firms are leading a more nefarious erosive charge on patient privacy. Unbeknownst to emergency room visitors, companies are setting up digital geofences around hospital perimeters that capture mobile phone entry to the premises. This initiates a cascade of events that allows marketing agencies hired by personal injury law firms, for example, to solicit patients directly with ads to their phone (while still in the ER). Though these ads can be cast while in a clinic or other medical locale, the system is sparked by arrival to the emergency room.

Think about that for a moment. Whether you voluntarily go to seek urgent...

A premature infant is born with a form of severe lung injury that carries a 20% chance of survival. Her physician decides to throw a medical “Hail Mary” and try an untested adult technique to bypass the injured lungs. The infant survives, and after a few more tries, the physician realizes that the survival rate may be as high as 80% with this new treatment. Does he know enough that the treatment should become standard practice, or is a randomized clinical trial required?

In modern medicine, randomized clinical trials (RCTs) are a very effective way to determine the efficacy of different treatments. In an RCT, patients are randomly assigned to receive one of the treatments under study, and the differences in their outcomes are measured. Randomization can be a very helpful tool to...

There is no denying when public figures experience medical issues they can draw greater awareness and attention toward disease prevention; informing society and providing beneficial education. But, the hospitalization of the First Lady, who is thankfully expected to make a full recovery for a “benign kidney condition,” raises concerns surrounding the intersection of patient privacy and a loved one seeking and holding elective office. Should an unelected citizen be unduly compelled to reveal any aspect of their health status? 

Many would argue that when someone runs for public office, everything is fair game. Perhaps it is time to re-examine that issue. Where...

Though the current buzzword in healthcare is “patient-centered,” it appears our “thought leaders” instead tend to subscribe to more paternalistic endeavors to control – oops! I mean steward - behavior. Look no further than the debacle of how forced, mandatory electronic medical records were implemented and the havoc that continues to cause (see here) or the American Academy of Pediatrics’ (AAP) recent strategy to make it okay for doctors, as a last resort, to refuse allowing families who decline vaccination to be a part of their practice.

A just published opinion...

Electronic medical records (EMRs) were pitched as a long-sought concept of computerized universal personal health material that would mitigate issues with access and barriers to care. In reality, when I speak of EMRs, I am referring to what they actually delivered to physicians, billing platforms that marginalize meaningful patient data necessary to inform diagnosis and therapeutic interventions.

If the promise lived up to an inkling of the reality, then the excessive clerical burden imposed on physicians to enter data, that often results in more eyes on the computer screen than the patient would not cause almost 1 in 5 U.S. physicians to plan to reduce their clinical hours in the coming year and nearly 1 in 50 to expect to leave the field...

Without a doubt, almost all alternative medicine is junk science. That would include widespread practices like acupuncture, which the biomedical literature has shown convincingly confers no real medical benefits compared to placebo.

But the placebo effect is powerful. It is far more than the "power of positive thinking." Instead, the placebo effect has real, measurable effects on the human body. Therefore, even if a "treatment" is nothing more than a placebo, some people undoubtedly will benefit from using it.

However, that raises a serious ethical question: Should...