Texas Abortion Law Can Go Into Effect Immediately

Associated Press

AUSTIN, Texas—A federal appeals court cleared the way Friday for the immediate enforcement of a new abortion law in Texas requiring doctors to conduct a sonogram before the procedure.

The three-judge panel on Tuesday lifted a temporary stay issued by a district court judge who found the new law potentially unconstitutional, but didn't issued a legal mandate. On Friday, the judges agreed to a request by Texas Attorney General Greg Abbott to cut short the typical three-week waiting period between a ruling and its implementation.

The new law requires doctors to conduct a sonogram before performing an abortion, to show the woman the image, to play the fetal heartbeat aloud and describe the features of the fetus at least 24 hours before the abortion. There are exceptions in the case of rape, incest, fetal deformities and for women who have to travel great distances to reach a doctor.

The most recent order doesn't give time for doctors fighting the law to appeal the decision, which under normal circumstances woudn't have gone into effect until Jan. 31. The Center for Reproductive Rights, which supports the doctors, didn't have an immediate reaction to Friday's order.

The entire story is here.

American College of Physicians Ethics Manual - Sixth Edition

American College of Physicians Ethics Manual -- The college released a new version of its professional guidelines and included a section about considering costs involved in treatment. "The manual is not a substitute for the experience and integrity of individual physicians, but it may serve as a reminder of the shared duties of the medical profession. ... Physicians must base their counsel on the interests of the individual patient, regardless of the insurance or medical care delivery setting. ... Physicians have a responsibility to practice effective and efficient health care and to use health care resources responsibly. Parsimonious care that utilizes the most efficient means to effectively diagnose a condition and treat a patient respects the need to use resources wisely and to help ensure that resources are equitably available" (Snyder et al., 1/3).

The supplement to the code of ethics can be found here.

Assisted suicide should be legal, says major report to parliament

MPs told that people with a terminal illness could be safely offered the choice to end their own lives

By Esther Addley

The Guardian

Originally published Wednesday 4 January 2012

MPs should consider changing the law on assisted suicide to allow some terminally ill people to end their lives at home with the help of their doctor, a major report into the subject has concluded.

The Commission on Assisted Dying, chaired by the former lord chancellor Lord Falconer, says a choice to end their own lives could be safely offered to some people with terminal illnesses, provided stringent safeguards were observed.

Describing the current law on assisted dying as "inadequate and incoherent", the commission will today outline a legal framework that would permit only those who had been diagnosed with less than a year to live to seek an assisted suicide, and then only if they met strict eligibility criteria. These would include:

• Two independent doctors were satisfied with the diagnosis.
• The person was aware of all the social and medical help available.
• They were making the decision voluntarily and with no sense of being pressurised by others or feeling "a burden".
• They were not acting under the influence of a mental illness, and were capable of taking the medication themselves, without help.

The 400-page report follows a year of investigation by the commission, whose members also include the former Metropolitan police commissioner Lord Blair, a former president of the General Medical Council, a leading consultant in disability equality, an Anglican priest, and medical, mental health, palliative care and social care specialists.

The rest of the story is here.

Report Finds Most Errors at Hospitals Go Unreported

By ROBERT PEAR

New York Times - Health

Published: January 6, 2012

Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report.

Yet even after hospitals investigate preventable injuries and infections that have been reported, they rarely change their practices to prevent repetition of the “adverse events,” according to the study, from Daniel R. Levinson, inspector general of the Department of Health and Human Services.

In the report, being issued on Friday, Mr. Levinson notes that as a condition of being paid under Medicare, hospitals are to “track medical errors and adverse patient events, analyze their causes” and improve care.

Nearly all hospitals have some type of system for employees to inform hospital managers of adverse events, defined as significant harm experienced by patients as a result of medical care.

“Despite the existence of incident reporting systems,” Mr. Levinson said, “hospital staff did not report most events that harmed Medicare beneficiaries.” Indeed, he said, some of the most serious problems, including some that caused patients to die, were not reported.

Adverse events include medication errors, severe bedsores, infections that patients acquire in hospitals, delirium resulting from overuse of painkillers and excessive bleeding linked to improper use of blood thinners.

The rest of the story is here.

Prison psychologist loses license, job

Former staffer who faked rape has license suspended by the Board of Psychology

By Laura Newell, Telegraph Staff Writer

Laurie Ann Martinez

A psychologist who allegedly faked her own rape earlier this year has lost her job with the California Department of Corrections and Rehabilitation.

Laurie Ann Martinez, a licensed psychologist for the state prison system who worked at New Folsom Prison, was terminated from her post. Her last day was Dec. 22, three days after her court appearance.

Her license has also been suspended by the state Board of Psychology.

The board is seeking to permanently revoke her license.

“The criminal allegations against Ms. Martinez are serious enough to warrant this action,” said Board Executive Officer Robert Kahane. “Our mission is to protect consumers, and we think allowing Martinez to continue to practice poses a threat to consumer health and safety.”

The rest of the story is here.

Other posts related to this story can be found here and here.

Vignette 9: Psychologist as Character Witness?

A psychologist receives a phone message from a former patient.  The former patient is asking for the psychologist to be a “character witness” as he has an upcoming hearing for a minor criminal offense. His attorney believes that some good, written character references will really help out with the case.

The psychologist pulls the former patient’s chart.  The psychologist has not worked with the patient for about two years. Additionally, none of the treatment issues had to do with impulse control or antisocial tendencies. Therapy lasted about a year and focused on depression and relationship issues. The psychologist recalls that the patient had always been good-natured, attended appointments regularly, and worked well in therapy.  The psychologist remembers the former patient as a likeable person.

How would you feel about receiving this request?

What ethical issues are involved?

What are your potential options?

If you decide to provide information, would you consider communicating with the prior patient’s attorney?  What would you need from the attorney?

One Ethical Decision-Making Model

Ethical Decision Making Model

This article can be found in the public domain here.

Company withdraws contracts controlling online comments by patients

The move comes after a complaint alleged that Medical Justice's business practices are unethical.

By ALICIA GALLEGOS, amednews staff. Posted Jan. 2, 2012.

Medical Justice Inc. is retiring its "vaccine against libel," a set of contracts providing authority to doctors over online comments posted by patients.

The contracts' demise follows a complaint made to the Federal Trade Commission alleging that Medical Justice is engaging in unethical business practices. A dentist is being sued for using one of the agreements.

The complaint and the lawsuit were filed on Nov. 29, 2011.

A day later, Medical Justice announced it will end its use of the contracts, said neurosurgeon Jeff Segal, MD, CEO and founder of Medical Justice. The company has informed its 3,000 physician and dentist members that the contracts are retired. Medical Justice recommends that doctors use its latest online tool -- the eMerit system -- to combat false posts and protect their reputations. But Dr. Segal said members are "free to do what they want to do," which includes continuing to use the contracts if they see fit. He said the company has not suggested that doctors call their patients to inform them of the contracts' retirement.

The entire story can be read here.

Lawsuit Accuses Company Of Fraudulently Cycling Patients Through Nursing Homes, Hospice Care

By Jordan Rau

Kaiser Health News Staff Writer

Originally published January 4, 2012

A national hospice company improperly cycled patients through nursing homes and hospice with a goal of making as much profit as possible from Medicare, according to a whistleblower lawsuit announced this week.

Federal attorneys also sued the hospice company, AseraCare, alleging it milked Medicare’s hospice benefit by pressuring its employees to enroll people into hospice who weren’t dying and resisted discharging them despite evidence they weren’t deteriorating. One hospice patient who should have been immobile from end-stage heart disease was healthy enough to go to his granddaughter’s graduation and a berry-picking excursion with a friend, the government charges.

For years, some critics of Medicare’s hospice benefit have said that the way the government pays providers gives them financial incentives to abuse the system. The suits against AseraCare, a Fort Smith, Ark.-based hospice company operating in 19 states, follow several other suits against big hospice companies but go further in their allegations that the company coordinated its use of nursing care and hospice care to maximize Medicare reimbursements.

The entire story is here.