Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Power Imbalance. Show all posts
Showing posts with label Power Imbalance. Show all posts

Sunday, February 19, 2023

Organs in exchange for freedom? Bill raises ethical concerns

Steve LeBlanc
Associated Press
Originally published 8 FEB 23

BOSTON (AP) — A proposal to let Massachusetts prisoners donate organs and bone marrow to shave time off their sentence is raising profound ethical and legal questions about putting undue pressure on inmates desperate for freedom.

The bill — which faces a steep climb in the Massachusetts Statehouse — may run afoul of federal law, which bars the sale of human organs or acquiring one for “valuable consideration.”

It also raises questions about whether and how prisons would be able to appropriately care for the health of inmates who go under the knife to give up organs. Critics are calling the idea coercive and dehumanizing even as one of the bill’s sponsors is framing the measure as a response to the over-incarceration of Hispanic and Black people and the need for matching donors in those communities.

“The bill reads like something from a dystopian novel,” said Kevin Ring, president of Families Against Mandatory Minimums, a Washington, D.C.-based criminal justice reform advocacy group. “Promoting organ donation is good. Reducing excessive prison terms is also good. Tying the two together is perverse.”

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Offering reduced sentences in exchange for organs is not only unethical, but also violates federal law, according to George Annas, director of the Center for Health Law, Ethics & Human Rights at the Boston University School of Public Health. Reducing a prison sentence is the equivalent of a payment, he said.

“You can’t buy an organ. That should end the discussion,” Annas said. “It’s compensation for services. We don’t exploit prisoners enough?”

Democratic state Rep. Carlos Gonzalez, another co-sponsor of the bill, defended the proposal, calling it a voluntary program. He also said he’s open to establishing a policy that would allow inmates to donate organs and bone marrow without the lure of a reduced sentence. There is currently no law against prisoner organ donation in Massachusetts, he said.

“It’s not quid pro quo. We are open to setting policy without incentives,” Gonzalez said, adding that it is “crucial to respect prisoners’ human dignity and agency by respecting their choice to donate bone marrow or an organ.”

Tuesday, April 20, 2021

State Medical Board Recommendations for Stronger Approaches to Sexual Misconduct by Physicians

King PA, Chaudhry HJ, Staz ML. 
JAMA. 
Published online March 29, 2021. 
doi:10.1001/jama.2020.25775

The Federation of State Medical Boards (FSMB) recently engaged with its member boards and investigators, trauma experts, physicians, resident physicians, medical students, survivors of physician abuse, and the public to critically review practices related to the handling of reports of sexual misconduct (including harassment and abuse) toward patients by physicians. The review was undertaken as part of a core responsibility of boards to protect the public and motivated by concerning reports of unacceptable behavior by physicians. Specific recommendations from the review were adopted by the FSMB’s House of Delegates on May 2, 2020, and are highlighted in this Viewpoint.

Sexual misconduct by physicians exists along a spectrum of severity that may begin with “grooming” behaviors and end with sexual assault. Behaviors at any point on this spectrum should be of concern because unreported minor violations (including sexually suggestive comments or inappropriate physical contact) may lead to greater misconduct. In 2018, the National Academies of Science, Engineering, and Medicine identified sexual harassment as an important problem in scientific communities and medicine, finding that greater than 50% of women faculty and staff and 20% to 50% of women students reportedly have encountered or experienced sexually harassing conduct in academia. Data from state medical boards indicate that 251 disciplinary actions were taken against physicians in 2019 for “sexual misconduct” violations (Table). The actual number may be higher because boards often use a variety of terms, including unprofessional conduct, physician-patient boundary issues, or moral unfitness, to describe such actions. The FSMB has begun a project to encourage boards to align their categorization of all disciplinary actions to better understand the scope of misconduct.

Monday, April 1, 2019

Psychiatrist suspended for ‘inappropriate relationship.’ He got a $196K state job.

Steve Contorno & Lawrence Mower
www.miamiherald.com
Originally posted February 28, 2019

Less than a year ago, Domingo Cerra Fernandez was suspended from practicing medicine in the state of Florida.

The Ocala psychiatrist allegedly committed one of the cardinal sins of his discipline: He propositioned a patient to have a sexual and romantic relationship with him. He then continued to treat her.

But just months after his Florida suspension ended, Cerra Fernandez has a new job. He’s a senior physician at the North Florida Evaluation and Treatment Center, a maximum-security state-run treatment facility for mentally disabled adult male patients.

How did a recently suspended psychiatrist find himself working with some of Florida’s most vulnerable and dangerous residents, with a $196,000 annual salary?

The Department of Children and Families, which runs the facility, knew about his case before hiring him to a job that had been vacant for more than a year. DaMonica Smith, a department spokeswoman, told the Herald/Times that Cerra Fernandez was up front about his discipline.

The info is here.

Monday, March 19, 2018

#MeToo in Medicine: Waiting for the Reckoning

Elizabeth Chuck
NBC News
Originally posted February 21, 2018

Here is an excerpt:

Health care organizations make clear that they do not condone inappropriate behavior. The American Medical Association calls workplace sexual harassment unethical and specifically states in its Code of Medical Ethics that “Sexual relationships between medical supervisors and trainees are not acceptable, even if consensual.”

Westchester Medical Center Health Network, where Jenkins says she was sexually harassed as a resident, maintains that it has never tolerated workplace harassment. In a statement to NBC News, it said that the surgeon in question "has not worked at Westchester Medical Center for years and we have no record of a report."

"Our policies on harassment are strict, clear and presented to all employees consistently," it said.

"Mechanisms have been and continue to be in place to enable confidential reporting and allegations involving staff are investigated swiftly and thoroughly. Disciplinary actions are taken, as appropriate, after internal review," the statement said, adding that Westchester Medical Center's policies were "continuously examined and enhanced" and that reporting sexual harassment was encouraged through its confidential 24-hour hotline.

More than a hotline is needed, said many females in medicine, who want to see an overhaul of their entire profession — with men made aware of what's unacceptable and women looking out for one another and supporting each other.

The article is here.

Wednesday, March 14, 2018

Oxfam scandal is not about morality, but abuse of power

Kerry Boyd Anderson
arabnews.com
Originally posted February 18, 2018

Here is an excerpt:

Two of these problems directly relate to the #metoo movement against sexual harassment and abuse. First, the Oxfam scandal is not about personal sexual immorality. It is about abuse of power and sexual exploitation. When these men entered a war zone or an area that had suffered a massive natural disaster, they were not dealing with women there on equal terms; they were in a position of power and relative wealth, and offered women in desperate circumstances money in exchange for sex. These women were part of the population the aid workers were supposed to be helping, so using them in this way constitutes a clear breach of trust. This is one of the #metoo movement’s key points — this type of behavior is not about personal morality, it is about abuse of power.

Another problem that the scandal highlights is the way that many organizations protect the men who are behaving badly. In the Oxfam case, the focus has been on one man in a leadership position: Roland van Hauwermeiren, who created an enabling environment and participated in the hiring of prostitutes. Van Hauwermeiren previously led a project team for the charity Merlin in Liberia, where a colleague reported that men on the team were hiring local women as prostitutes. After an internal investigation, he resigned. He later led Oxfam’s team in Chad, where similar accusations arose. Despite this, Oxfam put him in charge of a team in Haiti, where the behavior continued. Following an investigation, van Hauwermeiren resigned, but he then went on to work for Action Against Hunger in Bangladesh. 

Thursday, February 1, 2018

Ethics for healthcare data is obsessed with risk – not public benefits

Tim Spector and Barbara Prainsack
The Conversation
Originally published January 5, 2018

Here is an excerpt:

Health researchers working with human participants – or their identifiable information – need to jump through lots of ethical and bureaucratic hoops. The underlying rationale is that health research poses particularly high risks to people, and that these risks need to be minimised. But does the same rationale apply to non-invasive research using digital health data? Setting aside physically invasive research, which absolutely should maintain the most stringent of safeguards, is data-based health research really riskier than other research that analyses people's information?

Many corporations can use data from their customers for a wide range of purposes without needing research ethics approval, because their users have already "agreed" to this (by ticking a box), or the activity itself isn't qualified as health research. But is the assumptions that it is less risky justified?

Facebook and Google hold voluminous and fine-grained datasets on people. They analyse pictures and text posted by users. But they also study behavioural information, such as whether or not users "like" something or support political causes. They do this to profile users and discern new patterns connecting previously unconnected traits and behaviours. These findings are used for marketing; but they also contribute to knowledge about human behaviour.

The information is here.