“first do no harm”

No, Doctors, “Do No Harm” Does Not Mean “Make Anti-Israel/Gaza War Statements in Your Hospital”…

/ Jack Marshall / 9 Comments

We knew, or should have, that the medical profession was not immune from the ethics rot brought upon us by the advent of The George Floyd Freakout, the 2016 Post-Election Ethics Train Wreck, The Great Stupid (and its DEI sub-cult) and the rest. Here is a throbbing example.

At the University of California, San Francisco, one of the nation’s most respected medical schools and teaching hospitals, medical students and doctors have been protesting the war in Gaza. Chants of “intifada, intifada, long live intifada!” could be heard by patients in their hospital rooms at the U.C.S.F. Medical Center. It doesn’t really matter what the chants were: they could bebeen “Hey, hey, LBJ, how many kids did you kill today?” (one of my personal favorites.) Medical personnel should never promote political views in a hospital. Why isn’t that obvious?

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Horrifying Or Hilarious? Joy Behar Delves Into Medical Ethics

/ Jack Marshall / 11 Comments

Even though more than the usual number of mainstream media lackeys have been willing to suck it up and admit that the Fetterman-Oz debate last night was a disaster for Democrats, enough integrity-free hacks have reached for way to blame everyone but the candidate. But as Leo Bloom memorably said when his scheme failed in “The Producers,” “No way out…no way out….” This can’t be blamed on anyone but John Fetterman, his party and his staff. He should have withdrawn after his stroke in May. He should have been transparent about his medical condition. If he couldn’t talk right, and couldn’t process what he heard, then he should have just said he wasn’t capable of debating, and let voters deal with that as they chose. Instead, he subjected listeners to these painful moments:

I was preparing a post on the absurd lengths Democrats and journalists are going to try to minimize the damage., and then stumbled upon what Joy Behar added to the whitewash effort on “The View.” This deserves a special spotlight. It is not only the dumbest attempt to help Fetterman, it is not only peak commentator stupid, but it is peak “The View” stupid and peak Joy Behar stupid as well.

Today she said—I wouldn’t kid you:

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Monday Ethics Cool-Down, 7/27/2020: Lots of Stuff Hanging Around The Runway

/ Jack Marshall / 18 Comments

I have a long night of work ahead of me, so I don’t know what time it is.

Or care.

1. Res ipsa loquitur.  Oopsie! “Health company apologizes for falsely telling 600,000 US military members they were infected with coronavirus”

Tricare apologized for a poorly worded email that implied the recipient had  been infected with the Wuhan virus.

I guess the writer was a Rutgers English major.

On the bright side, it is better to get a false positive than a false negative.

2. Schadenfreude Alert! Seattle radio host  Paul Gallant  mocked President Donald Trump last month for suggesting Seattle’s riots were violent. Then, last night, the “mostly peaceful” demonstrations got his Starbucks. HIS STARBUCKS!!!

“I feel like I need to buy a firearm, because clearly this is going to keep happening. Enough is enough,” Gallant he added.

It was enough a long time ago, you pathetic jerk.

3.  Boy, when you can’t even trust the sports reporters…ESPN tweeted a video over the weekend of players from the WNBA’s New York Liberty and the Seattle Storm leaving the court, and wrote, “As the national anthem was played, the @nyliberty and @seattlestorm walked off the floor as part of the social justice initiative.” For this display, the women were roundly criticized.

Then ESPN tweeted  “Correction: Players left the court before the national anthem was played, not during.” That’s what I call a material mistake.

Nevertheless, at last checking,  the original misleading tweet is still up.

4. This is presumably justifiable because all cops in New Jersey are racists, as proven by the fact that a non-racist cop in Minneapolis killed a black man.  Kevin Trejo, 21, of Westwood, New Jersey has been arrested for  spitting into the coffee of a police officer at Starbucks.  Police have evidence  that Trejo had done this repeatedly with officers.  Trejo claims to have only done it just once. Oh! Well that’s OK, then!

Question 1: Is this a violent offense?

Question 2: Why would any police officer chance ordering a beverage at Starbucks? Continue reading →

Ethics Quiz: Therapist Biases And Ethics Confusion

/ Jack Marshall / 25 Comments

(Boy, does this freak disgust me...)

(Boy, does this freak disgust me or what...)

The Tennessee Senate’s Senate Health and Welfare Committee members have overwhelmingly approved a proposed bill that seeks to protect  therapists from 2014 changes in the American Counseling Association’s Code of Ethics. The Code decrees that “counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs and behaviors.” The bill, however, will allow practitioners to refuse to accept a patient without legal or professional penalties as long as they refer the individual  to another qualified professional.

The Tennessee Association for Marriage and Family Therapists opposes the legislation, saying “This bill is in direct opposition to the ethical code of the American Association of Marriage and Family Therapy and potentially harmful to clients,” the group said in a statement. “Our mandate to do no harm to the consumer, we believe, would be violated.” A therapist who testified before the committee opined that “they can keep their belief system and still offer good counseling but not based on their religious beliefs.” Others have objected to a legislative body dictating professional ethics.

Your Ethics Alarms Ethics Quiz today is…

Is the proposed bill reasonable and ethical, or just a way to allow bigoted counselors to discriminate?

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Jessica Rabbit Ethics

/ Jack Marshall / 21 Comments

From Left: Jessica, Pixie Before, Pixie After

                          From Left: Jessica, Pixie Before, Pixie After

Who could have predicted, when “Who Framed Roger Rabbit?” opened in theaters, that one of its greatest legacies would be a continuing obsession of young women to emulate her exaggerated, uh, features? Yet here is another example—and there have been quite a few—of a woman mutilating herself in pursuit of looking like the sexy Toon.  Model Pixee Fox—I’m sure that’s her real name—wore a waist-training corset for 24 hours a day and spent $120,000 on various cosmetic procedures including a recent operation to have six of her ribs removed in order to achieve Jessica’s apparent 48-14-40 figure.

“I’ve always been inspired by cartoons and Disney movies, all the curves and tiny waists,” Fox told reporters. “People often, they come up to me and say, ‘Don’t take this the wrong way, but you look like a cartoon.’ For me that’s a compliment. My inspiration started with Tinkerbell, but with my transformation, I’ve been starting to look like Jessica Rabbit.”

If you say so, Pixee!  Pixee is ill, it’s fair to say, so the ethical issues fall on the shoulders of  Dr. Barry Eppley, the Indiana surgeon who admits handling Fox’s surgery and also defends it.

I covered this the last time Ethics Alarms covered a wannabe Mrs. Rabbit (Jessica is a human Toon married to a member Leporidae Family). In that case, the happy aspiring Toon looked like this when all was done…

Lips Continue reading →

Religion + The Right Of A Woman To Control Her Own Body=Murder

/ Jack Marshall / 31 Comments

[I am tired, having engaged in a knockdown, drag-out session on legal ethics with a lively group of Federal bar practitioners. This was not the issue I wanted to come home to for the last post of the day. In fact, I gave up and am posting it this morning. Funny, the issue isn’t any easier now than it was yesterday.]

Charles Taze Russell, founder of Jehovah's Witnesses, and still getting kids killed since 1879.

Charles Taze Russell, founder of Jehovah’s Witnesses, and still getting kids killed since 1879.

A pregnant woman who was a Jehovah’s Witness checked into a Sydney, Australia hospital suffering from leukemia. She directed the staff that her treatment could not include blood transfusions, as her religious beliefs forbade them. She suffered from acute promyelocytic leukemia (APL), which is treatable, and often successfully. According to The American Cancer Society, “more than 90% of patients with APL go into remission with standard induction treatment.” Pregnant women with the cancer have an 83 percent remission rate, and their babies have a high rate of survival when their mothers are diagnosed in their second or third trimesters.

In the end, the fetus and the mother died for want of proper treatment.  “Staff were distressed, grappling with what was perceived as two ‘avoidable’ deaths,” doctors at the Prince of Wales Hospital in Australia wrote in a letter published this month in the Internal Medicine Journal.

Well, they should be distressed: they aided and abetted negligent homicide.  Continue reading →

Advice Malpractice: Good Advice Columnist, Bad Advice Columnist

/ Jack Marshall / 22 Comments

"Go jump in a lake!"

“Go jump in a lake!”

I cannot imagine being so bereft of wisdom, friends and mentors that I would ever be moved to ask a stranger to advise me regarding an important decision based solely on a letter describing my problem. Nevertheless, a lot of poor souls apparently do, and because they do, many of them probably act on the advice they get from Beth, Abby, The Ethicist and the rest. This means that anyone with the ego and chutzpah to hold themselves out as qualified to give such advice is ethically obligated to be able to do a competent job at it, and at very least to “do no harm.” Yes, unlike the law, advice columnist is one of the professions where the traditional ethical mission of medicine is not just appropriate, but essential.

Most advice columnists in the media are not competent, and some are dangerously reckless. The worst thing an advice columnist can do is to use the trusting and needy stranger as a potential recruit to steer toward the columnist’s ideologically-driven goals. The question being asked by desperate advice seekers, after all, is not “What would you do?” but rather “What should I do?” If the columnist answers the question presuming that the advice-seeker does or should see the world as the advice columnist does, then doing harm is the likely result.

Carolyn Hax ( Washington Post) is a wonderful advice columnist, and Emily Yoffe (“Dear Prudence”) is the other kind. Two recent responses by them illustrate the distinction between competent, skilled and ethical advice, and advice column malpractice. Continue reading →

Ashley Judd, Hillary Clinton, and Celebrity Malpractice

/ Jack Marshall / 30 Comments

Mount Rushmore

I had hoped to have my “Celebrity Code of Ethics” complete for this post, but it isn’t, so I’ll just allude to some of its likely provisions.

I like Ashley Judd, I really do. I’m not sure why she never became the reigning female light drama star of her generation; she’s every bit as good as Sandra Bullock or Julia Roberts, and that voice! Now she’s routinely relegated to repetitious action movies and will be playing Jennifer Lawrence’s mother any day now—oh well, that’s show biz. Judd is also more articulate and intellectually curious than the average celebrity, so it was with great pain and disappointment that I learned that she had recently said this, in an interview with Larry King, about the presidential prospects of Hillary Clinton:

“I think she might be the most overqualified candidate we’ve had since – you know, Thomas Jefferson or George Washington.”

Now, I don’t expect celebrities to be historians or experts on anything  other than their profession and areas of specialty. However, one tenet of celebrity ethics is the same as that of doctors: “First, do no harm.” That means, for someone like Judd, a celebrity has an ethical duty to recognize that a disturbing number of people think that because she is rich and famous, she is necessarily  informed, responsible and wise, as well as a role model, and therefore, unlike the usual drunk on a barstool, when that celebrity says something outrageously ignorant, stupid and misleading, hundreds of thousands of people believe it and align their own beliefs accordingly. That’s harmful, and doing it is unethical. Continue reading →

A Lawyer Argues “Do No Harm” Should Be Added To The Legal Ethics Rules, Thus Proving Herself To Be A Hopelessly Unethical Lawyer

/ Jack Marshall / 12 Comments

This is Alexa. She'll let you know if your client is good or bad, and whether you should help him. Just ask.

This is Alexa. She’ll let you know if your client is good or bad, and whether you should help him. Just ask.

Lawyer Alexa Van Brunt contributed a jaw-dropping op-ed to the Washington Post over the holidays. It was titled “The ‘torture’ memos prove America’s lawyers don’t know how to be ethical,” and argued that the legal profession needs the equivalent of the medical profession’s “First do no harm” ethical standard.

It was irresponsible for the Post to print such a piece, because it made its readers, most of whom are thoroughly confused about legal ethics already, even more confused. So far, I have yet to find any lawyer who regards Van Brunt’s theory as anything other than laughable, tragic, shocking, or proof that ideology rots the brain. She cannot possibly understand legal ethics or even what the duties of the legal profession are and compose such an embarrassing piece.

Alexa Van Brunt is, we are told, an attorney at the Roderick and Solange MacArthur Justice Center, a Clinical Assistant Professor at Northwestern University Law School and Center, and a Public Voices Fellow with The OpEd Project. This explains a lot. She is a public interest lawyer on a mission, and thus represents only causes that she thinks are good, right and important. Apparently she missed the part of law school where you learn that one of a lawyer’s jobs is to assist non-lawyer clients as they try to accomplish their goals, which they believe are good, right, and important. These often involve engaging in controversies with others, and zero-sum results. Someone is going to suffer “harm.”

In medicine, what “do no harm” means is frequently clear: make the patient better, not worse. There are usually not competing patients, where a limited amount of health must be allotted among suffering human beings. Thus a doctor will not ethically take a healthy heart from a living patient to give to another. In law, however, “Do no harm” would render many disputes beyond legal assistance. Is a defense lawyer who refuses to let a guilty client be convicted by insufficient evidence, jury bias and wrongful interpretation of the law doing harm by freeing a criminal, or is it harm to allow prosecutions to violate due process? Is a real estate lawyer who assists as a company purchases virgin land for the building of a factory doing harm to the environment, or is the lawyer for the environmental group that tries to block it doing harm to the economy?

Van Brunt’s primary focus is the torture issue, but even there, what is “harm” is muddy. Those who supported the use of torture believed that precluding it would place the U.S. population at risk. Alexa defines “harm” as violating international law and the Constitution, but the Constitution, some scholars believe, does not prohibit torture as the CIA practiced it, and in war, doing harm is necessary to win. Who decides whether a litigant who wants to sue for police brutality is going to do harm to public safety, or whether defending a police officer accused of murder will encourage police executions of unarmed men? Who decides, when it comes to  finding that a lawyer violated this new, sensitive ethics rule, what constitutes “harm”?

Why Alexa, of course! She and all those other good people who know with absolute certainty what is right and just in every case—they know what harm is. Just ask them. Meanwhile, client confidentiality is out, because sometimes a lawyer keeping his client’s secrets may cause harm to others. Providing legal advice to banks, defense contractors, auto manufacturers, gun-makers, processed food manufacturers, McDonalds, pharmaceuticals, the Defense Department, the CIA, pro-life organizations (abortion providers don’t harm anyone, of course), the NRA, the Republican Party, this all causes harm…by Alexa’s standards, and she knows best. We don’t need judges or juries, just let the consciences of lawyer and their associations decide which clients are virtuous enough to be worthy of legal representation.

The op-ed is not just absurd, but ignorant and alarming. How can anyone this warped and lacking in understanding of the law and the ethical duties of the profession be teaching at a law school, where she can assist in the minting of new lawyers as ignorant, arrogant and unethical as she is?

Talk about doing harm.

 

Comment of the Day: “‘The Ethicist’ and the Doctor”

/ Jack Marshall / 9 Comments

"Your secret is safe with me, but I have to ask...what that stolen Renoir doing up there?"

“Your secret is safe with me, but I have to ask…what that stolen Renoir doing up there?”

Jeff Long scores his first Comment of the Day with a welcome excursion into the thickets of medical confidentiality. As I expected, many readers were troubled by my support of strict patient-doctor confidentiality as dictates by AMA medical standards. Jeff does an excellent job elaborating on why I (and the professions like law, medicine and the clergy) take the position they do. In professional relationships, trust is essential, and you can trust professions that approve of breaching confidentiality when a damaging secret is involved.

Here is Jeff’s comment, on the post “The Ethicist and the Doctor.”

“First, with regard to Matthew’s example of the cheating spouse who contracts an STD, I think it would probably be difficult to come up with a better example of “the system working as intended.” In the world where doctors respect confidentiality, at least one person gets treated. In the world where the doctor blabs to the world (or at least, to the spouse), there’s a good chance that nobody does. In fact, if the cheater forgoes treatment out of fear of exposure, s/he is putting the spouse at even GREATER risk than in the former scenario, since the STD goes untreated and has a larger window in which to infect the spouse. Certainly, the ideal world is the one where the cheater gets treated AND confesses to the spouse, but the onus for that lies with the cheater. It’s not the doctor’s place. Continue reading →