Tag Archives: doctors
A recipient of Great Britain’s national health care, infant Charlie Gard was born with a rare genetic condition resulting in what is probably irreversable brain damage. He cannot move his arms or legs, eat or even breathe without a ventilator.
After 10 months of being kept alive, Charlie’s caretakers, the Great Ormond Street Hospital for Children in London, announced that it was time for Charlie to die. Chris Gard and Connie Yates, Charlie’s parents, wanted to take him to the United States to try an experimental treatment available here. The doctors at the hospital refused to allow them to take the child, and vetoed their decision, even though the parents had received sufficient funds from donations to pay for the effort. In the resulting lawsuit, British courts sided with the hospital. The parents then brought the case to the European Court of Human Rights, which declined to hear the case last week. The previous court rulings that it was in Charlie’s best interest to withdraw life support and that the state, not the parents, got to make this life and death decision stood.
The parents, Chris Gard and Connie Yates, appeared on a video this week,, sobbing and saying their son would be removed from life support at the hospital. “He’d fight to the very end, but we’re not allowed to fight for him anymore,” Gard said in the video statement. “We can’t even take our own son home to die.”
Initially, the hospital would not delay the fatal disconnection of the child from life support so family members could gather and say goodbye. It has since relented.
Observations: Continue reading
Two Unethical And Unconstitutional Laws On Guns, One From The Right, One From the Left, Bite The Dust. Good.
As last year’s flat-out demagoguery about banning gun ownership for citizens placed on the FBI’s no-fly list proved, Democrats will never let the Constitution get in the way of an emotion-based attack on gun rights. A rule implemented by former President Obama after the 2012 Sandy Hook shooting (“WE HAVE TO DO SOMETHING!!!”) would have required the Social Security Administration to report the records of some mentally ill beneficiaries to the FBI’s National Instant Criminal Background Check System. Those who have been deemed mentally incapable of managing their financial affairs — roughly 75,000 people — would have then been prevented from owning guns.
The American Civil Liberties Union and advocates for the disabled opposed the restriction, which was so broadly drawn that an Asperger’s sufferer could have his Second amendment rights taken away. And what, exactly, is the link between not being able to handle one’s financial affairs and violence? Hell, I can barely handle my financial affairs.
By a 57-43 margin, the Republican-led Senate voted last week to repeal the measure, and it now heads to the White House for President Trump’s signature.
Iowa Sen. Chuck Grassley, a leading Republican critic of the rule, said that it was filled with “vague characteristics that do not fit into the federal mentally defective standard” that could legally prohibit someone from buying or owning a gun. “If a specific individual is likely to be violent due to the nature of their mental illness, then the government should have to prove it,” Grassley said
Sen. Chris Murphy, a Democrat from Connecticut where the Sandy Hook massacre occurred, and thus obligated to grandstand regardless of the fact that he’s on shaky 2nd Amendment, 5th Amendment and also Equal Protection ground, declaimed on the Senate floor,
“The [Congressional Review Act] we have before us today will make it harder for the federal government to do what we have told them to do for decades, which is to put dangerous people and people who are seriously mentally ill on the list of people who are prohibited from buying a gun….If you can’t manage your own financial affairs, how can we expect that you’re going to be a responsible steward of a dangerous, lethal firearm?”
Well, I guess nobody in Congress should own a gun either, right, Senator? Continue reading
The Doctor, The Emergency And The Flight Attendant: A Depressing Ethics Tale With No Ethical Resolution In Sight
Tamika Cross, a young OB-GYN flying Delta from Detroit to Minneapolis, heard flight attendants calling for medical assistance when a passenger man two rows in front of her was found to be unconscious. Dr. Cross raised her hand, only to be told, according to Cross’s subsequent Facebook post on the incident, “Oh no, sweetie, put your hand down. We are looking for actual physicians or nurses or some type of medical personnel. We don’t have time to talk to you.”
Cross says she tried to explain that she was a physician, but was “cut off by condescending remarks,” from the attendant. A moment later, when there was a second call for medical assistance and Cross again indicated that she was ready to help, the same flight attendant said, according to Cross, “Oh wow, you’re an actual physician?” She then quizzed Cross about her credentials, area of practice, and where she worked. In the meantime, a white, middle-aged male passenger appeared, and Cross, she says, was dismissed.
On her now viral Facebook post, Dr. Cross concludes:
“She came and apologized to me several times and offering me Skymiles. I kindly refused. This is going higher than her. I don’t want Skymiles in exchange for blatant discrimination. Whether this was race, age, gender discrimination, it’s not right. She will not get away with this….and I will still get my Skymiles….”
What’s going on here?
1. This was an emergency situation.
2. Dr. Cross sincerely felt insulted and treated with disrespect.
3. She also feels that she was the victim of stereotyping,, bias and prejudice.
4. Her account can be presumed to be an honest recounting of how she experienced the episode.
5. The Roshomon principles apply. We do not know how the flight attendant perceived the situation as it developed, and will never know, since the incident is already tainted with accusations of racism.
6. This was an emergency situation.
7. There is no way to determine what the flight attendant was thinking.
8. Despite all of the above, observers, analysts and others will be inclined see the event as confirmation of their own already determined beliefs and assumptions.
9. This was a single incident, involving a set of factors interacting in unpredictable ways.
Next, some ethical observations…. Continue reading
“If Melania’s speech is similar to Michelle Obama’s speech, that should make us all very happy because we should be saying, whether we’re Democrats or Republicans, we share the same values. If we happen to share values, we should celebrate that, not try to make it into a controversy.”
—Dr. Ben Carson, making an absurd but original argument to justify Melania Trump’s plagiarism.
Observations while I clean up bits of my skull and brain and get the superglue: Continue reading
Sandeep Jauhar is a cardiologist, the author of “Doctored: The Disillusionment of an American Physician” and “Intern: A Doctor’s Initiation.”and a contributing op-ed writer for the New York Times. He recently penned a column for the paper that raised concerns about threats to doctor-patient confidentiality, specifically from the case, in Washington state, of Volk v. DeMeerleer.
Howard Ashby, a psychiatrist, was sued after his patient, Jan DeMeerleer, shot and killed an ex-girlfriend and her 9-year-old son before shooting himself. The estate of the victims, Rebecca and Phillip Schiering sued Dr. Ashby, alleging that he breached a duty to warn DeMeerleer’s victims even though the killer had made no specific threats toward the Schierings during his treatment. Last year, however, that judgment was reversed by an appeals court, which held that doctors could be required to warn “all foreseeable victims” of their potentially dangerous patients in their care.
It’s a terrible decision, and Jauhar does a good job explaining why. Unfortunately, he also writes this..
“I once took care of a business executive in the emergency room who had hired call girls during a weekend drug binge. When he saw a police officer outside his room, he quietly handed me an envelope containing a large amount of white powder. I wasn’t sure what to do with it, so I discarded it. For the next several hours the patient eyed me suspiciously, probably wondering whether I had ratted him out. But it never occurred to me to do so.”
Well, it should have. Confidentiality is one thing, assisting in a crime is another. The Hippocratic Oath says“What I may see or hear in the course of treatment, I will keep to myself.” That only means, however, that doctors who learn about criminal activity a patient may be involved in is bound not to report it (lawyers have the same obligation). Jauhar did more than not report criminal activity; he participated in it. He crossed the line by disposing of contraband. Continue reading
“A few moments later, the anesthesiologist walks in the room and asks, ‘What do you got?’ Dr. Canby says, ‘Vaginal delivery. Uterine atony. External massage failed. Give her some ketamine.’”…I look at Mrs. Lopez—her eyes are half-closed and vacant. Dr. Canby instructs me to hold her knee. A fellow medical student holds her other knee….Canby then performs an internal bimanual uterine massage. He places his left hand inside her vagina, makes a fist, and presses it against her uterus. I look down and see only his wrist; his entire hand is inside her. Canby puts his right hand on her abdomen and then massages her uterus between his hands. After a few minutes, he feels the uterus contract and harden. He says something like, ‘Atta girl. That’s what I like. A nice, tight uterus.’ And the bleeding stops. The guy saved her life…But then something happened that I’ll never forget. Dr. Canby raises his right hand into the air. He starts to sing ‘La Cucaracha.’ He sings, ‘La Cucaracha, la cucaracha, dada, dada, dada-daaa.’ It looks like he is dancing with her. He stomps his feet, twists his body, and waves his right arm above his head. All the while, he holds her, his whole hand still inside her vagina. He starts laughing. He keeps dancing. And then he looks at me. I begin to sway to his beat. My feet shuffle. I hum and laugh along with him. Moments later, the anesthesiologist yells, ‘Knock it off, assholes!’ And we stop.”
This is an operating room anecdote related in an anonymously authored article published this week in the Annals of Internal Medicine, a respected medical journal. The publication says that the piece is intended to shine light in a dark corner of the medical profession. Oh-oh. The essay is anonymous, I assume, because the author is afraid that there would be professional repercussions from his revealing this—what? Bad habit? Dirty secret? Crime? Reason for us to go stark, raving mad? Continue reading