Tag: radiology

Bioethics Blogs

In Defense of a Physician’s Right to Conscientious Objection, Part 2

Guest post by Cheyn Onarecker, MD

Today, I am continuing my comments on the recent editorial against conscientious objections from the New England Journal of Medicine (subscription required). My previous objections to the elimination of protections for conscientious objections included: 1) the importance of maintaining the traditional balance that has always existed between the needs of the patient and the physician, and 2) the fact that medical societies make decisions on the acceptability of certain procedures that are influenced by society and do not represent the views of a large percentage of its members. I will now add a couple more reasons.

Third, it is impractical and unreasonable to demand that persons considering a career in medicine should be prepared to violate their moral convictions. When the Church Amendment was passed in 1973, allowing physicians to be exempt from performing abortions, there was no outcry from the AMA or any other medical society denouncing the law or declaring that rights of conscience were unethical. Since then, the number of laws and provisions to protect conscience rights have increased, not decreased. Philosopher Mark Wicclair explains that modern medicine, in general, has accepted the right of conscientious objection, and no young person entering medicine today believes that their moral and religious convictions are incompatible with a career in medicine. In fact, the AMA issued a directive to medical schools to excuse students from performing activities that violate their ethical beliefs. Not only that, but how would physicians be able to predict that someday their chosen specialty would develop a controversial treatment?

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

The Medicalization of Mental Illness in Gun Violence

By Carolyn C. Meltzer, MD
Dr. Meltzer serves as the William P. Timmie Professor and Chair of the Department of Radiology and Imaging Sciences and as the Associate Dean for Research at the Emory University School of Medicine. Her work focuses on applying novel advanced imaging strategies to better understand brain structure-function relationships in normal aging, late-life depression, and Alzheimer’s disease. She is also involved in oncologic imaging research and, while at the University of Pittsburgh, oversaw the clinical evaluation of the world’s first combined PET/CT scanner. She established the Emory Center for Systems Imaging to broadly support the advance of imaging technologies in basic and translational research, including beta testing of the first human combined MRI/PET scanner. Dr. Meltzer has also served as the Chair of the Neuroradiology Commission and Chair of the Research Commission on the American College of Radiology’s Board of Chancellors, President of the Academy of Radiology Research, Trustee of the Radiological Society of North America Foundation, and President of the American Society of Neuroradiology.
On January 6, 2017, a young man pulled a semiautomatic handgun from his checked baggage and shot and killed several passengers in the Fort Lauderdale airport. In the days following the incident, information about erratic behavior and his prior involvement in incidents of domestic abuse emerged.
Image courtesy of Wikimedia Commons

The US has the highest rates of both gun-related deaths and mass-shooting incidents. In the latest available statistics from the Center for Disease Control and Prevention (CDC), 33,304 people were killed by firearms in 2014. Over the past decade (2007-2016), there have been 16 mass shootings in the US (Mother Jones’ Investigation: US Mass Shootings 1982-2016), including several — at Virginia Tech, an Aurora theatre, the Sandy Hook Elementary School, Charleston’s Emanuel African Methodist Episcopal Church, and the Pulse nightclub in Orlando – that drew substantial national attention.

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

Are Your Healthcare Prices Outrageous? Here’s What Happens When Prices Come Out Of The Dark

They both had shoulder pain, persistent despite weeks of physical therapy. Both received MRI examinations at reputable radiology facilities, looking for things like rotator cuff tears, labral disruptions and other anatomical abnormalities. What was different was the price they paid … Continue reading

The post Are Your Healthcare Prices Outrageous? Here’s What Happens When Prices Come Out Of The Dark appeared first on PeterUbel.com.

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

Web Roundup: Public Health by Lily Shapiro

I assume everyone is, like me, tired of (and stressed out about) the US election, so let’s take a break from that to take a quick look around at some interesting recent public health stories.

According to data released last month by the Institute for Health Metrics and Evaluation at the University of Washington, the maternal mortality rate in the US is rising, “defying global trends.” In a related article, Newsweek has a long piece on the ways that racism disproportionately disadvantages women of color in terms of maternal health care, exposing them to riskier pregnancies and deliveries; “even when controlling for age, socioeconomic status and education, the U.S. Centers for Disease Control and Prevention (CDC) reports that African-American women…face a nearly four times higher risk of death from pregnancy complications than white women.”

New research published in Radiology shows that playing football can affect the brains of children as young as 8. And, CMV Is a Greater Threat to Infants Than Zika, but Far Less Often Discussed.

Many of you perhaps heard about the fact that Médecins Sans Frontières this month turned down a donation of one million Prevnar13 vaccines from Pfizer. Prevnar13 is a vaccine which protects against a particular bacteria that causes pneumonia, the leading cause of death of children under 5 (1.4 million deaths per year), and is recommended for all infants. Pfizer makes USD 6.245 billion in revenue per year from this drug alone, but it is too expensive for MSF to purchase regularly. This article in The Atlantic details the problems with donations of this kind, the reasons for which MSF turned it down, and the opacity of vaccine prices on the global market.

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

Smarter Artificial Intelligence: A Not So Obvious Choice

By Shray Ambe


This post was written as part of a class assignment from students who took a neuroethics course with Dr. Rommelfanger in Paris of Summer 2016.

My name is Shray Ambe and I am a rising senior at Emory University. I am a Neuroscience and Behavioral Biology major who is pursuing a career in the medical field. Outside of the classroom, I am involved in organizing the booth for Emory’s Center for The Study of Human Health at the Atlanta Science Festival Expo every year and also enjoy volunteering at the Emory Autism Center and the Radiology Department at Emory University Hospital. 
At the 2016 Neuroethics Network in Paris, France, bioethicist and philosopher John Harris gave a lecture titled “How Smart Do We Want Machines to Be?” During his lecture, Harris discussed the potential impacts of artificial intelligence (AI) and stated “it doesn’t matter how smart they are; obviously the smarter the better.” But is smarter AI really “obviously” better? 
Renowned American inventor Ray Kurzweil has described the use of AI as the beginning of a “beautiful new era” in which machines will have the insight and patience to solve outstanding problems of nanotechnology and spaceflight, improve the human condition, and allow us to upload our consciousness into an immortal digital form, thus spreading intelligence throughout the cosmos. Kurzweil’s views on AI extoll the virtues of such technology and its potential to enhance the human race with its endless possibilities. However, his views also raise concerns about how such technology can not only be detrimental to the human condition, but also put its very existence at risk. 

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

In the Journals – June 2016, Part II by Anna Zogas

We have three special issues to conclude our highlighting of new articles in June! Here they are:

  • Surveillance and Embodiment: Dispositifs of Capture, in Body & Society
  • Perspectives on patienthood, practitioners and pedagogy, in Medical Humanities
  • Childbirth and Reproduction, in Sociology of Health & Illness

And, if you’re looking for more to read, the first part of this month’s roundup is here.

Body & Society

Surveillance and Embodiment: Dispositifs of Capture
Martin French, Gavin JD Smith 

This article provides an introduction to a special issue of Body & Society that explores the surveillance-embodiment nexus. It accentuates both the prevalence and consequence of bodies being increasingly converted into ‘objects of information’ by surveillance technologies and systems. We begin by regarding the normalcy of body monitoring in contemporary life, illustrating how a plurality of biometric scanners operate to intermediate the physical surfaces and subjective depths of bodies in accordance with various concerns. We focus on everyday experiences of bodily intermediation by surveillant dispositifs, and consider the broader political, epistemological, and ontological significance of these processes. We then point to the substantive intersections and divergences existing between body and surveillance studies. We conclude with an overview of the five articles appearing in this special issue. We describe how each contribution creates a template for imagining what a body is, and what a body might become, in a culture defined by proliferating data sharing behaviours, systems of codification, and practices of intermediation.

Surveillance, Privacy and the Making of the Modern Subject: Habeas what kind of Corpus?
Charlotte Epstein

In this article I consider how our experiences of bodily privacy are changing in the contemporary surveillance society.

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

Pediatric Clinical Ethics Summer Internship (Minneapolis)

Proudly serving as Minnesota’s children’s hospital since 1924, Children’s Hospitals and Clinics of Minnesota, is the eighth-largest pediatric health care organization in the U.S. 

Each year, Children’s provides care through nearly 13,000 inpatient visits and more than 200,000 emergency room and other outpatient visits. An independent, not-for-profit health care provider, Children’s has 319 staffed hospital beds and services available in all major pediatric specialties: emergency care; newborn and pediatric intensive care; outpatient and inpatient surgery; diagnostic services, including radiology and laboratory; and special programs in the areas of respiratory, cardiology, cancer, premature birth, adolescent development, child abuse, and epilepsy. 

This internship (June – August) will provide an introduction to clinical, research and/or organizational ethics for qualified individuals with a particular interest in pediatric clinical ethics. In addition, to provide opportunities for qualified candidates to work on department based projects, develop potential publication opportunities, and work on personal interest research.

Clinical Ethics Internship Requirements:

  • Attend Ethics Case Consultations and Care Conferences
  • Round with the Clinical Ethicists in the Intensive Care Units and with other clinical services.
  • Attend educational sessions sponsored by the Office of Ethics.
  • Attend all meetings of the Bioethics Committee and Subcommittees.
  • Develop a personal research project for presentation at final Bioethics Committee meeting.
  • Attend the IRB meetings with Clinical Ethicists to understand research ethics
  • Participate in directed reading program developed with senior leadership in the Office of Ethics
  • Light office administrative work as needed

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

What Physicians Can Learn from Veterinarians

Photo Credit: Rebecca Plevin / Marketplace

A while back, I linked to a story by Rebecca Plevin, out of California Public Radio, on the challenge of discussing health care costs.  Well, she has tuned up that piece and placed it on Marketplace. Here is a print version:

When a doctor prescribes a medication, most of us don’t ask how much it’ll cost. It makes sense: for a lot of people – both doctors and patients – talking about the cost of care is a totally foreign concept.

Peter Ubel is the perfect person to explain why that is. He’s a physician who now teaches at Duke University, specializing in the overlap of ethics, behavioral economics and medicine.

“Not that long ago, if a person had insurance, they had really good insurance that covered the vast majority of the expenses,” Ubel says. “So there really wasn’t much to talk about when it came to money.”

But these days there’s a lot more to talk about. The Kaiser Family Foundation says last year, 80 percent of people who got insurance through their job still faced an annual deductible that could run as high as $3,000 or more.

That means we all have skin in the game now, Ubel says.

“When the doctor recommends one medication to us, we might have reason now to ask whether another medicine would be almost as good and a lot cheaper,” he explains.

That type of conversation is still rare, but it is happening in at least one medical field.

At Mohawk Alley Animal Hospital in Los Angeles, Dr.

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

Thinking About the Body Through Visual Art

Readers of the Literature, Art & Medicine Blog may remember me as the first Artist in Residence at NYUSOM, or as the creator and teacher of Art & Anatomy in the Master Scholars Program in Humanistic Medicine [previously] [interview]. You may have seen my own or my students’ work on exhibit in the MSB (Medical Science Building) Gallery at NYU Langone Medical Center, or read Founding Editor Felice Aull’s insightful annotation of my work in the Database. Coming to the world of medicine as an artist, patient, and inhabiter of an unusual anatomy, I’ve been honored to have a voice in the humanistic medicine dialogue. Today I’m writing to introduce myself in a new role that I’m excited to take on, as the new Art Editor of the revamped, redesigned LitMed Database and Blog.

My first task as art editor was to find an image to represent Visual Art on the website’s new landing page. It was a challenge, but a fascinating one … and in the end I was happy to find the solution not in one perfect image but in bringing together this set of four. They represent an intriguing spectrum of cultures, time periods, media, and ways of thinking about the body, each gaining a deeper resonance by being juxtaposed with the others.

left to right: Laura Ferguson, Pavel Tchelitchew, Sopheap Pich, Leonardo da Vinci
more information and links to each image can be found at [insert link to Database page]

In each of these artworks, an image of the head or the brain is imbued with a sense of consciousness, an awareness of its own embodiment.

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

Multidisciplinary Learning for Medical Students

The clerkship years of medical school expose students to a
range of specialties medical practitioners may select as an area of advanced
study during residency. Pediatrics, surgery, general medicine, radiology,
psychiatry, and more are part of the array of educational exposures students
gain from during these rotations. As an educator facilitating discussion groups
which provide the opportunity for reflection, questioning, and connecting
expectations to the actual experiences, I have found that there are gaps in
understanding the roles of other personnel that are essential to the physician
role, but not always well defined. As we strive to encourage future physicians
to do their best to understand that the business of medicine takes a small
village of practitioners in order to work best, we do too little to help them
learn the perspective of these other providers. Lectures and readings may offer
some insight, but the street-level day to day operations may be a bit of a
mystery. I propose clerkship years include time spent working alongside professionals
beyond physicians such as pharmacists, billing specialists, security guards,
social workers, lab technicians, and visiting nurses. While learners may not be
able to fully walk in the shoes of other essential staff members, but being
alongside another who is willing to teach and share the tasks, the struggles
and rewards of their position. Many med students will someday be in position to
lead large groups of staff members in clinics, hospitals, and private offices.
Recognizing the unique roles, strengths, and limitations of the non-physicians
who contribute to the day to day operations of our vast healthcare industry
will help build well rounded doctors who are prepared to be effective leaders. 

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.