Tag: breast cancer

Bioethics News

Alzheimer’s Falls More Heavily on Women than on Men

December 28, 2016

(Scientific American) – Alzheimer’s dementia disproportionately affects women in a variety of ways. Compared with men, 2.5 times as many women as men provide 24-hour care for an affected relative. Nearly 19 percent of these wives, sisters and daughters have had to quit work to do so. In addition, women make up nearly two-thirds of the more than 5 million Americans living with Alzheimer’s today. According to the Alzheimer’s Association 2016 Alzheimer’s Disease Facts and Figures, an estimated 3.3 million women aged 65 and older in the United States have the disease. To put that number in perspective, a woman in her sixties is now about twice as likely to develop Alzheimer’s as breast cancer within her lifetime.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Study Finds ‘Striking’ Use of Double Mastectomy

December 21, 2016

(Science Daily) – Nearly half of early stage breast cancer patients considered having double mastectomy and one in six received it — including many who were at low risk of developing a second breast cancer, a new study finds. Many patients who chose double mastectomy demonstrated little knowledge of the lack of benefit this aggressive procedure has for most patients.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Angelina Jolie’s Breast Cancer Op-Ed Cost the Health System $14m in Unnecessary Tests

Three years ago, Angelina Jolie announced in a New York Times op-ed that she’d had a preventive double mastectomy after testing positive for mutations in the BRCA1 gene, which put her at an increased risk of breast and ovarian cancers

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

The Fraudulent Study That Killed Thousands of Breast Cancer Patients

American medical studies are supposed to be reviewed by the Institutional Review Board of a hospital or university, and today most countries have ethics committees that serve a prospective function, says Joseph Ali, Research Scholar at the Johns Hopkins Berman Institute of Bioethics and Associate Faculty at the Johns Hopkins Bloomberg School of Public Health

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Handing over the Control in Breast Reconstruction Surgery


A company named AirXpanders is in
the process of developing a medical device that will give women a
sense
of control over breast reconstruction surgery
.  The name of the product is AeroForm and it is currently under
review by the FDA.  
It
is approved in Europe and sold in Australia
. AeroForm is currently in clinical trials.

Using an implant is the current
standard of care for breast reconstruction.
  In order for an implant to achieve its
designed purpose, space must be made in the breast tissue.
  Before AeroForm, this space was achieved
through multiple visits to the doctor’s office using a saline injection. It was
a painful process for some women and could take months. AeroForm is a wireless,
needle-free tissue expansion device.
  A
device is surgically inserted into the breast that will deliver small amounts
of CO2 gas to expand the tissue as the saline used to do. The release of the
gas is controlled through an internal valve signaled by a wireless dose
controller operated by the patient. The patient can release the gas at her/his
own rate to make it less painful and can be done at home.
  It also can speed up the process from months
to weeks. The device is more expensive than saline injections but it reduces
the numbers of physician’s visits, so cost is comparable. 

The
process of restoring something so intimate may be embarrassing as well as
medicalizing part of one’s identity.
  This
device may be a way to restore lost confidence for breast cancer
survivors.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

A landmark case transforms informed consent in the UK

A ruling by a UK court last year forces doctors to tell their patients the full range of treatment options and allowing them to choose. The Royal College of Surgeons has warned of “a dramatic increase in the number of litigation pay-outs” made if doctors and hospitals do not make changes to the processes they use to gain consent from patients before surgery.

Traditionally it was up to British doctors to decide what risks to communicate to patients. But last year the UK Supreme Court held in a case called Montgomery vs Lanarkshire Health Board, that doctors must ensure patients are aware of any and all risks that an individual patient, not a doctor, might consider significant.

In other words, doctors can no longer be the sole arbiter of determining what risks are material to the patient.

In the past, litigation in malpractice suits was governed by the Bolam principle, which saw the judgement of medical experts as the main criterion for assessing reasonable care in negligence cases and for deciding what risks should be communicated to the patient for a chosen treatment.

Now the pendulum has swung from the “reasonable doctor” to the “reasonable patient”. This could mean a huge increase in the workload of doctors. A spokesman for the College said:

“It’s not hard to see how in many hospitals gaining a patient’s consent has become a paper tick-box exercise, hurriedly done in the minutes before a patient is wheeled into theatre for their procedure. Operating lists and consultation clinics are packed leaving little time for these important consent discussions.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Is It Fair to Reward Medicaid Patients for Receiving Flu Shots?

My son was underperforming at school, and I was gently encouraging him to try harder (if gesticulating like an over caffeinated Italian qualifies as gentle encouragement). He could not understand why I was upset: “Dad, most of my friends are doing drugs and engaging in unprotected sex. You should be rewarding me for being such a good kid.”

“Reward you for not being bad?!?,” I replied incredulously. That made no sense to me. “When you go above and beyond – when you exert exceptional effort to achieve important goals – then we can talk about what reward you have earned.”

The folks running South Carolina’s Medicaid program don’t appear to agree with my parenting philosophy. A couple years ago, they contracted with a private insurer, the Centene Corporation, to manage its Medicaid population. Part of the company’s approach involved rewarding Medicaid enrollees for receiving recommended preventive care.

This rewards program flips medical payment on its head. Normally, when people go to the family medicine doctor for an annual checkup, they are charged a modest copay for the visit. But through its CentAccount program, the folks at Centene pay patients for receiving such care. You got that right – they aren’t charged for the visit; they are rewarded for it!

When a Medicaid enrollee brings her infant in for a Well Child visit, she receives $10. If she makes all six visits for the year, she will get $25 in that final appointment, adding up to a $75 reward from taxpayers for bringing her child to appointments that the rest of us brought our kids to at our own expense.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

A New Edition of European Journal of Public Health Is Now Available

November 3, 2016

European Journal of Public Health (vol. 26, no. 5, 2016) is available online by subscription only.

Articles include:

  • An Examination of Unmet Health Needs as Perceived by Roma in Central and Eastern Europe” by Vishal S. Arora, Charlotte Kühlbrandt, and Martin McKee
  • Economic Downturns During the Life-Course and Late-Life Health: An Analysis of 11 European Countries” by Philipp Hessel and Mauricio Avendano
  • The Impact of the Housing Crisis on Self-Reported Health in Europe: Multilevel Longitudinal Modelling of 27 EU countries” by Amy Clair, Aaron Reeves, Rachel Loopstra, Martin McKee, Danny Dorling, and David Stuckler
  • Health Inequalities in the Netherlands: Trends in Quality-Adjusted Life Expectancy (QALE) by Educational Level” by Maria Gheorghe, Parida Wubulihasimu, Frederik Peters, Wilma Nusselder, and Pieter H.M. Van Baal
  • Socioeconomic Inequalities in Breast Cancer Incidence and Mortality in Europe—A Systematic Review and Meta-Analysis” by Adam Lundqvist, Emelie Andersson, Ida Ahlberg, Mef Nilbert, and Ulf Gerdtham
  • Employment Status and Income as Potential Mediators of Educational Inequalities in Population Mental Health” by Srinivasa Vittal Katikireddi, Claire L. Niedzwiedz, and Frank Popham
  • Gender Inequalities in Mental Wellbeing in 26 European Countries: Do Welfare Regimes Matter?” by Stefanie Dreger, Thomas Gerlinger, Gabriele Bolte

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

‘Going Flat’ After Breast Cancer

Before Debbie Bowers had surgery for breast cancer, her doctor promised that insurance would pay for reconstruction, and said she could “even go up a cup size.” But Ms. Bowers did not want a silicone implant or bigger breasts. “Having something foreign in my body after a cancer diagnosis is the last thing I wanted,” said Ms. Bowers, 45, of Bethlehem, Pa. “I just wanted to heal.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.