Wednesday, November 14, 2012
HCEC Pearls and Pitfalls: Suggested Do’s and Don’t’s for Healthcare Ethics Consultants
Joseph A. Carrese and the Members of the
American Society for Bioethics and Humanities
Clinical Ethics Consultation Affairs Standing Committee
1. Don't assume that the question you are asked to address is a matter of ethics, or that it is the primary issue or the only issue. Do take the time to clarify for yourself (and your team) the following: What are the relevant concerns, and are they a matter of ethics?
Those requesting an ethics consultation recognize that a problem exists. However, they may not be able to accurately determine whether the problem is truly a matter of ethics or not, and even if they can, they may not be able to correctly articulate the precise nature of the ethical concerns (that is, the values about which there is uncertainty or conflict). Further, requesters may not appreciate that, in addition to the question(s) they have raised, other important ethical concerns may be involved. One important task for HCECs, then, is to determine if the request is appropriate for ethics consultation and, if so, to clarify the ethical concern(s). 1 If the request does not involve an ethics question (that is, what should be done in the face of uncertainty or conflict about values), it should be referred to other resources in the healthcare system that are better equipped to handle such requests. For example, if the requester is seeking a legal opinion, he or she should be referred to legal counsel. Similar to making a diagnosis in clinical medicine, where precision in diagnosis leads to appropriate intervention, clearly and accurately identifying and describing the ethical concerns in an ethics consultation will more likely lead to a correct and helpful analysis and appropriate recommendations. Another parallel to clinical medicine is that, as the case unfolds over time, new issues may emerge. An initial set of questions, even when addressed and resolved, may lead to awareness of new ethical issues as the case evolves. The consultant should be attentive and open to this possibility and revisit the ethics question(s) in the consultation, as needed.
The other 11 suggestions are here.
Thanks to Ken Pope for this article.
Tuesday, November 13, 2012
How celebrity child sex scandal has rocked the BBC
By Simon Hooper
Special to CNN
Originally published October 22, 2012
In life he was one of Britain's best loved children's television personalities, an icon of the pop music world, flamboyant friend of the famous, renowned for his eccentricities and honored for his tireless charity work.
But in death, Jimmy Savile now stands accused of being a pedophile who used his status and celebrity to prey on young girls throughout decades in the public spotlight, his gravestone already removed amid an outpouring of public revulsion. Prime Minister David Cameron has even suggested the removal of Savile's knighthood might be considered in light of the allegations.
As presenter of "Jim'll Fix It," the BBC's flagship Saturday teatime kids' show from the mid-70s until the mid-90s, Savile cultivated an image as the nation's kindly uncle who could make children's dreams come true with a twirl of his trademark cigar.
Yet an ITV documentary -- "Exposure: The Other Side of Jimmy Savile" -- broadcast in early October portrayed the late star as a nightmarish figure whose sexual predilection for teenagers was known about, laughed off or suspected by many within the entertainment industry but never openly challenged.
The entire story is here.
Special to CNN
Originally published October 22, 2012
In life he was one of Britain's best loved children's television personalities, an icon of the pop music world, flamboyant friend of the famous, renowned for his eccentricities and honored for his tireless charity work.
But in death, Jimmy Savile now stands accused of being a pedophile who used his status and celebrity to prey on young girls throughout decades in the public spotlight, his gravestone already removed amid an outpouring of public revulsion. Prime Minister David Cameron has even suggested the removal of Savile's knighthood might be considered in light of the allegations.
As presenter of "Jim'll Fix It," the BBC's flagship Saturday teatime kids' show from the mid-70s until the mid-90s, Savile cultivated an image as the nation's kindly uncle who could make children's dreams come true with a twirl of his trademark cigar.
Yet an ITV documentary -- "Exposure: The Other Side of Jimmy Savile" -- broadcast in early October portrayed the late star as a nightmarish figure whose sexual predilection for teenagers was known about, laughed off or suspected by many within the entertainment industry but never openly challenged.
The entire story is here.
School Psychologist Pleads No Contest To Taking Photo Of Woman's Pubic Area
By David Owens
The Hartford Courant
Originally published November 1, 2012
In November 2011, as many people suffered through the power outages that followed the October snowstorm, David Pino of Keen Court opened his home to a friend who had no electricity.
The 36-year-old woman, a longtime friend of Pino and his wife, was going to stay the night. Before going to bed, the group had several drinks.
The guest was going to sleep on a day bed in a home office, but Pino suggested that she sleep in the master bedroom with Pino's wife. He said he would sleep on the day bed.
Early the next morning, the woman later told police, something went wrong.
The entire story is here.
The Hartford Courant
Originally published November 1, 2012
In November 2011, as many people suffered through the power outages that followed the October snowstorm, David Pino of Keen Court opened his home to a friend who had no electricity.
The 36-year-old woman, a longtime friend of Pino and his wife, was going to stay the night. Before going to bed, the group had several drinks.
The guest was going to sleep on a day bed in a home office, but Pino suggested that she sleep in the master bedroom with Pino's wife. He said he would sleep on the day bed.
Early the next morning, the woman later told police, something went wrong.
The entire story is here.
Monday, November 12, 2012
U.S. Suicide Rate Jumped During Recession as Unemployment Rose
By Phil Serafino
Bloomberg News
Originally posted November 4, 2012
The suicide rate in the U.S. increased during the recession, a sign that rising joblessness took a toll on Americans’ mental health, researchers said.
About 1,580 additional suicides occurred annually in the U.S. from 2008 to 2010 than would have been expected based on statistical trends before the recession, according to a letter published today in the Lancet journal by researchers from the U.K., Hong Kong and the U.S. They looked at suicide mortality statistics from the U.S. Centers for Disease Control and Prevention for 1999 through 2010, according to the letter.
The findings add to evidence from other countries that the recession and debt crisis have harmed mental health. Previous studies found that Greece and Spain, two of the countries hit hardest by the economic duress, showed increases in illnesses including depression.
The entire story is here.
Bloomberg News
Originally posted November 4, 2012
The suicide rate in the U.S. increased during the recession, a sign that rising joblessness took a toll on Americans’ mental health, researchers said.
About 1,580 additional suicides occurred annually in the U.S. from 2008 to 2010 than would have been expected based on statistical trends before the recession, according to a letter published today in the Lancet journal by researchers from the U.K., Hong Kong and the U.S. They looked at suicide mortality statistics from the U.S. Centers for Disease Control and Prevention for 1999 through 2010, according to the letter.
The findings add to evidence from other countries that the recession and debt crisis have harmed mental health. Previous studies found that Greece and Spain, two of the countries hit hardest by the economic duress, showed increases in illnesses including depression.
The entire story is here.
Sunday, November 11, 2012
Psychologists helping psychologists
Determining your responsibilities when you believe a colleague may have behaved unethically.
By Rebecca A. Clay
The Monitor on Psychology
October 2012, Vol 43, No. 9
Print version: page 36
If you saw another psychologist do something that appeared unethical, would you know how to respond?
Many psychologists don't, says Beth Kaplan Westbrook, PsyD, co-chair of APA's Advisory Committee on Colleague Assistance (ACCA) and a private practitioner in Portland, Ore. They may be unsure about laws in their state and how those laws interact with APA's Ethics Code. They may lack the information they need. Or they may be nervous about the liability issues that could arise, either from reporting a colleague or failing to do so.
ACCA is working to make sure psychologists are clear about how to react when a colleague needs help. In addition to creating a series of online resources, the group is urging state, provincial and territorial psychological associations (SPTAs) to create colleague assistance programs that can stop problems before they become crises.
"Health professionals aren't immune from the same problems that affect the general public," says Westbrook, citing as examples substance abuse and mental health disorders. "ACCA's main purpose is not only to help people get the treatment they need, but also to focus on prevention—to have programs in place so that psychologists can seek help or refer colleagues as problems arise."
The entire story is here.
Saturday, November 10, 2012
Caregiving as moral experience
By Arthur Kleinman
The Lancet
Volume 380, Issue 9853, Pages 1550 - 1551
3 November 2012
Everyone who has been in love or built a family knows that there are things, essential things, that money can't buy. Patients with serious illness and their network of caregivers know this too, because those things that really matter to us are threatened and must be defended. And many clinicians, reflecting on what is at stake in health care not only for patients but for themselves, know the same thing: the market has an important role in health-care financing and health systems reform, but it should not reach into those quintessentials of caregiving that speak to what is most deeply human in medicine and in living. This is the moral limit of an economic paradigm. Or at least it should be.
But we live in a truly confused age. The market model seems to have infiltrated so thoroughly into human lives and medicine that in certain circles—policy making and analysis, hospital and clinic administration, and even clinical work—economic rationality with its imperative of containing costs and maximising efficiency has come to mute the moral, emotional, religious, and aesthetic expressions of patients and caregivers. Most take it for granted and accept its implications. Models from economic psychology, behavioural economics, and business studies, based on the narrowest calculations of what a “rational” person would choose as most cost-effective, are now routinely applied to clinical decision making and the organisation of care.
(cut)
The great failure of contemporary medicine to promote caregiving as an existential practice and moral vision that resists reduction to the market model or the clarion call of efficiency has diminished professionals, patients, and family caregivers alike. It has enabled a noisy and ubiquitous market to all but silence different motives, ideals, hopes, and behaviours that must be expressed, because they are as much who we are as economic rationality.
The entire piece is here.
doi:10.1016/S0140-6736(12)61870-4
The Lancet
Volume 380, Issue 9853, Pages 1550 - 1551
3 November 2012
Everyone who has been in love or built a family knows that there are things, essential things, that money can't buy. Patients with serious illness and their network of caregivers know this too, because those things that really matter to us are threatened and must be defended. And many clinicians, reflecting on what is at stake in health care not only for patients but for themselves, know the same thing: the market has an important role in health-care financing and health systems reform, but it should not reach into those quintessentials of caregiving that speak to what is most deeply human in medicine and in living. This is the moral limit of an economic paradigm. Or at least it should be.
But we live in a truly confused age. The market model seems to have infiltrated so thoroughly into human lives and medicine that in certain circles—policy making and analysis, hospital and clinic administration, and even clinical work—economic rationality with its imperative of containing costs and maximising efficiency has come to mute the moral, emotional, religious, and aesthetic expressions of patients and caregivers. Most take it for granted and accept its implications. Models from economic psychology, behavioural economics, and business studies, based on the narrowest calculations of what a “rational” person would choose as most cost-effective, are now routinely applied to clinical decision making and the organisation of care.
(cut)
The great failure of contemporary medicine to promote caregiving as an existential practice and moral vision that resists reduction to the market model or the clarion call of efficiency has diminished professionals, patients, and family caregivers alike. It has enabled a noisy and ubiquitous market to all but silence different motives, ideals, hopes, and behaviours that must be expressed, because they are as much who we are as economic rationality.
The entire piece is here.
doi:10.1016/S0140-6736(12)61870-4
Friday, November 9, 2012
DSM-5 Field Trials Discredit the American Psychiatric Association
By Allen Frances, M.D.
The Huffington Post
Originally posted October 31, 2012
The $3 million DSM-5 Field Trials have been a pure disaster from start to finish. First, there was the poor choice of design. The study restricted itself to reliability -- the measurement of diagnostic agreement among different raters. Unaccountably, it failed to address two much more crucial questions -- DSM-5's potential impact on who would be diagnosed and on how much its dramatic lowering of diagnostic thresholds would increase the rates of mental disorder in the general population. There was no possible excuse for not asking these simple-to-answer and vitally important questions. We have a right to know how much DSM-5 will contribute to the already rampant diagnostic inflation in psychiatry, especially since this risks even greater overuse of psychotropic drugs.
The entire story is here.
The Huffington Post
Originally posted October 31, 2012
The $3 million DSM-5 Field Trials have been a pure disaster from start to finish. First, there was the poor choice of design. The study restricted itself to reliability -- the measurement of diagnostic agreement among different raters. Unaccountably, it failed to address two much more crucial questions -- DSM-5's potential impact on who would be diagnosed and on how much its dramatic lowering of diagnostic thresholds would increase the rates of mental disorder in the general population. There was no possible excuse for not asking these simple-to-answer and vitally important questions. We have a right to know how much DSM-5 will contribute to the already rampant diagnostic inflation in psychiatry, especially since this risks even greater overuse of psychotropic drugs.
The entire story is here.
Thursday, November 8, 2012
Suit filed against Capitola psychologist for allegedly sexually abusing a child patient
By Jessica M. Pasko
The Santa Cruz Sentinel
Originally published October 23, 2012
A civil lawsuit has been filed against a Capitola psychologist who is facing criminal charges of sexual abuse against a child.
Dr. John William Visher was arrested last month at his La Selva Beach home after Capitola police investigated allegations that he committed lewd acts against an 8-year-old girl. The girl had been his patient and detectives believe the incidents occurred at Visher's former Bay Avenue office in 2009.
Last week, the girl's family filed a personal injury suit against Visher in the civil divisions of Santa Cruz County Court. It charges him with sexual harassment, professional negligence and intentional infliction of emotional distress, and seeks unspecified damages.
Visher pleaded not guilty on Oct. 9 to five felony charges that include lewd acts upon a child, sending obscene material and possession of material depicting a minor engaging in sexual conduct. He is due back in court Nov. 14.
The entire story is here.
The Santa Cruz Sentinel
Originally published October 23, 2012
A civil lawsuit has been filed against a Capitola psychologist who is facing criminal charges of sexual abuse against a child.
Dr. John William Visher was arrested last month at his La Selva Beach home after Capitola police investigated allegations that he committed lewd acts against an 8-year-old girl. The girl had been his patient and detectives believe the incidents occurred at Visher's former Bay Avenue office in 2009.
Last week, the girl's family filed a personal injury suit against Visher in the civil divisions of Santa Cruz County Court. It charges him with sexual harassment, professional negligence and intentional infliction of emotional distress, and seeks unspecified damages.
Visher pleaded not guilty on Oct. 9 to five felony charges that include lewd acts upon a child, sending obscene material and possession of material depicting a minor engaging in sexual conduct. He is due back in court Nov. 14.
The entire story is here.
Wednesday, November 7, 2012
Students Rate Mental Health Services
By Allie Grasgreen
Inside Higher Ed
Originally published October 30, 2012
More than 62 percent of students who withdrew from college with mental health problems did so for that reason, a new national survey shows.
The survey, released today by the National Alliance on Mental Illness, aims to gauge, based on student perceptions, whether colleges are meeting students' mental health needs and how they can better support those students' academic experience. The results are mixed.
From August to November 2011, the NAMI surveyed 765 people diagnosed with a mental health condition who are currently enrolled in college (68 percent were) or were enrolled within the past five years. The vast majority -- 71 percent -- attended public or private four-year colleges, while 19 percent attended community colleges (the others were online, trade or technical and specialty colleges). Eighty-two percent of respondents were white and the same percentage were female (women are much more likely than men to seek counseling on campus), and more than 60 percent were between the ages of 18 and 27 (with 37 percent in the traditional college ages of 18-22). Nearly eight in 10 identified as straight.
Consistent with other national surveys, depression is one of the most common problems for students, with 27 percent reporting it as their primary diagnosis.
Read more here.
Inside Higher Ed
Originally published October 30, 2012
More than 62 percent of students who withdrew from college with mental health problems did so for that reason, a new national survey shows.
The survey, released today by the National Alliance on Mental Illness, aims to gauge, based on student perceptions, whether colleges are meeting students' mental health needs and how they can better support those students' academic experience. The results are mixed.
From August to November 2011, the NAMI surveyed 765 people diagnosed with a mental health condition who are currently enrolled in college (68 percent were) or were enrolled within the past five years. The vast majority -- 71 percent -- attended public or private four-year colleges, while 19 percent attended community colleges (the others were online, trade or technical and specialty colleges). Eighty-two percent of respondents were white and the same percentage were female (women are much more likely than men to seek counseling on campus), and more than 60 percent were between the ages of 18 and 27 (with 37 percent in the traditional college ages of 18-22). Nearly eight in 10 identified as straight.
Consistent with other national surveys, depression is one of the most common problems for students, with 27 percent reporting it as their primary diagnosis.
Read more here.
Subscribe to:
Posts (Atom)