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

Sunday, November 13, 2011

Children’s hospital loses personal info of 500,000 patients


wftv.com

In a potential security breach at Nemours Children’s Health System, officials say they have lost the personal information of thousands of Florida patients.

Company officials say the patient information was being stored in a filing cabinet at a facility in Delaware. Officials said inside the cabinet were nonpassword protected computer backup tapes containing the personal and financial information of 500,000 Florida patients.

The whole story and video can be found here.

Saturday, November 12, 2011

DSM 5 Against Everyone Else

By Allen Frances, M.D.
Psychology Today Blog

Allen Frances, MD
So far, opposition to DSM 5 has been expressed by the following organizations: British Psychological Society; American Counseling Association; Society for Humanistic Psychology (APA Division 32); Society for Community Research and Action: Division of Community Psychology (APA Division 27); Society for Group Psychology & Psychotherapy (APA Division 49); Developmental Psychology (APA Division 7); UK Council for Psychotherapy; Association for Women in Psychology; Constructivist Psychology Network; Society for Descriptive Psychology; and the Society of Indian Psychologists.

An editorial by the Society Of Biological Psychiatry wondered whether DSM 5 was necessary at all. The community of personality disorders researchers is virtually unanimous in its opposition to the DSM 5 personality disorders section. There has also been widespread opposition to the sections on somatic, autistic, gender, paraphilic, and psychotic disorders.

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Strikingly, there seems to be virtually no support for DSM 5 outside the very narrow circle of the several hundred experts who have created it and the leadership of the American Psychiatric Association (APA) which stands to reap large profits from its publication. There is no group and precious few individuals outside of APA who have anything good to say about DSM 5. And even within the DSM 5 work groups and the APA governance structures, there is widespread discontent with the process and considerable disagreement about the product.

The entire blog can be accessed here.


Friday, November 11, 2011

Ghost Writing Persists in Major Medical Journals

By Robert Preidt
MedicineNet.com

Honorary and ghost authors were involved in 21% of articles published in six leading medical journals in 2008, which shows that this type of inappropriate authorship remains a problem, a new study says.

Honorary authors are people named as authors despite not making a substantial enough contribution to take responsibility for the research. Ghost authors are people who play a major role in the research or who participate in writing the article, but are not named as authors.

The lack of transparency and accountability associated with both types of inappropriate authorship has been a concern for decades, according to the study authors.

The entire report can be read here.

The original article concludes:

"Ensuring appropriate authorship remains an important issue for authors, academic and research institutions, and scientific journals. Full transparency in authorship is essential for maintaining integrity and accountability in scientific publication and ensuring public confidence in medical research. The results of this study should raise awareness among the scientific community about the importance of ensuring appropriate authorship credit and responsibility. Future research should continue to monitor inappropriate authorship and investigate ways that the scientific community could increase its effectiveness in addressing the problem."

Further information about the original article can be found here.
BMJ 2011; 343:d6128 doi: 10.1136/bmj.d6128 (Published 25 October 2011)
Cite this as: BMJ 2011; 343:d6128

Dutch 'Lord of the Data' Forged Dozens of Studies

By Gretchen Vogel
Science Magazine

Diederik Stapel
One of the Netherlands' leading social psychologists made up or manipulated data in dozens of papers over nearly a decade, an investigating committee has concluded.

Diederik Stapel was suspended from his position at Tilburg University in the Netherlands in September after three junior researchers reported that they suspected scientific misconduct in his work. Soon after being confronted with the accusations, Stapel reportedly told university officials that some of his papers contained falsified data. The university launched an investigation, as did the University of Groningen and the University of Amsterdam, where Stapel had worked previously. The Tilburg commission today released an interim report (in Dutch), which includes preliminary results from all three investigations. The investigators found "several dozens of publications" in which fictitious data has been used. Fourteen of the 21 Ph.D. theses Stapel supervised are also tainted, the committee concluded. 

The entire story can be read here.

Diederik Stapel returned his doctoral degree as reported today (11/11/11) in Science Insider.

An additional and more comprehensive report (added 11/17/11) can be found here.

Photo by Jack Tummers.

Thursday, November 10, 2011

Dilemma 7: An Invitation to Assess


You are checking your email after a busy day. The following email catches your attention.


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From: PsychBuilder – High Tech Psychology at Low Cost
Sent: Monday, November 10, 2011 6:37 PM
Subject: Online Assessment Tool to Promote your Practice

Dear Psychologist,

My name is Dr. Rob West, President and CEO of PsychBuilder Inc. located in San Jose, California. My company has developed a unique opportunity for you and your associates. PsychBuilder Inc. developed the first internet-based administration and scoring of the Personality Assessment Symptom Scale-2, the PASS-2. Psychologists have used the PASS-2 for psychological diagnoses and evaluations for a number of years. The PASS-2 is administered online, from any computer, iPad, or iPhone connected to the internet. The test usually takes approximately 40 to 60 minutes to administer. Results will be available to you and the patient online.

Important to an entrepreneurial psychologist like you, this assessment bridges the gap between psychology and primary care. Numerous patients from family practice offices can be given the internet link (http://www.psychbuilder.org/) and a security code to complete the PASS-2. The test is designed to determine if the patient can benefit from psychotherapy, psychotropic agents, or other psychological services. While it is not a complete assessment, it can guide patients to you for further psychological consultation.

After a patient completes the assessment, an email will be sent to you (based on the security code) and the patient within 24 hours, providing a secure link to review the results of the PASS-2. Patient contact information will be part of the administration process.

The cost of the online administration is $25, to be paid by the patient. For this to be a successful venture, we ask you to promote this program to your referring physicians, nurse practitioners, and physician assistants in order to enhance their ability to identify, evaluate and provide needed treatment for their patients.

We have great data on the PASS-2 for reliability and validity in identifying primary care patients who can benefit from psychological services. Unfortunately, many patients struggling with mental health issues in primary care settings are not properly identified or treated.

Because of busy primary care practices, the PASS-2 can be completed at home, if the office does not have internet access for patient use.

The physician, nurse practitioner, or physician’s assistant will offer patients this important opportunity via a specially designed 4 x 6 card. On that card, there will be information that explains the importance of completing this assessment, the cost, and that a licensed psychologist will review the results and contact the patient by phone within 3 to 5 business days.

An important factor is that there is no cost to you, as the psychologist. You will receive a high quality report that offers diagnostic possibilities, suicide potential, and treatment planning options for new patients.

I encourage you to review our web site at http://www.psychbuilder.com/. If you have further questions, feel free to contact me.

Sincerely,


Robert West, PhD, ABPP
Psychologist

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What are potential ethical issues with this invitation?


What clinical concerns arise for you in this scenario?


What should you do with this email solicitation?


What would you likely do with this email solicitation?

Wednesday, November 9, 2011

Losing the Battle: The Challenge of Military Suicide

Policy Brief
Center for a New American Security

Dr. Margaret C. Harrell and Nancy Berglass

This policy brief has four objectives. First, it examines the phenomenon of suicide within the U.S. military community, including both the frequency of suicide and the extent to which suicide is related to military service.  It outlines steps taken by the Department of Defense (DOD), the armed services and the Department of Veterans Affairs (VA) to reduce suicide in the armed forces and among veterans. It then identifies obstacles to reducing suicides further and makes recommendations to address each of those obstacles.

The entire publication can be found here.




Help for Service Members, Veterans and Military Families
Veterans Crisis Line: 1.800.273.TALK (8255), Press 1

Suicide, Warning Signs And Issues Faced By Friends And Family

Medical News Today

A study focusing on the family and friends of people who were suicidal has highlighted the main challenges they face when trying to judge whether a person is in danger and decide what they should do about it.

The research was carried out by Dr. Christabel Owens from the Peninsula College of Medicine and Dentistry, supported by Devon NHS Partnership Trust and funded by the UK Medical Research Council. The findings are published in the British Medical Journal on 22nd October 2011 (online 19th October 2011).

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The findings of the research show that relatives and friends did not always receive clear and unambiguous warning signals from the suicidal individual, and that, even when it was obvious that something was seriously wrong, they could not always summon the courage to take action.

Family members and friends of those who may be contemplating suicide are confronted by powerful emotional blocks, particularly fear. They may be afraid of intruding into another person's emotional life or afraid of damaging a cherished relationship by 'saying the wrong thing'. The whole situation is emotionally charged, and that affects the way in which people respond.

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Dr. Owens: "It is sad that, in the course of our research, we have repeatedly come across examples of people who did go to their GP, were given a cursory risk assessment and sent home with little or no support, and subsequently killed themselves. In other cases, a relative has taken their concerns to a GP and asked for advice, and has been told that the case cannot be discussed with them for reasons of patient confidentiality and that the person must visit the GP themselves."

The entire study can be found here.

Recognising and responding to suicidal crisis within family and social networks: qualitative study

BMJ 2011; 343:d5801 doi: 10.1136/bmj.d5801 (Published 18 October 2011)
Cite this as: BMJ 2011; 343:d5801

Tuesday, November 8, 2011

Ohio Teacher Convicted of Sex with Students

Stacy Schuler
LEBANON, Ohio — A high school teacher was convicted Thursday of having sex with five students, some of them football players, after a judge rejected an insanity defense that argued the teens took advantage of her.

Stacy Schuler was sentenced to a total of four years in prison for the encounters with the Mason High School students at her home in Springboro in southwest Ohio in 2010. She can ask a judge to free her from prison after six months.

The 33-year-old Schuler, who could have faced decades in prison, cried as she was handcuffed and led out of the courtroom.

The five teens testified that Schuler, a health and gym teacher, had been drinking alcohol at the time of the encounters and was a willing participant who initiated much of the contact. The teens were about 17 at the time. The age of consent in Ohio is 16, but it's illegal for a teacher to have sex with a student.

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Testimony from a defense psychologist had suggested that Schuler's medical and physical ailments, combined with her vegan diet and use of alcohol and an antidepressant, helped impair her ability to tell right from wrong.

A psychologist for the prosecution rebutted that testimony, saying that the use of alcohol does not meet the state standard for an insanity defense and that willingly getting drunk is not a legal defense for a crime.

The entire story can be found here.

More Schools Take Action to Stem Anti-Gay Bullying

By Christina Hoag
Los Angeles, Associated Press
Published on October 22, 2011

A history teacher amends his lessons on the civil rights movement to include the push for gay equality.  A high school removes Internet filters blocking gay advocacy websites. Six gay students sue their district, saying officials failed to protect them from bullies.

After anti-gay bullying led to a spate of teen suicides last year, school districts across the country are stepping up efforts to prevent such incidents, while more students are coming forward to report bullies.

"It's an issue that has taken over the public consciousness since last fall," said Jill Marcellus, spokeswoman for the Gay-Straight Alliance Network. "People realize it doesn't have to be this way. We can make it better."

Awareness of anti-gay bullying is increasing as acceptance of gay people has grown in society. Gay marriage is legal in several states, gays are now permitted to serve openly in the military and, in California, schools will soon have to teach gay-rights history.

Kids, even as young as middle school age, feel more emboldened to openly express their sexual or gender orientation, but many are not prepared for a possible backlash, gay-rights advocates say.

According to a 2009 survey by the Gay, Lesbian and Straight Education Network, 85 percent of gay teens reported harassment at school within the previous year and two-thirds felt unsafe at school because of their sexual orientation. The problem also extends to boys perceived as effeminate and girls deemed masculine.

A lot of people have the idea that coming out as soon as possible will make themselves feel more comfortable," said Raymond Ferronato, a 16-year-old gay junior in Antioch, Calif. "I tell them come out when you're ready to come out, and only do it when you're safe."

Schools became aware last year of how unsafe it can be.

Five gay teens, ranging from middle school to college age, killed themselves in California, Indiana, Minnesota, Texas and New Jersey, after being bullied, in some cases for years. Last month, 14-year-old Jamey Rodemeyer killed himself in Buffalo, N.Y., after years of homophobic harassment.

The rest of the story can be read here.