M. Bennet Broner is a medical ethicist.
In past decades, physicians practiced medicine. The majority were dedicated to patient well-being. They were paternalistic and decided what was in their patients’ best interests, and patients generally trusted their judgments. In the 1970s, ethicists concluded that patients and clinicians should make treatment decisions jointly. This position has been championed since then, despite multiple surveys demonstrating that more than 50 percent of patients prefer their physicians to be the decision-makers. …
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In a 2023 study, researchers explored the medical needs of elderly, mentally deficient individuals who lived alone. A common comment by interviewed physicians was that they knew some patients required greater supervision or care, but they acceded to patient choices to return home. Are clinicians placing too great an emphasis on competency and patient rights rather than on patient well-being?
Everyone knows the phrase: “First, do no harm.” Yet today, deciding …
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Last September, NBC News aired a one-sided report on the arrangement between a county coroner and a medical school apropos the transfer of unclaimed corpses with reportedly inadequate effort to find family. In addition to a grieving family, an academic bioethicist was interviewed who expressed horror at the transfer procedure. The report did a disservice both to bioethics and to necessary medical training and research.
In a similar incident, a coroner …
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Recently, consumer articles heralded that blood tests for detecting Alzheimer’s dementia (AD) and many cancers were close to clinical availability. Given the narrow window in which AD must be diagnosed for present treatments to be effective, and questions regarding the utility of early cancer detection, will these tests provide any patient advantage?
Presently, there are two medications to treat AD. Neither is curative, but they slow disease progress by about five …
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According to the National Institutes of Health, the majority of individuals experience several traumatic events in their lifetimes, but do they all develop post-traumatic stress disorder (PTSD)? If you question the general populace or the media, they would indicate that PTSD is extremely common. Although it varies by sub-population, for the general populace, 13 and above, the rate of diagnosed PTSD is 4 percent to 8 percent. It is highest …
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Eight female nurses at a United Kingdom hospital are suing their employer for not assuring their psychological and physical safety. The nurses work in specialized areas that require their changing uniforms once daily. There is a trans-female nurse, similarly specialized, who changes with them. He wanders about the locker room in briefs or nude, the women report, ogling them as they exchange clothing. It has also been related that he …
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I attended a workshop on developing equitable health information materials, emphasizing that people are more responsive to data when individuals of similar complexion and/or features are represented. This concept originated in education, where research indicated that youth learned better from teachers with similar characteristics, and it was subsequently extended to health care. However, universal application is unrealistic, as Black children will not always have Black teachers, and patients of color …
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Another recent correlational study on the relationship between talcum powder (TP) and female reproductive tract cancers was published. This research originated in the 1970s when gynecologists at one hospital noted that an unusually high number of women were experiencing these cancers. They reviewed medical records and, in looking at possible causative agents, noted that many of the affected women used TP. They published their findings, and additional case review studies …
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I read an array of medical literature, both technical and public. But despite my education, experience, and reasonable intelligence, I find myself bewildered by the overwhelming deluge of information and recommendations: frequently contradictory, at times inaccurate, and often meaningless, that presently inundates individuals. If I can be befuddled, what about the average person with a high school diploma or a bachelor’s degree and little medical experience?
Perhaps there is so much …
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There are frequent accusations against physicians and other health care professionals regarding their behavior and/or education: they cannot communicate, are misogynist, racist, and ageist, and are poorly educated, despite American physicians training longer than those in other developed countries. But are these complainants aiming at the most obvious, though not most significant, target? There are more pressing problems than patient-provider relationships, as serious as they are, weightier concerns that are …
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A recent TV advertisement attempted to recruit clients for a class action suit against a pharmaceutical manufacturer (PM) for a medication side effect (SE). The “cause of action” was unstated: was it the side effect’s existence or that the company failed to emphasize its severity?
The SE was acknowledged not only by the company but also the FDA, which nonetheless approved the medication (RX), determining that its benefits outweighed the side …
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The American Heart Association (AHA) recently published a statement on the importance of shared decision-making (SDM) between physicians and patients. This concept, though at least 50 years old, has become popular in the last decade or so, with expectations of improving patient care, satisfaction, safety, care efficiency, and cost reduction. Though some preliminary research appears to support these promises, other researchers have found that it can increase costs and decrease …
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While surfing cellphone news headlines, my attention was caught by one from the New York Post that blared: “Dutch are Euthanizing Autistic People.” The Post aims for sensationalism, and the headline implied mass slaughter, akin to the Nazi gassing of individuals with mental disabilities. As euthanasia is of academic interest to me, I felt compelled to read the story.
The article’s basis was a study conducted at Kingston University, London. …
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Regressive legislators in a Southwestern state discovered that doctoral-level nursing students, future nurse practitioners at the state university, were receiving education in human sexuality. As watchdogs of public morality, and with a conviction that these students were being educated to “groom” children to become transgender individuals, they did not pause to verify the information, review course materials, or speak with the instructors. Instead, they immediately began complaining to the media …
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Recently, I heard a news report regarding several states’ attorneys general suing the federal government to eliminate the requirement that health care providers be immunized against COVID. They argued that as fully immunized individuals still contract COVID, and that allowing unimmunized people to be rehired would relieve provider shortages, the regulation was unhelpful.
Initially, I agreed that rehiring these individuals would generate some relief for those staff members who have worked …
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“First do no harm” is the opening line of the Hippocratic Oath, and virtually everyone is familiar with it, as it is quoted on every TV medical drama at least once a season. We tend to think that the oath was highly influential in medical training and practice when it was written circa 400 BCE. Still, it had limited applicability, as it only applied to students trained in Hippocrates’ style …
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Recently, I heard a news report regarding several state attorneys general suing the federal government to eliminate the requirement that health care providers be immunized against COVID. They argued that as fully immunized individuals still contract COVID, and that allowing unimmunized people to be rehired would relieve provider shortage, the regulation was unhelpful.
Initially, I agreed, as rehiring these individuals would generate some relief for those staff members who have worked …
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Less than a year ago, a position paper/meta-analysis was published whose authors concluded that the pain reliever acetaminophen, and products containing this compound, were contraindicated in pregnancy as they could result in premature or stillborn births or developmental defects. Earlier studies appeared more positive and resulted in recommendations for its use by professional and governmental organizations. The present authors acknowledged this disjunction and made both the routine recommendations for further …
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In my first bioethics class, the components of health education (HE) were just being developed, and despite the passage of time, full understanding remains elusive as HE proved far more complex than originally conceived. We learned, simplistically, by present standards, that the provider (MD, DO, PA, NP) only needed to deliver information at a patient’s level of understanding, and the patient would provide a reasoned response. The constant over the …
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Since the mass shooting in Uvalde, TX, rapidly after that in Buffalo, NY, I have read and heard several simplistic public media pieces suggesting easy means of preventing these acts. They unanimously indicated that mass shooters (MS), especially those who are younger, can be detected before their fatal actions by their statements or writings online or on paper. If these raise concerns, they can be reported to authorities, and this …
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