Tag: patients

Bioethics News

South Africa to Try Japanese Drug Against Resistant Form of TB

March 24, 2017

(Reuters) – South Africa launched a new drug program to treat multidrug-resistant tuberculosis (TB) on Friday in a bid to combat the leading cause of natural deaths in Africa’s most industrialized economy. The Health Department said it will run a clinical research program for the drug Delamanid, made by Japan’s Otsuka Holdings Co Ltd, involving 400 patients over the next two years.“Resistance is very minimal to it. The added advantage of this drug is it is more tolerable,” Health Minister Aaron Motsoaledi told a briefing for World TB Day in Johannesburg.

Source: Bioethics.com.

This article was originally published on Bioethics.com under a Creative Commons License.

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

Doctor Turns Up Possible Treatment for Deadly Sepsis

March 24, 2017

(NPR) – It’s hard not to get excited about news of a potentially effective treatment for sepsis, a condition that leads to multiple organ failure and kills more people in the hospital than any other disease. But there have been so many false promises about this condition over the years, it’s also wise to treat announcements — like one published online by the journal, Chest — with caution. The study, from Eastern Virginia Medical School in Norfolk, Va., reported some remarkable success in treating patients who were at high risk of sudden death.

Source: Bioethics.com.

This article was originally published on Bioethics.com under a Creative Commons License.

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

With Patients Demanding Experimental Drugs, ‘Right to Try’ Is Becoming the Law of the Land

The movement has been fueled in no small part by the anti-regulatory sentiment that propelled Donald Trump’s rise to the presidency and by the explicit support of Vice President Mike Pence

Source: Bioethics Bulletin by the Berman Institute of Bioethics.

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

Why Trumpcare Is DOA: It Doesn’t Address Outrageous Healthcare Prices

Paul Ryan is “excited” that the American Health Care Act, as Republicans call their bill, will trim the federal budget by several hundred billion dollars over the next decade. The 24 million people who are expected to lose insurance under the AHCA aren’t excited about the bill, which will cut government spending at their expense, with potentially fatal consequences for those who go without timely medical care.

Debates over healthcare reform often ask us to pick our poison. We either save money or we save lives.

But these debates ignore an antidote to this poisonous choice. If we tackle high healthcare prices, we can insure Americans at the same time as we curb healthcare expenditures.

This antidote is not theoretical conjecture. In fact, most developed countries provide universal insurance to their residents while spending far less per capita than the U.S. This affordable coverage exists in countries where healthcare payment is socialized, like the UK and Canada, and where it is privatized, like Germany and Switzerland. That’s because all these healthcare systems work to rein in high healthcare prices. As a result, appendectomies cost half as much in Switzerland as in America; and knee replacements cost 30% less in the UK than in the U.S.

Unfortunately, prices have been largely absent from healthcare reform debates in the U.S., whether those reforms are crafted by Democrats or Republicans. It’s true that politicians from both sides of the aisle occasionally speak out about pharmaceutical prices. Both Donald Trump and Hillary Clinton criticized pharmaceutical CEOs, like smirking Martin Shkreli, who made the news after enacting outrageous price hikes.

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

Conscientious Objection Accommodation in Healthcare – Clashing Perspectives

by Brian D. Earp / (@briandavidearp)

On behalf of the Journal of Medical Ethics, I would like to draw your attention to the current issue, now available online, which is almost entirely dedicated to the vexing question of conscientious objection in healthcare. When, if ever, should a healthcare provider’s personal conviction about the wrongness of some intervention (be it abortion, euthanasia, or whatever) be accommodated?

In a paper that has already attracted much attention, Ricardo Smalling and Udo Schuklenk argue that medical professionals have no moral claim to conscientious objection accommodation in liberal democracies.

In part, they base their argument on their judgment that “the typical conscientious objector does not object to unreasonable, controversial professional services—involving torture, for instance—but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive” (emphasis added).

It seems clear that a lot hinges on what is meant by “unreasonable” there–and on who should get to decide what falls under that label. One answer to this question might be, “society should get to decide, through the enactment of laws, which ideally express the view of the majority of people as to what is reasonable or unreasonable in medical and other contexts.”

“Therefore,” this answer continues, “if a doctor thinks that some legally allowed service X is immoral, then she should rally her fellow citizens to lobby their representatives to change the relevant law; but she should not be excused from providing the service, if by law the patient is entitled to receive it.”

“And if she really doesn’t want to do X,” the answer concludes, “she can always leave the profession and take up some other line of work.”

This is a rough summary of what Smalling and Schuklenk do in fact say.

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

Texas Considers Letting Doctors Lie to Patients

by Craig Klugman, Ph.D.

The Texas Senate just passed a new bill (SB 25) that would shield doctors from a lawsuit if a baby is born with a disability even if the doctor knew of the concern and chose not to tell the parents. Opponents of the bill say that it permits doctors to lie to their patients if the doctor believes that knowledge might lead the woman to choose an abortion. The Houston Chronicle reports the bill’s aim is to “chip away at abortion rights.”

The Texas law does not go as far as a 2015 Arizona law that mandated physicians lie to patients by telling them that an abortion can be reversed. The new Texas bill would “allow” doctors to lie to patients and shield them from lawsuit unless the patient could prove gross negligence. The burden is on the patient to prove that the doctor should not have lied.

One of the first rules of professionalism that I teach in undergraduate and medical school bioethics courses is that in general, you never lie to the patient. Telling the truth is a bedrock concept necessary to respect patient autonomy. In order to make decisions, patients need to have knowledge of their condition and their treatment options (risks, benefits, and alternatives).

There are a few circumstances in which lying to patients is ethically acceptable: If the physician has strong reasons to believe that information would push the patient to do harm to him/herself or others, or if the family has requested that a patient not be told information because of cultural practices and the patient has agreed that she/he does not want to know the news.

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

Aid-in-Dying Laws and the Physician’s Duty to Inform

Guest Post: Mara Buchbinder

Paper: Aid-in-dying laws and the physician’s duty to inform

Why do so many people assume that any clinical communication about aid-in-dying (AID, also known as assisted suicide), where it is legal, ought to be patient-initiated? Physician participants in my ongoing study tend to assume that physicians should wait for patients to initiate discussions of AID. The clinical ethics literature on communication about AID has reinforced this expectation by focusing on how to respond to patient requests. Consequently, bioethics has largely remained silent on whether there is a professional duty to inform terminally ill patients about AID laws and their clinical and legal requirements.

As a medical anthropologist, I pay attention to such gaps in professional discourse, as they often indicate ideas that are so taken for granted that they escape formal expression. In this case, bioethics’ silence on professional obligations to inform patients about AID suggests to me that initiating such a discussion is widely viewed as dangerous. But why? My recent article in the Journal of Medical Ethics began with this puzzling question.

In the United States, where my research is based, in addition to many other Western societies, there is a pervasive cultural stigma against talking about death, as described in the Institute of Medicine’s 2014 Report on Dying in America. Yet there is something bigger at stake here for physicians, who may be more accustomed than most people to talking about death and dying: the idea that mentioning the possibility of hastening one’s death can be deeply injurious to the patient and the patient-provider relationship.

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

M[Emory] Enhancement and its Implications

By Shweta Sahu
Imagine a situation in which you suffer from severe anterograde amnesia, a form of short term memory loss, and can’t recall information presented to you even 7 seconds before– let alone being able to remember the one thing you went to Target to buy, but forgot. Such is the case of Clive Wearing, a man known for his lack of short term memory. His wife notes, “you ask him a question and he’ll give you an answer but while he’s giving me the answer, he’s already forgotten the question. That’s how short it is.” He himself notes “the brain has been totally inactive—day and night the same—no thoughts at all.” Though this is one of the most severe cases of amnesia observed, it underscores how crucial memory is not only to every day functioning, but also for one’s sense of self. Autobiographical memories and the ability to recall these emotional and important events are an integral component of one’s identity. These events, in turn, get tied into personal narratives that our personalities are built on. In the case of Mr. Wearing, he is stuck in this personality because of the damage to his hippocampus and closely related brain regions, an area of the brain necessary for transferring information from short term to long term memory. As a result, he reports that he feels like he is dead and is constantly waking up into a new reality.
Video courtesy of YouTube

Realizing how significant memory is one thing, but the ability to recover or enhance memory is another.

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

Doctors Consider Ethics Of Costly Heart Surgery For People Addicted To Opioids

Cardiologists, surgeons and infectious disease doctors can fix the infection, but not the underlying problem of addiction. And when patients who are still addicted to opioids leave the hospital, many keep injecting drugs, often causing repeat infections that are more costly and more challenging to cure

Source: Bioethics Bulletin by the Berman Institute of Bioethics.

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

When No Treatment Exists, Parents Turn to Gene Therapy to Save Their Kids

Families of patients are starting advocacy groups, raising money for research, and founding biotech companies to advance cures for rare diseases

Source: Bioethics Bulletin by the Berman Institute of Bioethics.

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.