Morning Ethics Warm-Up I Expected Not To Get Posted In The Morning, 3/26/2021: “Ouch!” Edition

Dentist

Therein lies a tale

I arrived at the appointed time for my triple tooth extraction to be told that I would be required to pay the entire cost of my surgery on the spot, and the amount was a cool $4000. This, despite the fact that I had been told (by the doctor) that I could wait before deciding on the various treatment options, and having not received clear (to me, at least) information that the office took no general medical coverage at all, just dental insurance, and my dental insurance was not among the blessed. (Raising the related issue of why my dentist would refer me to an oral surgeon who did not accept the insurance that the dentist did, without alerting me in advance. “We tried to call you,” the snotty desk staff said. Really? I had no messages on my home or office lines. “We only call our patients on their cell phones,” I was told. Then why do you ask for the other numbers? If you have essential information to convey, and you can’t reach a patient by cell, why wouldn’t you try the other contact options? Where on the form does it say that the only number you will use is the cell phone? I only included the cell number because it was asked for: I use cell phones when traveling, period, and during the lockdown it is usually uncharged. If I am going to be expected to hand over 4 grand on the spot, I need to be told, and the information I provided gave an easy means to tell me. What I suspect is that the 20-somethings behind the desk, living on their smart phones themselves, would never dream that anyone wouldn’t do the same. It wasn’t a policy, it was an unwarranted and incompetent assumption.

I informed the staff that its conduct was unethical and unprofessional, and that its attitude was arrogant and obnoxious. Then I walked out. I don’t care if the next oral surgeon costs as much or more: I don’t trust people who treat me like this. Screw ’em.

1. It’s a banner day in the history of “the ends justifies the means” medical ethics! On this date in 1953, American medical researcher Dr. Jonas Salk announced on national radio that he had successfully tested a vaccine against poliomyelitis, the virus that causes polio. Salk had conducted the first human trials of his vaccine on former polio patients, on himself, and his family. The general consensus among ethicists is that self-experimentation is ethical: as one scholarly paper put it, “Organizational uncertainty over the ethical and regulatory status of self-experimentation, and resulting fear of consequences is unjustified and may be blocking a route to human experiments that practicing scientists widely consider appropriate, and which historical precedent has shown is valuable.” But using one’s family as guinea pigs? Unethical, absolutely. The researcher, in this case Salk, has undue influence over such subjects, and consent cannot be said to be voluntary.

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Home-Grown Mengeles, And What We Must Learn From Them

Josef Mengele: researcher, utilitarian, monster

We knew, or should have known, that this extremely ugly shoe was bound to drop eventually.

Last autumn, when the U.S. apologized for federal doctors infecting prisoners and mental patients in Guatemala with syphilis 65 years ago, it put us on notice that a vile and unethical cultural standard had taken hold of the American medical and scientific communities in the 20th century, one that held  it was “right” for the weakest, most powerless and most disposable of human beings to be tricked, coerced or bribed into serving as subjects for experiments that could lead to miraculous cures and treatments for the rest of the population. This–depriving human beings of their rights and lives in the interest of science—is “the ends justify the means” at its worst. But the Guatemala experiments proved that this was once flourishing and respectable in the U.S. scientific and medical research communities, so it would have been surprising if there weren’t more stories of home-grown Mengeles, and sure enough, there were. The U.S. acknowledged as much when it apologized for the Guatemalan tests. Now we have details. Continue reading