Tag Archives: medical ethics

Ethics Quote Of The Day: Clinical Psychologist Dr. Jordan B. Peterson [UPDATED]

“Because in order to be able to think, you have to risk being offensive. I mean, look at the conversation we’re having right now. You’re certainly willing to risk offending me in the pursuit of truth. Why should you have the right to do that? It’s been rather uncomfortable. […] You’re doing what you should do, which is digging a bit to see what the hell is going on. And that is what you should do. But you’re exercising your freedom of speech to certainly risk offending me, and that’s fine. More power to you, as far as I’m concerned.”

—–University of Toronto Clinical Psychologist Dr. Jordan B. Peterson responding to a British Journalist who asked him in an interview, “Why should your right to freedom of speech trump a trans person’s right not to be offended?

When the interviewer, Cathy Newman, was unable to muster a response, Peterson said,  “Ha! Gotcha.” To her credit, Newman replied,

“You have got me. You have got me. I’m trying to work that through my head. It took awhile. It took awhile. It took awhile.”

I’ll give her credit for having sufficient integrity to admit that she hadn’t thought the issue through, but that’s all I’ll give her credit for. What Peterson said should be obvious to any half-conscious and minimally educated individual. The episode is less about great truths dawning as the result of a sage’s perceptive words than it is about the relentless shallowness of journalists, making their presumptuous efforts to mold the thought and opinions of anyone else not just ridiculous, but infuriating.

Can you sense that I’m losing patience with journalists today? Perhaps it was hearing this, from non-doctor, non-smart person, fake-news purveyor for anti-Trump shill CNN Alisyn Camerota yesterday:

“So in 2009 the president’s calcium score, before he was president, was 34. In 2013, before he was president, it was 98. Today it’s 133. And as you see from the little cheat sheet, fine print below, a score of over 100 means a high risk of heart attack or heart disease within three to five years.”

…leading to this graphic…

But the President’s physician. asked directly by Dr. Sanjay Gupta, CNN’s medical authority, said he did not:

Never mind. A CNN doctor who has never examined the President feels empowered to contradict the doctor who has, and who is responsible for his health. With any normal patient, Gupta’s conduct would be a breach of medical ethics, interfering with the doctor patient relationship. In this case, since the news media can get away with anything, it’s just one more example of arrogant, unethical journalism, manufacturing fake news.

Or perhaps of wishful thinking.

 

UPDATE: Moments after I posted this, CNN sent me this graphic with Dr. Gupta’s smiling face:

Yeah, I’d like to cut right to the facts, but on CNN, the snark, bias, stupidity and opinion make the facts all but impossible to detect. Talk about irony! What are ‘”facts” to you, Doctor? Indeed, what are “facts” to your whole network?

 

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Morning Ethics Warm-Up, 1/15/18: Icons, Shitholes And Chianti

Good Morning, and Happy Martin Luther King Day.

1 Priorities, priorities…Rep. John Lewis (D-Ga) has made his career out of the fact that he was an associate of Dr. King during the civil rights movement.  On Sunday’s”This Week” on ABC’, Lewis said on he would not vote for legislation that prevents a government shutdown if it did not first resolve the Deferred Action for Childhood Arrivals program. “I, for one, will not vote on government funding until we get a deal for DACA,” the alleged icon said.

That’s right: Lewis, and presumably many of his colleagues, would waste millions of dollars and interfere with life and daily needs of American citizens to obtain a path to citizenship for 800,000 currently illegal residents, and create a permanent incentive for foreign citizens to break our laws so they can get their kids an entitlement.  It’s more important to give illegal residents what they have no right to have, then to ensure legal citizens what their taxes pay for. This is the unethical result when ideology takes precedence over common sense.

2. Fake news also takes precedence, apparently. “Trump’s Words Eclipsing Deal For Dreamers” reads the above-the-fold headline on today’s New York Times. There are many other similar headlines on display. If, in fact, it is true that the President’s (alleged, disputed, reported initially via hearsay, denied by the speaker, and intentionally misrepresented by critics even if the alleged version is accepted) words have a decisive impact on a DACA deal, then the DACA adherents were posturing all along. What difference does it make to DACA what the President says off-the cuff in a private meeting? Apparently it is more important to Democrats and the “resistance” to denigrate the President than to accomplish substantive policy goals. Good to know.

UPDATE: I just read the opinion of conservative blogger Liz Shield after I wrote this. She said,

My position on sh!ithole-gate is this: It’s not appropriate for the President of the United States use this kind of language. Now, this was a private meeting and perhaps Trump did not think the Democrats would sabotage the DACA negotiations and, in this regard, Trump is terribly naive. There will be no good faith discussions on any policy because the policy of the Democrats is that Trump must FAIL, even at the expense of the Democrat constituencies they claim to be fighting so hard for. That is their position and I hope the president gets hip to this soon. Instead, the conversation we are having is not about policy but rather that Trump is a RACIST. Which is, coincidentally, the sole platform held by his political enemies.

Pretty much. The last sentence is unfair, though: their platform is that the President is a racist, senile, crazy, stupid, a Nazi, a traitor, a liar, a sexual predator and not really President. Continue reading

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Ethics Quiz: The DNR Tattoo

 Paramedics brought a 70-year-old man to the University of Miami hospital emergency room after finding him on the street, intoxicated and unconscious. Doctors tried to revive him got no response. Then they had an unusual problem: The man had a ‘Do not resuscitate’ tattoo on his chest, with a line under the ‘not.’ There was also something that looked like his signature. Tattoos are not legally-binding DNR orders, and in Florida, there are  very specific requirements for DNRs. to be legal.  Both a doctor and the patient must sign it, and they must be on paper, not on chests.

The doctors decided to respect the man’s tattoo. They did not try to revive him after the initial efforts failed

Your Ethics Alarms Ethics Quiz of the Day:

Was that the right call?

Continue reading

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Oh, NO! ANOTHER Ethics Story That I Don’t Understand At All! EVERYTHING IS SEEMINGLY SPINNING OUT OF CONTROL!

Emory University Hospital in Georgia had scheduled kidney transplant surgery for a 2-year-old boy to take place on October 3. The organ donor, however, the boy’s father, Anthony Dickerson, violated his parole. Hospital administrators then postponed the surgery until Dickerson could comply with parole requirements for an additional three months.

The boy’s mother, Carmella Burgess, received a letter from the hospital that said Dickerson would be re-evaluated as a donor in January after it receives documentation of his success.

What warped reasoning is going into this decision? The boy’s health care needs are the same. The kidney being donated is the same. The father is still a willing donor. Why would the hospital care whether Dickerson had violated parole or not? Why would anything Dickerson did change the hospital’s medical duty to his son, or warrant postponing life and death surgery? So the father was discovered eating puppies. So he was found to be a convert to Isis. So he is caught saying nice things about Harvey Weinstein, Donald Trump or Satan. In fact, Dickerson violated parole in September and was charged with possession of a gun. So what?

“They’re making this about dad,” Burgess told the Atlanta Journal-Constitution. “It’s not about dad. It’s about our son.”

That seems to be an accurate analysis.

If anyone can explain how this can possibly be ethical conduct by the hospital, please do.

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Comment Of The Day (2): “Observations On Britain’s Charlie Gard Ethics Fiasco”

This is the second outstanding comment on the Charlie Gard post, and it boldly ventures into the ethics jungle of euthanasia. The discussion must go there, for if society has limited resources, and we have more limited resources than Paul Krugman and Bernie Sanders admit, then when people use up their allotted portion, they either have to die or someone else has to pick up the bill. The recent surge in popularity for single-payer health care is due in part to the old saw about how soldiers think when going into battle. It’s everyone else who’s at risk, not you. Or as my dad liked to put it, “Gee, I’m going to miss those other guys!”

Increasingly, as I get older and think about how different my family’s life would be if both Mom and Dad hadn’t contrived to pop off quickly after relatively short illnesses and minimal hospitalization, I see the same consideration in planning for my loved ones. I don’t want to waste my son’s inheritance to pay for the last and worst years of my life; indeed, I think it would be unconscionable to do so. However, that needs to be my choice, not the Death Panel’s.

Here is Mrs Q’s Comment Of The Day on the post,  “Observations On Britain’s Charlie Gard Ethics Fiasco”:

When medical care is socialized, nihilism & scientism combine to control those who can be useful to the state & those who need to be eliminated from it.

Dutch lawmakers are looking at a Completed Life Bill that would allow those 75+ in age to choose medical euthanasia. The lawmaker pushing the bill, Alexander Pechtold, said it would allow the Netherlands to…

“take the next step for our civilization.”

And what step is that exactly?

The Gard case highlights the dark workings of Marxism for what it is by defining life in terms of how much of a burden it supposedly is to others. That the “greater good” is better served when certain people s lives are considered “complete.”

Baby Gard, as Jack noted, cannot continue to be a financial burden in the context of socialized medicine because in such a paradigm, there are not enough resources to support all of those represented by it. Remember socialism ALWAYS promises more than it can ever deliver and always spends more than it has.

I love it when people tell me how great the health care in France is, while many there complain the immigrants are a drain on the system because they have not put their money into it for years. Or Canada, where our friends cannot afford private insurance and go without certain medications & treatments because they’re not covered by state. Or Europe, where rates of Downs Syndrome are jarringly low because doctors have advocated so severely for abortion of these unborn, that in some countries it has literally been years since such a child has been born. Continue reading

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Comment Of The Day (1): “Observations On Britain’s Charlie Gard Ethics Fiasco”

I thought that the Charlie Gard story would stimulate some excellent thoughts on ethics and public policy from readers, and for once I was right. This is the first of two superb Comments of the Day it generated, and there were several others as well.

Here is Ryan Harkins’ Comment Of The Day on the post,  “Observations On Britain’s Charlie Gard Ethics Fiasco.”

The idea of the state telling me I could not seek medical aid for my child when I had both the money to pay for it and a provider willing to give me the services is terrifying. My sixteen-month-old daughter has been receiving the majority of her sustenance through a feeding tube for the past six months. Prior to that, we had been struggling to get her to eat enough calories so that she would gain just an ounce or two, only to find that weight gain vanish when she caught a cold or a stomach bug. Granted, the gastroparesis she suffers is not a severe condition, but without the feeding tube she would risk starving. The thought that the state might step in, tell me that they not only would not pay for my daughter’s tube and care any more, but also expressly forbid me from feeding my daughter through the tube, makes me shake uncontrollably. If I have to fight for my daughter without the state’s help, fine by me. But for the state to forbid me from fighting for my daughter? That is unconscionable.

However, at this time, I don’t have to face that issue. I live in a place and a time when I don’t have to contend with general threat, and my daughter’s condition is not terminal and readily treatable. I hope that my child-rearing and my fear for my daughter helps me to have empathy for the parents of Charlie Gard. I also hope that I can step back away from the emotional turmoil this issue raises and try to understand what is happening here.

The principle dilemma in the case of this poor baby boy lies in the fundamental tension between the fact that human dignity demands we do fight for life, while at the same time we know that we will all ultimately die. Because human life bears an intrinsic dignity, its wrong to deprive a human being of what it needs to survive. Because all humans ultimately die, it can become, through the use of extreme or unethical means, against human dignity to fight against death when death is inevitable.

Why would it be wrong, in some circumstances, to keep fighting against death? The most clear-cut examples are when the means of preserving life are unethical. Bathing in the blood of virgins, selling one’s soul to the devil, killing an innocent to harvest his organs, transferring one’s consciousness into the unwilling body of another — all these (fantastical as some of them are) represent tactics to extend life that obviously violate ethical principles.

What about less obvious examples? Let’s consider a man in a coma. His state is persistent, perhaps even vegetative, but his body is capable of processing food and drink, although he is incapable of eating and drinking orally. A feeding tube could provide him with all the nourishment he needs, and he could be kept alive for years in such a fashion. To stop feeding him through the tube would be to deliberately deprive him of sustenance he needs to survive, and thus would be unethical. Death is not inevitable in this case, except in the most sweeping sense.

In times past, a feeding tube would not have been possible, or if possible, not recommended because of infection, and thus this would not have been a serious alternative. Absent any means of delivering food to the man in the coma, no one could be faulted for not providing food. And if trying to use a feeding tube would actually kill him quicker, or have negligible effect, then the extreme measure of using a feeding tube would not be ethical. However, since we are at time with the technology that makes the use of a feeding tube fairly easy and safe, we no longer have that excuse to deprive a person of nutrients.

What about a slightly different case, when the man in the coma can no longer process foods even through a feeding tube? Then providing food actually causes harm without any gain. Perhaps nutrients could be provided through an IV, but one would be justified, and perhaps is even obligated, to stop providing food through the feeding tube.

Now, the most challenging cases are when a person is terminally ill, but there are procedures that exist that can extend life. To what extent are we obligated to provide care? It depends on the nature of the treatment, the cost of the treatment, and the effects of the treatment. A person is fully justified in accepting that death cannot be stopped and let the terminal illness run its course. A person is not justified in taking steps to deliberately end that life, but is justified in procuring palliative care that eases the pain of the dying, even if it hastens death. But one is not obliged to pay for or undergo an extensive, dangerous, expensive procedure that will not provide a cure, but only a short extension of life.

It should be clear, though, that just because one is not obliged to pay for or undergo extreme care, it does not follow that one is obliged to never pay for or undergo such procedures. If a person has the money and desire to attempt such care, and that care is available, that person should not be denied.

Is there any instance, then, when that person could be denied that extraordinary care? Again, we are assuming that the person can pay for it and the care is available, so we aren’t discussing an instance in which the terminally ill patient is displacing someone else’s care.

I personally cannot think of an instance in which we could rightly deny that care. What I do know is that, in Catholic theology, death does not mark the end of the existence of a person. The soul survives death, and the soul will be reunited with the body at the Resurrection. There is danger in pursuing treatments at any cost, and that danger lies in the denial of the afterlife. That has consequences for one’s eternal soul. Continue reading

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Observations On Britain’s Charlie Gard Ethics Fiasco

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

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